Thirty-five years later: Long-term effects of the Matlab maternal and child health/family planning program on older women's well-being
| Autor: | Andrew D. Foster, Randall Kuhn, Tania Barham, Elisabeth Dowling Root, Patrick Turner, Jane Menken, Brachel Champion, Abdur Razzaque, Gisella Kagy, Jena Derakshani Hamadani, Warren C. Jochem |
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| Rok vydání: | 2021 |
| Předmět: |
Aging
Time Factors media_common.quotation_subject Maternal Health family planning Social Sciences long-term follow-up Context (language use) Fertility Reproductive health and childbirth Overweight Body Mass Index Cohort Studies 03 medical and health sciences 0302 clinical medicine Clinical Research Behavioral and Social Science 0502 economics and business medicine Humans 050207 economics Socioeconomic status Contraception Behavior media_common Aged Pediatric Bangladesh Multidisciplinary business.industry Prevention Contraception/Reproduction 05 social sciences Child Health health Health Services Good Health and Well Being Family planning 030220 oncology & carcinogenesis Family Planning Services Well-being Female medicine.symptom Underweight business Body mass index Demography |
| Zdroj: | Proc Natl Acad Sci U S A Proceedings of the National Academy of Sciences of the United States of America, vol 118, iss 28 |
| ISSN: | 1091-6490 |
| Popis: | Family planning programs are believed to have substantial long-term benefits for women’s health and well-being, yet few studies have established either extent or direction of long-term effects. The Matlab, Bangladesh, maternal and child health/family planning (MCH/FP) program afforded a 12-y period of well-documented differential access to services. We evaluate its impacts on women’s lifetime fertility, adult health, and economic outcomes 35 y after program initiation. We followed 1,820 women who were of reproductive age during the differential access period (born 1938–1973) from 1978 to 2012 using prospectively collected data from the Matlab Health and Demographic Surveillance System and the 1996 and 2012 Matlab Health and Socioeconomic Surveys. We estimated intent-to-treat single-difference models comparing treatment and comparison area women. MCH/FP significantly increased contraceptive use, reduced completed fertility, lengthened birth intervals, and reduced age at last birth, but had no significant positive impacts on health or economic outcomes. Treatment area women had modestly poorer overall health (+0.07 SD) and respiratory health (+0.12 SD), and those born 1950–1961 had significantly higher body mass index (BMI) in 1996 (0.76 kg/m(2)) and 2012 (0.57 kg/m(2)); fewer were underweight in 1996, but more were overweight or obese in 2012. Overall, there was a +2.5 kg/m(2) secular increase in BMI. We found substantial changes in lifetime contraceptive and fertility behavior but no long-term health or economic benefits of the program. We observed modest negative health impacts that likely result from an accelerated nutritional transition among treated women, a transition that would, in an earlier context, have been beneficial. |
| Databáze: | OpenAIRE |
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