Anaemia among men in India: a nationally representative cross-sectional study

Anemia Men 300/200pxAn international research team comprising of the Harvard T. H. Chan School of Public Health, the University Heidelberg, the Public Health Foundation of India, the University of Goettingen and more, analyzed the prevalence of anemia among men in India, how it varies across states and compared the findings with the prevalence among women regarding geographical and sociodemographic variation. This cross-sectional study analyzed data from a representative household survey from January 2015 to December 2016, carried out in India’s 29 states and seven Union Territories. This study included more than 106 thousand men and more than 633 thousand women. The findings showed, that men had a prevalence of any anemia with 23.2%, moderate or severe anemia with 5.1% and severe anemia with 0.5%. Men ranging from 20-34 years showed the lowest probability of anemia, which is a similar result to women across age groups. Socio-economic factors like less household wealth, lower education, rural areas, smoking and underweight increase the probability of anemia among men. The outcome showed, that the geographical and sociodemographic variation of anemia is similar regarding men and women, although many studies and interventions have focused on women and children. Future efforts in anemia reduction targeting men can be adjusted to the existing interventions reducing anemia among women.

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Inadequate care for high blood pressure patients along the treatment system

blood pressureA research team composed of academics from Harvard T.H. Chan School of Public Health, the University of Göttingen and the Medical Faculty of Heidelberg and various partner institutions from study countries analyzed the healthcare of hypertension in 44 low- and middle-income countries. They used a model known as the “cascade methodology”. The researchers found that less than half of those affected are diagnosed with high blood pressure. Only 30 percent of these patients are treated and only one tenth have the disease under control. "High blood pressure can be treated relatively well and cheaply," says Sebastian Vollmer, Professor of Development Economics at the University of Göttingen. "Undiagnosed or untreated hypertension, on the other hand, is a considerable risk for the people affected and can lead to significant complications, including death.” Read paper

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EASAC report “The imperative of climate action to protect human health in Europe”

KlimawandelProf. Dr. Vollmer was part of a European Academies’ Science Advisory Council (EASAC) working group on climate change and health. He was nominated by the National Academy of Sciences Leopoldina. The new EASAC report “The imperative of climate action to protect human health in Europe” highlights an alarming range of health risks due to climate change, and the benefits of rapid phase out of fossil fuels. The scientists elaborated different pathways that will lead to increased health risks if no urgent action is taken to reduce greenhouse emission.
The pathways are increased exposure to high temperatures and extreme events such as floods and droughts, air pollution and allergens; Weakening of food and nutrition security; Increased incidence and changing distribution of some infectious diseases (including mosquito-borne, food-borne and water-borne diseases); Growing risk of forced migration;
The solutions proposed by the scientists of the EASAC were decarbonization of the economy, healthier diets, climate-smart food systems, strengthening communicable disease surveillance and response systems. Furthermore, the impacts of climate change should not only be viewed on the European level, but rather on the global level.

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Variation in health system performance for managing diabetes among states in India: A cross-sectional study of individuals aged 15 to 49 years.

Diabetes_4Prenissl et al. determined the proportion of adults with diabetes in India who have reached each step of the care cascade. Moreover, they analyzed the variation of these cascade indicators among states and socio-demographic groups. This analysis included 729,829 participants. Among those with diabetes (19,453 participants), 52.5% (95% CI, 50.6–54.4%) were “aware”, 40.5% (95% CI, 38.6–42.3%) “treated”, and 24.8% (95% CI, 23.1–26.4%) “controlled”. Living in a rural area, male sex, less household wealth, and lower education were associated with worse care cascade indicators. The greatest loss in the care cascade takes place at the awareness stage. Read paper

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Data Collection for Nigerian Partnership for Education Project

Nigeria_projectThe Nigerian Partnership for Education Project (NIPEP) aims to improve access to and quality of primary education in five states in Northern Nigeria. The baseline data collection for the evaluation of the project took place between June and August 2018 in Sokoto State and was accompanied by Ann-Charline Weber, Lisa Bogler, and Sebastian Vollmer in cooperation with a team from the Federal University of Technology, Akure, in Nigeria. Read more.

