Spatial spillover impact of determinants on child mortality in Pakistan: evidence from Spatial Durbin Model

BACKGROUND

Child mortality is a major challenge to public health in Pakistan and other developing countries. Reduction of the child mortality rate would improve public health and enhance human well-being and prosperity. This study recognizes the spatial clusters of child mortality across districts of Pakistan and identifies the direct and spatial spillover effects of determinants on the Child Mortality Rate (CMR).

METHOD

Data of the multiple indicators cluster survey (MICS) conducted by the United Nations International Children's Emergency Fund (UNICEF) was used to study the CMR. We used spatial univariate autocorrelation to test the spatial dependence between contiguous districts concerning CMR. We also applied the Spatial Durbin Model (SDM) to measure the spatial spillover effects of factors on CMR.

RESULTS

The study results showed 31% significant spatial association across the districts and identified a cluster of hot spots characterized by the high-high CMR in the districts of Punjab province. The empirical analysis of the SDM confirmed that the direct and spatial spillover effect of the poorest wealth quintile and MPI vulnerability on CMR is positive whereas access to postnatal care to the newly born child and improved drinking water has negatively (directly and indirectly) determined the CMR in Pakistan.

CONCLUSION

The instant results concluded that spatial dependence and significant spatial spillover effects concerning CMR exist across districts. Prioritization of the hot spot districts characterized by higher CMR can significantly reduce the CMR with improvement in financial statuses of households from the poorest quintile and MPI vulnerability as well as improvement in accessibility to postnatal care services and safe drinking water.

First Price Sealed-Bid Auctions with Bidders’ Heterogeneous Risk Behavior: An Adversarial Risk Analysis Approach

Bidders’ bidding behavior is analyzed in first price sealed-bid (FPSB) auctions using an adversarial risk analysis (ARA) framework. However, using nonstrategic play and level-k thinking solution concepts, modeling is performed by assuming only two bidders. Also, the aleatory and concept uncertainties have not been yet taken into account by using an ARA framework for these auctions. In this paper, we apply an ARA approach to model bidders’ bidding behavior in a more realistic way for FPSB auctions. We assume n bidders that may have different wealth and heterogeneous risk behaviors. We use nonstrategic play and level-k thinking solution concepts, and we take into account aleatory uncertainty in addition to epistemic uncertainty. Finally, concept uncertainty is taken into account to find ARA solutions for these auctions. We also provide numerical examples to illustrate our methodology.

Proactive Personality and Innovative Work Behavior: Through the Juxtapose of Schumpeter's Theory of Innovation and Broaden-And-Build Theory

This study aimed to unfold the implicit interplay of open innovation (OI) and perceived insider status (PIS) between the relationship of proactive personality (PP) and innovative work behavior (IWB). The phenomenon studied the moderated mediation of OI and PIS through the combined optic of the theory of innovation and the broaden-and-build theory. The nature of this study was post-positivist. The two-step approach of structural equation modeling was implemented. First, quantitative data were collected through an online questionnaire from the employees of IT industries in China. The study sample consisted of 460 responses used for data analysis in SPSS and AMOS version 26. This study was based on mediated moderation, which was statistically similar to Model 15 of the process macro. There were six hypotheses based on the theoretical framework. The result of H6 was rejected, which demonstrated that the conditional direct effect of OI and PIS mediated moderation on PP and IWB. The results comprehensively testified to the theoretical framework.

A new role for Women Health Volunteers in urban Islamic Republic of Iran

An action research project was carried out by a team from the National Public Health Management Centre in Tabriz, Iran to test the following hypothesis: Health Volunteers are more able to support health improvements by focusing on community participation and empowerment through facilitating communities to define and solve their own problems than by only providing information on health problems. Training on participatory approaches was given to Women Health Volunteers (WHV) in a pilot area. The results gave evidence that local people could identify and act upon their own health needs and request more information from professionals to improve their own health. Further research is needed however to assess how the pilot can be scaled up and how initial enthusiasm can be sustained.

