Abstract:
BACKGROUND:On Dec 1, 2006, Mexico's public health-care insurance scheme, Seguro Popular, implemented the Medical Insurance Century XXI (SMSXXI) programme, to provide insurance to children younger than 5 years without social security. SMSXXI aims to increase access to health services, decrease out-of-pocket health expenses (OOPHE), and reduce health inequities. SMSXXI covers uninsured, primarily low-income, populations who might be most at risk of the financial and health consequences of costly medical interventions. METHODS:We assessed the effects of SMSXXI on health outcomes and financial protection for Mexico's children using multiple nationally representative surveys and administrative data sources spanning 2001-16. The identification of effects relied on detailed hospital-level affiliation data mapping the geographical expansion of SMSXXI's coverage across the country over time. The units of analysis included hospitals, households, and children. Primary outcomes were neonatal and infant mortality, self-reported morbidity (health status, influenza, and diarrhoea), and child's height. Secondary outcomes were OOPHE, hospital discharges, and quality of service provision. Effects controlled for fixed and time-variant confounders using double-difference and triple-difference estimation strategies. Where feasible, we also estimated effects using exogenous variation in programme eligibility rules that limited enrolment in SMSXXI to children born after Dec 1, 2006. FINDINGS:SMSXXI was not associated with early (<1 week) neonatal mortality, but was associated with a reduction in late (<28 days) neonatal mortality by 0·139 deaths per 1000 livebirths (95% CI 0·032-0·246), or 7% (2-12) relative to the comparison base of 1·98 deaths per 1000 livebirths in 2006. SMSXI was associated with a reduction in infant mortality from conditions covered by the programme by 0·147 deaths per 1000 livebirths (0·023-0·271), or 5% (1-10) relative to the comparison base of 2·73 deaths per 1000 livebirths. The effects were largest in high baseline mortality areas. Long-term health effects, 8 years after the onset of SMSXXI, were reflected in a 0·434 cm (0·404-0·459) height increase for birth cohorts exposed to the programme and an average effect on height of 0·879 cm (0·821-0·932) for low-income populations. About 3-6 years after SMSXXI started, children reported having better health status and lower incidence of influenza and diarrhoea. The programme led to a 14% reduction (7-28) in OOPHE, primarily from hospital-related expenses. No effects were detected on hospital discharges, suggesting that SMSXXI might not have increased use. INTERPRETATION:SMSXXI promoted access to covered interventions and encouraged better primary care. The programme also promoted increased supply and quality of care by improving human and physical resources sensitive to unmet needs. Increased resource availability and improved supply of health care, rather than increased use, contributed to reduce infant mortality and improved long-term health as proxied by self-reported morbidity and child height. Consistent with the programme's focus on uninsured and low-income populations, the effects on mortality, long-term health status, and OOPHE were concentrated in vulnerable groups. FUNDING:Inter-American Development Bank.
journal_name
Lancet Glob Healthjournal_title
The Lancet. Global healthauthors
Celhay P,Martinez S,Muñoz M,Perez M,Perez-Cuevas Rdoi
10.1016/S2214-109X(19)30326-2subject
Has Abstractpub_date
2019-10-01 00:00:00pages
e1448-e1457issue
10issn
2214-109Xpii
S2214-109X(19)30326-2journal_volume
7pub_type
杂志文章abstract:BACKGROUND:Insufficient physical activity is a leading risk factor for non-communicable diseases, and has a negative effect on mental health and quality of life. We describe levels of insufficient physical activity across countries, and estimate global and regional trends. METHODS:We pooled data from population-based ...
journal_title:The Lancet. Global health
pub_type: 杂志文章
doi:10.1016/S2214-109X(18)30357-7
更新日期:2018-10-01 00:00:00
abstract:BACKGROUND:Tuberculosis is recognised as a major cause of morbidity and mortality in children, with most cases in children going undiagnosed and resulting in poor outcomes. Household contact management, which aims to identify children with active tuberculosis and to provide preventive therapy for those with HIV or thos...