Hypertension screening, awareness, treatment, and control in India: A nationally representative cross-sectional study among individuals aged 15 to 49 years.

indian_adult_kl Non communicable diseases are increasingly important in low and middle income countries worldwide. This study analyzed health care systems in 44 low and middle-income countries focusing on the performance of hypertension care. Thus, only 45 percent of people are aware of their diagnosis, as this first large-scale population-based study of hypertension care shows. The study is based on STEPS-data of the World Health Organization (WHO) and other nationally representative data. The findings highlight the vital need for improvements in several health care systems. It shows, that less than half of those who are affected are diagnosed with hypertension. Treatment is given to one-third of the patients and only one-tenth gained control of the disease. Hypertension is a major risk factor regarding stroke, heart attacks, and resulting deaths. Lacking awareness and insufficient treatment have lifted hypertension to one of the most common non-communicable diseases. Besides the improvement of health systems and treatment, awareness and information of the public have to be raised. Thus promising diagnosis, treatment and easy control of this disease, the results picture a low performance in several healthcare systems.Read more

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Prof. Vollmer was invited by SynTalk (Mumbai, India) as a SynTalkr for #TPPP (The Public Private Puzzles, February 23, 2019).

Latest Thinking ( What is the Global Economic Burden of Diabetes

New Blog Post Online: How psychosocial interventions can help with money management

BlogVoxDev Financial literacy is known to be one of the biggest constraints to people in poverty handling their budgets. A new study with the involvement of Janina Steinert and Prof. Sebastian Vollmer reveals that psychosocial factors matter more in this regard than previous research had shown. In an RCT, they tested a combined financial literacy and parenting programme for families in South Africa. Findings indicate that the combination of financial and psychosocial components resulted in higher saving and an improved general economic wellbeing. Read more.

Summer School on Global Health and Poverty

school390During a two-week program, exceptional students from all over the world came to Göttingen to work on Global Health and Poverty. Hosted by the CeMIS, the Chair for Development Economics, and Göttingen’s Shortterm Programs, this Summer School provided international Master’s and PhD students the opportunity to discuss and learn about important issues on the epidemiological transition, infectious diseases, and global health systems. Internationally renowned lecturers – such as Barry Bloom, former Dean of the Harvard School of Public Health – shared their knowledge on today’s most pressing challenges of the field. Read more.

Putting Noncommunicable Diseases on the Agenda - HPACC Workshop on Access to Care

WorkshopToday, approximately 2 out of every 3 deaths globally are attributable to noncommunicable diseases (NCDs), equivalent to 71% of all deaths. Cardiovascular diseases account for most NCD deaths, or 17.9 million people annually, followed by cancers (9.0 million), respiratory diseases (3.9 million), and diabetes (1.6 million). Changing patterns of population age distributions and causes of death are at the forefront of discussions on global development and require the reordering of healthcare priorities. Read more.

Improving Children Health and Cognition: Evidence from School-Based Nutrition Intervention in India

Salt_IndiaWe present experimental evidence on the impact of delivering double-fortified salt (DFS), salt fortified with iron and iodine, through the Indian school-feeding program called “mid-day meal” on anemia, cognition, and math and reading outcomes of primary school children. We conducted a field experiment that randomly provided a one-year supply of DFS at a subsidized price to public primary schools in one of the poorest regions of India. The DFS treatment had significantly positive impacts on hemoglobin levels and reduced the prevalence of any form of anemia by 20 percent but these health gains did not translate into statistically significant impacts on cognition and test scores. While exploring the heterogeneity in effects, we find that treatment had statistically significant gains in anemia and test scores among children with higher treatment compliance. We further estimate that the intervention was very cost effective and can potentially be scaled up rather easily. Read more.

