Poverty has serious consequences for children's well-being as well as for their achievements in adult life. The Multiple Overlapping Deprivation Analysis for the European Union (EU-MODA) compares the living conditions of children across the EU member states. Rooted in the established multidimensional poverty measurement tradition, EU-MODA contributes to it by using the international framework of child rights to inform the construction of indicators and dimensions essential to children's material wellbeing, taking into account the needs of children at various stages of their life cycle. The study adds to the literature on monetary child poverty and material deprivation in the EU by analysing several age-specific and rights-based dimensions of child deprivation individually and simultaneously, constructing multidimensional deprivation indices, and studying the overlaps between monetary poverty and multidimensional deprivation. The paper demonstrates the application of the EU-MODA methodology to three diverse countries: Finland, Romania and the United Kingdom. The analysis uses data from the ad hoc material deprivation module of the EU-SILC 2009 because it provides comparable micro-data for EU member states and contains child-specific deprivation indicators.

ObjectivesThe study aimed to understand the impact of integrating a fee waiver for the National Health Insurance Scheme (NHIS) with Ghana’s Livelihood Empowerment Against Poverty (LEAP) 1000 cash transfer programme on health insurance enrolment.SettingThe study was conducted in five districts implementing Ghana’s LEAP 1000 programme in Northern and Upper East Regions.ParticipantsWomen, from LEAP households, who were pregnant or had a child under 1 year and who participated in baseline and 24-month surveys (2497) participated in the study.InterventionLEAP provides bimonthly cash payments combined with a premium waiver for enrolment in NHIS to extremely poor households with orphans and vulnerable children, elderly with no productive capacity and persons with severe disability. LEAP 1000, the focus of the current evaluation, expanded eligibility in 2015 to those households with a pregnant woman or child under the age of 12 months. Over the course of the study, households received 13 payments.Primary and secondary outcome measuresPrimary outcomes included current and ever enrolment in NHIS. Secondary outcomes include reasons for not enrolling in NHIS. We conducted a mixed-methods impact evaluation using a quasi-experimental design and estimated intent-to-treat impacts on health insurance enrolment among children and adults. Longitudinal qualitative interviews were conducted with an embedded cohort of 20 women and analysed using systematic thematic coding.ResultsCurrent enrolment increased among the treatment group from 37.4% to 46.6% (n=5523) and decreased among the comparison group from 37.3% to 33.3% (n=4804), resulting in programme impacts of 14 (95% CI 7.8 to 20.5) to 15 (95% CI 10.6 to 18.5) percentage points for current NHIS enrolment. Common reasons for not enrolling were fees and travel.ConclusionWhile impacts on NHIS enrolment were significant, gaps remain to maximise the potential of integrated programming. NHIS and LEAP could be better streamlined to ensure poor households fully benefit from both services, in a further step towards integrated social protection.Trial registration numberRIDIE-STUDY-ID-55942496d53af.

This paper describes and reviews the process of constructing a Multidimensional Child Poverty Measure in three sub-Saharan Africa countries: Mali, Malawi, and Tanzania. These countries recently (in 2015 and 2014) constructed such indicator using UNICEF’s Multiple Overlapping Deprivation Analysis (MODA) methodology and conducted a comprehensive Child Poverty study including both deprivation and monetary poverty. This work describes how the indicator was adapted in the different contexts, discussing critical issues arisen during the process of the study, and it discusses the results of these studies in comparison. The goal is to offer an overview of the different national processes and how similar or different factors influence the results.

This study provides with a first indication on the number of multidimensionally poor children in sub-Saharan Africa. It presents a methodology measuring multidimensional child deprivation within and across countries, and it is in line with the Sustainable Development Goal 1 focusing on multidimensional poverty by age and gender. Using the Multiple Overlapping Deprivation Analysis (MODA) methodology, the study finds that 67% or 247 million children are multidimensionally poor in the thirty sub-Saharan African countries included in the analysis. Multidimensional poverty is defined as missing two to five aspects of basic child well-being captured by dimensions anchored in the Convention on the Rights of the Child, namely nutrition, health, education, information, water, sanitation, and housing. The analysis also predicts the multidimensional child poverty rates for the whole sub-Saharan African region estimating 64% or 291 million children to be multidimensionally poor. In comparison, monetary poverty rates measured as less than USD 1.25 PPP per capita spending a day and weighted by the child population size finds 48% poor children. The results of this study highlight the extent of multidimensional poverty among children in sub-Saharan Africa and the need for children to have a specific poverty measure in their own right.

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