Long-term Effects of Health and Development Interventions in Rural Bangladesh

孟加拉国农村地区健康和发展干预措施的长期影响

• 批准号: 7779739
• 负责人: JANE A MENKEN
• 金额: $ 58.09万
• 依托单位: UNIVERSITY OF COLORADO
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-05-01 至 2015-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7779739
• 关键词: Accounting; Address; Adolescence; Adult; Affect; Age; Aging; Archives; Area; Bangladesh; Censuses; Characteristics; Child; Child health care; Childbirth; Childhood; Cognition; Colorado; Communities; Community Surveys; Contraceptive Agents; Data; Data Set; Deltastab; Developing Countries; Development; Disadvantaged; Disease; Economic Development; Economics; Education; Effectiveness; Elderly; Environmental Protection; Evaluation; Event; Family; Family Planning; Family Planning Programs; Family Sizes; Family member; Fathers; Fertility; Floods; Funding; Generations; Geographic Information Systems; Goals; Health; Health Policy; Household; Human Development; Immunization; Income; Individual; Inequality; Infant; Institutes; Institution; Intervention; Irrigation; Labor Migrations; Left; Life; Link; Long-Term Effects; Longitudinal Studies; Low Prevalence; Maps; Marketing; Marriage; Maternal and Child Health; Measures; Mental Health; Morbidity - disease rate; Mothers; Nomads; Outcome; Output; Parents; Participant; Pattern; Perinatal Care; Personal Satisfaction; Persons; Population; Poverty; Public Health; Publications; Randomized; Recording of previous events; Records; Relative (related person); Reporting; Request for Proposals; Research; Research Infrastructure; Research Personnel; Rivers; Rural; Sampling; Scholarship; Schools; Services; Siblings; Side; Site; Social Welfare; Social support; Socioeconomic Status; Source; Surveys; System; Telephone; Testing; Time; Universities; Vaccines; Variant; Water; Wireless Technology; Woman; Women Status; base; beneficiary; child bearing; cognitive function; design; disorder prevention; economic outcome; empowerment; evidence base; experience; follow-up; geographic difference; girls; grandchild; human capital; improved; intergenerational; international center; intervention effect; intervention program; labor force participation; migration; mortality; new technology; population health; population survey; poverty alleviation; programs; public health relevance; reproductive; research study; rural area; sex; social; socioeconomics; therapy development; transmission process; uptake; young adult

DESCRIPTION (provided by applicant): We plan to study long-term effects of health and human capital interventions in the developing world. Matlab, Bangladesh, is one of the few settings that combines targeted interventions, long duration of follow-up (over 30 years), and detailed tracking of attrition across an unusually rich set of outcomes and for several generations of potential beneficiaries. A population of over 200,000 has been followed since the mid-1970s. A quasi- randomized maternal and child health and family planning (MCH/FP) program was introduced in the late 1970s. Considerable evidence demonstrates key pre-program similarities in the MCH/FP and comparison areas. When flood control and microcredit interventions were later introduced, villages had access to none or 1-3 interventions. The NIA-funded Matlab Health and Socioeconomic Survey (MHSS1) was carried out in 1996. We propose a follow-up survey to MHSS1 and a new archive of existing longitudinal data from 1974- 2011. MHSS2 will provide detailed information on health, human capital, labor and marriage outcomes, old-age support, and socioeconomic status 30 years after the initiation of the MCH/FP intervention. The intended outputs of this project are unique datasets for longitudinal health and demographic research; a detailed first report; and several initial studies related to the specific aims. We address three specific aims. First: Study the impacts of MCH/FP interventions on long-term health and welfare outcomes in the two generations targeted by interventions - women of reproductive age at program placement (age 38-73 in 2011) and individuals who were children during a period of program variation (age 22- 34 in 2011). Data on SES prior to intervention and information on those who left the population prior to MHSS1 permit analysis of program effects with unusually effective accounting of self-selection and attrition. Second: Study the impact of the MCH/FP interventions through intergenerational relationships and transmission of poverty. We ask how improvements in child health and reduced family size affect social support and well-being of elders and how the program affected children of program participants. Rich data on family connections in 1996 and 2011 will facilitate understanding intergenerational effects of the program. Third: Study the impact of the MCH/FP interventions in the context of microcredit and flood control interventions as well as social, demographic, and cultural changes. Detailed community data, including historical mapping of infrastructure and facilities, permit testing detailed hypotheses about relative contributions of and interactions between health, credit, and infrastructure interventions on the path to human development. These interventions - in maternal and child health and family planning, poverty alleviation, and environmental protection - pertain to four of the eight UN Millennium Development Goals. Impacts of single and multiple interventions on health, wealth, and life chances can be studied for four generations defined by age at access to interventions. PUBLIC HEALTH RELEVANCE: Maternal and child health and family planning programs are essential to public health programs worldwide; their effectiveness in improving child health and their relationship to fertility reduction in developing countries is well-established. Excellent continuously collected records exist for a large population in which an MCH/FP program was introduced 30 years ago and two programs to improve economic wellbeing were introduced more recently. These data combined with a follow-up survey permit examination of long-term effects on health and other aspects of individual and family social and economic well-being. The study will inform evidence-based public health policy and strategies to improve health.