Christian Bommer, Esther Heesemann, Vera Sagalova and Prof. Sebastian Vollmer receive Science Award of the German Society of Health Economics

Bommer_dggoe We congratulate Christian Bommer, Esther Heesemann, Vera Sagalova and Prof. Sebastian Vollmer from the Development Economics group at CeMIS. They received the Science Award of the German Society of Health Economics at the annual meeting on March 5th. They received the prize for their article on "The Global Economic Burden of Diabetes: A Cost-of-Illness Study”, published in The Lancet Diabetes & Endocrinology in 2017. In the article, they estimate that diabetes treatment as well as diabetes related production losses account for $US1.3 trillion globally, equivalent to 1.8 percent of global GDP. Christian Bommer, Esther Heesemann and Vera Sagalova have already been awarded with the University of Göttingen's Foundation Council Award for "Herausragende Nachwuchspublikation" ("Outstanding Publication by Junior Researchers") for the same article by the end of 2017. For further information and a link to the article, see the press release here.

Geographic and sociodemographic variation of cardiovascular disease risk in India: A cross-sectional study of 797,540 adults.

cardiac_klThis study aimed to determine how Cardiovascular disease (CVD) risk—and the factors that determine risk—varies among states in India, by rural-urban location, and by individual-level sociodemographic characteristics. For that purpose, two large household surveys carried out between 2012 and 2014, which included a sample of 797,540 adults aged 30 to 74 years across India were used. Different risk scores were used as outcome variables, that were: the Framingham risk score, Harvard–NHANES, Globorisk, and WHO–ISH scores. CVD risk tended to be highest in North, Northeast, and South India. Similarly, household wealth quintile and living in an urban area were positively associated with CVD risk among both sexes, but the associations were stronger among women than men. Also, for our other sociodemographic characteristics, we found significant differences. Read more.

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Summer School "Global Health and Poverty" in Göttingen

From 28 May to 8 June 2018, the University of Göttingen will welcome up to 20 advanced international students (Masters or PhD level) working in global health or development economics for the "Global Health and Poverty" summer school. Organised by CeMIS/ Department of Economics Professor Sebastian Vollmer, the school will address the central health challenges of the world today, focusing particularly on their many intersections with poverty. To do this, participants will look at the complex interplay of a person’s health status and economic prosperity or deprivation in the context of low- and middle-income countries.Read more.

Project on Access to Care for Cardiometabolic Diseases (HPACC)

HPACC team klein_formatApproximately two out of every three deaths globally are attributable to non-communicable diseases such as cardiovascular disease, about 80% in low- and middle-income countries. Catastrophic household expenditures on treatment and lost productivity from these diseases have brought them to the forefront of discussions on global development and achieving the Sustainable Development Goals. Yet major research gaps remain.Read more.

3ie Impact Evaluation Report for Gram Varta Available

Gram Varta completedThe Gram Varta programme aims to improve women and child health indicators in Bihar, India through community empowerment and behavioural change. The study utilized a randomized control design of 180 villages and conducted survey research in 6,000 households in about 90 villages pre and post- implementation of Gram Varta. Results from the impact evaluation found some evidence that Gram Varta increased women’s involvement in the community, heightened their self-confidence to refuse intercourse with their husbands or demand that they use protection, reduced domestic violence, decreased women’s preference for sons, encouraged optimism for pregnant women and their mindfulness of health needs during pregnancy, and lastly, increased mutual trust within the community. Although consistent evidence for improvements in health indicators was not found, the findings highlight the importance of participatory learning approaches and their potential to empower women.
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PhD student Lisa Bogler wins prize as outstanding economics graduate

Lisa_Sartorius_PrizeLisa Bogler was awarded the "Florenz Satorius Preis" as an outstanding graduate student in Economics at the University of Göttingen on October 20. Ms Bogler completed her MA thesis, Evaluation of Gram Varta in Madhepura, India, regarding HNWASH knowledge and practices, earlier this year. The Development Economics/CeMIS PhD student is now working on health economics, with a focus on Indonesia. The prizes, which were donated by the Sartorius AG in Göttingen, were also awarded to outstanding graduates from Business Administration, Business Information Systems, and Business and Human Resource Education.Read more.

