Health policy and education最新文献

This paper examines a wide range of evidence on the relationship between parental education and child health. Ideally, measures of child nutritional status, morbidity and mortality would have been included, but very few studies on morbidity were found which included education. The data reviewed here indicate that maternal education is closely related to child health measured either by nutritional status or by infant and child mortality. The effect of father's education on infant and child mortality appears to be about one half that of mother's education.

The exact mechanisms through which education acts to affect child health are unclear. Better nutrition among the children of the more educated has been well-documented here, but it is unclear to what extent these effects result from improved knowledge and to what extent from higher income. The analysis does suggest that income differences cannot explain all the effect or perhaps even as much as half.

This paper explores the mechanism through which socioeconomic status affects infant deaths. The data used here come from a prospective study in rural Bangladesh. Both neonatal deaths and postneonatal deaths were found to be higher in number among those whose mothers have no schooling. Again, education of the mother has been found to be related to gestational month at termination and this gestational month at termination (which is the maturity of the newborn) determines the neonatal death.

The other factors affecting infant mortality were the height of the mother and the weight of the infant. The taller the mother, the fewer the neonatal and post-natal deaths. The weight of the infant has a direct relationship to its survival during infancy.

The education of a mother is strongly and positively correlated with the survival rate of her children. This paper combines household data from the Colombian Census of 1973 and characteristics of the 900 residential areas in Colombia, to test various hypotheses concerning the mechanism by which mother's education and public policies affect child survival and the distribution of health benefits resulting from policy interventions. The hypothesis is advanced that education provides people with skills in acquiring and decoding new information and thus effectively lowers the costs of using more beneficial child health and contraceptive technologies. Since a primary function of health and family planning programs is to disseminate information on these same technologies, the hypothesis is tested that mother's education and these program interventions may substitute for each other in improving child health and reducing family size. The empirical analysis confirms that in urban areas the availability of medical services, family planning activities, transportational infrastructure and climate, in addition to mother's education, are associated with child mortality ratios and fertility within a birth cohort of mothers. The least educated mothers are the most strongly affected, in terms of their reduced fertility and increased child survival rates, by the local urban health programs. The evidence is, thus, consistent with the substitution hypothesis. No effects of program interventions and medical facilities are found on rural populations, though both child mortality ratios and fertility are lower for more educated rural women.

Analyses were performed to investigate several hypotheses concerning the multiple determinants of levels of life expectancy in developing countries in recent decades and some possible explanation for the observed variations in amount of gain in life expectancy from the 1950's to the 1970's. The findings were significant. For level of life expectancy the results of this present work conform by and large to results of other scholars in this area, although the present work is unique in that only developing countries were included. From the 1960's to the 1970's there has been a shift in the relative importance of economic indicators and general social indicators in favor of the social indicators. In the period 1960–1965 some 70% of the variation in levels of life expectancy was associated with per capita income and literacy rates in a ratio of about three to two in favor of the economic variable. By 1970–1975 the ratio has become six to one in favor of literacy. In addition, the multivariate model showed that the sanitation variables began to appear as significant correlates of levels of life expectancy in the more recent time period, playing a larger role than level of income per capita. Work pursued as part of a separate but concurrent project explored explicitly this three-way interaction between literacy, life expectancy and sanitation.

For change in life expectancy from 1950 through 1970, associations were quite different. Per capita income was not associated with the absolute change in life expectancy, and the associations with literacy were much smaller than earlier observed with level of life expectancy at a point in time. In the multivariate model the primary correlates with change were the sanitation variables and health personnel as represented by population per midwife. Tests for such associations with variations in amount of gain in life expectancy have not been found in other literature and comparison with other findings can therefore not be made directly. The present work suggests that it may be lower skill levels of health manpower and activities in sanitation that are the main correlates in a multivariate model of absolute change in life expectancy.

Employers in health care sometimes rely upon various standardized testing procedures in selecting, promoting, and training personnel. Within the health professions, voluntary certification programs have developed to permit individuals to demonstrate competence and become recognized as qualified practitioners. This article addresses the problems which can occur, but are not widely recognized, when employers use voluntary certification examinations in the selection process.

The impact of the federal government's “Uniform Guidelines on Employee Selection Procedures” upon voluntary certification activities is uncertain at best, and frightening, at worst. While the Guidelines require employers to use only validated examinations where adverse impact upon protected minority groups exists, they do not effectively address the use of professional certifying examinations and fail to provide guidance for either certifying agencies or employers. This leaves great potential for conflict, since circumstances in which employment is terminated, an employee denied promotion, or even denied opportunities for entry into positions based on an employer's use of voluntary certifying examinations, are increasing daily. How does an employer validate a national certifying examination that he does not administer? How does the certifying agency protect itself from allegations of discrimination or anti-trust violations based on actions of an employer with whom the agency has no contact?

This article offers no answers to these troublesome questions. However, it may help eliminate another problem noted by the author — widespread ignorance of the seriousness of these circumstances for employers and certifying agencies. From first-hand experience and research into the development of the Uniform Guidelines, the author points out many of the difficulties which await those who rely on non-validated examinations or choose to ignore the government's edict that examinations used in selection must have a demonstrated relationship to the job. Finally, the article proposes solutions to the dilemma faced by certifying organizations and suggests that, by becoming more aware of the Uniform Guidelines, employers and testing groups have the opportunity to protect themselves before a problem occurs.