| 1. |
- Anderson, Siwan, et al.
(författare)
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Political Selection in Local Elections: Evidence from Rural Uganda
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Political selection is crucial to the quality of governance. Yet our general knowledge of the individual characteristics that correlate with the political selection process is scant. Our paper contributes to this knowledge gap by collecting detailed data on the quality, perceptions, attitudes, and promises of all candidates involved in a recent local election in rural Uganda. Our context is unique - with two separate governing bodies for males and females. The paper demonstrates, that male and female political selection into these two parallel institutions share important similarities but also differ along several dimensions.
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| 2. |
- Björkman Nyqvist, Martina, et al.
(författare)
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A Mother's Voice: Impacts of Spousal Communication Training on Child Health Investments
- 2023
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Building on prior evidence that mothers often have a stronger preference for spending on children than fathers do, we use a randomized experiment to evaluate the impacts of a communication training program for mothers on child health in Uganda. The hypothesis is that the training will enable women to better convey their knowledge and preferences to their husbands and, thereby, boost investments in children’s health. We find that the program increases spousal discussion about the family’s health, nutrition, and finances. However, this does not increase overall adoption of health-promoting behaviors or improve child anthropometrics. One exception is that the communication training increases women’s and children’s intake of protein-rich foods as well as household spending on these foods.
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| 3. |
- Björkman Nyqvist, Martina, et al.
(författare)
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Associations between birth kit use and maternal and neonatal health outcomes in rural Jigawa state, Nigeria : A secondary analysis of data from a cluster randomized controlled trial
- 2018
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Ingår i: PLoS ONE. - : Public Library of Science. - 1932-6203. ; 13:12, s. 1-22
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Tidskriftsartikel (refereegranskat)abstract
- Background The burden of maternal and neonatal mortality remains persistently high in Nigeria. Sepsis contributes significantly to both maternal and newborn mortality, and safe delivery kits have long been promoted as a cost-effective intervention to ensure hygienic delivery practices and reduce sepsis. However, there is limited evidence on the effectiveness of home birth kit distribution by community health workers, and particularly the impact of this intervention on health outcomes. This paper reports a secondary analysis of data from a cluster randomized trial in rural northern Nigeria in which birth kits were distributed by community health workers to pregnant women in their homes, analyzing non-experimental variation in receipt and use of birth kits. More specifically, associations between pregnant women’s baseline characteristics and receipt and use of birth kits, and associations between birth kit use, care utilization and maternal and newborn outcomes were assessed. Methods and findings Baseline, post-birth and endline data related to 3,317 births observed over a period of three years in 72 intervention communities in Jigawa state, Nigeria, were analyzed using hierarchical, logistic regression models. In total, 140 women received birth kits, and 72 women used the kits. There were no associations between baseline demographic characteristics, health history, and knowledge and attitudes and receipt of a kit, suggesting that community health workers did not systematically target the distribution of birth kits. However, women who used the kit reported reduced odds of past pregnancy complications (OR = 0.44, 95% CI: 0.19-1.00) as well as significantly higher odds of feeling generally healthy at baseline (OR = 2.00, 95% CI: 1.06-3.76), of exposure to radio media (OR = 1.97, 95% CI: 1.21-3.22), and of perceiving themselves as having a low-risk pregnancy (OR = 3.05, 95% CI:1.39-6.68). While there were no significant associations between birth kit use and facility based delivery, skilled birth attendance or post-natal care, women who used a kit exhibited significantly lower odds of completing four or more ANC visits (adjusted OR = 0.39, 95% CI: 0.18-0.85) and significantly higher odds of reporting prolonged labor (adjusted OR = 4.75, 95% CI: 1.36-16.59), and post-partum bleeding (adjusted OR = 3.25, 95% CI: 1.11-9.52). Conclusions This evidence suggests that use of birth kits is low in a rural population characterized by minimal baseline utilization of maternal and neonatal health services, and the use of birth kits was not associated with reductions in maternal or neonatal morbidity. While further research is required to understand how the effectiveness of birth kits may be shaped by the mechanism through which women access and utilize the kits, our findings suggest that the provision of kits to women outside of the formal health system may be associated with increased risk of adverse outcomes.
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| 4. |
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| 5. |
- Björkman Nyqvist, Martina, et al.
(författare)
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Community Health Educators and Maternal Health: Experimental Evidence from Northern Nigeria
- 2023
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Ingår i: Journal of Development Studies. - : Taylor and Francis Group. - 1743-9140 .- 0022-0388. ; 59:1, s. 73-93
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- The slow pace of improvement in service delivery and health outcomes for pregnant women and newborns in developing countries has been a major concern for policy makers in recent decades. This paper presents the results from a randomized controlled trial of a community health worker program designed to enhance uptake of child and maternal health services in Northern Nigeria. Three interventions were evaluated: the deployment of community health educators, health educators with the provision of safe birth kits, and health educators with community dramas. The results suggest that the interventions increased utilization of antenatal, postnatal, and infant care. Maternal and newborn health practices improved as well as health knowledge. In addition, the community health worker program was more effective when supplemented with additional program components.