journal_title:The Lancet. Global health
pub_type: 杂志文章
doi:10.1016/S2214-109X(18)30401-7
更新日期:2018-12-01 00:00:00
abstract:BACKGROUND:Social protection interventions might improve tuberculosis outcomes and could help to control the epidemic in Brazil. The aim of this study was to evaluate the independent effect of the Bolsa Familia Programme (BFP) on tuberculosis treatment outcomes in Brazil. METHODS:We prospectively recruited and followe...
journal_title:The Lancet. Global health
pub_type: 杂志文章,多中心研究
doi:10.1016/S2214-109X(18)30478-9
更新日期:2019-02-01 00:00:00
abstract:BACKGROUND:In accordance with the age parameters specified in Sustainable Development Goal target 3.4, current policy and monitoring of non-communicable disease (NCD) mortality trends focus on people aged 30-69 years. This approach excludes the majority of NCD deaths, which occur at older ages. We aimed to compare card...
journal_title:The Lancet. Global health
pub_type: 杂志文章
doi:10.1016/S2214-109X(19)30069-5
更新日期:2019-05-01 00:00:00
abstract:BACKGROUND:A quarter of a century ago, two global events-the International Conference on Population and Development in Cairo, and the Fourth World Conference on Women in Beijing-placed gender equality and reproductive health and rights at the centre of the development agenda. Progress towards these goals has been slowe...
journal_title:The Lancet. Global health
pub_type: 杂志文章
doi:10.1016/S2214-109X(20)30060-7
更新日期:2020-04-01 00:00:00
abstract:BACKGROUND:The average age at which people start smoking has been decreasing in many countries, but insufficient evidence exists on the adult hazards of having started smoking in childhood and, especially, in early childhood. We aimed to investigate the association between smoking habits (focusing on the age when smoke...
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pub_type: 杂志文章
doi:10.1016/S2214-109X(20)30221-7
更新日期:2020-06-01 00:00:00
abstract:BACKGROUND:Progress in reproductive, maternal, newborn, and child health (RMNCH) in Kenya has been inconsistent over the past two decades, despite the global push to foster accountability, reduce child mortality, and improve maternal health in an equitable manner. Although several cross-sectional assessments have been ...
journal_title:The Lancet. Global health
pub_type: 杂志文章
doi:10.1016/S2214-109X(17)30246-2
更新日期:2017-08-01 00:00:00
abstract::Intervention coverage-the proportion of the population with a health-care need who receive care-does not account for intervention quality and potentially overestimates health benefits of services provided to populations. Effective coverage introduces the dimension of quality of care to the measurement of intervention ...
journal_title:The Lancet. Global health
pub_type: 杂志文章,评审
doi:10.1016/S2214-109X(20)30104-2
更新日期:2020-05-01 00:00:00
abstract:BACKGROUND:Low blood glucose concentrations are common in sick children who present to hospital in low-resource settings and are associated with increased mortality. The cutoff blood glucose concentration for the diagnosis and treatment of hypoglycaemia currently recommended by WHO (2·5 mmol/L) is not evidence-based. W...
journal_title:The Lancet. Global health
pub_type: 杂志文章,随机对照试验
doi:10.1016/S2214-109X(20)30388-0
更新日期:2020-12-01 00:00:00
abstract:BACKGROUND:The rise in contraceptive use has largely been driven by short-acting methods of contraception, despite the high effectiveness of long-acting reversible contraceptives. Several countries in Latin America and the Caribbean have made important progress increasing the use of modern contraceptives, but important...
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abstract:BACKGROUND:In South Africa, sputum smear microscopy has been replaced with Xpert MTB/RIF as the initial diagnostic test for tuberculosis. In a pragmatic parallel cluster-randomised trial, we evaluated the effect on patient and programme outcomes. METHODS:We randomly allocated 20 laboratories (clusters) in medium-burde...
journal_title:The Lancet. Global health
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doi:10.1016/S2214-109X(15)00100-X
更新日期:2015-08-01 00:00:00
abstract:BACKGROUND:People who inject drugs (PWID) are a key population affected by the global HIV and hepatitis C virus (HCV) epidemics. HIV and HCV prevention interventions for PWID include needle and syringe programmes (NSP), opioid substitution therapy (OST), HIV counselling and testing, HIV antiretroviral therapy (ART), an...
