Empirical growth studies have often found average years of schooling to be unrelated with economic growth. This note shows that the significant positive effect of schooling can only be realised after an economy crosses a threshold level of development.

ObjectiveThe purpose of this study is to assess the impact of microfinance health interventions (health insurance and health-awareness programmes) on health-related outcomes among female informal workers in Pakistan.DesignWe conducted a retrospective, quasi-experimental study among a total of 442 female borrowers from seven microfinance providers (MFPs) across four provinces of Pakistan in 2018. A standardised tool was used for data collection. Probit regression was used to identify the probability of female borrowers gaining improvements in health outcomes based on their sociodemographic characteristics. Propensity score matching (PSM) was used to assess the overall impact of health interventions.Primary outcome measuresFour health-related outcomes reported by the women were used: perception of good health overall, ability to visit a general practitioner, ability to purchase prescribed medicine and intake of multivitamins.ResultsWe found that women receiving health interventions had a greater probability of better health outcomes when they were from Punjab province, borrowing in groups and attending monthly meetings at MFPs. Even with a small loan amount, all four health-related outcomes were significantly associated with receiving health insurance and health-awareness programmes. PSM results show a greater likelihood of overall perceived good health (nearest neighbour matching (NNM) =17.4%; kernel matching (KM) =11.8%) when health insurance is provided and a significant improvement in the ability to purchase prescribed medicine when a health-awareness programme is provided (NNM=10.1%; KM=11.7%).ConclusionHealth and social policies are vital to secure health and well-being among poor women working in the informal sector. Targeting improved equity across female population groups for health interventions will in the long run improve poor women’s health, income-earning abilities and capacity expansion for small businesses.

Background Pakistan has one of the highest rates of chronic liver disease (CLD) burden in the world. Poor and underserved patients of CLD in the country may suffer from limited health-seeking behaviors, but there is not much research in this area. The aim of this study is to identify the factors influencing health-seeking behaviors in CLD patients to better plan support for these patients. Methods We conducted a cross-sectional study. Data was collected over a four-month period from May 2022 to August 2022. A total of 850 patients visiting the Pakistan Kidney and Liver Institute and Research Centre were part of the study. We used correlation tests and multivariate logistic regression to investigate the relationship between the health-seeking behavior and the independent study domains (economic stability, health literacy, social support, experiencing grief, mental health, healthcare service quality, and coping strategies). Results Main results suggest that patients with hepatocellular carcinoma, non-viral liver disease, and cirrhosis have less health-seeking behavior, compared to patient with chronic viral hepatitis. Multivariate logistic regression results reveal that the following groups have lower odds for health-seeking behavior: (i) illiterate people; (ii) those living in rented homes; (iii) those belonging to nuclear families; and (iv) those with low monthly household income. The following study domains also show lower odds for health-seeking behavior: (i) health illiteracy; (ii) low health service quality; (iii) low ability to use coping strategies; (iv) grief; (v) lack of social support; (vi) mental health challenges; and (vii) economic instability. Conclusions Our study highlights that the majority of CLD patients are poor, illiterate, or semi-literate and in urgent need of holistic care with respect to health literacy, mental health counseling, financial help, and improved support from provider and families. This is only possible through the integration of social policy officers and social workers in the tertiary health sector of the country.

This study aimed to identify social determinants of maternal and child health (SDoH) in Pakistan. Using a qualitative study design, data were collected from community members in seven underserved areas of Lahore City, Pakistan. A total of 22 qualitative in-depth interviews and 10 focus group discussions (FGDs) were conducted. The participants included basic health unit healthcare staff, women of reproductive ages, male family members, mothers-in-law, and religious leaders. We found that maternal and child health is adversely affected by the following socioeconomic and environmental barriers: (i) poor housing quality and sanitation; (ii) inadequate food supply and safety; (iii) unsatisfactory public sector school services; (iv) a lack of safety and security; (v) scarce poverty alleviation efforts and loan schemes; (vi) unsatisfactory transport and internet services; and (vii) inadequate health services. The targets for maternal and child health in Pakistan cannot be met without close coordination between the primary health sector, local governance, and macro state structures, which collectively must monitor and improve housing adequacy, food security, public sector services (primary healthcare services, public schooling, public transport, and public internet access), overall safety, and poverty emergence.