Browsing by Author "Macleod, B."

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    The impact of immunization on the association between poverty and child survival: Evidence from Kassena-Nankana District of northern Ghana
    (Scandinavian Journal of Public Health, 2009-11) Bawah, A.A.; Phillips, J.F.; Adjuik, M.; Vaughan-Smith, M.; Macleod, B.; Binka, F.N.
    Background: Research conducted in Africa has consistently demonstrated that parental poverty and low educational attainment adversely affect child survival. Research conducted elsewhere has demonstrated that low-cost vaccines against preventable diseases reduce childhood mortality. Therefore, the extension of vaccination to impoverished populations is widely assumed to diminish equity effects. Recent evidence that childhood mortality is increasing in many countries where vaccination programmes are active challenges this assumption. Data and methods: This paper marshals data from accurate and complete immunization records and survival histories for 18,368 children younger than five years in a rural northern Ghanaian population that is generally impoverished, but where family wealth and parental educational differentials exist nonetheless. Time-conditional Weibull hazard models are estimated to test the hypothesis that childhood immunization offsets the detrimental effects of poverty and low educational attainment. Conclusions: Findings show that the adverse effects of poverty disappear and that the effects of educational attainment are reduced in survival models that control for immunization status. This finding lends empirical support to policies that promote immunization as a strategic component of poverty-reduction programmes. © 2010, the Nordic Societies of Public Health. All rights reserved.
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    The long-term fertility impact of the navrongo project in northern Ghana
    (2012-09) Phillips, J.F.; Jackson, E.F.; Bawah, A.A.; Macleod, B.; Adongo, P.; Baynes, C.; Williams, J.
    This study assesses the long-term fertility impact of the Community Health and Family Planning Project of the Navrongo Health Research Centre in Ghana and addresses policy debates concerning the role of family planning programs in rural Africa. Conducted in a remote traditional area on Ghana's northern border, the study tests the hypothesis that convenient family planning service delivery can induce and sustain reproductive change in a societal context that would not be expected to foster demographic transition. By 1999, results indicated that significant fertility decline arose in the early years of the project, associated with the combination of services provided by community nurses and social mobilization activities focused on men. When project strategies were scaled up, social mobilization components were neglected. As a consequence, the long-term impact of scaled-up operations was negligible. Results suggest that initial effects met the need for child spacing without introducing a sustained demographic transition. © 2012 The Population Council, Inc.