We estimate whether a land reform program led to higher incomes for ethnic minority households. In 2002, in the Central Highlands of Vietnam, Program 132 directed the transfer of farm land to ethnic minority households that had less than one hectare of land. Using the 2002 Vietnam Household Living Standards Survey as a baseline, in 2008 we resurveyed over one-thousand households to provide a retrospective evaluation of the impact of their participation in Program 132. Contrary to official reports, our findings show that there was considerable deviation from the planned program parameters: many eligible households did not receive land, while ineligible households often did. We estimate that beneficiaries of the program in the province of Kon Tum experienced increases of household income largely in line with what one would expect from a small plot of poor farm land. Outside Kon Tum, where participation rates were substantially lower, the story is more mixed, and household incomes did not improve with program participation. Overall, our results underscore the limitations of simple transfers of land as a mechanism for improving the living standards of ethnic minorities. Our results also show the significant gap that can exist between program design and decentralized implementation. We discuss the potential implications for program evaluation.
ObjectiveDetermine the detection rate from an expanded targeted early cytomegalovirus (CMV) testing program implemented from a large healthcare system (Intermountain Healthcare, IHC).Study DesignRetrospective review.SettingTertiary medical center.MethodsAn electronic system was modified to include indications for testing whenever a provider placed an order for CMV testing. A retrospective analysis of this database was performed.ResultsFrom March 1, 2021 to August 31, 2022, there were 3450 (8.8%) patients who underwent CMV testing out of 39,245 total live births within the IHC system. Since the formal implementation of this program in 2019, annual CMV testing has increased almost 10‐fold: 2668 CMV tests were performed in 2021 compared to 289 CMV tests in 2015. The most frequent indication for congenital CMV (cCMV) testing was small for gestational age (SGA) (68.2%), followed by macrocephaly (13.5%), an abnormal hearing test (5.0%), and microcephaly (4.4%). Fourteen cCMV‐infected infants were diagnosed all of them meeting the criteria for symptomatic cCMV. The most common indication resulting in a positive diagnosis was those who presented with SGA (n = 10 patients). The positivity rate would result in a prevalence of 35.7 symptomatic cCMV cases diagnosed per 100,000 live births, numbers comparable to those expected for universal cCMV screening.ConclusionAn expanded targeted early cCMV testing program may improve detection rates of symptomatic cCMV cases and should be considered as a feasible alternative approach to universal or hearing‐targeted early CMV testing.
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