Karen A Grépin
Dados Biográficos
| ID | 172154 |
|---|---|
| NOME | Karen A Grépin |
| PRENOMES | Karen A |
| SOBRENOME | Grépin |
| ASSINATURA | GRÉPIN K A |
| AFILIAÇÕES | University of Hong Kong |
| ORCID | 0000-0003-4368-0045 |
| VERIFICADO | Sim |
| TOTAL DE OBRAS | 58 |
| TOTAL DE CITAÇÕES | 57 |
| TOTAL COMO AUTOR | 53 |
| TOTAL COMO EDITOR | 5 |
| PRIMEIRO ANO DE PUBLICAÇÃO | 2009 |
| ANO MAIS RECENTE DE PUBLICAÇÃO | 2026 |
| ÍNDICE H | 4 |
Factors Associated with Caregiving and Mental Stress among Family Caregivers for People with Disabilities
Family caregivers in East Asian societies such as Hong Kong bear a significant share of care responsibilities for individuals with disabilities due to rising disability prevalence, limited formal services, and cultural norms rooted in filial piety. This study examines factors associated with caregiving provision, weekly caregiving hours, and mental stress among family caregivers in Hong Kong households. We used data from the 2019–2020 Hong Kong G…
Geospatial analysis of Covid-19 vaccine access in Kenya
Background: COVID-19 vaccines have reduced severe illness and mortality, yet inequitable distribution delayed rollout in many low- and middle-income countries (LMICs), including Kenya, where only 36% of adults were fully vaccinated by October 2022. While sociodemographic and attitudinal determinants of uptake are well documented, role of geographic access remain underexplored at individual level. This study assessed population coverage by travel …
The effect of an educational campaign on contraception seeking in Northern Nigeria
In Nigeria, unmet need for contraception results in three million unintended pregnancies annually. Despite no-cost contraception availability at health facilities, only 38% of reproductive-aged women in Nigeria used effective contraception methods in 2023. We evaluated the impact of a radio-based contraception education campaign on contraception seeking in Kano State, Nigeria. Using monthly, facility-level data from Nigeria’s National Health Mana…
Evaluating geographic accessibility to Covid-19 vaccination across 54 countries/regions
BACKGROUND: The COVID-19 pandemic has revealed significant disparities in global vaccine accessibility, particularly affecting low and middle-income countries (LMICs). However, current research on COVID-19 vaccine accessibility primarily focuses on individual countries or high-income countries (HIC). We aimed to evaluate geographic accessibility to COVID-19 vaccination on a multicountry scale, covering comparisons across LMICs and HICs. Additiona…
The socioeconomic and health system determinants of financial protection indicators
Examining national health insurance fund members’ preferences and trade-offs for the attributes of contracted outpatient facilities in Kenya
Patient choice of health facilities is increasingly gaining recognition for potentially enhancing the attainment of health system goals globally. In Kenya, National Health Insurance Fund (NHIF) members are required to choose an NHIF-contracted outpatient facility before accessing care. Understanding their preferences could support resource allocation decisions, enhance the provision of patient-centered care, and deepen NHIF’s purchasing decisions…
Understanding the drivers and barriers of elderly vaccination in post-pandemic China
Vaccination coverage among older adults in China remains suboptimal despite increased awareness of vaccination during the COVID-19 pandemic. This study aimed to investigate the key drivers and barriers to elderly vaccination in China. A qualitative study was conducted using the Critical Medical Anthropology (CMA) and the Integrative Model of Behavioral Prediction (IMBP) frameworks. Data were collected through in-depth interviews with 22 elderly i…
Financing health in sub-Saharan Africa 1990–2050
In 2021, global life expectancy at birth was 74 years whereas in sub-Saharan Africa it was 66 years. Yet in that same year, $92 per person was spent on health in sub- Saharan Africa, which is roughly one fifth of what the next lowest geographic region—North Africa and Middle East—spent ($379). The challenges to healthy lives in sub-Saharan Africa are many while health spending remains low. This study uses gross domestic product, government, and h…
Ambitions and realities
Strengthening resilient and sustainable systems for health (RSSH) is central to the Global Fund’s strategy, however questions persist about the Global Fund’s role in the health systems strengthening space, and the extent to which investments are designed to achieve strengthening objectives, or just fill in gaps in the system. This paper reports on findings from the Prospective Country Evaluations (PCE), a multi-country multi-year evaluation of Gl…
The adoption of international travel measures during the first year of the Covid-19 pandemic
OBJECTIVE: To describe the adoption of international travel measures during the first year of the COVID-19 pandemic. METHODS: To comprehensively analyze the measures adopted, we constructed a dataset based on the WHO's Public Health and Social Measures (PHSM) database, which covered 252 countries, territories, or other areas (CTAs), including all 194 WHO Member States, from December 31, 2019, to December 31, 2020. We examined the adoption of meas…