journal_title:The Lancet. Global health
pub_type: 杂志文章,评审
doi:10.1016/S2214-109X(17)30373-X
更新日期:2017-12-01 00:00:00
abstract::Development assistance for health (DAH), the value of which peaked in 2013 and fell in 2015, is unlikely to rise substantially in the near future, increasing reliance on domestic and innovative financing sources to sustain health programmes in low-income and middle-income countries. We examined innovative financing in...
journal_title:The Lancet. Global health
pub_type: 杂志文章,评审
doi:10.1016/S2214-109X(17)30198-5
更新日期:2017-07-01 00:00:00
abstract:BACKGROUND:The need for multiple clinical visits remains a barrier to women accessing safe legal medical abortion services. Alternatives to routine clinic follow-up visits have not been assessed in rural low-resource settings. We compared the effectiveness of standard clinic follow-up versus home assessment of outcome ...
journal_title:The Lancet. Global health
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/S2214-109X(15)00150-3
更新日期:2015-09-01 00:00:00
abstract:BACKGROUND:The way in which a government chooses to finance a health intervention can affect the uptake of health interventions and consequently the extent of health gains. In addition to health gains, some policies such as public finance can insure against catastrophic health expenditures. We aimed to evaluate the hea...
journal_title:The Lancet. Global health
pub_type: 杂志文章
doi:10.1016/S2214-109X(14)70346-8
更新日期:2015-05-01 00:00:00
abstract:BACKGROUND:The risk of severe COVID-19 if an individual becomes infected is known to be higher in older individuals and those with underlying health conditions. Understanding the number of individuals at increased risk of severe COVID-19 and how this varies between countries should inform the design of possible strateg...
journal_title:The Lancet. Global health
pub_type: 杂志文章
doi:10.1016/S2214-109X(20)30264-3
更新日期:2020-08-01 00:00:00
abstract::The public health community has tried for decades to show, through evidence-based research, that safe water, sanitation, and hygiene (WASH) and clean cooking fuels that reduce household air pollution are essential to safeguard health and save lives in low-income and middle-income countries. In the past 40 decades, the...
journal_title:The Lancet. Global health
pub_type: 杂志文章,评审
doi:10.1016/S2214-109X(20)30476-9
更新日期:2021-01-11 00:00:00
abstract:BACKGROUND:To contribute to the WHO initiative, VISION 2020: The Right to Sight, an assessment of global vision impairment in 2020 and temporal change is needed. We aimed to extensively update estimates of global vision loss burden, presenting estimates for 2020, temporal change over three decades between 1990-2020, an...
journal_title:The Lancet. Global health
pub_type: 杂志文章
doi:10.1016/S2214-109X(20)30425-3
更新日期:2021-02-01 00:00:00
abstract:BACKGROUND:Attainment of universal health coverage is a global health priority. The Myanmar Government has committed to attainment of universal health coverage by 2030, but progress so far has not been assessed. We aimed to estimate national and subnational health service coverage and financial risk protection. METHOD...
journal_title:The Lancet. Global health
pub_type: 评论,杂志文章
doi:10.1016/S2214-109X(18)30318-8
更新日期:2018-09-01 00:00:00
abstract:BACKGROUND:In 2002-04, we did a randomised controlled trial in southern Nepal, and reported that children born to mothers taking multiple micronutrient supplements during pregnancy had a mean birthweight 77 g greater than children born to mothers taking iron and folic acid supplements. Children born to mothers in the s...
journal_title:The Lancet. Global health
pub_type: 杂志文章,随机对照试验
doi:10.1016/S2214-109X(14)70314-6
更新日期:2014-11-01 00:00:00
abstract:BACKGROUND:2·6 million stillbirths occur annually worldwide. The association between malaria in pregnancy and stillbirth has yet to be comprehensively quantified. We aimed to quantify the association between malaria in pregnancy and stillbirth, and to assess the influence of malaria endemicity on the association. METH...