描述（由申请人提供）：我们计划研究发展中国家健康和人力资本干预措施的长期影响。孟加拉国的Matlab是少数几个将有针对性的干预措施、长期随访（超过30年）和详细跟踪自然减员结合在一起的环境之一，这些环境涵盖了一系列异常丰富的成果和几代潜在受益人。自1970年代中期以来，对20多万人口进行了跟踪。20世纪70年代末引入了准随机妇幼保健和计划生育方案。相当多的证据表明，在妇幼保健/计划生育和比较领域的关键计划前的相似之处。后来，在实行防洪和小额信贷干预措施时，村庄没有获得任何干预措施，或只有1-3项。1996年进行了由国家卫生研究所资助的Matlab健康和社会经济调查。我们建议对MHSS 1进行后续调查，并对1974- 2011年的现有纵向数据进行新的存档。MHSS 2将提供有关妇幼保健/计划生育干预开始后30年的健康、人力资本、劳动和婚姻结果、老年支助和社会经济状况的详细信息。 该项目的预期产出是：用于纵向健康和人口研究的独特数据集;详细的第一份报告;以及与具体目标有关的几项初步研究。 我们提出三个具体目标。第一个：研究妇幼保健/计划生育干预措施对干预措施所针对的两代人的长期健康和福利结果的影响-方案安置时的育龄妇女（2011年38-73岁）和方案变化期间的儿童（2011年22- 34岁）。SES干预前的数据和那些谁离开人口之前MHSS 1允许程序的影响进行分析，异常有效的会计自我选择和磨损。 第二：通过代际关系和贫困的传递研究妇幼保健/计划生育干预措施的影响。我们询问儿童健康的改善和家庭规模的缩小如何影响社会支持和老年人的福祉，以及该计划如何影响计划参与者的子女。关于1996年和2011年家庭联系的丰富数据将有助于理解该方案的代际影响。 第三：研究妇幼保健/计划生育干预措施在小额信贷和防洪干预措施以及社会、人口和文化变化方面的影响。详细的社区数据，包括基础设施和各种设施的历史分布图，可以检验关于卫生、信贷和基础设施干预措施在人类发展道路上的相对贡献和相互作用的详细假设。 这些干预措施--妇幼健康和计划生育、扶贫和环境保护--与联合国八项千年发展目标中的四项有关。单一和多种干预措施对健康，财富和生活机会的影响可以研究四代人，按获得干预措施的年龄定义。 公共卫生关系：妇幼健康和计划生育项目对全球公共卫生项目至关重要;它们在改善儿童健康方面的有效性及其与发展中国家降低生育率的关系已得到公认。大量人口中存在良好的连续收集记录，其中30年前引入了妇幼保健/计划生育方案，最近引入了两个改善经济福利的方案。这些数据与后续调查相结合，可以审查对健康以及个人和家庭的社会和经济福祉的其他方面的长期影响。这项研究将为改善健康的循证公共卫生政策和战略提供信息。