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Dibaba DB, Alemu BM, Debela SA. Impact of water, sanitation, and hygiene (WASH) interventions on gender-specific school attendance and learning outcomes: A systematic review and meta-analysis protocol. PLoS One 2024; 19:e0308144. [PMID: 39088447 PMCID: PMC11293655 DOI: 10.1371/journal.pone.0308144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2024] [Accepted: 07/17/2024] [Indexed: 08/03/2024] Open
Abstract
The Water, Sanitation, and Hygiene (WASH) interventions have been acknowledged for their role in the public health and educational outcomes. While there are strong evidences that reveal that WASH facilities do reduce the prevalence of infectious diseases and improve the learning environment, data remain thin and equivocal on the differential impacts of WASH facilities on education by gender. The literature reviewed does not, in most cases; go to the extent of investigating if indeed both men and women students have unique needs especially in underprivileged areas. This is the point from which the present systematic review and meta-analysis intend to fill this gap by assessing the global evidence on the effect of WASH interventions on educational outcomes with due consideration given to gender. This systematic review will include international databases used for the search, such as PubMed, Google Scholar, Web of Science, Europe PubMed Central, and Scopus. Study eligibility will include cross-sectional studies published in English on the impact of WASH interventions on school attendance and academic performance, stratifying gender-specific outcomes. Data extracted will be analyzed using the STATA software version 17. The percentage of heterogeneity will be quantified through the I2 statistics to show the variability between the included studies. Based on the observed results, diversity will be checked among the outcomes of the study and based on that random-effect model will be used to estimate the pooled effect size. I will, therefore, make use of the Egger and Begg tests for checking statistical asymmetry. Publication bias will be assessed with funnel plots. These will ensure the methodologies used provide comprehensive and rigorous data analysis, which will give strong insights into the impacts of the WASH intervention on educational outcomes. Prospero registration number: Systematic review and Meta-analysis registration number: PROSPERO CRD42024536477.
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Affiliation(s)
- Dinaol Bedada Dibaba
- Ethiopian Institute of Water Resources, Addis Ababa University, Addis Ababa, Ethiopia
- Department of Public Health, College of Health Science, Salale University, Fitche, Ethiopia
| | | | - Sisay Abebe Debela
- Ethiopian Institute of Water Resources, Addis Ababa University, Addis Ababa, Ethiopia
- Department of Public Health, College of Health Science, Salale University, Fitche, Ethiopia
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Li H, Zhang W, Yan J. Physical activity and sedentary behavior among school-going adolescents in low- and middle-income countries: insights from the global school-based health survey. PeerJ 2024; 12:e17097. [PMID: 38680891 PMCID: PMC11055511 DOI: 10.7717/peerj.17097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 02/21/2024] [Indexed: 05/01/2024] Open
Abstract
Background The Global School Student Health Survey (GSHS) is being carried out by students in various countries across the globe to advance improved health programs for youth. However, in comparison to high-income countries, adolescents in low- and middle-income countries (LMICs) are generally at an early stage of understanding regarding physical activity (PA) and sedentary behavior (SB), often exhibiting low levels of PA and high levels of SB. Furthermore, there is limited evidence connecting PA and SB in school-going adolescents from LMICs. Purpose The objective of this review was to synthesize the available evidence regarding PA and sedentary behavior among school-going adolescents in LMICs using data from the GSHS. Method On March 18, 2023, a systematic literature search was performed across four electronic databases, namely Web of Science, PubMed, ScienceDirect, and EBSCO with n odaterestrictions. Studies were eligible if they: (1) utilization of data sourced from the Global Student-based Health Survey; (2) exploration of physical activity; (3) specific focus on adolescents; (4) conducted in low- and middle-income countries; (5) study design encompassing observational; (6) published as English journal articles. Results Among the 29 studies included in the analysis, the majority revealed elevated levels of sedentary behavior and diminished levels of PA in low- and middle-income countries. Furthermore, notable disparities in physical engagement and sedentary behavior were noted between male and female adolescents (p < 0.001). Augmented PA among teenagers was observed to correlate with higher consumption of vegetables and fruits (AOR = 1.30; 95% CI [1.13-1.50]; p < 0.001), decreased alcohol consumption, and a reduced prevalence of loneliness and depression (aOR 1.37, 95% CI [1.18-1.59]). Conclusions The results of this review affirm that in contrast to high-income countries, adolescents in low- and middle-income countries (LMICs) are in the early stages of comprehending physical activity, marked by low levels of PA. Physical activity and sedentary behavior in school-going adolescents from LMICs appear to be influenced by factors such as policies, cultural norms, socioeconomic conditions, as well as gender, and age.
