Explore the vast range of titles available.

To explore the extent to which national policies guaranteeing breastfeeding breaks to working women may facilitate breastfeeding. An analysis was conducted of the number of countries that guarantee breastfeeding breaks, the daily number of hours guaranteed, and the duration of guarantees. To obtain current, detailed information on national policies, original legislation as well as secondary sources on 182 of the 193 Member States of the United Nations were examined. Regression analyses were conducted to test the association between national policy and rates of exclusive breastfeeding while controlling for national income level, level of urbanization, female percentage of the labour force and female literacy rate. Breastfeeding breaks with pay are guaranteed in 130 countries (71%) and unpaid breaks are guaranteed in seven (4%). No policy on breastfeeding breaks exists in 45 countries (25%). In multivariate models, the guarantee of paid breastfeeding breaks for at least 6 months was associated with an increase of 8.86 percentage points in the rate of exclusive breastfeeding (P < 0.05). A greater percentage of women practise exclusive breastfeeding in countries where laws guarantee breastfeeding breaks at work. If these findings are confirmed in longitudinal studies, health outcomes could be improved by passing legislation on breastfeeding breaks in countries that do not yet ensure the right to breastfeed.

Objectives. Operating at a societal level, public policy is often one of our best approaches to addressing social determinants of health (SDH). Yet, limited data availability has constrained past research on how national social policy choices affect health outcomes. We developed a new data infrastructure to illustrate how globally comparative data on labor policy might be used to examine the impact of social policy on health. Methods. We used multivariate ordinary least squares regression models to examine the relationship between the duration of paid maternal leave and neonatal, infant, and child mortality rates in 141 countries when controlling for overall resources available to meet basic needs measured by per capita gross domestic product, total and government health expenditures, female literacy, and basic health care and public health provision. Results. An increase of 10 full-time-equivalent weeks of paid maternal leave was associated with a 10% lower neonatal and infant mortality rate (p≤0.001) and a 9% lower rate of mortality in children younger than 5 years of age (p≤0.001). Paid maternal leave is associated with significantly lower neonatal, infant, and child mortality in non-Organisation for Economic Co-operation and Development (OECD) countries and OECD countries. Conclusions. This preliminary study, using newly available worldwide policy data, demonstrates the potential strength of using globally comparative data to examine SDH. Further data development to make multilevel modeling of the impact of labor conditions possible and to broaden which social policies can be examined is a critical next step.

Background The Sustainable development goals (SDGs) have the potential to have a significant impact on maternal and child health through their commitments both to directly addressing health services and to improving factors that form the foundation of social determinants of health. To achieve change at scale, national laws and policies have a critical role to play in implementing the SDGs’ commitments. One particular policy that could advance a range of SDGs and importantly improve maternal and infant health is paid parental leave. Methods This article analyzes literature on paid leave and related policies relevant to SDG 1 (poverty), SDG 3 (health), SDG 5 (gender equality), SDG 8 (decent work), and SDG 10 (inequality). In addition, this article presents global data on the prevalence of policies in all 193 UN Member States. Results A review of the literature finds that paid parental leave may support improvements across a range of SDG outcomes relevant to maternal and child health. Across national income levels, paid leave has been associated with lower infant mortality and higher rates of immunizations. In high-income countries, studies have found that paid leave increases exclusive breastfeeding and may improve women’s economic outcomes. However, factors including the duration of leave, the wage replacement rate, and whether leave is made available to both parents importantly shape the impacts of paid leave policies. While most countries now offer at least some paid maternal leave, many provide less than the 6 months recommended for exclusive breastfeeding, and only around half as many provide paternal leave. Conclusions To accelerate progress on the SDGs’ commitments to maternal and child health, we should monitor countries’ actions on enacting or strengthening paid leave policies. Further research is needed on the duration, wage replacement rate, and availability of leave before and after birth that would best support both child and parental health outcomes and social determinants of health more broadly. In addition, further work is needed to understand the extent to which paid leave policies extend to the informal economy, where the majority of women and men in low- and middle-income countries work.

While global enrollment in primary education has increased significantly particularly since it became a target of the United Nations “Education for All” initiative and one of the Millennium Development Goals, primary completion rates have remained virtually unchanged since 1999. Evidence from studies of individual programs in a range of countries suggests that enrollment in pre-primary education can improve school readiness and achievement in primary school, and therefore, potentially raise primary completion rates. As research has also found that provision of free education is associated with higher enrollment, we hypothesize that provision of free and compulsory pre-primary education will be associated with higher primary school completion rates. Further, we hypothesize that free pre-primary education will have the largest impact where completion rates have been lowest. Using a database of quantitative, globally comparable measures of national provision of free pre-primary education we created, and data from UNESCO’s Institute for Education Statistics, we analyze the 104 nations with complete data. We conduct multivariate quantile regression analyses. We find that, controlling for national income and level of urbanization, provision of at least 1 year of free and compulsory pre-primary education is associated with a nearly 10 percentage point increase in primary school graduation rates for countries at the median and a 12 percentage point increase in rates for primarily low- and lower-middle-income countries at the lower end of the distribution.

