The impact of rural-urban migration on child survival

Large rural-urban child mortality differentials in many developing countries suggest that rural families can improve their children's survival chances by leaving the countryside and settling in towns and cities. This study uses data from Demographic and Health Surveys in 17 countries to assess the impact of maternal rural-urban migration on the survival chances of children under age two in the late 1970s and 1980s. Results show that, before migration, children of migrant women had similar or slightly higher mortality risks than children of women who remained in the village. In the two-year period surrounding their mother's migration, their chances of dying increased sharply as a result of accompanying their mothers or being left behind, to levels well above those of rural and urban non-migrant children. Children born after migrants had settled in the urban area, however, gradually experienced much better survival chances than children of rural non-migrants, as well as lower mortality risks than migrants' children born in rural areas before migration. The study concludes that many disadvantaged urban children would probably have been much worse off had their mothers remained in the village, and that millions of children's lives may have been saved in the 1980s as a result of mothers moving to urban areas.     

灾难性卫生支出的城乡差异及分配敏感性研究

目的:分析实现全民医保后我国灾难性卫生支出的发展趋势、城乡差异及分配敏感性状况。方法:利用中国家庭动态跟踪调查2012年与2014年数据,采用世界卫生组织关于灾难性卫生支出及分配敏感性计算的方法。结果:2012—2014年,灾难性卫生支出总体发生率和发生强度均有明显下降。总体而言,灾难性卫生支出的收入分配状况相对均等。但是,发生率绝对值较高,且城乡有别,农村受到的灾难性卫生支出冲击更大;穷富有别,灾难性卫生支出更多发生在穷人身上。2012年城市发生率比农村更不均等,2014年正好相反。2012—2014年,所有家庭平均差距的集中指数由负变正。结论:全民医保对于降低灾难性卫生支出发生率与发生强度有一定作用;有限的保障内容、水平可能导致医保无法改善甚至加剧灾难性卫生支出的强度;收入水平与医疗保险差异导致农村、穷人遭受更大的灾难性卫生支出发生风险。     

Gender differences in rural-urban migration and its impact on depression in later life

Although rural-to-urban migration has been well researched, how gender shapes processes and outcomes, including later-life health outcomes, has not been thoroughly investigated. Guided by a life course perspective, this study explores gender differences in rural-urban migration patterns and its association with depression in later life among Chinese older adults. Exploiting rich life history data from the China Health and Retirement Longitudinal Study, we employ sequence analysis to identify the typical migration trajectories of Chinese older adults. Moderated mediation analysis is then used to examine gender-specific health pathways linking migration trajectories and later-life depression. The results indicate that: rural migrants who settled in urban regions have lower level of depression in later life than ‘return migrants' who moved back to rural areas or those who were rural non-migrants; the gender gap in depression is marginally smaller among early urban settlers than rural non-migrants; and household income in later life has stronger mediation effects for migrant men than for migrant women. The study therefore highlights the importance of considering the role of gender when designing policies aiming to improve the health and wellbeing of migrants in later life.     

Health care in China: a rural-urban comparison after the socioeconomic reforms.

This article provides an overview of the current Chinese health care system with particular emphasis on rural-urban differences. China''s post-1978 economic reforms, although they improved general living standards, created some unintended consequences, as evidenced by the disintegration of the rural cooperative medical system and the sharp reduction in the number of "barefoot doctors", both of which were essential elements in the improvement of health status in rural China. The increase in the elderly population and their lack of health insurance and pensions will also place enormous pressure on services for their care. These changes have disproportionately affected the rural health care system, leaving the urban system basically intact, and have contributed to the rural-urban disparity in health care. Based on recent data the article compares current rural-urban differences in health care policy, systems, resources, and outcomes, and proposes potential solutions to reduce them.     

Effects of rural-urban return migration on women's family planning and reproductive health attitudes and behavior in rural China

This study examines the effects of rural–urban return migration on women's family planning and reproductive health attitudes and behavior in the sending areas of rural China. Based on data from a survey of rural women aged 16–40 in Sichuan and Anhui Provinces in 2000, our study finds that migrant women returning from cities to the countryside, especially those who have been living in a large city, are more likely than nonmigrant women to adopt positive family planning and reproductive health attitudes and behavior in their rural communities of origin. We find, moreover, that living in a rural community where the prevalence of such return migrant women is higher is positively associated with new fertility and gender attitudes and with knowledge of self-controllable contraceptives. The findings of significant rural-urban return-migration effects have important policy implications for shaping family planning and reproductive health attitudes and behaviors in rural China.     