Understanding China’s shifting priorities and priority-setting processes in development assistance for health
Over the past two decades, China has become a distinctive and increasingly important donor of development assistance for health (DAH). However, little is known about what factors influence China’s priority-setting for DAH. In this study, we provide an updated analysis of trends in the priorities of Chinese DAH and compare them to comparable trends among OECD Development Assistance Committee (DAC) donors using data from the AidData’s Global Chines…
An analysis of WHO’s Temporary Recommendations on international travel and trade measures during Public Health Emergencies of International Concern
During Public Health Emergencies of International Concern (PHEICs), The International Health Regulations (IHR) require the WHO to issue Temporary Recommendations on the use of international travel and trade measures. During the COVID-19 pandemic, WHO’s initial recommendation against ‘any travel or trade restriction’ has been questioned, and virtually all countries subsequently used international travel measures. WHO’s Recommendations to States Pa…
Unmasking the truth
High levels of compliance with public health measures are critical to ensure a successful response to the COVID-19 pandemic and other public health emergencies. However, most data on compliance are self-reported and the tendency to overreport due to social desirability could yield biased estimates of actual compliance. A list experiment is a widely used method to estimate social desirability bias in self-reported estimates of sensitive behaviours…
Budget monitoring, accountability practices and their influence on the efficiency of county health systems in Kenya
Public Finance Management (PFM) practices influence the attainment of health system goals. PFM processes are implemented within the budget cycle which entails the formulation, execution, and monitoring of government budgets. Budget monitoring and accountability actors, structures, and processes are important in improving the efficiency of health systems. This study examined how the budget monitoring and accountability processes influence the effi…
The impact of Covid-19 and national pandemic responses on health service utilisation in seven low- and middle-income countries
BACKGROUND: The COVID-19 pandemic has disrupted health services worldwide, which may have led to increased mortality and secondary disease outbreaks. Disruptions vary by patient population, geographic area, and service. While many reasons have been put forward to explain disruptions, few studies have empirically investigated their causes. OBJECTIVE: We quantify disruptions to outpatient services, facility-based deliveries, and family planning in …
Identifying barriers to the production and use of routine health information in Western Province, Zambia
Recent decades of improvements to routine health information systems in low- and middle-income countries (LMICs) have increased the volume of health data collected. However, countries continue to face several challenges with quality production and use of information for decision-making at sub-national levels, limiting the value of health information for policy, planning and research. Improving the quality of data production and information use is…
Domestic Burdens Amid Covid-19 and Women’s Mental Health in Middle-Income Africa
This article analyzes two longitudinal datasets (October – December 2020; April 2021) of 1,000 and 900 women in Kenya and Nigeria, respectively, alongside in-depth qualitative interviews with women at risk of changes to time use, to study two pandemic issues: women’s substitution of paid for unpaid work and how these shifts compromise their mental health. Women devote more time to domestic care (30–38 percent), less time to employment (29–46 perc…
Do referrals improve the representation of women in mobile phone surveys
Random digit dial surveys with mobile phones risk under-representation of women. To address this, we compare the characteristics of women recruited directly with those of women recruited through referrals from male household members. The referral process improves representation of vulnerable groups, such as young women, the asset poor, and those living in areas with low connectivity. Among mobile phone users, we show a referral (rather than a dir…
The Gendered Consequences of Covid-19 for Internal Migration
Scant evidence exists to identify the effects of the pandemic on migrant women and the unique barriers on employment they endure. We merge longitudinal data from mobile phone surveys with subnational data on COVID cases to examine whether women were left more immobile and vulnerable to health risks, relative to men, during the pandemic in Kenya and Nigeria. Each survey interviewed approximately 2000 men and women over three rounds (November 2020–…
Data flows during public health emergencies in LMICs
WuhanDiary and #WuhanLockdown
