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- Pérez, Wilton, 1979-, et al.
(författare)
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Progress towards millennium development goal 1 in northern rural Nicaragua
- 2012
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Ingår i: International Journal for Equity in Health. - 1475-9276. ; 11:1, s. 43
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND:Millennium Development Goal 1 encourages local initiatives for the eradication of extreme poverty. However, monitoring is indispensable to insure that actions performed at higher policy levels attain success. Poverty in rural areas in low- and middle-income countries remains chronic. Nevertheless, a rural area (Cuatro Santos) in northern Nicaragua has made substantial progress toward poverty eradication by 2015. We examined the level of poverty there and described interventions aimed at reducing it.METHODS:Household data collected from a Health and Demographic Surveillance System was used to analyze poverty and the transition out of it, as well as background information on family members. In the follow-up, information about specific interventions (i.e., installation of piped drinking water, latrines, access to microcredit, home gardening, and technical education) linked them to the demographic data. A propensity score was used to measure the association between the interventions and the resulting transition from poverty.RESULTS: Between 2004 and 2009, poverty was reduced as a number of interventions increased. Although microcredit was inequitably distributed across the population, combined with home gardening and technical training, it resulted in significant poverty reduction in this rural area.CONCLUSIONS:Sustainable interventions reduced poverty in the rural areas studied by about one- third.
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| 2. |
- Pérez, Wilton, et al.
(författare)
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Tracking progress towards equitable child survival in a Nicaraguan community : neonatal mortality challenges to meet the MDG 4
- 2011
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Ingår i: BMC Public Health. - 1471-2458. ; 11, s. 455
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Tidskriftsartikel (refereegranskat)abstract
- Background:Nicaragua has made progress in the reduction of the under-five mortality since 1980s. Data for the national trends indicate that this poor Central American country is on track to reach the Millennium Development Goal-4 by 2015. Despite this progress, neonatal mortality has not showed same progress. The aim of this study is to analyse trends and social differentials in neonatal and under-five mortality in a Nicaraguan community from 1970 to 2005.Methods:Two linked community-based reproductive surveys in 1993 and 2002 followed by a health and demographic surveillance system providing information on all births and child deaths in urban and rural areas of Leon municipality, Nicaragua. A total of 49 972 live births were registered.Results:A rapid reduction in under-five mortality was observed during the late 1970s (from 103 deaths/1000 live births) and the 1980s, followed by a gradual decline to the level of 23 deaths/1000 live births in 2005. This community is on track for the Millennium Development Goal 4 for improved child survival. However, neonatal mortality increased lately in spite of a good coverage of skilled assistance at delivery. After some years in the 1990s with a very small gap in neonatal survival between children of mothers of different educational levels this divide is increasing.Conclusions:After the reduction of high under-five mortality that coincided with improved equity in survival in this Nicaraguan community, the current challenge is the neonatal mortality where questions of an equitable perinatal care of good quality must be addressed.
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| 3. |
- Valladares, Eliette, et al.
(författare)
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Neuroendocrine response to violence during pregnancy : impact on duration of pregnancy and fetal growth
- 2009
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Ingår i: Acta Obstetricia et Gynecologica Scandinavica. - 0001-6349. ; 88:7, s. 818-823
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To study the neuroendocrine release of cortisol in response to perceived stress among pregnant women exposed to partner violence and how this affects the duration of pregnancy and the intrauterine growth of the infant. DESIGN: Cross-sectional community-based study. SETTING: Health and Demographic Surveillance System of Leon, Nicaragua. POPULATION: One-hundred and forty-seven pregnant women. METHODS: Standardized scales to measure intimate partner violence, social resources, perceived stress, and socio-economic conditions were applied. Two salivary samples for cortisol were collected in the morning and afternoon on the same day. Linear regression and path analysis were used. MAIN OUTCOME MEASURES: Cortisol levels, gestational age, and weight at delivery. RESULTS: Partner violence during the pregnancy, low social resources, and perceived maternal stress were associated with high level of salivary cortisol. Pregnant women with high cortisol levels were significantly more likely to give birth to small-for-gestational age babies, but not to deliver preterm. A substantial decrease of birthweight, 121-186 g, was associated with an increase in cortisol in association with violence exposure. CONCLUSION: Partner violence during pregnancy is a stressor that provokes high levels of cortisol, which is associated with reduction of birthweight.
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