New publications

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• Measuring health-related quality of life measures in children: lessons from a pilot study - with Sarah Abraham, Elizabeth Edginton, David Cottrell. Research in Psychotherapy, Psychopathology, Process and Outcome [Published May 2022] Available here

There is a debate in the health outcomes literature regarding who the most appropriate respondent is when assessing children's health-related quality of life (HRQoL). In some cases, parent-proxy may be the only practical option where children are unable to self-complete an HRQoL questionnaire. However, children's self-reported values may be preferable because HRQoL is subjective and represents the respondent own perception of health. We collected the youth version of the EQ-5D-3L as part of a feasibility study comparing psychoanalytic child psychotherapy with usual care for children aged 5-11 years with treatment resistant conduct disorders. The questionnaires were completed at baseline and 4-month follow-up by the child via face-to-face researcher administration, and by one parent as a proxy respondent. Children and primary carers were mostly concordant regarding overall child's health. Parents reported more problems in 'doing usual activities' and 'feeling worried, sad or unhappy' and fewer problems with 'pain' and 'looking after oneself' than children did. The reports regarding 'mobility' were very similar between children and proxy-respondents. The assessment of quality of life by children using self-report questionnaires is possible with the help of a face-to-face researcher, providing evidence that children should be asked to self-complete HRQoL questionnaires in trial studies.

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• Locus of control and self-esteem as predictors of maternal and child healthcare services utilization in Nigeria - with Josephine Aikpitanyi, Friday Okonofua, Lorretta Favour C. Ntoimo. Frontiers in Health Services, section Cost and Resource Allocation, [Published 28th April 2022] Available here

Do psychological traits matter for healthcare utilisation? In this study we investigate the influence of locus of control and self-esteem on the utilization of maternal and child healthcare services in Nigeria. We explore the differences in utilization of antenatal care, skilled birth care, postnatal care, and child vaccination by women having internal and external locus of control and women having high and low self-esteem. We collected information on non-cognitive traits of 1,411 randomly selected women along with information on utilization of various indicators of maternal and child healthcare services. We found that women's internal locus of control is a significant predictor of utilization of antenatal care, skilled birth care and completion of child vaccination. We also found that having a high self-esteem is a significant predictor of utilization of antenatal care, postnatal care and completion of child vaccination after adjusting for other control variables.

Our findings offer important insights for enhancing participants' engagement in intervention programs that are initiated to improve maternal and child health outcomes in lower-middle-income countries.​

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• Searching for sustainability in health systems: Toward a multidisciplinary evaluation of mobile health innovations - with Florence Degavre, Suzanne Kieffer, David Bol, Rémi Dekimpe, Charlotte Desterbecq, Thibault Pirson, Georgiana Sandu. Sustainability [Published 27 April 2022] Available here

Mobile health (mHealth) innovations are considered by governments as game changers toward more sustainable health systems. However the evaluation of mHealth innovations mainly focuses on the clinical aspects and lacks an integrated framework on its sustainability. In this paper, we propose to include disciplinary complementarities into a multi-dimensional vision to evaluate the non-clinical aspects of mHealth innovations. We performed a targeted literature review to find how the sustainability of mHealth innovations was appraised in each discipline and identify some of the challenges ahead of researchers working on mobile health innovations in contributing to shaping a more sustainable health system.​

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• Rationing of a scarce life-saving resource: Public preferences for prioritizing COVID-19 vaccination - with Jeroen Luyten and Roselinde Kessels. Health Economics, Volume 31, Issue 2, February 2022, Pages 342-362 [initially available as CEPR Covid Economics Issue 57 November 2020 here]

In the face of limited COVID-19 vaccine supply, governments have had to identify priority groups for vaccination.

In this paper we present the results of a discrete choice experiment and a best-worst ranking exercise we conducted on a representative sample of 2060 Belgians in order to elicit their views on how to set fair vaccination priorities.

We found that when asked directly, our respondents prioritized essential workers, the elderly or those with pre-existing conditions. However, priorities changed when elicited indirectly through observing choices between pairs of individuals competing for a vaccine. The elderly were given lower priority and respondents divided within two clusters. One cluster (N = 1058) primarily wanted to target virus spreaders in order to control transmission whereas the other cluster (N = 886) wanted to prioritize those who were most at risk because of a pre-existing health condition. ​

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• Measuring educational inequality of opportunity: pupil’s effort matters - with Niaz Asadullah, Alain Trannoy, and Gaston Yalonetzky. World Development Volume 138, February 2021, 105262. Available here

​In this paper, we use original data from secondary schools in rural Bangladesh that provide us with a comprehensive view of the importance of overall effort when measuring inequalities of opportunity in education. We decompose the predicted variance of student performance in mathematics and English by source (effort, circumstances, etc.) and subgroup (within- and between-schools) using parametric estimates of educational production functions. We found that pupils’ effort, preferences, and talents contribute between 31% and 40% of the total predicted variances in performance scores. The contribution of overall effort falls by 10% when the correlation between effort and circumstances is taken into account. These findings are robust to the choice of estimation strategy (i.e. combined within- and between-schools variation models versus multilevel random-effect models). All in all, these results advocate that social determinism in education can be mitigated by individual effort at school.

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• Inequality of opportunities in health and death: an investigation from birth to middle age in Great Britain - with Damien Bricard, Florence Jusot and Alain Trannoy. Available in International Journal of Epidemiology, Volume 49, Issue 5, October 2020, Pages 1739–1748. Available here

We use data from the 1958 National Child Development Study and observe individual health from birth to the age of 54, including premature death.

We compare and test the differences between the cumulative distribution functions of health status at each age according to the father’s occupation. At all ages, individuals born to a ‘professional’, ‘senior manager or technician’ father report a better health status and have a lower mortality rate than individuals born to ‘skilled’, ‘partly skilled’ or ‘unskilled’ manual workers and individuals without a father at birth. The gap in the probability to report good health between individuals born into high social backgrounds compared with low, increases from 12 percentage points at age 23 to 26 percentage points at age 54.

Health gaps are even more marked in health states at the bottom of the health distribution when mortality is combined with self-assessed health. There is increasing inequality of opportunities in health over the lifespan in Great Britain. The tag of social background intensifies as individuals get older.