Social media can be both a source of information and misinformation during health emergencies. During the COVID-19 pandemic, social media became a ubiquitous tool for people to communicate and represents a rich source of data researchers can use to analyse users’ experiences, knowledge and sentiments. Research on social media posts during COVID-19 has identified, to date, the perpetuity of traditional gendered norms and experiences. Yet these stu…
The impact of institutional delivery on neonatal and maternal health outcomes
INTRODUCTION: Persistently high rates of neonatal and maternal mortality have been associated with home births in many low-income and middle-income countries (LMICs). However, causal evidence of the effect of institutional deliveries on neonatal and maternal health outcomes is limited in these settings. METHODS: We investigate the effect of institutional deliveries on neonatal mortality and maternal postpartum complications in rural India using d…
Disruptions in maternal health service use during the Covid-19 pandemic in 2020
The COVID-19 pandemic has heterogeneously affected use of basic health services worldwide, with disruptions in some countries beginning in the early stages of the emergency in March 2020. These disruptions have occurred on both the supply and demand sides of healthcare, and have often been related to resource shortages to provide care and lower patient turnout associated with mobility restrictions and fear of contracting COVID-19 at facilities. I…
How to estimate health service coverage in 58 districts of Benin with no survey data
The global movement to use routine information for managing health systems to achieve the Sustainable Development Goals, relies on administrative data which have inherent biases when used to estimate coverage with health services. Health policies and interventions planned with incorrect information can have detrimental impacts on communities. Statistical inferences using administrative data can be improved when they are combined with random proba…
Assessing routine health information system performance during the tenth outbreak of Ebola virus disease (2018–2020) in the Democratic Republic of the Congo
The Democratic Republic of Congo has implemented reforms to its national routine health information system (RHIS) to improve timeliness, completeness, and use of quality data. However, outbreaks can undermine efforts to strengthen it. We assessed the functioning of the RHIS during the 2018–2020 outbreak of Ebola Virus Disease (EVD) to identify opportunities for future development. We conducted a qualitative study in North Kivu, from March to May …
Approaches and Alternatives to the Wealth Index to Measure Socioeconomic Status Using Survey Data
Monitoring progress towards the Sustainable Development Goals by 2030 requires the global community to disaggregate targets along socio-economic lines, but little has been published critically analyzing the appropriateness of wealth indices to measure socioeconomic status in low- and middle-income countries. This critical interpretive synthesis analyzes the appropriateness of wealth indices for measuring social health inequalities and provides an…
We also deserve help during the pandemic”
The coronavirus disease 2019 (COVID-19) pandemic poses particular challenges for migrant workers around the world. This study explores the unique experiences of foreign domestic workers (FDWs) in Hong Kong, and how COVID-19 impacted their health and economic wellbeing. Interviews with FDWs ( n = 15) and key informants ( n = 3) were conducted between May and August 2020. FDWs reported a dual-country experience of the pandemic, where they expressed…
Local adaptations to a global health initiative
Global health initiatives (GHIs) are implemented across a variety of geographies and cultures. Those targeting maternal health often prioritise increasing facility delivery rates. Pressure on local implementers to meet GHI goals may lead to unintended programme features that could negatively impact women. This study investigates penalties for home births imposed by traditional leaders on women during the implementation of Saving Mothers, Giving L…
Forum
The COVID-19 pandemic has affected virtually every aspect of life, for individuals, communities, nations, regions, and the international system. In this forum, scholars from around the world with diverse areas of expertise consider the contributions of international relations (IR) scholarship in our understanding of the politics and governance challenges surrounding the pandemic. The seven essays that follow together examine how our current state…
Reconceptualizing successful pandemic preparedness and response
Pandemic preparedness and COVID-19 response indicators focus on public health outcomes (such as infections, case fatalities, and vaccination rates), health system capacity, and/or the effects of the pandemic on the economy, yet this avoids more political questions regarding how responses were mobilized. Pandemic preparedness country rankings have been called into question due to their inability to predict COVID-19 response and outcomes, and COVID…
New approaches to ranking countries for the allocation of development assistance for health