Levels and trends of childhood undernutrition by wealth and education according to a Composite Index of Anthropometric Failure: evidence from 146 Demographic and Health Surveys from 39 countries

InequalityChildhood undernutrition is linked to 45% of all child deaths and is connected to lower adult height, lower educational achievement, and lower economic productivity later in life. The severity of childhood undernutrition is emphasized in the Sustainable Development Goals (SDGs) and the global target to reduce stunting and wasting in children under five years of age by 2025. There is a growing recognition that nutrition can play a key role in promoting and achieving many of the SDGs, as malnutrition not only derives from a lack of sufficient and adequately nutritious and safe food, but from a host of interacting processes linking health care, education, hygiene and sanitation, access to resources, and more. Read more.

Launch of Lancet Commission on Diabetes in sub-Saharan Africa

Diabetes In 2014, The Lancet Diabetes & Endocrinology Commission on Diabetes in sub-Saharan Africa convened a team of academics, clinicians, economists, and people who work in governmental and non-governmental organisations to identify targets and milestones for diabetes, and ways of strengthening health systems in sub-Saharan Africa to make cost-effective intervention possible. As part of this team, Prof. Dr. Sebastian Vollmer, Christian Bommer, Esther Heesemann and Vera Sagalova from Göttingen University have contributed to the Commission's work from a health economics point of view. The findings of the Commission are summarized in a peer-reviewed scientific report published in The Lancet Diabetes & Endocrinology.
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Diabetes and hypertension in India: A nationally representative study of 1.3 million adults.

hypertension_klIn this paper we addressed the question of how the prevalence of diabetes and hypertension in India vary by geographical area and sociodemographic characteristics. The conducted population-based study was cross-sectional and nationally representative. It was carried out between 2012 and 2014. A total of 1.320.555 adults 18 years or older with plasma glucose (PG) and blood pressure (BP) measurements were included in the analysis. The main outcome variables were diabetes and hypertension. The crude prevalence of diabetes and hypertension was 7.5% (95% CI, 7.3%-7.7%) and 25.3% (95% CI, 25.0%-25.6%), respectively. Being in the richest household wealth quintile compared with being in the poorest quintile was associated with only a modestly higher probability of diabetes (rural: 2.81 percentage points; 95% CI, 2.53-3.08 and urban: 3.47 percentage points; 95% CI, 3.03-3.91) and hypertension (rural: 4.15 percentage points; 95% CI, 3.68-4.61 and urban: 3.01 percentage points; 95% CI, 2.38-3.65). There were large differences in diabetes and hypertension rates between states. Education seemed to have a rather negligible effect. Read more.

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The Global Economic Burden of Diabetes in Adults aged 20 to 79: A Cost-of-Illness Study.

diabetes2_klThe WHO 2016 Global Report on Diabetes estimates that over 420 million adults are living with diabetes. The growing prevalence of diabetes, specifically in low- and middle-income countries, reveals the massive shifts in health trends since the 1990s. In cooperation with an international team of scientists, economists Christian Bommer, Esther Heesemann, Vera Sagalova and Prof. Sebastian Vollmer from the University of Göttingen have calculated that in 2015 the worldwide economic burden of diabetes reached $1.3 trillion or 1.8 percent of the global GDP. The results of the study are published in the Lancet Diabetes & Endocrinology.Read more.

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Diabetes in sub-Saharan Africa - from clinical care to health policy


diabetes1_klIn 1990, the leading causes of death in sub-Saharan Africa were HIV/AIDS, lower respiratory infections, diarrhoeal diseases, malaria, and vaccine-preventable diseases in children, in more recent years, cardiovascular diseases and their risk factors are replacing infectious diseases as the leading causes of death in this region, and rates of increase of cardiovascular risk factors
are predicted to be greater in sub-Saharan Africa than in other parts of the world. However, the true burden of diabetes, other cardiovascular risk factors, and macrovascular and microvascular complications in sub-Saharan Africa are unknown. Moreover, health systems in countries in sub-Saharan Africa are unable to cope with the current burden of diabetes and its complications. Scarce health-care resources should be focused on the management of diabetes and other risk factors to prevent complications. Lastly, more evidence is needed about the benefits and risks (to individuals and health systems) of screening before programmes are rolled out across sub-Saharan Africa.Read more

