Coverage of non-receipt of cash transfer (Livelihood Empowerment Against Poverty) and associated factors among older persons in the Mampong Municipality, Ghana - a quantitative analysis

Estimates of multidimensional poverty and its determinants among older people in rural China: evidence from a multicenter cross-sectional survey

BACKGROUND

In 2020, China declared that the absolute poverty in the country had been eradicated, but older people in rural areas are deprived in multiple domains. Poverty is multidimensional and involves deprivations in health, social welfare, living standards, and income. This study focused on assessing the poverty status of rural older persons and providing a basis for decision-making at all levels of government in China.

METHODS

A multicenter cross-sectional survey was conducted in four rural areas of China. Individuals aged 60 years and older were selected through stratified sampling. People with aphasia and severe cognitive impairment were excluded. An electronic questionnaire was used to collect older people's information, including basic demographics, major illnesses, disabilities, chronic diseases, functional disorders, and ability to perform activities of daily living. It also asked about the medical, financial, and social security assistance that respondents received, food and clothing standards, safe housing, clean energy, safe drinking water, and reliable electricity. Specific questions were asked regarding income sufficiency, financial support from children, and pension income. Multidimensional poverty measurements were used to compare regional disparities and indicators differences. Logistic regression was used to identify the risk factors influencing poverty.

RESULTS

A total of 1272 older people were analyzed. Of them, 704 (55.35%) were women and 652 (51.26%) were aged between 60 and 69 years. The most frequently mentioned causes of poverty were illness, a lack of employment, inadequate technology, and poor transportation. We found that as multidimensional poverty indicators increased (from 6 to 10), the number of poor older people decreased (from 1218 to 437), as did the poverty incidence (from 95.75 to 34.36%) and multifaceted poverty index (from 53.41 to 25.06%). Xuanwei had the highest incidence of poverty (66.61%) and multidimensional poverty index (0.66) among the four provinces studied. Regarding the contribution of indicators, financial alleviation made the greatest contribution to multidimensional poverty among rural older adults (up to 70.51%). Age, marital status, education level, awareness of poverty alleviation policies, and region were significant predictors of multidimensional poverty among older rural residents(P < 0.05).

CONCLUSIONS

China's subsidy system and financial support must be enhanced. Particular attention should be given to the re-education of rural older individuals, basic vocational education should be strengthened in rural areas, and social participation should be encouraged.

Prevalence, perceptions and associated factors of health insurance enrollment among older persons in selected cash grant communities in Ghana: a cross-sectional mixed method

BACKGROUND

Universal Health Coverage has been openly recognized in the United Nations health-related Sustainable Development Goals by 2030, though missing under the Millennium Development Goals. Ghana implemented the National Health Insurance Scheme programme in 2004 to improve financial access to healthcare for its citizens. This programme targeting low-income individuals and households includes an Exempt policy for older persons and indigents. Despite population ageing, evidence of the participation and perceptions of older persons in the scheme in cash grant communities is unknown. Hence, this paper examined the prevalence, perceptions and factors associated with health insurance enrollment among older persons in cash grant communities in Ghana.

METHODS

Data were from a cross-sectional household survey of 400 older persons(60 + years) and eight FGDs between 2017 and 2018. For the survey, stratified and simple random sampling techniques were utilised in selecting participants. Purposive and stratified sampling techniques were employed in selecting the focus group discussion participants. Data analyses included descriptive, modified Poisson regression approach tested at a p-value of 0.05 and thematic analysis. Stata and Atlas-ti software were used in data management and analyses.

RESULTS

The mean age was 73.7 years. 59.3% were females, 56.5% resided in rural communities, while 34.5% had no formal education. Two-thirds were into agriculture. Three-fourth had non-communicable diseases. Health insurance coverage was 60%, and mainly achieved as Exempt by age. Being a female [Adjusted Prevalence Ratio (APR) 1.29, 95%CI:1.00-1.67], having self-rated health status as bad [APR = 1.34, 95%CI:1.09-1.64] and hospital healthcare utilisation [APR = 1.49, 95%CI:1.28-1.75] were positively significantly associated with health insurance enrollment respectively. Occupation in Agriculture reduced insurance enrollment by 20.0%. Cited reasons for poor perceptions of the scheme included technological challenges and unsatisfactory services.

CONCLUSION

Health insurance enrollment among older persons in cash grant communities is still not universal. Addressing identified challenges and integrating the views of older persons into the programme have positive implications for securing universal health coverage by 2030.

Impact of Safety Nets on Household Coping Mechanisms for COVID-19 Pandemic in Malawi

Background

Covid-19 pandemic induced various shocks to households in Malawi, many of which were failing to cope. Household coping mechanisms to shocks have an implication on household poverty status and that of a nation as a whole. In order to assist households to respond to the pandemic-induced shocks positively, the government of Malawi, with support from non-governmental organizations introduced Covid-19 Urban Cash Intervention (CUCI) and other safety nets to complement the existing social protection programs in cushioning the impact of the shocks during the pandemic. With these programmes in place, there is a need for evidence regarding how the safety nets are affecting coping. Therefore, this paper investigated the impact that safety nets during Covid-19 pandemic had on the following household coping mechanisms: engaging in additional income-generating activities, receiving assistance from friends and family; reducing food consumption; relying on savings; and failure to cope.

Methods

The study used a nationally representative panel data from the Malawi High Frequency Phone Survey on Covid-19 (HFPS Covid-19) and complemented it with the fifth Integrated Household Panel Survey (IHPS), also known as living standards measurement survey. Five Random Effects Probit Models were estimated, one for each coping mechanism.

Results

Findings from this study indicated that beneficiaries of safety net programs were more likely to rely on remittances from friends and family than the people who had no safety nets. Furthermore, the safety net recipients were less likely to reduce food consumption or rely on savings than the non-recipients. Despite the interesting findings, we also noticed that safety nets had no significant impact on household engagement in other income-generating activities in response to shocks.

Conclusion

The results imply that safety nets in Malawi during the Covid-19 pandemic had a positive impact on consumption and prevented the dissolving of savings. Therefore, these programs have to be scaled up, and the volumes be revised upwards.