The distributions of income and health within and across countries are changing. This challenges the way donors allocate development assistance for health (DAH) and particularly the role of gross national income per capita (GNIpc) in classifying countries to determine whether countries are eligible to receive assistance and how much they receive. Informed by a literature review and stakeholder consultations and interviews, we developed a stepwise…
Factors influencing modes of transport and travel time for obstetric care
Transportation is an important barrier to accessing obstetric care for many pregnant and postpartum women in low-resource settings, particularly in rural areas. However, little is known about how pregnant women travel to health facilities in these settings. We conducted 1633 exit surveys with women who had a recent facility delivery and 48 focus group discussions with women who had either a home or a facility birth in the past year in eight distr…
The Unintended Consequences of Information Provision
Why do some international agreements fail to achieve their goals? Rather than states' engaging in cheap talk, evasion, or shallow commitments, the World Health Organization's (WHO) International Health Regulations (IHR)-the agreement governing states' and WHO's response to global health emergencies-point to the unintended consequences of information provision. The IHR have a dual goal of providing public health protection from health threats whil…
Evaluating Quality of Contraceptive Counseling
The Method Information Index (MII) is calculated from contraceptive users’ responses to questions regarding counseling content—whether they were informed about methods other than the one they received, told about method‐specific side effects, and advised what to do if they experienced side effects. The MII is increasingly reported in national surveys and used to track program performance, but little is known about its properties. Using additional…
Allocating external financing for health
Most donors of external financing for health use allocation policies to determine which countries are eligible to receive financial support and how much support each should receive. Currently, most of these policies place a great deal of weight on income per capita as a determinant of aid allocation but there is increasing interest in putting more weight on other country characteristics in the design of such policies. It is unclear, however, how …
Aligning Funding and Need for Family Planning
With limited international resources for family planning, donors must decide how to allocate their funds to different countries. How can a donor for family planning decide whether countries are adequately prioritized for funding? This article proposes an ordinal ranking framework to identify under‐prioritized countries by rank‐ordering countries by their need for family planning and separately rank‐ordering them by their development assistance fo…
Domestic Burdens Amid Covid-19 and Women’s Mental Health in Middle-Income Africa
This article analyzes two longitudinal datasets (October – December 2020; April 2021) of 1,000 and 900 women in Kenya and Nigeria, respectively, alongside in-depth qualitative interviews with women at risk of changes to time use, to study two pandemic issues: women’s substitution of paid for unpaid work and how these shifts compromise their mental health. Women devote more time to domestic care (30–38 percent), less time to employment (29–46 perc…
Do referrals improve the representation of women in mobile phone surveys
Random digit dial surveys with mobile phones risk under-representation of women. To address this, we compare the characteristics of women recruited directly with those of women recruited through referrals from male household members. The referral process improves representation of vulnerable groups, such as young women, the asset poor, and those living in areas with low connectivity. Among mobile phone users, we show a referral (rather than a dir…
Best Resources on … Health Workers in Developing Countries
yet until recently researchers and policymakers paidrelatively little attention to their role in developing countries.This is due in part to the inherent complexities and limitedavailability of data—both of which have also held back researchin the world’s wealthier countries. But in low- and middle-income countries, these difficulties have been exacerbated bya tendency to focus on more visible issues.In recent years, however, this has changed. Th…
How to do (or not to do) … Tracking data on development assistance for health
Development assistance for health (DAH) has increased substantially in recent years and is seen as important to the improvement of health and health systems in developing countries. As a result, there has been increasing interest in tracking and understanding these resource flows from the global health community. A number of datasets, each with its own strengths and weaknesses, are available to track DAH. In this article we review the available d…
Understanding Global Health Governance
China’s role as a global health donor in Africa