Objective: To determine whether workplace flexibility policies influence parents’ ability to meet their children’s preventive primary health care needs. Patients and Methods: Study sample included 917 employed adults with at least 1 child younger than 18 years in their household from a nationally representative survey of US adults. Multivariate logistic regression analyses of factors influencing parental ability to meet their children’s preventive primary health care needs were conducted. Analyses assessed the effect of having access to schedule flexibility, a supervisor who is accommodating about work adjustments when family issues arise, and the ability to make personal calls without consequences on the odds of a parents’ being unable to meet their child’s preventive health care needs. Results: Being able to make a personal phone call at work was associated with a 56% (P < .05) reduction in the odds of being unable to meet children’s preventive health needs. Working at a job that allowed for schedule adjustments was associated with more than 40% (P < .05) lower odds of being unable to meet preventive care needs. Conclusion: Feasible steps to increase flexibility at work could make a substantial difference in parents’ ability to obtain preventive care for their children.

Research has demonstrated that paid sick leave reduces the spread of COVID-19 and other infectious diseases and improves preventive care and access to treatment across a wide range of conditions. However, the Us has no national paid sick leave policy, and even unpaid leave via the Family and Medical Leave Act (FMLA) of 1993-often viewed as a foundation for new paid leave legislation-is often inaccessible to workers. We analyzed data from a nationally representative survey to determine the extent to which specific FMLA features produce gaps and disparities in leave access. We then used comparative policy data from 193 countries to analyze whether these policy features are necessary or prevalent globally, or whether there are common alternatives. We found that the FMLA's minimum hours requirement disproportionately excludes women, whereas its tenure requirement disproportionately excludes Black, Indigenous, and multiracial workers. Latinx workers also face greater exclusion because of employer size requirements. Of the 94 percent of countries that provide permanent paid sick leave, none broadly restrict leave based on employer size, and 93 percent cover part-time workers without a minimum hours requirement. Enacting permanent paid sick leave that is accessible regardless of employer size, tenure, or hours is critical and feasible.

Context: Policies legislating paid leave from work for new parents, and to attend to individual and family illness, are common across Organisation for Economic Co-operation and Development (OECD) countries. However, there exists no comprehensive review of their potential impacts on economic, social, and health outcomes. Methods: We conducted a systematic review of the peer-reviewed literature on paid leave and socioeconomic and health outcomes. We reviewed 5,538 abstracts and selected 85 published papers on the impact of parental leave policies, 22 papers on the impact of medical leave policies, and 2 papers that evaluated both types of policies. We synthesized the main findings through a narrative description; a meta-analysis was precluded by heterogeneity in policy attributes, policy changes, outcomes, and study designs. Findings: We were able to draw several conclusions about the impact of parental leave policies. First, extensions in the duration of paid parental leave to between 6 and 12 months were accompanied by attendant increases in leave-taking and longer durations of leave. Second, there was little evidence that extending the duration of paid leave had negative employment or economic consequences. Third, unpaid leave does not appear to confer the same benefits as paid leave. Fourth, from a population health perspective, increases in paid parental leave were consistently associated with better infant and child health, particularly in terms of lower mortality rates. Fifth, paid paternal leave policies of adequate length and generosity have induced fathers to take additional time off from work following the birth of a child. How medical leave policies for personal or family illness influence health has not been widely studied. Conclusions: There is substantial quasi-experimental evidence to support expansions in the duration of job-protected paid parental leave as an instrument for supporting women's labor force participation, safeguarding women's incomes and earnings, and improving child survival. This has implications, in particular, for countries that offer shorter durations of job-protected paid leave or lack a national paid leave entitlement altogether.

The United States does not guarantee families a wide range of supportive workplace policies such as paid maternity and paternity leave or paid leave to care for sick children. Proposals to provide such benefits are invariably met with the complaint that the costs would reduce employment and undermine the international competitiveness of American businesses. In this article, Alison Earle, Zitha Mokomane, and Jody Heymann explore whether paid leave and other work-family policies that support children s development exist in countries that are economically competitive and have low unemployment rates. Their data show that the answer is yes. Using indicators of competitiveness gathered by the World Economic Forum, the authors identify fifteen countries, including the United States, that have been among the top twenty countries in competitiveness rankings for at least eight often years. To this group they add China and India, both rising competitors in the global economy. They find that every one of these countries, except the United States, guarantees some form of paid leave for new mothers as well as annual leave. And all but Switzerland and the United States guarantee paid leave for new fathers. The authors perform a similar exercise to identify thirteen advanced countries with consistently low unemployment rates, again including the United States. The majority of these countries provide paid leave for new mothers, paid leave for new fathers, paid leave to care for children's health care needs, breast-feeding breaks, paid vacation leave, and a weekly day of rest. Of these, the United States guarantees only breast-feeding breaks (part of the recently passed health care legislation). The authors' global examination of the most competitive economies as well as the economies with low unemployment rates makes clear that ensuring that all parents are available to care for their children's healthy development does not preclude a country from being highly competitive economically.

Metodos Se realizo un analisis del numero de paises que garantizan los permisos de lactancia, el numero diario de horas garantizado y la duracion de esos permisos. A fin de obtener informacion actual y detallada sobre las estrategias nacionales, se examinaron tanto la legislacion original como fuentes secundarias de 182 de los 193 Estados Miembros de las Naciones Unidas. Se llevaron a cabo analisis de regresion para examinar la asociacion entre la estrategia nacional y las tasas de lactancia exclusiva, al tiempo que se tuvo en cuenta el nivel de ingresos nacional, el nivel de urbanizacion, el porcentaje de mujeres de la poblacion activa y la tasa de alfabetizacion femenina.