Health educaton in developing countries.

Health education is of great relevance in developing communities as it is a means of improving the health level which is an integral part of the overall socioeconomic development. It must be undertaken in conjunction with health services which should involve consumer participation at an early stage. Its focus is on changing behavior in respect to healthful living both at the individual and community levels. Health education subjects in developing communities include maternal and child health (MCH), nutrition, family planning and infectious diseases. Every member in the health team must be a health educator. Personal methods, especially when used by indigenous community health workers, are best suited to induce health behavior change in developing communities. Mass media as a rule is less suited for this, although radio can inform large segments of the population.     

Health and wellbeing of older people in Anglo-Australian and Italian-Australian communities: a rural-urban comparison.

OBJECTIVE: The health and wellbeing of urban and rural Anglo- and Italian-Australian residents was compared using five domains which are deemed to influence the outcome 'ageing well'. The five domains included physical and functional status, social supports, material resources, activity and leisure, and mental efficacy. DESIGN: A cross-sectional survey carried out in a two-stage data collection process included a brief telephone interview and face-to-face interview using semistructured schedules with several psychometric measures. SETTINGS: Eastern and Western Melbourne and Mildura, Victoria, Australia. MAIN OUTCOME MEASURES: Health and wellbeing of urban and rural community-dwelling Anglo- and Italian-Australian men and women aged 50-89 years. PARTICIPANTS: Urban and rural community-dwelling Anglo- and Italian-Australian men and women aged 50-89 years. There were 364 urban Anglo-Australians, 149 rural Anglo-Australians, 190 urban Italian-Australians, and 77 rural Italian-Australians. RESULTS: Urban Anglo-Australian residents reported significantly higher general and emotional health but also reported significantly higher stress levels than their rural counterparts. The rural Italian-Australian residents reported higher resilience and personal control but poorer general and emotional health than the urban residents. CONCLUSION: If health disparities between urban and rural residents are to be successfully addressed, the link between place of residence, health status and wellbeing must be explored.     

Health and nutrition effects of cash crop production in developing countries: a comparative analysis.

The paper presents results of a comparative analysis of the health and nutritional effects of cash crop production in 6 countries--The Gambia, Guatemala, Kenya, Malawi, the Philippines, and Rwanda. The 6 country case studies were conducted during the same time period and used a similar, although not identical, research protocol. Participation in cash crop schemes resulted in increases in household income. Short-term increases in household income did not result in a decrease in the incidence of illness in preschool-aged children nor in the total time that preschoolers were ill. Increases in household income did result in increases in the preschooler's energy consumption; however, the income/calorie consumption links, although significant, were weak. The household income gains did not have an immediate or large impact on preschooler nutritional status. While, in the longer term, increases in income may bring about improvements in preschooler health, in the short term, it appears that increases in income must be accompanied by improvements in the health environment in order to have a significant effect in reducing preschooler morbidity and improving child nutritional status.     

Health aid and governance in developing countries

Despite anecdotal evidence that the quality of governance in recipient countries affects the allocation of international health aid, there is no quantitative evidence on the magnitude of this effect, or on which dimensions of governance influence donor decisions. We measure health‐aid flows over 1995–2006 for 109 aid recipients, matching aid data with measures of different dimensions of governance and a range of country‐specific economic and health characteristics. Everything else being equal, countries with more political rights receive significantly more aid, but so do countries with higher corruption levels. The dependence of aid on political rights, even when we control for other governance indicators, suggests that health aid is sometimes used as an incentive to reward political reforms. Copyright © 2010 John Wiley & Sons, Ltd.     

Health economics and applications in developing countries

The concept of health human capital guides the statistical study of (1) health production functions, (2) derived demands for medical and behavioral health inputs, and (3) determinants of health and productivity outcomes. Health inputs are generally endogenous to health outcomes, and prices of health inputs are the most common instrumental variable for identifying estimates of the causal effects of health inputs. But when health input prices are modified by individual regional migration, the regional prices no longer satisfy the requirement of being independent of preferences and omitted variables. Then the difficulty of evaluating health program effects reinforces the need to design randomized regional treatments, in order to be able to evaluate without bias the consequences of critical health interventions, such as are needed today to deal with the HIV/AIDS epidemic.