journal_title:The Lancet. Global health
pub_type: 杂志文章,meta分析,评审
doi:10.1016/S2214-109X(17)30340-6
更新日期:2017-11-01 00:00:00
abstract:BACKGROUND:More timely estimates of malaria prevalence are needed to inform optimal control strategies and measure progress. Since 2014, Tanzania has implemented nationwide malaria screening for all pregnant women within the antenatal care system. We aimed to compare malaria test results during antenatal care to two po...
journal_title:The Lancet. Global health
pub_type: 杂志文章
doi:10.1016/S2214-109X(19)30405-X
更新日期:2019-12-01 00:00:00
abstract:BACKGROUND:Caesarean section prevalence is increasing in Asia and Latin America while remaining low in most African regions. Caesarean section delivery is effective for saving maternal and infant lives when they are provided for medically-indicated reasons. On the basis of ecological studies, caesarean delivery prevale...
journal_title:The Lancet. Global health
pub_type: 杂志文章,评审
doi:10.1016/S2214-109X(18)30241-9
更新日期:2018-08-01 00:00:00
abstract:BACKGROUND:The burden of dengue virus (DENV) infection across geographical regions of India is poorly quantified. We estimated the age-specific seroprevalence, force of infection, and number of infections in India. METHODS:We did a community-based survey in 240 clusters (118 rural, 122 urban), selected from 60 distric...
journal_title:The Lancet. Global health
pub_type: 杂志文章
doi:10.1016/S2214-109X(19)30250-5
更新日期:2019-08-01 00:00:00
abstract:BACKGROUND:Few studies have reported long-term data on mortality rates for children admitted to hospital with pneumonia in Africa. We examined trends in case fatality rates for all-cause clinical pneumonia and its risk factors in Malawian children between 2001 and 2012. METHODS:Individual patient data for children (<5...
journal_title:The Lancet. Global health
pub_type: 杂志文章
doi:10.1016/S2214-109X(15)00215-6
更新日期:2016-01-01 00:00:00
abstract:BACKGROUND:In malarious areas, pregnant women are more likely to have detectable malaria than are their non-pregnant peers, and the excess risk of infection varies with gravidity. Pregnant women attending antenatal clinic for their first visit are a potential pragmatic sentinel group to track the intensity of malaria t...
journal_title:The Lancet. Global health
pub_type: 杂志文章,meta分析,评审
doi:10.1016/S2214-109X(15)00049-2
更新日期:2015-10-01 00:00:00
abstract:BACKGROUND:No study of long-term protection following killed oral cholera vaccination has been done outside of the historically cholera-endemic areas of south Asia, or has examined protection after a single-dose vaccination regimen. To address this, we examined the duration of protection of the standard two-dose regime...
journal_title:The Lancet. Global health
pub_type: 杂志文章
doi:10.1016/S2214-109X(18)30284-5
更新日期:2018-09-01 00:00:00
abstract:BACKGROUND:The intermittent administration of seasonal malaria chemoprevention (SMC) is recommended to prevent malaria among children aged 3-59 months in areas of the Sahel subregion in Africa. However, the cost-effectiveness and cost savings of SMC have not previously been evaluated in large-scale studies. METHODS:We...
journal_title:The Lancet. Global health
pub_type: 杂志文章
doi:10.1016/S2214-109X(20)30475-7
更新日期:2021-02-01 00:00:00
abstract:BACKGROUND:Global rollout of dolutegravir-based antiretroviral therapy (ART) has been hampered in part by insufficient safety data in pregnancy. We compared birth outcomes among women initiating dolutegravir-based ART with those among women initiating efavirenz-based ART in pregnancy in Botswana. METHODS:In this obser...
journal_title:The Lancet. Global health
pub_type: 杂志文章
doi:10.1016/S2214-109X(18)30218-3
更新日期:2018-07-01 00:00:00
abstract:BACKGROUND:The effects of political regimes on health are unclear because empirical evidence is neither strong nor robust. Traditional econometric tools do not allow the direction of causality to be established clearly. We used a new method to investigate whether political transition into democracy affected child morta...
journal_title:The Lancet. Global health
pub_type: 杂志文章
doi:10.1016/S2214-109X(16)30104-8
更新日期:2016-09-01 00:00:00