Economic interventions to improve population health: a scoping study of systematic reviews

Khan, Mishal; Guan, Bernie Y.; Audimulam, Jananie; Liceras, Francisco Cervero; Coker, Richard; Yoong, Joanne

doi:10.1186/s12889-016-3119-5

Cited by 10 publications

(5 citation statements)

References 47 publications

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“…In addition, the excess poultry production in the Full Intervention group at endline allowed mothers a sustainable means of livelihood -something that could be sold to support the purchase of other household needs, including medicines, other types of foods that increased the household dietary diversity, clothing, and school fees for children. This reinforces livelihood support interventions that focus on utility and economic improvement to address health-related issues (35,43).…”

Section: Discussionmentioning

confidence: 65%

Sustainability and scalability of egg consumption in Burkina Faso for infant and young child feeding

et al. 2023

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IntroductionMalnutrition is a significant challenge to the health of women and children in Burkina Faso. Given the critical role of animal source food on the health of infants and young children (IYC), interventions continue to explore the potential for eggs to prevent malnutrition.MethodsUsing data from the Un Oeuf intervention, which significantly increased IYC egg consumption, combined with quantitative and qualitative data from endline and 3-month follow-up, we explore the barriers and facilitating factors to IYC egg consumption and the sustainability and scalability of the intervention.ResultsChild egg consumption was high at follow-up in the Control, Partial, and Full Intervention arms (83.3, 88.2%, and 100, respectively). The Full Intervention arm had the highest mean number of eggs consumed (2.9, 2.6, and 5.7), which reflected a slight reduction from endline (6.2). All participants owned chickens at follow-up (100%), however, flock size varied. The Full Intervention arm had more chickens (mean 8.8) than the Control (5.1) or Partial Intervention (6.2) arms, which was a 50% reduction in below endline (18.5 chickens). Qualitative results indicate that chicken ownership, education about the nutritional value of eggs, and spousal support facilitated IYC egg consumption. Barriers included egg production, cultural taboos, and animal health. Motivational factors reported included the observed improvement in child health, increased availability of mothers' time, and mothers' financial independence. Knowledge sharing within the Full and Partial Intervention groups was widely reported, and the sustainability of IYC egg consumption was reinforced by accountability among mothers and to community leaders, flipbooks distributed during the project, and high motivation.DiscussionMain findings indicate that mothers who received the full Un Oeuf intervention were able to overcome barriers to feeding their child an egg daily, were able to improve their livelihood, were motivated to continue feeding their child eggs, and saw the addition of eggs into the child's diet as sustainable. Future nutrition sensitive agriculture interventions should consider tailoring this approach for other LMIC contexts. Future research is needed to explore a possible threshold in the number of household chickens necessary to continuously feed a child an egg a day.

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Section: Discussionmentioning

confidence: 65%

Sustainability and scalability of egg consumption in Burkina Faso for infant and young child feeding

et al. 2023

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“…The literature has now gone beyond investigating the determinants to identifying potential interventions. Khan et al carried out a rapid scoping review [ 22 ] and found 195 systematic reviews of economic interventions. They found that taxes and subsidies could be used to encourage use of services and healthy patterns of consumption, income transfer programs can support individuals to meet their needs and encourage treatment adherence and that incentives can be used to alter provider and patient behavior.…”

Section: Introductionmentioning

confidence: 99%

The macro-economic determinants of health and health inequalities—umbrella review protocol

et al. 2017

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BackgroundThe economic determinants of health have been widely recognised as crucial factors affecting health; however, to date, no comprehensive review has been undertaken to summarise these factors and the ways in which they can influence health. We conceptualise the economy as a complex system made up of underlying approaches, regulation from institutions, markets, finance, labour, the public-private balance as well as production and distributional effects, which collectively impact on health through the effect of moderators. This protocol details the methods for an umbrella review to explore the macro-economic factors, strategies, policies and interventions that affect health outcomes and health inequalities.MethodsWe will identify relevant systematic reviews using search terms derived from the Journal of Economic Literature classification. Reviews will be included if they meet the Database of Abstracts and Reviews of Effects criteria for systematic reviews. Reviews of studies with and without controls will be included; both association and intervention studies will be included. Primary outcomes will include but are not limited to morbidity, mortality, prevalence and incidence of conditions and life expectancy. Secondary outcomes will include health inequalities by gender, ethnicity or socio-economic status. Six databases will be searched using tailored versions of our piloted search strategy to locate relevant reviews. Data will be extracted using a standardized pro forma, and the findings will be synthesized into a conceptual framework to address our review aim.DiscussionOur umbrella review protocol provides a robust method to systematically appraise the evidence in this field, using new conceptual models derived specifically to address the study question. This will yield important information for policymakers, practitioners and researchers at the local, national and international level. It will also help set the future research agenda in this field and guide the development of interventions.Systematic review registrationThis umbrella review protocol has been registered with PROSPERO CRD42017068357.Electronic supplementary materialThe online version of this article (10.1186/s13643-017-0616-2) contains supplementary material, which is available to authorized users.

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“…It may include government expenditure that expands basic incomes through social protection programmes or employment, improves transport and infrastructure or promotes a healthier environment. For example, recent evidence has found that social protection expenditures can improve health outcomes and reduce health inequalities (WHO, 2008; Stuckler et al ., 2009; Ataguba et al ., 2015; Khan et al ., 2016). Further research, focussing on countries with more disaggregated government expenditure data, and particularly social protection data, is needed to explore this further.…”

Section: Discussionmentioning

confidence: 99%

Does government expenditure reduce inequalities in infant mortality rates in low- and middle-income countries?: A time-series, ecological analysis of 48 countries from 1993 to 2013

Baker

Hone

Reeves

et al. 2018

HEPL

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Inequalities in infant mortality rates (IMRs) are rising in some low- and middle-income countries (LMICs) and decreasing in others, but the explanation for these divergent trends is unclear. We investigate whether government expenditures and redistribution are associated with reductions in inequalities in IMRs. We estimated country-level fixed-effects panel regressions for 48 LMICs (142 country observations). Slope and Relative Indices of Inequality in IMRs (SII and RII) were calculated from Demographic and Health Surveys between 1993 and 2013. RII and SII were regressed on government expenditure (total, health and non-health) and redistribution, controlling for gross domestic product (GDP), private health expenditures, a democracy indicator, country fixed effects and time. Mean SII and RII was 39.12 and 0.69, respectively. In multivariate models, a 1 percentage point increase in total government expenditure (% of GDP) was associated with a decrease in SII of -2.468 [95% confidence intervals (CIs): -4.190, -0.746] and RII of -0.026 (95% CIs: -0.048, -0.004). Lower inequalities were associated with higher non-health government expenditure, but not higher government health expenditure. Associations with inequalities were non-significant for GDP, government redistribution, and private health expenditure. Understanding how non-health government expenditure reduces inequalities in IMR, and why health expenditures may not, will accelerate progress towards the Sustainable Development Goals.

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Economic interventions to improve population health: a scoping study of systematic reviews

Cited by 10 publications

References 47 publications

Sustainability and scalability of egg consumption in Burkina Faso for infant and young child feeding

Sustainability and scalability of egg consumption in Burkina Faso for infant and young child feeding

The macro-economic determinants of health and health inequalities—umbrella review protocol

Does government expenditure reduce inequalities in infant mortality rates in low- and middle-income countries?: A time-series, ecological analysis of 48 countries from 1993 to 2013

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