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The role of household socioeconomic status for the stunting-age pattern.

shack_klReducing stunting is an important part of the global health agenda. Despite likely changes in risk factors as children age, determinants of stunting are typically analyzed without taking into account age-related heterogeneity. We aim to fill this gap by providing an in-depth analysis of the role of socioeconomic status (SES) as a moderator for the stunting-age pattern. We found that stunting rates are similar in newborn children from households of low and high socioeconomic status but diverge markedly between the sixth and 20th month of life. Additionally, differences between children from poor and rich households cannot simply be explained by the presence or absence of determinants that are modifiable through nutrition-specific interventions but are also strongly moderated by determinants related to nutrition-sensitive interventions.Read more

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Diabetes diagnosis and care in sub-Saharan Africa: pooled analysis of individual data from 12 countries.

overweight_klDespite widespread recognition that the burden of diabetes is rapidly growing in many countries in sub-Saharan Africa, nationally representative estimates of unmet need for diabetes diagnosis and care are in short supply for the region. We pooled data from 12 nationally representative population-based surveys in sub-Saharan Africa, representing 38 311 individuals with a biomarker measurement for diabetes. Across the surveys, the median prevalence of diabetes was 5% (range 2–14). We estimated seven measures of met need for diabetes-related care across the 12 surveys: (1) percentage of the overweight or obese population who received a blood glucose measurement (median 22% [IQR 11–37]); and percentage of the diabetic population who reported that they (2) had ever received a blood glucose measurement (median 36% [IQR 27–63]); (3) had ever been told that they had diabetes (median 27% [IQR 22–51]); (4) had ever been counselled to lose weight (median 15% [IQR 13–23]); (5) had ever been counselled to exercise (median 15% [IQR 11–30]); (6) were using oral diabetes drugs (median 25% [IQR 18–42]); and (7) were using insulin (median 11% [IQR 6–13]). We further estimate demographic and economic gradients of met need for diabetes diagnosis and care. Read more

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Evaluation of the impact of a new general hospital in Managua, Nicaragua

Hospital Premature Unit In developing countries, high population growth and rural-urban migration put considerable pressure on existing urban health infrastructure and human resources. Managua, the capital of Nicaragua, for the first time in 32 years has built a new general hospital.Read more about the project.

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Evaluating the Impact of Safe Childbirth Checklists on the Quality of Care and Birth Outcomes in (Public) Health Facilities

Indonesia_1 Despite a global commitment and remarkable achievements to improve maternal and neonatal mortality, 800 women and 7700 newborns die each day from complications during pregnancy, childbirth, and in the postnatal period.
In efforts to reduce maternal mortality and morbidity, the World Health Organization (WHO) has developed a Safe Childbirth Checklist (SCC) to support the delivery of essential maternal and perinatal care practices and address the major causes of maternal and neonatal deaths.Read more about the project.

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The Association of Parental Education with Childhood Undernutrition in Low- and Middle-Income Countries: Comparing the Role of Paternal and Maternal Education.

schoolchildren_klA team comprising Sebastian Vollmer, Christian Bommer, Aditi Krishna, Kenneth Harttgen and SV Subramanian systematically investigated the differences in maternal and paternal education and their association with childhood undernutrition. Using 180 Demographic and Health Surveys (DHS) from 62 countries, and covering the years 1990 to 2014, they show that both higher maternal and paternal education levels are associated with lower childhood undernutrition with maternal education being the stronger determinant in specifications failing to adjust for household wealth and local area characteristics. However, when these controls are introduced, the observed differences are strongly weakened or disappear entirely. The findings suggest that paternal education is also an important factor for reducing childhood undernutrition and should therefore receive increased attention in the literature. Read more

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Development Economics Conference - Göttinger Schule

From June 23rd - 24th more than 150 development economists from all over the world gathered in Göttingen to celebrate the 50th birthday of Professor Dr. Stephan Klasen. The celebration was a two-day conference that covered a broad range of topics in development economics such as gender, education, and agriculture. All of Klasen's former and current PhD students, collaborators, and friends were invited to participate.
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Safe Childbirth Checklist Pakistan

Pakistan_smallThe GIZ Project in Pakistan is a research project on the Safe Childbirth Checklist (SCC) in the province of Khyber Pakhtunkhwa in Pakistan. The research is conducted in the districts Haripur and Nowshera. Read more.

