Dataset Information

Accessibility, affordability, accountability, sustainability and social justice of early childhood education in China: A case study of Shenzhen.

ABSTRACT: This study examined the accessibility, affordability, accountability, sustainability, and social justice of early childhood education (ECE) services in Shenzhen, China, using Li et al.'s (2017) '3A2S' framework. Government documents and secondary data during the past decade were collected and evaluated. The results indicated that: (1) the ECE services have improved in the dimensions of accessibility, affordability, accountability, sustainability, and social justice; (2) more efforts should be made in increasing fiscal budget into ECE services and ensuring the quality of the ECE services; and (3) the government needs to take up more responsibilities to strike a balance between market force and governmental regulation. Implications and suggestions are also included.

SUBMITTER: Xie S

PROVIDER: S-EPMC7425551 | biostudies-literature | 2020 Nov

REPOSITORIES: biostudies-literature

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Accessibility, affordability, accountability, sustainability and social justice of early childhood education in China: A case study of Shenzhen.

Xie Sha S Li Hui H

Children and youth services review 20200813

This study examined the accessibility, affordability, accountability, sustainability, and social justice of early childhood education (ECE) services in Shenzhen, China, using Li et al.'s (2017) '3A2S' framework. Government documents and secondary data during the past decade were collected and evaluated. The results indicated that: (1) the ECE services have improved in the dimensions of accessibility, affordability, accountability, sustainability, and social justice; (2) more efforts should be ma ...[more]

PMID: 32836604

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Project description:Global food demand is increasing due to population growth and dietary transitions, resulting from rising incomes, are associated with increased prevalence of non-communicable diseases. Improving the sustainability of the food sector is also critical for achieving the Sustainable Development Goals. This study assesses for the first time the greenhouse gases emissions (Carbon Footprint - CF), the water footprint (WF) and the cost of three omnivorous diets recommended in Spain due to their health benefits: the Mediterranean diet (MD), the Southern European Atlantic diet (SEAD) and the Spanish dietary guidelines (NAOS). Analysis was conducted using standard Life Cycle Assessment and WF methods together with current Spanish food price data. The dietary energy recommendation of the SEAD is greater than that of MD and NAOS (11 and 15% respectively), and SEAD also has greater animal source food content than the other two diets. SEAD has a concomitantly higher CF, WF and cost scores in comparison with MD (+30%, +23% and +21% respectively) and NAOS (+15%, +9% and +21% respectively). Adjusting recommendations to meet the suggested Spanish adult dietary energy of 2228 kcal.capita-1.day-1 changed the environmental profiles of the diets and the NAOS has the highest environmental impact. However, the isocaloric diets had approximately the same cost. Analysis of the WF of the diets identified the major contribution of precipitation (the green WF) to the overall WF (88% of the total) and the significant contribution of animal-source foods to dietary WF. Regardless of the dietary scenario, better scores were identified for the Spanish recommendations analysed than those reported for other healthy diets identified in Europe. Differences in the recommended intake levels of certain food groups, cooking techniques and the origin of food products are behind these results. Environmental indicators should be considered alongside nutrition and health metrics when defining national dietary guidelines. Supporting citizens to follow healthy and environmentally-friendly dietary recommendations through, among other things, information campaigns and nutritional education programmes is essential. It is recommended the incorporation not only of health, but also of environmental indicators of these dietary options in the national dietary guidelines, as well as implementation of information campaigns and nutritional education programs among citizens to promote their adhesion since balanced dietary habits rich on plant-based products and low on animal-based ones involve multiple health and environmental benefits.

Project description:BackgroundNewborn screening (NBS) can prevent inborn errors of metabolism (IEMs), which may cause long-term disability and even death in newborns. However, in China, tandem mass spectrometry (MS/MS) screening has just started. This study aimed to assess the cost-effectiveness of NBS using MS/MS in Shenzhen under the nationally recommended program, as well as evaluate the value and affordability of introducing this new screening technology.MethodsA Markov model was built to estimate the cost and quality-adjusted life-years (QALYs) of different screening programs. We compared PKU screening using traditional immunofluorescence (IF) with the other 11 IEMs not screened and all 12 IEMs screened using MS/MS, and the programs detecting different numbers of IEMs chosen from the national recommended program were also compared. A sensitivity analysis and budget impact analysis (BIA) were performed.ResultsThe incremental cost-effectiveness ratio (ICER) of detecting all 12 IEMs in the national program is 277,823 RMB per QALY, below three times per capita GDP in Shenzhen. MS/MS screening in Shenzhen can be cost-effective only if at least three diseases (PKU, PCD and MMA) are covered and when the screening program covers five diseases (PKU, PCD, MMA, MSUD, IVA), the ICER closely approaches its critical threshold. The BIA indicated the implementation cost of the national program to be around 490 million RMB over 10 years and showed no difference in budget between programs detecting different numbers of IEMs.ConclusionsWe conclude that the newborn screening using MS/MS in Shenzhen is cost-effective, and the budget affordable for the Shenzhen government. Two concepts for selecting the IEMs to be detected are also presented. One is to choose the most cost-effective screening programs detecting highest number of IEMs to achieve a minimal ICER. The other considers the curability and affordability of the disease as the basis of healthcare decisions to screen suitable IEMs, achieving an ICER under the threshold and close to the minimum value.

Dataset Information

Accessibility, affordability, accountability, sustainability and social justice of early childhood education in China: A case study of Shenzhen.

Publications

Accessibility, affordability, accountability, sustainability and social justice of early childhood education in China: A case study of Shenzhen.

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