Surviving an Epidemic: Families and Well-Being, Malawi 1998-2020

在流行病中生存：1998-2020年马拉维的家庭和福祉 项目摘要：在整个东部和南部非洲（ESA），一个显着的队列正在达到中老年人 年龄：艾滋病流行病幸存者。有些人感染了艾滋病毒，但每个人都在这个共同- 霍特感染了艾滋病毒。没有人能逃脱一场对其健康和社会都具有毁灭性影响的流行病 影响，以及一个在一个同样面临贫困，饥荒和基本不确定性的地区受到沉重打击的地区 生命这一批幸存者是运气好吗？在如此可怕的环境中， 在这种背景下，幸存者及其家人的健康和福祉受到了什么影响？如何呈现 人口变化，健康，福利和经济发展，在欧空局的经验形成的epi， 流行病和用于生存流行病的策略？这些和相关的问题“生存的 将通过利用一个异常丰富的数据来源：马拉维纵向研究， 家庭与健康（MLSFH）队列，1998-2020年。扩展、公开发布和分析的动机 到2020年的《劳动力可持续健康计划》是多方面的：（a）《1998-2020年劳动力可持续健康计划》将提供一个独特的机会， 关于STE的问题，这是其他ESA数据无法提供的机会。(b)1998-2020年劳动、社会和家庭福利部还将 特别是让研究人员了解流行病和战略的STE采用 个人和家庭继续影响着欧空局的流行病和人口转变。(c)年底 几乎可以肯定的是，这一流行病的蔓延并不标志着全球卫生危机的结束（这一时期的一个例子是， 我们需要更好地理解这一机制， 低收入国家的公民如何科普这种危机。1998-2020年劳动、社会和家庭部的具体目标 因此包括：目标1：收集并公开发布2016- 2020年的新的MLSFH数据，用于（a）幸存的MLSFH 受访者及其家人，（B）幸存和死亡受访者的子女，以及（c）移民， 预计N（调查）6，300加上1，200名已故受访者的数据。所涉及的主题包括： 存在，死亡率和发病率，家庭和住户动态，社会资本和网络，身心健康， 家庭生产和消费以及代际关系。目标2：使用1998-2020年劳动力、社会和家庭福利部， 从人种学方法到计量经济学方法， 结构方程模型，通过识别因素，社会背景和 在劳动、社会保障和家庭健康部受访者中，个人/家庭行为在增强生存、复原力和福祉方面的作用， 他们的孩子和其他家庭成员。目标3：分析STE的后果和持久印记， (a)幸存成人和幸存者子女的身心健康和非传染性疾病 （B）生育率、对儿童的投资和受不同影响的家庭的人力资本 （c）移民和汇款;（d）应对新的冲击和危机的能力。

Surviving the Epidemic: Families and Well-Being, Malawi 1998–2020 Project Summary: Across Eastern and Southern Africa (ESA), a remarkable cohort is reaching middle and older ages: those who have survived the AIDS epidemic. Some were infected with HIV, but everybody in this co- hort was affected by HIV. Nobody could escape an epidemic that was devastating for both its health and social implications, and one that struck hard in a region also dealing with poverty, famines, and basic uncertainties of life. Were the survivors of this cohort just lucky? What promoted survival and resilience in such a terrible context, and what influenced health and well-being among the survivors and their families? How is present demographic change, health, well-being and economic development in ESA shaped by the experience of the epi- demic and by the strategies used to survive the epidemic? These and related questions about “Surviving the Epidemic” (STE) will be studied by exploiting an unusually rich data source: the Malawi Longitudinal Study of Families and Health (MLSFH) cohort, 1998–2020. The motivation to expand, publicly-release and analyze the MLSFH until 2020 is multifold: (a) The MLSFH 1998–2020 will provide a unique opportunity to investigate questions about STE, an opportunity not available from other ESA data. (b) The MLSFH 1998–2020 will also be exceptional in allowing researchers to understand how the epidemic and the strategies for STE employed by individuals and families continue to shape the epidemiological and demographic transitions in ESA. (c) The end of the epidemic will almost certainly not mark the end of global health crises (an example at the time of this submission is the considerable concern about Zika in the Americas), and we need to better understand the mech- anisms of how low-income country citizens cope with such crises. The Specific Aims for the MLSFH 1998-2020 therefore include: Aim 1: Collect and publicly-release new MLSFH data from 2016–20 for (a) surviving MLSFH respondents and their families, (b) children of surviving and deceased respondents, and (c) migrants, with an expected N(surveyed) 6,300 plus data on 1,200 deceased respondents. The topics to be covered include well- being, mortality & morbidity, family & household dynamics, social capital & networks, physical & mental health, household production & consumption, and intergenerational relations. Aim 2: Using the MLSFH 1998–2020 and diverse methodological approaches for longitudinal data ranging from ethnographic methods to econometric structural equation modeling, analyze the determinants of STE by identifying the factors, social contexts and individual/household behaviors influencing survival, resilience, and well-being among MLSFH respondents, their children, and other family members. Aim 3: Analyze the consequences and lasting imprints of STE on (a) physical/mental health and non-communicable diseases among surviving adults and children of survivors and non-survivors, (b) fertility, investments in children and human capital in families differentially affected by the epidemic and STE, (c) migration and remittances, and (d) coping capabilities for new shocks and crises.