Jun.-Prof. Dr. Sebastian Vollmer: 2015 KfW Development Bank Prize for Scientific Excellence

Vollmer_klein Format Jun.-Prof. Dr. Sebastian Vollmer, Chair of Development Economics ('Juniorprofessur'), has received the 2015 KfW Development Bank Prize for Scientific Excellence. The prize was jointly awarded to Sebastian Vollmer and Dr. Kenneth Harttgen (ETH Zürich) for the paper: "Association between economic growth and early childhood undernutrition: evidence from 121 Demographic and Health Surveys from 36 low-income and middle-income countries," published in The Lancet Global Health. The authors investigate the relationship between economic growth and childhood undernutrition. While it is a common belief that undernutrition improves in economic growth, the authors find that economic growth does not automatically equate to reductions in childhood undernutrition.Read more.

Monks, Gents and Industrialists : the Long Run Impact of the Dissolution of the English Monasteries

monastery_klIn the late medieval period the overwhelming majority of land in England was held by the Crown, the Aristocracy and the Church. In two acts passed in 1532 and 1534 Parliament made Henry VIII, head of the Church. At first, Henry’s objective was to redirect the revenues that the monastries paid to the Pope to himself. So, he ordered a survey of church incomes the Valor Ecclesiasticus just shortly before it was decided to dissolve all monasteries. This paper investigated the long-run economic impact of the Dissolution of the monasteries in England. To measure the impact of the Dissolution at the parish level we digitized the Valor Ecclesiasticus. We then showed that the greater was monastic income according to the Valor, the more industrialization there was in 1838 in terms of the presence and number of textile mills and the number of mill employees. We also showed that greater levels of monastic income in 1535 were associated with a smaller proportion of the labor force employed in agriculture according to the 1831 Census, and a larger share of the labor force employed in manufacturing and retail. Furthermore, we explored some of the likely channels via which the Dissolution might have impacted industrialization. Read more

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HIV surveys in older adults: better data, better health.

hiv_klMost nationally representative HIV surveys, including those of the Demographic and Health Surveys Programme, limit eligibility for HIV testing to adults younger than 50 years or 55 years of age. These age limits reflect the belief that HIV is a disease acquired in youth and with consequences in middle age. However, as the epidemic evolves, information about HIV in older people will become essential, and age limits for surveys should be removed for six reasons which we discuss in the paper. Read more

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Association between economic growth and early childhood undernutrition: evidence from 121 Demographic and Health Surveys from 36 low-income and middle-income countries.

children_klIn this paper evidence has been provided that merely economic growth is not enough for the improvement of early childhood undernutrition. The sample consisted of nationally representative cross-sectional surveys of children aged 0–35 months, and the outcome variables were stunting, underweight, and wasting. The main independent variable was per-head gross domestic product (GDP) in constant prices and adjusted for purchasing power parity. Logistic regression models were run to estimate the association between changes in per-head GDP and changes in child undernutrition outcomes. Models were adjusted for country fixed effects, survey-year fixed effects, clustering, and demographic and socioeconomic covariates for the child, mother, and household. A quantitatively very small to null association was observed between increases in per-head GDP and reductions in early childhood undernutrition. The findings emphasize the need for direct health investments to improve the nutritional status of children in low-income and middle-income countries. Read more.

