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TARGETING, UNIVERSALISM AND SINGLE MOTHER POVERTY: A MULTI-LEVEL ANALYSIS ACROSS 18 AFFLUENT DEMOCRACIES
ABSTRACTWe examine the influence of individual characteristics and targeted and universal social policy on single mother poverty with a multi-level analysis across 18 affluent democracies. Although single mothers are disproportionately poor in all countries, there is even more cross-national variation in single mother poverty than for poverty among the overall population. By far, the U.S. has the highest rate of poverty among single mothers. The analyses show that single mother poverty is a function of the household's employment, education, age composition, and the presence of other adults. Beyond individual characteristics, social policy exerts substantial influence on single mother poverty. We find that two measures of universal social policy significantly reduce single mother poverty. Alternatively, one measure of targeted social policy does not have significant effects, while another measure is only significantly negative when controlling for universal social policy. Moreover, the effects of universal social policy are larger. Additional analyses show that universal social policy does not have counterproductive consequences in terms of family structure or employment, while the results are less clear for targeted social policy. Although debates often focus on altering the behavior or characteristics of single mothers, welfare universalism could be an even more effective anti-poverty strategy.
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TARGETING, UNIVERSALISM AND SINGLE MOTHER POVERTY: A MULTI-LEVEL ANALYSIS ACROSS 18 AFFLUENT DEMOCRACIES
BackgroundCommunity mobilisation interventions for HIV prevention among female sex workers (FSWs) aim to organise FSWs for collective action and challenge the structures of power that underlie HIV risk. Assessing intervention impact is challenging because the importance of direct individual exposure to intervention components may decrease over time as change occurs at social-normative, policy and other structural levels. In this paper, the authors examine changes over time in consistent condom use among FSWs in Rajahmundry, Andhra Pradesh, the location of a long-standing community mobilisation intervention.MethodsThe authors analyse cross-sectional data collected among FSWs at three time points (n=2276) using respondent-driven sampling. Multiple logistic regression was used to assess the association of programme exposure with consistent condom use and whether this association varied over time.ResultsThe proportion of FSWs having no exposure or only receptive exposure to the intervention decreased over time, while active utilisation increased from 19.4% in 2006 to 48.5% in 2009–2010. Consistent condom use with clients also increased from 56.3% in 2006 to 75.3% in 2009–2010. Multivariate analysis showed that age, age at start of sex work, venue, living conditions and programme exposure were significantly associated with condom use. The positive association between programme exposure and consistent condom use did not vary significantly over time.ConclusionsFindings indicate improvements in HIV risk reduction behaviour among FSWs and suggest that the intervention has substantial reach in the FSW population. The intervention's strategies may be contributing to population-level HIV risk reduction among FSWs.
The rise of democracy across the world brought with it expectations that governments would be more attentive and responsive to the welfare of the people, creating better services and better health. Indeed, a considerable body of scholarship finds that democracy has significant, direct effects on multiple measures of well-being, particularly life expectancy and infant mortality. Despite several recent critiques, the paramount theme is that democracy is good for health. This study contributes to this literature by assessing the relationship between democracy and child diarrhea and malnutrition across 52 developing countries. Using a multilevel modeling strategy, the analysis examines the country-level effects of democracy and development on child health, while simultaneously taking into account wealth, education, and other household characteristics at the individual level. Contrary to much previous scholarship, democracy does not exhibit a significant association with diarrhea or malnutrition. Instead, gross domestic product (GDP) per capita and improved sanitation and water have substantial effects on child health at the country level. At the individual level, household wealth and maternal education have the largest health-enhancing impact on child diarrhea and malnutrition. Furthermore, the size and strength of the relationship between wealth and health does not vary by political regime. These results demonstrate the enduring importance of socioeconomic status regardless of political context, and they support a small but growing literature that calls the democracy–health link into question.
ObjectivesExamine factors associated with awareness and active utilisation of a community mobilisation intervention (CMI) to address HIV risk in female sex workers (FSWs) in a context characterised by multiple forms of sex work.DesignData came from two rounds, conducted in Spring 2006 and Spring 2007, of a serial cross-sectional survey of FSWs (n=812 in round 1, n=673 in round 2) recruited through respondent-driven sampling in Rajahmundry, Andhra Pradesh, India.MethodsDescriptive statistics compared characteristics of programme aware and unaware FSWs and from among the aware, to characterise active program users. Multinomial logistic regression was used to assess factors associated with programme exposure.ResultsBetween Rounds 1 and 2, programme awareness increased from 41.8% to 69.6% of respondents, and active utilisation (among those who were aware) increased from 49.2% to 61.0%. Street-based FSWs were under-represented and brothel-based FSWs overrepresented in both groups and rounds. Geographic proximity and literacy were associated with programme awareness but not utilisation. The most important factor associated with both forms of intervention exposure across rounds was willingness to be identified in public as a FSWs (OR 2.2–4.8).ConclusionPublic visibility is a critical component of CMIs. Such interventions should develop strategies for involving FSWs that allow them to remain invisible, while also working to reduce the threat associated with public visibility. In contexts where sex work occurs in multiple venues, it is important to develop CMIs that include and address the needs of FSWs working in them all.
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