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

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的长期影响。Matlab，孟加拉国，是为数不多的结合了有针对性的干预措施，长时间的随访（超过30年），并在一组异常丰富的结果和几代潜在受益者中详细跟踪损耗的设置之一。自1970年代中期以来，对20多万人口进行了跟踪调查。一个准随机的妇幼保健和计划生育（MCH/FP）方案在20世纪70年代末推出。相当多的证据表明，MCH/FP和比较领域的关键项目前相似之处。当后来引入防洪和小额信贷干预措施时，村庄无法获得任何或1-3项干预措施。nia资助的Matlab健康和社会经济调查（MHSS1）于1996年开展。我们建议对MHSS1进行后续调查，并建立1974- 2011年现有纵向数据的新档案。MHSS2将提供在妇幼保健/计划生育干预开始30年后关于健康、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；详细的初次报告；以及一些与具体目标相关的初步研究。我们有三个具体目标。首先：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————在方案安置时的育龄妇女（2011年为38-73岁）和在方案变动期间的儿童（2011年为22- 34岁）。干预前的社会经济地位数据和MHSS1之前离开人群的信息允许对项目效果进行分析，并对自我选择和流失进行异常有效的核算。第二：研究妇幼保健/计划生育干预措施通过代际关系和贫困传递的影响。我们询问儿童健康的改善和家庭规模的缩小如何影响老年人的社会支持和福祉，以及该方案如何影响方案参与者的子女。1996年和2011年家庭关系的丰富数据将有助于了解该计划的代际影响。第三，在小额信贷和防洪干预以及社会、人口和文化变化的背景下，研究妇幼保健/计划生育干预措施的影响。详细的社区数据，包括基础设施和设施的历史地图，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——在妇幼保健和计划生育、减轻贫困和环境保护方面——涉及联合国千年发展目标的八项目标中的四项。单一和多重干预措施对健康、财富和生活机会的影响可以研究四代人，以获得干预措施的年龄来界定。

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.