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Eva Deuchert
Former Member
Title
Prof. Dr.
Last Name
Deuchert
First name
Eva
Phone
+41 71 224 2318
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1 - 10 of 15
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PublicationEvaluating Nationwide Health Interventions : Malawi's insecticide-treated-net distribution programmeWe evaluate Malawi's main malaria prevention campaign, a nationwide insecticide-treated-net distribution scheme, in terms of its effect on infant mortality. Methodologically, evaluating such nationwide health interventions is particularly difficult. There is no contemporaneous comparison group that has not been subject to the intervention. Moreover, common environmental trends, the availability of new drugs and a variety of other health improving measures used at the same time imply that the often advocated before-after estimator is not a good choice. We propose an alternative estimator that can be used if the intervention influences health through its effect on individual health-seeking behaviour but has no other effect on the outcome. We also suggest some plausibility checks and falsification tests to assess the validity of the identifying assumptions that we impose in applications. Using the estimator proposed we find that Malawi's insecticide-treated-net distribution campaign reduced all-cause child mortality by about 1 percentage point, which corresponds to about 40% of the total reduction in infant mortality from 8.2% to 5.4% over the study period.Type: journal articleJournal: Journal of the Royal Statistical Society: Series AVolume: 2Issue: 177DOI: 10.1111/rssa.12031
Scopus© Citations 3 -
PublicationA Short Note on Economic Development and Socioeconomic Inequality in Female Body WeightThe origin of the obesity epidemic in developing countries is still poorly understood. It has been prominently argued that economic development provides a natural interpretation of the growth in obesity. This paper tests the main aggregated predictions of the theoretical framework to analyze obesity. Average body weight and health inequality should be associated with economic development. Both hypotheses are confirmed: we find higher average female body weight in economically more advanced countries. In relatively nondeveloped countries, obesity is a phenomenon of the socioeconomic elite. With economic development, obesity shifts toward individuals with lower socioeconomic statusType: journal articleJournal: Health EconomicsVolume: 2013Issue: early viewDOI: 10.1002/hec.2968
Scopus© Citations 17 -
PublicationWould you train me with my mental illness? Evidence from a discrete choice experimentThe low employment among people with disabilities in general, and mental illnesses in particular, generates high costs to society. Supported Education and Employment - a rehabilitation method that directly places patients in a realistic work environment - has been shown to be effective in increasing competitive employment for people with mental disorders. Employers are the key players because they provide the workplace and any ongoing training needed. Supported Education and Employment has not yet been widely implemented since it is difficult to find employers willing to provide these workplaces. Using a discrete choice experiment, this paper analyzes barriers to do so. Our results confirm that the overall willingness to accept employees with mental disorders is currently relatively low and that non-cognitive dysfunctions are the main deterrents.Type: journal articleJournal: Journal of Mental Health Policy and EconomicsVolume: 16Issue: 2
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PublicationA consistent partnership formation model: Application to the United KingdomWe apply a consistent sexual partnership formation model which hinges on the assumption that one gender's choices drives the process (male or female dominant model). The other gender's behaviour is imputed. The model is fitted to UK sexual behaviour data and applied to a simple incidence model of HSV-2. With a male dominant model (which assumes accurate male reports on numbers of partners) the modelled incidences of HSV-2 are 77% higher for men and 50% higher for women than with a female dominant model (which assumes accurate female reports). Although highly stylized, our simple incidence model sheds light on the inconsistentType: journal articleJournal: Mathematical BiosciencesVolume: 235Issue: 2
Scopus© Citations 1 -
PublicationThe Virgin HIV Puzzle : Can Misreporting Account for the High Proportion of HIV Cases in Self-reported Virgins?It is widely believed that HIV is predominantly sexually transmitted in Sub-Saharan Africa. This claim is inconsistent with national representative data from Lesotho, Zimbabwe, and Swaziland which reveals that a significant proportion of HIV infections occurred in adolescents who claim to be virgins. Two explanations for this observation have been proposed: adolescents misreport sexual status or non-sexual risks are more prevalent than previously asserted. This paper empirically uncovers the implicit assumptions underlying this discussion, by estimating the proportion of sexually transmitted HIV infections assuming that misreporting is irrelevant, and the proportion of misreporting necessary to conclude that HIV is predominantly sexually transmitted. It shows that under the no-misreporting assumption, 70% of HIV cases in the respective sample of unmarried adolescent women is not due to sexual transmission. The assumption that HIV is predominantly sexually transmitted is valid only if more than 55% of unmarried adolescent women who are sexually active have misreported sexual activity status. This research is designed to gain better understanding on the importance of different transmission modes. This is important to design combination prevention to achieve maximum impact on HIV preventionType: journal articleJournal: Journal of African EconomiesVolume: 20Issue: 1DOI: 10.1093/jae/ejq032
Scopus© Citations 3 -
PublicationDo Men and Women Have the Same Average Number of Lifetime Partners?It is generally thought that for sake of consistency men and women must have the same average number of lifetime partners. However, this is not the case in general. When men have younger partners, women enter sexual relationships more quickly than men and have a higher number of lifetime partners. A male dominant model applied to UK data on the male rate of entry into a sexual relationship and the male partnership formation function shows that in a stationary population (zero growth rate) women have 9.1% more partners than men. In a stable population with an intrinsic growth rate of 2% and a larger but still plausible difference between the ages of partners, women have 24.6% more partners than men. Given that in sex surveys men report more partners than women, the resulting bias in estimated numbers of partners may therefore be larger than previously thoughtType: journal articleJournal: Mathematical Population StudiesVolume: 17Issue: 4