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| 6. |
- Björkman Nyqvist, Martina, et al.
(författare)
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Experimental Evidence on the Long-Run Impact of Community-Based Monitoring
- 2017
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Ingår i: American Economic Journal. - : American Economic Association. - 1945-7782 .- 1945-7790. ; 9:1, s. 33-69
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Tidskriftsartikel (refereegranskat)abstract
- We evaluate the longer run impact of a local accountability intervention in primary health care provision in Uganda. Short-run improvements in health care delivery and health outcomes remained in the longer run despite minimal follow-up. We find no impact on the quality of care or health. outcomes of a lower cost intervention that focused on encouraging participation but did not provide information on staff performance. We provide suggestive evidence that informed beneficiaries are more likely to identify and challenge (mis)behavior by providers and, as a result, turn their focus to issues that they can manage locally.
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| 7. |
- Björkman Nyqvist, Martina, et al.
(författare)
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High maternal mortality in Jigawa State, Northern Nigeria estimated using the sisterhood method
- 2017
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Ingår i: BMC Pregnancy and Childbirth. - : BMC (part of Springer Nature). - 1471-2393. ; 1:163
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Tidskriftsartikel (refereegranskat)abstract
- Background: Maternal mortality is extremely high in Nigeria. Accurate estimation of maternal mortality is challenging in low-income settings such as Nigeria where vital registration is incomplete. The objective of this study was to estimate the lifetime risk (LTR) of maternal death and the maternal mortality ratio (MMR) in Jigawa State, Northern Nigeria using the Sisterhood Method. Methods: Interviews with 7,069 women aged 15-49 in 96 randomly selected clusters of communities in 24 Local Government Areas (LGAs) across Jigawa state were conducted. A retrospective cohort of their sisters of reproductive age was constructed to calculate the lifetime risk of maternal mortality. Using most recent estimates of total fertility for the state, the MMR was estimated. Results: The 7,069 respondents reported 10,957 sisters who reached reproductive age. Of the 1,026 deaths in these sisters, 300 (29.2%) occurred during pregnancy, childbirth or within 42days after delivery. This corresponds to a LTR of 6.6% and an estimated MMR for the study areas of 1,012 maternal deaths per 100,000 live births (95% CI: 898-1,126) with a time reference of 2001. Conclusions: Jigawa State has an extremely high maternal mortality ratio underscoring the urgent need for health systems improvement and interventions to accelerate reductions in MMR. Trial registration: The trial is registered at clinicaltrials.gov ( NCT01487707 ). Initially registered on December 6, 2011. © 2017 The Author(s).
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| 8. |
- Björkman Nyqvist, Martina, et al.
(författare)
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HIV, risk, and time preferences : Evidence from a general population sample in Lesotho
- 2022
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Ingår i: Health Economics. - : Wiley. - 1057-9230 .- 1099-1050. ; 31:5, s. 904-911
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Tidskriftsartikel (refereegranskat)abstract
- Identifying individuals most at risk of HIV infection is a priority for policymakers. Apart from specific groups, however, little is known about how to identify those at high risk in the population. Research suggests that attitudes toward risk and time preferences may influence risky sexual behavior, but no studies have so far investigated the interplay between risk attitudes, time preference, and HIV infection. We collect data on risk and time preferences using hypothetical games (multiple price list method) at baseline and data on HIV status at baseline (2010) and endline (2012) allowing us to calculate incidence rate over a 2-year period among 675 participants, males and females 18–32 years old in Lesotho. We find robust evidence of a statistically significant positive associations between HIV incidence and prevalence and risk-loving attitudes, while the associations with risky behaviors and time preferences are not statistically significant. A measure of attitude toward risk, relatively easy to administer to individuals in a survey, is thus associated with future HIV status. This is an important finding for policymakers and suggests the importance of targeting HIV prevention programs to risk-loving individuals and therefore improving program efficiency.
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| 9. |
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| 10. |
- Björkman Nyqvist, Martina, et al.
(författare)
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Incentivizing Safer Sexual Behavior : Evidence from a Lottery Experiment on HIV Prevention
- 2018
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Ingår i: American Economic Journal. - : American Economic Association. - 1945-7782 .- 1945-7790. ; 10:3, s. 287-314
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Tidskriftsartikel (refereegranskat)abstract
- We investigate the effect of a financial lottery program in Lesotho with relatively low expected payments but a chance to win a high prize conditional on negative test results for sexually transmitted infections. The intervention resulted in a 21.4 percent reduction in HIV incidence over two years. Lottery incentives appear to be particularly effective in targeting individuals with ex ante risky sexual behavior, consistent with the hypothesis that lotteries are more valued by individuals willing to take risks.
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