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The extent to which education provides protection in the face of a large-scale natural disaster is investigated. Using longitudinal population-representative survey data collected in two provinces on the island of Sumatra, Indonesia, before and after the 2004 Indian Ocean tsunami, we examine changes in a broad array of indicators of well-being of adults. Focusing on adults who were living, before the tsunami, in areas that were subsequently severely damaged by the tsunami, better educated males were more likely to survive the tsunami, but education is not predictive of survival among females. Education is not associated with levels of post-traumatic stress among survivors 1 year after the tsunami, or with the likelihood of being displaced. Where education does appear to play a role is with respect to coping with the disaster over the longer term. The better educated were far less likely than others to live in a camp or other temporary housing, moving, instead, to private homes, staying with family or friends, or renting a new home. The better educated were more able to minimize dips in spending levels following the tsunami, relative to the cuts made by those with little education. Five years after the tsunami, the better educated were in better psycho-social health than those with less education. In sum, education is associated with higher levels of resilience over the longer term.

Background In Ethiopia, pregnancy, and childbearing begin at an early age. Teenage pregnancy has long-term implications for girls, their families, and communities. However, multilevel predictors of teenage pregnancy are not well studied yet. Several studies are focused only on the effects of individual-level characteristics but ignored the community level effect. This, in turn, could result in biased estimation of predictors of teenage pregnancy. Therefore, this study aimed to identify the individual and community level factors that determine teenage pregnancy in Ethiopia. Method The data were extracted from the 2016 Ethiopian Demographic and Health Survey. The study included a sample from 645 clusters of 2679 (weighted) women aged 20–24 years. The data were collected using a two-stage cluster design that includes selection of enumeration areas as a first stage and selection of households as a second stage. A two-level mixed-effect logistic regression model was fitted to determine the individual and community level factors associated with teenage pregnancy. Result The study revealed that 2134(79.6%) of women aged 20–24 years experienced pregnancy during their adolescent stage. Being sexually active before age 15[AOR = 7.9; 95%CI: 4.5, 13.8]; being married before age 15[AOR = 30; 9%CI: 16.7, 53.9] and being a rural dweller [AOR = 2.2; 95%CI: 1.4, 3.6] were positively associated with teenage pregnancy. A woman living in a community with a lower proportion of contraceptive users [AOR = 2.3; 95%CI: 1.5, 3.5]; had also a statistically significant association with teenage pregnancy. Conclusions and recommendation Various factors at both the individual and community level determined teenage pregnancy. Therefore, the government should work on the prevention of early marriage, early sexual initiation and on improving the utilization of family planning in the community to protect them from pregnancy that occur at early age.

Elections are now common in low-income societies. However, they are frequently flawed. We investigate a Nigerian election marred by violence. We designed and conducted a nationwide field experiment based on anti-violence campaigning. The campaign appealed to collective action through electoral participation, and worked through town meetings, popular theatres and door-to-door distribution of materials. We find that the campaign decreased violence perceptions and increased empowerment to counteract violence. We observe a rise in voter turnout and infer that the intimidation was dissociated from incumbents. These effects are accompanied by a reduction in the intensity of actual violence, as measured by journalists.

In 2012, the London Summit on Family Planning adopted the ambitious goal of increasing access to contraception for 120 million additional women and girls in the world’s poorest countries by 2020. Family Planning 2020 (FP2020) was established as a coordinating body to monitor progress. In order to monitor country progress and to change course in the event of stagnating or declining use, data were needed more frequently and more quickly than data provided by typical surveys. Performance Monitoring and Accountability 2020 (PMA2020) was created to provide rapid and frequent estimates of modern contraceptive use in FP2020 priority countries. Currently operational in ten countries (Burkina Faso, DRC, Ethiopia, Ghana, India, Indonesia, Kenya, Niger, Nigeria, and Uganda), PMA2020 conducts surveys every six months to one year, providing FP2020, governments, and other stakeholders frequent information on contraceptive use, demand, and supply that can inform policies and programs and identify areas for improvement.

The use of a single geographical unit to both collect and disseminate census data is common in many countries across the world, especially in developing countries. In South Africa this approach poses some challenges, as the design of small geographical units called enumeration areas to facilitate data collection differs considerably from the design of units that aid data analysis and interpretation. We aimed to create optimised census output areas using the Automated Zone-design Tool (AZTool) program, using the 2001census enumeration areas as building blocks at various spatial levels, for both rural and urban settings in two South African provinces. The results were consistent and stable. The primary criterion of the confidentiality limit of 500 people was respected at all geographical levels or regions, in both urban and rural settings, for newly created optimised output areas. For the second criterion, lower intra-area correlation values at lower geographical levels for both rural and urban areas showed that higher geographical levels produced more homogeneous output areas than did lower geographical levels or regions. Our obtained intra-area correlation of 0.62 for the two provinces combined indicated that the selected homogeneity variables were good indicators of social homogeneity for creating optimised output areas in South Africa. We conclude that the AZTool software can be used to effectively and objectively create optimised output areas for South African data. Further research on the comparison of the newly created output areas with existing output areas in South Africa should be explored.