Basic development needs approach in the Eastern Mediterranean Region: from theory to practice

Poverty and health are mutually reinforcing and deprivation in one area produces negative effects in the other. Unfortunately at the beginning of the 21st century, the number of people living in absolute poverty continues to rise with grim health consequences. Many studies have clearly established that health is related to and influenced by a complex of environmental, social and economic factors ultimately related to each other. Therefore, actions undertaken outside of the health sector are likely to have effects much greater than those obtained through the health sector alone. Thus, the countries of the World Health Organization Eastern Mediterranean Region have adopted basic development needs to address all the determinants of health collectively through community empowerment in order to transform social lifestyles and enhance human development. This article presents the contribution made by basic development needs in empowering local communities and vulnerable groups to acquire their essential needs through the efficient use of available resources. The assessment surveys of the ongoing programme conducted periodically in different countries have demonstrated significant reduction in poverty levels and improvement in quality of life indices pertaining to a wide range of fields, including health, nutrition and other social sectors.

Female health workers boost primary care

Women residing in villages in three districts of Pakistan were recruited, trained to deliver primary care and mobilize their communities for health, assigned to limited catchment areas, provided with supervisory and managerial support, and remunerated. Their comprehensive activities substantially reduced infant, child and maternal mortality within a year and generated positive perceptions of family planning in the communities. The programme was cost-effective and appeared suitable as a model for reforming the organization and provision of health care services.

Seven-day viable analysis of some ophthalmic preparations with different concentrations of benzalkonium chloride

The efficacy of zinc sulphate and boric acid ophthalmic preparations, containing benzalkonium chloride as preservative have been investigated against Gram-negative Escherichia coli and Pseudomonas aeruginosa and Gram-positive Staphylococcus aureus bacteria. The viability of bacteria was checked after 7 days though they were completely suppressed after 24 hours of inoculation. Zinc sulphate increased the antimicrobial activity of benzalkonium chloride, whereas the boric acid or its combination with zinc sulphate reduced the same. The Pseudomonas aeruginosa was found to be viable against zinc sulphate, boric acid or its combination at a concentration of 0.01% to 0.005% of the preservative. Escherichia coil and Staphylococcus aureus also exhibited resistance but to a lesser extent than Pseudomonas aeruginosa. This viability may be dangerous in case of multidose ophthalmic preparations.

Studies on the antimicrobial activity of honey

Ten samples of crude and processed honey were used to determine antimicrobial activity against twenty five species of pathogenic and nonpathogenic bacteria, commonly encountered in human infections. The antifungal activity was checked against ten parasitic and saprophytic fungi. Most of the samples of honey used in the study showed broad spectrum antibacterial and promising antifungal activity.

Therapeutic efficacy of ACTH in symptomatic infantile spasms with hypsarrhythmia

The records of twenty-six infants with both symptomatic infantile spasms and classic hypsarrhythmia were reviewed to determine the efficacy of various ACTH dosages and time of initiation of therapy. Mean age of infantile spasm onset was 6.4 months. Most patients (13) had sustained perinatal hypoxic-ischemic insults. Seventeen patients (65%) had complete cessation of spasms. Between these responders and the 9 nonresponders there was no difference in duration of spasms prior to treatment (2.6 and 2.0 months) or mean ACTH dose (87.4 and 84.5 U/m2, respectively). Infants treated with high-dose ACTH (> 100 U/m2) did not have an improved response rate. The most favorable outcomes were associated with spasm onset at > 8 months of age (all of whom were responders, regardless of dose) or when treatment was started within 1 month of onset of infantile spasms with > 80 U/m2 ACTH (88% responders). Infants treated more than 2 months after onset often did not respond (57%) regardless of dose. Nonresponders with spasm onset at < 4 months of age had the worst prognoses; all had poorly controlled seizures and regressed developmentally. Although all infants in the study were neurologically abnormal, development either improved or did not deteriorate in most responder infants following spasm resolution and one-half remained seizure free. Nonresponder infants continued to have infantile spasms or other seizure types. These data suggest that ACTH is valuable in the treatment of significantly impaired infants with symptomatic infantile spasms, but the most important determinants of outcome may be age of onset and rapidity of treatment rather than dosage.