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Cara Ebert: 2014 H.K. Nieuwenhuis Thesis Award

Cara_Klein Format Cara Ebert, PhD candidate at the Chair of Development Economics ('Juniorprofessur'), has received the 2014 H.K. Nieuwenhuis Thesis Award for her master's thesis "Nature or Nurture: Evidence from Indonesia." The thesis disentangles factors in the intergenerational education persistence that are attributable to the genetic ability transmission from parents to their children (nature) from factors that are attributable to the family environmental background (nurture). While for advanced countries, the existing research shows that genetics determine the intergenerational education persistence; this work finds that it is family environmental factors that determine the children's educational success in Indonesia. The results suggest that in contexts where levels of education and child rearing standards are relatively low, an additional year of parental schooling is effective in improving nurturing skills and that intergenerational returns to education exist.
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Fact Finding Mission in Indonesia

Indonesia_small In May 2015 J.Prof. Vollmer, Jana Kuhnt, and Rivayani Darmawan conducted a fact-finding mission in Indonesia to elaborate on possible partners for their Safe Childbirth Checklist Project.
After visiting different Indonesian universities, the team decided to partner with the Syiah Kuala University in Banda Aceh. The project preparation is on-going and the implementation phase will start in February 2016.
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Gram Varta

Gram Varta is a development program that aims to enhance health knowledge and health behavior regarding general health, nutrition, water, and sanitation and hygiene (HNWASH). The Gram Varta program was first launched in the Indian state of Bihar in 2011 as part of the Government of Bihar's Sector Wide Approach to Strengthen Health (SWASTH). Using a participatory learning approach, health training meetings are held in already established local women’s self-help groups. Read more.

Fact Finding Mission Cameroon

Cameroon_small Antimicrobial resistance (AMR) is a growing concern in today's society. In developing countries, where antibiotic stewardship is largely non-existent, this problem is particularly severe. In most developing countries there exist no guidelines for prescriptions, empirical treatment prevails, and patients can buy antibiotic medications over the counter. These mechanisms lead to excessive and often incorrect uses of antibiotics, which in turn promote AMR.
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Study on Impacts of Double Fortified Salt on Children's Cognitive Development

Double_Fortified_Salt Iron is considered an essential micronutrient for brain development, physical activity, and resistance against infections. It has been estimated that underdeveloped cognitive development due to iron deficiency is associated with a 5-10 points lower intelligence quotient (WHO/UNICEF/UNU, 2011). The provision of nutrition supplements and of micronutrient fortified foods are considered to be a promising means to break the micronutrient poverty trap. Whereas research on the biological relationship between fortified food and improvements in health is well established, the effectiveness of different distribution channels for fortified food has not yet extensively been studied.
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An African Growth Miracle? Or: What do Asset Indices Tell us about Trends in Economic Performance?

african_index_klUsing changes in the possession of household assets over the past 20 years, several recent papers have argued that economic growth and poverty reduction in Africa was substantially better than suggested by national income data and income poverty statistics, which suffer from well-known weaknesses. We scrutinize these claims and first argue that trends in assets provide biased proxies for trends in incomes or consumption. In particular we show that the relationship between growth in assets and growth in incomes or consumption is extremely weak; instead, we find evidence of asset drift using macro and micro data, which is consistent with the claims we make about possible biases in the use of asset indices. As a result, we find no evidence supporting the claim of an African growth miracle that extends beyond what has been reported in official GDP/capita and consumption figures. Read more.

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Long-Run Trends of Human Aging and Longevity.

senior_klIn this paper, we ask whether future improvements of life expectancy will be bounded from above by human life span. Life span, in contrast to life expectancy, is conceptualized as a biological measure of longevity driven by the intrinsic rate of bodily deterioration. From these observations, it should be clear that life span, in contrast to life expectancy, cannot be defined as a mere statistical measure without biological foundation. Hence, we have introduced to the economic science a theoretical foundation of human life span based on two strong empirical regularities, the Gompertz–Makeham law and the compensation effect of mortality. Our results showed that contemporaneous humans start out as young adults much more healthy than their forefathers a century ago but they are also aging faster. For a long time of our history, this trend was consistent with the observation of rising life expectancy under an invariant life span. If life span was indeed immutable, as it presumably is for other animals, future improvements in life expectancy would soon end. Life expectancy, as we have shown in this paper, is bounded from above by life span. For the second half of the twentieth century, however, we were able to present evidence for an expanding life span of about 8 years. Read more.

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