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Affiliation(s)
- Hui Li
- College of Physical Education and Health Sciences, Zhejiang Normal University, Jinhua, China
| | - Wenyu Zhang
- Foundation Department of Education, Shandong Communication and Media College, Jinan, China
| | - Jin Yan
- School of Physical Education and Sports Science, Soochow University, Suzhou, China
- Centre for Active Living and Learning, College of Human and Social Futures, University of Newcastle, Newcastle, NSW, Australia
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Verguet S, Gautam P, Ali I, Husain A, Meyer S, Burbano C, Lloyd-Evans E, Coco M, Mphangwe M, Saka A, Zelalem M, Giyose BB, Li Z, Erzse A, Hofman K, Giner C, Avallone S, Kuusipalo H, Kristjansson E, Schultz L, Bundy DAP, Angrist N. Investing in school systems: conceptualising returns on investment across the health, education and social protection sectors. BMJ Glob Health 2023; 8:e012545. [PMID: 38114237 DOI: 10.1136/bmjgh-2023-012545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 09/04/2023] [Indexed: 12/21/2023] Open
Abstract
Public policies often aim to improve welfare, economic injustice and reduce inequality, particularly in the social protection, labour, health and education sectors. While these policies frequently operate in silos, the education sphere can operate as a cross-sectoral link. Schools represent a unique locus, with globally hundreds of millions of children attending class every day. A high-profile policy example is school feeding, with over 400 million students worldwide receiving meals in schools. The benefits of harmonising interventions across sectors with a common delivery platform include economies of scale. Moreover, economic evaluation frameworks commonly used to assess policies rarely account for impact across sectors besides their primary intent. For example, school meals are often evaluated for their impact on nutrition, but they also have educational benefits, including increasing attendance and learning and incorporating smallholder farmers into corporate value chains. To address these gaps, we propose the introduction of a comprehensive value-for-money framework for investments toward school systems that acknowledges the return to a common delivery platform-schools-and the multisectoral returns (eg, education, health and nutrition, labour, social protection) emerging from the rollout of school-based programmes. Directly building on benefit-cost analysis methods, this framework could help identify interventions that yield the highest gains in human capital per budget expenditure, with direct implications for finance ministries. Given the detrimental impact of COVID-19 on schoolchildren and human capital, it is urgent to build back stronger and more sustainable welfare systems.
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Affiliation(s)
- Stéphane Verguet
- Department of Global Health and Population, Harvard TH Chan School of Public Health, Boston, Massachusetts, USA
| | - Pratibha Gautam
- Department of Global Health and Population, Harvard TH Chan School of Public Health, Boston, Massachusetts, USA
| | - Iman Ali
- Tufts University, Medford, Massachusetts, USA
| | | | | | | | | | | | | | - Albert Saka
- Ministry of Education Science and Technology, Lilongwe, Malawi
| | - Meseret Zelalem
- Maternal, Child and Adolescent Health Lead Executive Officer, Ethiopia Ministry of Health, Addis Ababa, Ethiopia
| | - Boitshepo Bibi Giyose
- FAO/AUDA-NEPAD (African Union Development Agency - New Partnership for Africa's Development), Johannesburg, South Africa
| | - Zhihui Li
- Tsinghua Vanke School of Public Health, Beijing, China
| | - Agnes Erzse
- SAMRC Wits Centre for Health Economics and Decision Science PRICELESS SA, University of Witwatersrand School of Public Health, Johannesburg, South Africa
| | - Karen Hofman
- SAMRC Wits Centre for Health Economics and Decision Science PRICELESS SA, University of Witwatersrand School of Public Health, Johannesburg, South Africa
| | - Céline Giner
- Organization for Economic Cooperation and Development, Paris, France
| | - Sylvie Avallone
- QualiSud, Univ Montpellier, Institut Agro, CIRAD, Avignon Université, Université de La Réunion, Montpellier, France
| | - Heli Kuusipalo
- National Institute for Health and Welfare, Helsinki, Finland
| | | | - Linda Schultz
- Research Consortium for the School Meals Coalition, London School of Hygiene and Tropical Medicine, London, UK
| | - Donald A P Bundy
- Research Consortium for the School Meals Coalition, London School of Hygiene and Tropical Medicine, London, UK
| | - Noam Angrist
- University of Oxford, Oxford, Oxfordshire, UK
- Youth Impact, Gaborone, Botswana
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Ngo TD. Demographic trends and population health: tackling inequality in a world of eight billion people. BMJ Glob Health 2023; 8:bmjgh-2023-012137. [PMID: 37015733 PMCID: PMC10083788 DOI: 10.1136/bmjgh-2023-012137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 03/11/2023] [Indexed: 04/06/2023] Open
Affiliation(s)
- Thoai D Ngo
- Social and Behavioral Science Research Department, Population Council, New York, New York, USA
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Nandi A, Zahra F, Austrian K, Haberland N, Ngô TD. Growth failure among children of adolescent mothers at ages 0-5 and 6-12 years in India. Ann N Y Acad Sci 2023; 1522:139-148. [PMID: 36924008 DOI: 10.1111/nyas.14984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2023]
Abstract
Adolescent motherhood has been linked with poor health outcomes at birth for children, including high neonatal mortality, low birthweight, and small-for-gestational-age rates. However, longer-term growth outcomes in the children of adolescent mothers in low-resource settings remain inadequately studied. We used longitudinal data from the India Human Development Surveys, 2004-2005 and 2011-2012 (n = 12,182) and employed regression and propensity score matching analysis to compare the following growth indicators of children born to adolescent mothers (ages 19 years or below) with those born to older mothers. Growth indicators included height and weight during ages 0-5 years and 6-12 years and change in height and weight between the two periods. In regression-based estimates, children born to adolescent mothers were 0.01 m shorter and weighed 0.2 kg less than children of older mothers at ages 0-5 years. At ages 6-12 years, those born to adolescent mothers were 0.02 m shorter and weighed 0.97 kg less. The height difference between the two groups increased by 0.01 m and the weight difference grew by 0.77 kg over time. Height and weight difference between the two groups worsened among boys over time, while for girls, only the weight gap worsened. The results were similar when using propensity score matching methods. Public policies for reducing child marriage, combined with targeted health, nutrition, and well-being programs for adolescent mothers, are essential for both preventing adolescent childbearing and reducing its impact on growth failure among children in India.
