Standard-Nutzungsbedingungen:Die Dokumente auf EconStor dürfen zu eigenen wissenschaftlichen Zwecken und zum Privatgebrauch gespeichert und kopiert werden.Sie dürfen die Dokumente nicht für öffentliche oder kommerzielle Zwecke vervielfältigen, öffentlich ausstellen, öffentlich zugänglich machen, vertreiben oder anderweitig nutzen.Sofern die Verfasser die Dokumente unter Open-Content-Lizenzen (insbesondere CC-Lizenzen) zur Verfügung gestellt haben sollten, gelten abweichend von diesen Nutzungsbedingungen die in der dort genannten Lizenz gewährten Nutzungsrechte.
Standard-Nutzungsbedingungen:Die Dokumente auf EconStor dürfen zu eigenen wissenschaftlichen Zwecken und zum Privatgebrauch gespeichert und kopiert werden.Sie dürfen die Dokumente nicht für öffentliche oder kommerzielle Zwecke vervielfältigen, öffentlich ausstellen, öffentlich zugänglich machen, vertreiben oder anderweitig nutzen.Sofern die Verfasser die Dokumente unter Open-Content-Lizenzen (insbesondere CC-Lizenzen) zur Verfügung gestellt haben sollten, gelten abweichend von diesen Nutzungsbedingungen die in der dort genannten Lizenz gewährten Nutzungsrechte.
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Background: The desire for universal health coverage in developing countries has brought attention to communitybased health insurance (CBHI) schemes in developing countries. The government of Uganda is currently debating policy for the national health insurance programme, targeting the integration of existing CBHI schemes into a larger national risk pool. However, while enrolment has been largely studied in other countries, it remains a generally under-covered issue from a Ugandan perspective. Using a large CBHI scheme, this study, therefore, aims at shedding more light on the determinants of households’ decisions to enrol and renew membership in these schemes. Methods: We collected household data from 464 households in 14 villages served by a large CBHI scheme in southwestern Uganda. We then estimated logistic and zero-inflated negative binomial (ZINB) regressions to understand the determinants of enrolment and renewing membership in CBHI, respectively. Results: Results revealed that household’s socioeconomic status, husband’s employment in rural casual work (odds ratio [OR]: 2.581, CI: 1.104-6.032) and knowledge of health insurance premiums (OR: 17.072, CI: 7.027-41.477) were significant predictors of enrolment. Social capital and connectivity, assessed by the number of voluntary groups a household belonged to, was also positively associated with CBHI participation (OR: 5.664, CI: 2.927-10.963). More positive perceptions on insurance (OR: 2.991, CI: 1.273-7.029), access to information were also associated with enrolment and renewing among others. Burial group size and number of burial groups in a village, were all significantly associated with increased the likelihood of renewing CBHI. Conclusion: While socioeconomic factors remain important predictors of participation in insurance, mechanisms to promote inclusion should be devised. Improving the participation of communities can enhance trust in insurance and eventual coverage. Moreover, for households already insured, access to correct information and strengthening their social network information pathways enhances their chances of renewing.
This chapter emphasizes the complexity and plurality of the types and magnitudes of causal relationships between poverty and environmental degradation, based on a review of the literature. The authors use case studies focused on the issue of land degradation to illustrate these relationships. Land degradation (LD) is infl uenced by natural and anthropogenic factors, including socioeconomic conditions. LD is of importance to people because it decreases the provision of terrestrial ecosystem services and the benefi ts they provide for human well-being. A key question is whether lower levels of well-being lead to more or less destructive resource use and management strategies. The authors call for a systematic and science-based assessment of LD worldwide as a necessary fi rst step toward the inclusion of LD in global measures of well-being.
Standard-Nutzungsbedingungen:Die Dokumente auf EconStor dürfen zu eigenen wissenschaftlichen Zwecken und zum Privatgebrauch gespeichert und kopiert werden.Sie dürfen die Dokumente nicht für öffentliche oder kommerzielle Zwecke vervielfältigen, öffentlich ausstellen, öffentlich zugänglich machen, vertreiben oder anderweitig nutzen.Sofern die Verfasser die Dokumente unter Open-Content-Lizenzen (insbesondere CC-Lizenzen) zur Verfügung gestellt haben sollten, gelten abweichend von diesen Nutzungsbedingungen die in der dort genannten Lizenz gewährten Nutzungsrechte. AcknowledgementsThis work is supported by the Bill and Melinda Gates Foundation, under the project "WATSAN-AGICULTURE -guiding pro-poor investments in the nexus among domestic water quality and quantity, sanitation and hygiene, and agriculture from the bottom-up." We would like to acknowledge the support from the Center for Development Research (ZEF), the Ethiopian Economics Association (EEA), the Welthungerhilfe and the Organization for Rehabilitation and Development in Amhara (ORDA) during our field research in Ethiopia. We are also grateful to the members of the AG-WATSAN project for their valuable comments and suggestions at several of our project seminars and workshops. We also thank Evita H. Pangaribowo for her guidance in the preparation of the field work and the data collectors for their hard work during the household survey. AbstractThis paper examines the impact of drinking water quality and sanitation behavior on child health in rural districts of Ethiopia. Using primary household survey data and microbiological water test for Escherichia coli, we use various estimation methods to quantify the impacts of water quality and sanitation behavior on diarrhea incidence among children under five years old. Our results show that uncontaminated household storage water and safe child stool disposal decrease incidence of child diarrhea by 16% and 23% respectively. In contrast, neighborhood concentration of pit latrine increases incidence of child diarrhea by 12%. The latter result casts serious doubt on the assumed health and social benefits of moving from open to fixed-location defecation. Creating open defecation free communities in rural areas is not enough to achieve the desired health benefits of sanitation. To protect rural households from the risk of contracting communicable diseases, existing pit latrines should be upgraded to make them safer to use -fly-proofed and hygienic. There is a need for appropriate policy actions to improve household drinking water quality and to change people's behavior towards safe sanitation practices. Increasing access to clean water supply and providing means for safe excreta disposal will bring significant health and social gains. Moreover, promotion of hygiene education campaigns about household water treatment, safe water storage and handling, washing hands with soaps at critical times, and adequately removing child feces from the domestic environment can also help ensure that people preserve good health in their h...
This study aims at assessing the determinants of microbiological contamination of household drinking water under multiple-use water systems in rural areas of Ethiopia. For this analysis, a random sample of 454 households was surveyed between February and March 2014, and water samples from community sources and household storage containers were collected and tested for fecal contamination. The number of Escherichia coli (E. coli) colony-forming units per 100 mL water was used as an indicator of fecal contamination. The microbiological tests demonstrated that 58% of household stored water samples and 38% of protected community water sources were contaminated with E. coli. Moreover, most improved water sources often considered to provide safe water showed the presence of E. coli. The result shows that households' stored water collected from unprotected wells/springs had higher levels of E. coli than stored water from alternative sources. Distance to water sources and water collection containers are also strongly associated with stored water quality. To ensure the quality of stored water, the study suggests that there is a need to promote water safety from the point-of-source to point-of-use, with due considerations for the linkages between water and agriculture to advance the Sustainable Development Goal 6 of ensuring access to clean water for everyone.
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