BACKGROUND: There is a growing recognition of China's role as a global health donor, in particular in Africa, but there have been few systematic studies of the level, destination, trends, or composition of these development finance flows or a comparison of China's engagement as a donor with that of more traditional global health donors. METHODS: Using newly released data from AidData on China's development finance activities in Africa, developed …
Maternal education and child mortality in Zimbabwe
The promise of Mama Kits
There is growing interest in the use of incentives to increase the utilisation of maternal health services globally, including the use of in-kind goods. As part of the Saving Mothers, Giving Life (SMGL) programme, pregnant women in three districts in Uganda were incentivised to deliver in a facility by the promise of 'Mama Kits' - clean delivery kits augmented with goods for newborns. We collected and analysed qualitative data from 18 focus group…
Factors influencing modes of transport and travel time for obstetric care
Transportation is an important barrier to accessing obstetric care for many pregnant and postpartum women in low-resource settings, particularly in rural areas. However, little is known about how pregnant women travel to health facilities in these settings. We conducted 1633 exit surveys with women who had a recent facility delivery and 48 focus group discussions with women who had either a home or a facility birth in the past year in eight distr…
Local adaptations to a global health initiative
Global health initiatives (GHIs) are implemented across a variety of geographies and cultures. Those targeting maternal health often prioritise increasing facility delivery rates. Pressure on local implementers to meet GHI goals may lead to unintended programme features that could negatively impact women. This study investigates penalties for home births imposed by traditional leaders on women during the implementation of Saving Mothers, Giving L…
Aligning Funding and Need for Family Planning
With limited international resources for family planning, donors must decide how to allocate their funds to different countries. How can a donor for family planning decide whether countries are adequately prioritized for funding? This article proposes an ordinal ranking framework to identify under‐prioritized countries by rank‐ordering countries by their need for family planning and separately rank‐ordering them by their development assistance fo…
Transnational wealth-related health inequality measurement
The study of international differences in wealth-related health inequalities has traditionally consisted of country-by-country comparisons using own-country relative measures of socioeconomic status, which effectively ignores absolute differences in both wealth and health that can differ between and within countries. To address these limitations, we propose an alternative approach: that of constructing a transnational measure of wealth-related he…
The impact of an mHealth monitoring system on health care utilization by mothers and children
Maternal and child mortality rates remain unacceptably high globally, particularly in sub-Saharan Africa. A popular approach to counter these high rates is interventions delivered using mobile phones (mHealth). However, few mHealth interventions have been implemented nationwide and there has been little evaluation of their effectiveness, particularly at scale. Therefore, we evaluated the Rwanda RapidSMS programme-one of the few mHealth programmes…
Allocating external financing for health
Most donors of external financing for health use allocation policies to determine which countries are eligible to receive financial support and how much support each should receive. Currently, most of these policies place a great deal of weight on income per capita as a determinant of aid allocation but there is increasing interest in putting more weight on other country characteristics in the design of such policies. It is unclear, however, how …
New approaches to ranking countries for the allocation of development assistance for health
The distributions of income and health within and across countries are changing. This challenges the way donors allocate development assistance for health (DAH) and particularly the role of gross national income per capita (GNIpc) in classifying countries to determine whether countries are eligible to receive assistance and how much they receive. Informed by a literature review and stakeholder consultations and interviews, we developed a stepwise…
The socio-economic distribution of exposure to Ebola
Socio-economic factors are widely believed to have been an important driver of the transmission of Ebola Virus Disease (EVD) during the West African outbreak of 2014-16, however, studies that have investigated the relationship between socio-economic status (SES) and EVD have found inconsistent results. Using nationally representative household survey data on whether respondents knew a close friend or family member with Ebola, we explore the SES d…
Measuring and explaining changing patterns of inequality in institutional deliveries between urban and rural women in Ghana