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Affiliation(s)
- Arindam Nandi
- The Population Council, New York City, New York, USA.,One Health Trust, Washington, DC, USA
| | - Fatima Zahra
- The Population Council, New York City, New York, USA
| | | | | | - Thoại D Ngô
- The Population Council, New York City, New York, USA
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Jabbarian J, Werner LK, Kagoné M, Lemp JM, McMahon S, Horstick O, Kazianga H, Kobiané JF, Fink G, De Neve JW. "It's the poverty"-Stakeholder perspectives on barriers to secondary education in rural Burkina Faso. PLoS One 2022; 17:e0277822. [PMID: 36395341 PMCID: PMC9671424 DOI: 10.1371/journal.pone.0277822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 11/04/2022] [Indexed: 11/18/2022] Open
Abstract
Universal primary and secondary education is a key target of the Sustainable Development Goals. While substantial gains have been made at the primary school level, progress towards universal secondary education has slowed, particularly in sub-Saharan Africa. In this study, we aimed to determine perceived barriers of secondary schooling in rural Burkina Faso, where secondary school completion is among the lowest globally (<10%). We conducted a two-stage qualitative study using semi-structured interviews (N = 49). In the first stage, we sampled enrolled students (n = 10), out-of-school adolescents (n = 9), parents of enrolled students (n = 5), parents of out-of-school adolescents (n = 5) and teachers (n = 10) from a random sample of five secondary schools. In a second stage, we interviewed key informants knowledgeable of the school context using snowball sampling (n = 10). Systematic analysis of the pooled sample was based on a reading of interview transcripts and coding of the narratives in NVivo12 using the diathesis-stress model. Recurring themes were classified using a priori developed categories of hypothesized barriers to secondary schooling. Major reported barriers included school-related expenses and the lack of school infrastructure and resources. Insufficient and heterogeneous French language skills (the official language of instruction in Burkina Faso) were seen as a major barrier to secondary schooling. Forced marriages, adolescent pregnancies, and the low perceived economic benefits of investing in secondary schooling were reported as key barriers among young women. Our results guide future interventions and policy aimed at achieving universal secondary education and gender equity in the region.
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Affiliation(s)
- Jan Jabbarian
- Heidelberg Institute of Global Health, Medical Faculty and University Hospital, University of Heidelberg, Heidelberg, Germany
| | - Luisa Katharina Werner
- Heidelberg Institute of Global Health, Medical Faculty and University Hospital, University of Heidelberg, Heidelberg, Germany
- Faculty of Medicine, Albert-Ludwigs-Universität Freiburg, Freiburg, Germany
| | - Moubassira Kagoné
- Heidelberg Institute of Global Health, Medical Faculty and University Hospital, University of Heidelberg, Heidelberg, Germany
- Health Research Center of Nouna (Centre de Recherche en Santé de Nouna—CRSN), Ministry of Health, Nouna, Burkina Faso
| | - Julia Margarete Lemp
- Heidelberg Institute of Global Health, Medical Faculty and University Hospital, University of Heidelberg, Heidelberg, Germany
| | - Shannon McMahon
- Heidelberg Institute of Global Health, Medical Faculty and University Hospital, University of Heidelberg, Heidelberg, Germany
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States of America
| | - Olaf Horstick
- Heidelberg Institute of Global Health, Medical Faculty and University Hospital, University of Heidelberg, Heidelberg, Germany
| | - Harounan Kazianga
- Department of Economics and Legal Studies in Business, Spears School of Business, Oklahoma State University, Stillwater, OK, United States of America
| | - Jean-François Kobiané
- Institut Supérieur des Sciences de la Population (ISSP), Université Joseph Ki-Zerbo, Ouagadougou, Burkina Faso
| | - Günther Fink
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Jan-Walter De Neve
- Heidelberg Institute of Global Health, Medical Faculty and University Hospital, University of Heidelberg, Heidelberg, Germany
- * E-mail:
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