Item request has been placed! ×
Item request cannot be made. ×
loading  Processing Request

Multivariate mixed-effects ordinal logistic regression models with difference-in-differences estimator of the impact of WORTH Yetu on household hunger and socioeconomic status among OVC caregivers in Tanzania.

Item request has been placed! ×
Item request cannot be made. ×
loading   Processing Request
  • معلومة اضافية
    • المصدر:
      Publisher: Public Library of Science Country of Publication: United States NLM ID: 101285081 Publication Model: eCollection Cited Medium: Internet ISSN: 1932-6203 (Electronic) Linking ISSN: 19326203 NLM ISO Abbreviation: PLoS One Subsets: MEDLINE
    • بيانات النشر:
      Original Publication: San Francisco, CA : Public Library of Science
    • الموضوع:
    • نبذة مختصرة :
      Background: Although most of the livelihood programmes target women, those that involve women and men have been evaluated as though men and women were a single homogenous population, with a mere inclusion of gender as an explanatory variable. This study evaluated the impact of WORTH Yetu (an economic empowerment intervention to improve livelihood outcomes) on household hunger, and household socioeconomic status (SES) among caregivers (both women and men) of orphaned and vulnerable children (OVC) in Tanzania. The study hypothesized that women and men respond to livelihood interventions differently, hence a need for gender-disaggregated impact evaluation of such interventions.
      Methods: This is a secondary analysis of longitudinal data, involving caregivers' baseline (2016-2019) and follow-up (2019-2020) data from the USAID Kizazi Kipya project in 25 regions of Tanzania. Two dependent variables (ie, outcomes) were assessed; household hunger which was measured using the Household Hunger Scale (HHS), and Socioeconomic Status (SES) using the Principal Component Analysis (PCA). WORTH Yetu, a livelihood intervention implemented by the USAID Kizazi Kipya project was the main independent variable whose impact on the two outcomes was evaluated using multivariate analysis with a multilevel mixed-effects, ordinal logistic regression model with difference-in-differences (DiD) estimator for impact estimation.
      Results: The analysis was based on 497,293 observations from 249,655 caregivers of OVC at baseline, and 247,638 of them at the follow-up survey. In both surveys, 70% were women and 30% were men. Their mean age was 49.3 (±14.5) years at baseline and 52.7 (±14.8) years at the follow-up survey. Caregivers' membership in WORTH Yetu was 10.1% at the follow-up. After adjusting for important confounders there was a significant decline in the severity of household hunger by 46.4% among WORTH Yetu members at the follow-up compared to the situation at the baseline (adjusted Odds Ratio (aOR) = 0.536, 95% Confidence Interval (CI) [0.521, 0.553]). The decline was 45.7% among women (aOR = 0.543 [0.524, 0.563]) and 47.5% among men (aOR = 0.525 [0.497, 0.556]). Regarding SES, WORTH Yetu members were 15.9% more likely to be in higher wealth quintiles at the follow-up compared to the situation at the baseline (aOR = 1.159 [1.128, 1.190]). This impact was 20.8% among women (aOR = 1.208 [1.170, 1.247]) and 4.6% among men (aOR = 1.046 [0.995, 1.101]).
      Conclusion: WORTH Yetu was associated with a significant reduction in household hunger, and a significant increase in household SES among OVC caregivers in Tanzania within an average follow-up period of 1.6 years. The estimated impacts differed significantly by gender, suggesting that women and men responded to the WORTH Yetu intervention differently. This implied that the design, delivery, and evaluation of such programmes should happen in a gender responsive manner, recognising that women and men are not the same with respect to the programmes.
      Competing Interests: The authors have declared that no competing interests exist.
      (Copyright: © 2024 Exavery et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
    • References:
      Am J Public Health. 2005;95 Suppl 1:S144-50. (PMID: 16030331)
      BJOG. 2018 Dec;125(13):1716. (PMID: 29916205)
      Int J Med Sci. 2013 Aug 28;10(11):1459-61. (PMID: 24046518)
      Int J Epidemiol. 1997;26 Suppl 1:S6-14. (PMID: 9126529)
      Environ Health Perspect. 1993 Dec;101 Suppl 4:23-38. (PMID: 8206038)
      Lancet. 2004 Sep 11-17;364(9438):937-52. (PMID: 15364185)
      BMC Public Health. 2020 Aug 17;20(1):1251. (PMID: 32807138)
      J Int AIDS Soc. 2012 Jun 14;15 Suppl 1:1-10. (PMID: 22713350)
      PLoS One. 2020 Sep 18;15(9):e0239163. (PMID: 32946528)
      J Health Care Poor Underserved. 2018;29(1):349-372. (PMID: 29503305)
      Glob Food Sec. 2018 Mar;16:69-74. (PMID: 29552461)
      Am J Epidemiol. 2007 Sep 15;166(6):646-55. (PMID: 17615092)
      Curr Dev Nutr. 2020 Mar 19;4(4):nzaa037. (PMID: 32296741)
      Psychol Methods. 2011 Dec;16(4):373-90. (PMID: 22040372)
      Psychiatry Res. 2020 Jan;283:112452. (PMID: 31255320)
      Malar J. 2018 Dec 7;17(1):459. (PMID: 30526608)
      Public Health Nutr. 2012 Jul;15(7):1276-83. (PMID: 22152760)
      Lancet. 2020 Aug 22;396(10250):521-522. (PMID: 32763153)
      PLoS One. 2022 Feb 25;17(2):e0264315. (PMID: 35213627)
      Sociol Health Illn. 2021 May;43(4):971-994. (PMID: 33780030)
      Int J Environ Res Public Health. 2021 Jun 27;18(13):. (PMID: 34199117)
      Health Soc Care Community. 2021 Jan;29(1):227-240. (PMID: 32633059)
      BMC Health Serv Res. 2020 Apr 3;20(1):275. (PMID: 32245468)
      Biomed Res Int. 2014;2014:658056. (PMID: 24696862)
      Health Policy Plan. 2006 Nov;21(6):459-68. (PMID: 17030551)
      SAHARA J. 2016 Dec;13(1):162-9. (PMID: 27619011)
    • الموضوع:
      Date Created: 20240416 Date Completed: 20240418 Latest Revision: 20240425
    • الموضوع:
      20240425
    • الرقم المعرف:
      PMC11020529
    • الرقم المعرف:
      10.1371/journal.pone.0301578
    • الرقم المعرف:
      38626125