Scopus© Citations 2 -
PublicationMaternal Healthcare and the Spread of AIDS in Burkina Faso and CameroonThis paper analyzes whether exposure to maternal healthcare is associated with a higher risk of HIV infection. Using data provided by Demographic and Health Surveys in Burkina Faso and Cameroon, the paper finds that women are 26% to 78% more likely to be HIV positive if they received tetanus toxoid injections during their last pregnancy. The analysis does not provide empirical evidence for the hypotheses that this association might be due to reverse causality, omitted variables or self-selection.Type: journal articleJournal: World Health and PopulationVolume: 9Issue: 3
Scopus© Citations 8 -
PublicationFailure to use auto-disable syringes in immunization services is associated with HIV prevalence: an international ecological analysisPurpose A growing body of evidence strongly suggests that unsafe health care is an important factor driving the human immunodeficiency virus (HIV) epidemic in sub-Saharan Africa. We investigate whether nonuse of autodisable syringes and other health care indicators predict national HIV prevalence. Methods These ecologic analyses use countries as study units in descriptive analyses and regression analyses. Two sets of observations are used: (i) all low- and lower-middle-income countries, and (ii) all sub-Saharan African countries with available data. Results In the descriptive analysis, health care indicators (health expenditures, vaccination coverage, and use of autodisable syringes) have a U-shaped relationship with HIV prevalence in the larger sample. Greater density of physicians is associated with lower HIV prevalence. In sub-Saharan Africa, antenatal care coverage is associated with increasing HIV prevalence. In regression analyses, nonuse of autodisable syringes is associated robustly with greater HIV prevalence in all models. For the larger sample, greater HIV prevalence also is associated with higher Gini Index, less female economic activity, less urbanization, and less percentage of Muslims. In sub-Saharan Africa, tetanus vaccination coverage has a U-shaped association with HIV prevalence. Low physician density and percentage of Muslims are associated with HIV prevalence. Other economic and health care indicators and epidemic age are not significant correlates of HIV prevalence. Conclusions This analysis adds to the other sources of evidence for health care transmission of HIV (in sub-Saharan Africa and regions with similar epidemiologic characteristics) by showing that health care indicators (failure to use autodisable syringes and greater tetanus coverage) are associated robustly with greater HIV prevalence. We recommend that resources be reallocated to address health care transmission of HIV/acquired immunodeficiency syndrome.Type: journal articleJournal: Annals of EpidemiologyVolume: 17Issue: 3
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PublicationPlausible and implausible parameters for mathematical modeling of nominal heterosexual HIV transmissionPurpose Several mathematical models simulate a HIV/AIDS epidemic by using the assumption that heterosexual transmission is the major or sole transmission mode. The validity of these models has been unclear. To understand the validity of these models, empirical estimates for relevant model parameters are needed that can be compared with parameters used in mathematical models. Methods A brief review of per-contact transmission probabilities based on HIV-discordant, monogamous couples is provided, and sources of bias in transmission efficiency estimates are discussed. Average number of partnerships and the distribution of partnerships are estimated for seven sub-Saharan African countries. Distribution parameters are fitted to the Poisson distribution, negative binomial distribution, and the discrete Pareto (Zipf) distribution, using the maximum likelihood method. The Pearson ?2 test statistic is used to measure goodness of fit, and the Akaike and Bayesian information criteria are also provided. To balance the reported number of partnerships, missing number of prostitutes is estimated. These empirical estimates for relevant model parameters are compared with parameters used in representative models of nominal heterosexual HIV transmission in Africa. Results Reported transmission efficiencies (unadjusted for competing exposures that inflate estimates) per sexual episode range from 0.0003 to 0.0012. Average number of partnerships is less than 1.5 in all countries. The discrete Pareto distribution fits the data better than the Poisson or negative binominal distribution. In almost all countries, female reported number of partners follows a discrete Pareto distribution. To close the sex disparity gap in number of partnerships, between 0.13% and 0.69% of the female population would need to be classified as prostitutes. Comparing these estimates with the parameter values used in existing mathematical models shows that existing models use grossly inflated per contact transmission efficiencies or rely on implausible assumptions regarding contact frequency, which results in implausibly high per-partner transmission rates. Assumptions regarding average number of partners are too high, and the distribution of partnerships is not supported by available data. As a consequence, existing mathematical models overestimate nominally heterosexually transmitted HIV infection in sub-Saharan Africa. Conclusions Existing models of nominal heterosexual HIV transmission for sub-Saharan Africa rely on assumptions inconsistent with empirical evidence. Simulations have not accurately portrayed the epidemiological situation in sub-Saharan Africa, and conclusions drawn from these models should be interpreted with great caution. To realistically simulate HIV spread in sub-Saharan Africa's general population nominally due to heterosexual HIV transmission, parameter values should be based on the most accurate data.Type: journal articleJournal: Annals of EpidemiologyVolume: 17Issue: 3
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PublicationType: journal articleJournal: International Journal of STD and AIDSVolume: 18Issue: 4