Relative to urban women, rural women have lower rates of institutional deliveries due primarily to lower levels of wealth, which results in financial barriers in accessing maternal health services. Economic empowerment of rural women is crucial in order to close the gap in institutional delivery between urban and rural women
Evaluating Quality of Contraceptive Counseling
The Method Information Index (MII) is calculated from contraceptive users’ responses to questions regarding counseling content—whether they were informed about methods other than the one they received, told about method‐specific side effects, and advised what to do if they experienced side effects. The MII is increasingly reported in national surveys and used to track program performance, but little is known about its properties. Using additional…
Approaches and Alternatives to the Wealth Index to Measure Socioeconomic Status Using Survey Data
Monitoring progress towards the Sustainable Development Goals by 2030 requires the global community to disaggregate targets along socio-economic lines, but little has been published critically analyzing the appropriateness of wealth indices to measure socioeconomic status in low- and middle-income countries. This critical interpretive synthesis analyzes the appropriateness of wealth indices for measuring social health inequalities and provides an…
Women are most affected by pandemics — lessons from past outbreaks
The social and economic impacts of COVID-19 fall harder on women than on men. Governments need to gather data and target policy to keep all citizens equally safe, sheltered and secure.
Impact of a free care policy on the utilisation of health services during an Ebola outbreak in the Democratic Republic of Congo
BACKGROUND: During past outbreaks of Ebola virus disease (EVD) and other infectious diseases, health service utilisation declined among the general public, delaying health seeking behaviour and affecting population health. From May to July 2018, the Democratic Republic of Congo experienced an outbreak of EVD in Equateur province. The Ministry of Public Health introduced a free care policy (FCP) in both affected and neighbouring health zones. We e…
Impact of the Covid-19 pandemic and response on the utilisation of health services in public facilities during the first wave in Kinshasa, the Democratic Republic of the Congo
INTRODUCTION: Health service use among the public can decline during outbreaks and had been predicted among low and middle-income countries during the COVID-19 pandemic. In March 2020, the government of the Democratic Republic of the Congo (DRC) started implementing public health measures across Kinshasa, including strict lockdown measures in the Gombe health zone. METHODS: Using monthly time series data from the DRC Health Management Information…
Evidence of the effectiveness of travel-related measures during the early phase of the Covid-19 pandemic
Managing borders during public health emergencies of international concern
BACKGROUND: The near universal adoption of cross-border health measures during the COVID-19 pandemic worldwide has prompted significant debate about their effectiveness and compliance with international law. The number of measures used, and the range of measures applied, have far exceeded previous public health emergencies of international concern. However, efforts to advance research, policy and practice to support their effective use has been h…
A tale of two city-states
The East Asian experience in tackling COVID-19 has been highly praised, but this high-level generalisation neglects variation in pandemic response measures adopted across countries as well as the socio-political factors that shaped them. This paper compares the early pandemic response in Singapore and Hong Kong, two Asian city-states of similar sizes, a shared history of SARS, and advanced medical systems. Although both were able to contain the v…
The failure of private health services
For decades, governments and development partners promoted neoliberal policies in the health sector in many LMICs, largely motivated by the belief that governments in these countries were too weak to provide all the health services necessary to meet population needs. Private health markets became the governance and policy solution to improve the delivery of health services which allowed embedded forms of market failure to persist in these countri…
More than a public health crisis
Gender norms, roles and relations differentially affect women, men, and non-binary individuals' vulnerability to disease. Outbreak response measures also have immediate and long-term gendered effects. However, gender-based analysis of outbreaks and responses is limited by lack of data and little integration of feminist analysis within global health scholarship. Recognising these barriers, this paper applies a gender matrix methodology, grounded i…
Medicine (46 obras) · Economics (38 obras) · Economic growth (32 obras) · Environmental health (27 obras) · Global Maternal and Child Health (27 obras) · Political science (25 obras) · Business (23 obras) · Pandemic (22 obras) · Population (22 obras) · Public health (20 obras)