Zimbabwe conducts Malaria Indicator Surveys after 3 years and Demographic and Health Surveys to track the impact of malaria interventions. The last one to be conducted was in 2016 and had set an aim aimed to collect data to track malaria indicators as well as to save as the baseline source for the Malaria Strategic Plan (2016-2020). Malaria Indicator Survey-2016 utilized the frame of enumeration areas (EAs) from the Zimbabwe Master Sample (ZMS12) created after the 2012 population census for each of the survey districts. The design for the survey was a representative probability sample to produce estimates at national level for the respective domains, which are the forty-four malaria-endemic districts. Survey teams comprised of Ministry of Health personnel who administered the standard questionnaire (adapted to country setting) to respondents within sampled EAs, performed RDT, anaemia test, prepared microscopic slide and collected DBS and data analysis of collected information was analysed. Microscopic slides examined centrally at the National Institute of Health Research. The overall protection coverage by at least one major vector control measure, IRS and/or Nets, was 82.5%. Use of nets among high-risk groups 32.5% For children under five and 24.5% for pregnant women. LLIN utilization quite low taking into consideration the net ownership per household, which was 58% for the general population. Moreover, IPTp coverage has remained almost unchanged since the 2012 MIS, with only a third of pregnant women receiving at least two doses of IPTp. Malaria prevalence appears to be on the decline with 2016 MIS recording 0.2% compared to 0.4% as of 2012 MIS. Plasmodium falciparum remains the predominant parasite species in the country at 98%. The results indicated that some progress has been made in malaria control although there is still subsequent low malaria risk perception that comes with the reduced prevalence. It has been shown that there is low use of interventions shown by the low use of LLINs by vulnerable groups like pregnant women and children under five.

Unsuppressed HIV viral load is an important marker of sustained HIV transmission. We investigated the prevalence, predictors, and high-risk areas of unsuppressed HIV viral load among HIV-positive men and women. Unsuppressed HIV viral load was defined as viral load of >_400 copies/mL. Data from the HIV Incidence District Surveillance System (HIPSS), a longitudinal study undertaken between June 2014 to June 2016 among men and women aged 15-49 years in rural and peri-urban KwaZulu-Natal, South Africa, were analysed. A Bayesian geoadditive regression model which includes a spatial effect for a small enumeration area was applied using an integrated nested Laplace approximation (INLA) function while accounting for unobserved factors, non-linear effects of selected continuous variables, and spatial autocorrelation. The prevalence of unsuppressed HIV viral load was 46.1% [95% CI: 44.3-47.8]. Predictors of unsuppressed HIV viral load were incomplete high school education, being away from home for more than a month, alcohol consumption, no prior knowledge of HIV status, not ever tested for HIV, not on antiretroviral therapy (ART), on tuberculosis (TB) medication, having two or more sexual partners in the last 12 months, and having a CD4 cell count of <350 cells/L. A positive non-linear effect of age, household size, and the number of lifetime HIV tests was identified. The higher-risk pattern of unsuppressed HIV viral load occurred in the northwest and northeast of the study area. Identifying predictors of unsuppressed viral load in a localized geographic area and information from spatial risk maps are important for targeted prevention and treatment programs to reduce the transmission of HIV.

The use of a single geographical unit to both collect and disseminate census data is common in many countries across the world, especially in developing countries. In South Africa this approach poses some challenges, as the design of small geographical units called enumeration areas to facilitate data collection differs considerably from the design of units that aid data analysis and interpretation. We aimed to create optimised census output areas using the Automated Zone-design Tool (AZTool) program, using the 2001 census enumeration areas as building blocks at various spatial levels, for both rural and urban settings in two South African provinces. The results were consistent and stable. The primary criterion of the confidentiality limit of 500 people was respected at all geographical levels or regions, in both urban and rural settings, for newly created optimised output areas. For the second criterion, lower intra-area correlation values at lower geographical levels for both rural and urban areas showed that higher geographical levels produced more homogeneous output areas than did lower geographical levels or regions. Our obtained intra-area correlation of 0.62 for the two provinces combined indicated that the selected homogeneity variables were good indicators of social homogeneity for creating optimised output areas in South Africa. We conclude that the AZTool software can be used to effectively and objectively create optimised output areas for South African data. Further research on the comparison of the newly created output areas with existing output areas in South Africa should be explored.

CONTEXT: Researchers have long assumed that familiarity between an interviewer and a survey participant reduces the validity of responses, especially for such sensitive behaviors as abortion. However, little empirical evidence exists on this issue. METHODS: Data on 6,041 women aged 15–49 and 133 interviewers who took part in the second (2017) round of the Performance Monitoring and Accountability 2020 survey in Rajasthan, India, were used to examine the effect of interviewer–respondent acquaintance and participation in the prior survey round on women's reporting of induced abortion. Associations were identified using multivariate, multilevel models that adjusted for respondent, interviewer and community characteristics, and that included interviewer random effects. RESULTS: On average, interviewers completed interviews with 41 respondents from their assigned cluster; they reported that they were acquainted with 61% of respondents and that 13% of respondents had participated in the prior survey round. Four percent of women reported having had an abortion. Neither interviewer–respondent acquaintance nor participation in the previous survey round was associated with abortion reporting in any of the multivariate models or in additional sensitivity analyses. CONCLUSIONS: The findings do not support the hypothesis that respondent familiarity with the interviewer or the survey process is associated with lower reporting of sensitive behaviors, like abortion. Future studies should further explore these and other design features to identify those that provide statistically significant improvements in the reporting of abortion and other sensitive behaviors.

There is little consensus on where and how employment is decentralising in metropolitan areas. However, a number of key processes have been brought to light, and different cities have tended to display different processes: strong CBDs, suburban polynucleation, job dispersal, scattering, edgeless cities and perhaps 'keno capitalism'. This paper explores the distribution and growth of employment at a fine spatial scale. It is shown that, at this scale, there are very dynamic processes of growth and decline throughout metropolitan areas, but that these processes are organised at a wider scale by stable employment centres and by links between these centres. The structures and processes thus revealed suggest that the spatial economy of metropolitan areas should be approached as a chaotic system. From an empirical perspective, this means that, depending on the scale of analysis and the way data are considered, polynucleation, dispersal and chaos are all observed: this may partly explain the lack of consensus in the literature. The only process not evident within Canadian cities is scattering, but this process may in fact be occurring within some areas identified as suburban employment zones.