Ashish Bajracharya

Bio: Ashish Bajracharya is an academic researcher from Population Council. The author has contributed to research in topics: Reproductive health & Population. The author has an hindex of 13, co-authored 30 publications receiving 694 citations. Previous affiliations of Ashish Bajracharya include Cornell University.

Factors associated with HIV testing among young men who have sex with men in Myanmar: A cross-sectional study

Abstract: Introduction In Myanmar, men who have sex with men (MSM) experience high risk of HIV infection. However, access to HIV testing and prevention services remains a challenge among this marginalized population. The objective of this study was to estimate population prevalence and correlates of prior HIV testing among young MSM (YMSM) and informs the development of HIV testing and intervention programmes that respond to the specific needs of this population. Methods Five hundred and eighty-five YMSM aged 18 to 24 years were recruited using respondent-driven sampling (RDS) in a cross-sectional survey conducted in six townships of Myanmar. RDS-adjusted population estimates were calculated to estimate prevalence of HIV testing; RDS-weighted logistic regression was used to examine correlates of HIV testing in the past 6 months and in a lifetime. Results There were 12 participants who reported receiving a HIV-positive test; of those, five were tested in the past 6 months. The RDS-weighted prevalence estimates of lifetime (any prior) HIV testing was 60.6% (95% CI: 53.3% to 66.4%) and of recent (≤ 6 months) HIV testing was 50.1% (95% CI: 44.1% to 55.5%). In multivariable analysis, sexual identity was associated with lifetime but not recent HIV testing. Lifetime and recent HIV testing were associated with having three or more male sexual partners in the past 12 months (adjusted ORs (aORs) = 2.28, 95% CIs: 1.21 to 4.32 and 2.69, 95% CI: 1.59 to 4.56), having good HIV-related knowledge (aORs = 1.96, 95% CIs: 1.11 to 3.44 and 1.77, 95% CI: 1.08 to 2.89), reporting high HIV testing self-efficacy (aORs = 13.5, 95% CIs: 6.0 to 30.1 and 9.81, 95% CI: 4.27 to 22.6) and having access to and use of non-HIV health-related services in the past 12 months (aORs = 13.2, 95% CIs: 6.85 to 25.6 and 7.15, 95% CI: 4.08 to 12.5) respectively. Conclusions HIV testing coverage among YMSM aged 18 to 24 years old in Myanmar is still suboptimal. Integrated HIV testing and prevention services in existing health service provision systems with tailored HIV information and education programmes targeting YMSM to improve HIV-related knowledge and self-efficacy may help to promote regular HIV testing behaviour and contribute to sustainable control of the HIV epidemic among this marginalized population in Myanmar.

The Role of Grandparents in the Lives of Youth

Abstract: Recent demographic trends suggest that grandparents may play influential roles in the lives of their grandchildren. Despite this, the role of grandparents in the lives of youth remains an understudied topic. Using data from a nationally-representative group of youth aged 14–19 from the 1992 Wave Two National Survey of Families and Households (NSFH), this study seeks to better understand the role of grandparents in the lives of grandchildren by examining which factors predict the quality of the grandparent-grandchild relationship, and what the implications of this relationship are for youth. Key factors influencing the quality of the grandparent-grandchild relationship are distance, the parent’s relationship with both the grandparent and the child, and age of both the child and parent. Results do not support the hypothesis that grandparents influence the dimensions of youth well-being examined here.

Maternal working conditions and child well-being in welfare-leaving families.

Abstract: In the wake of welfare reform, thousands of low-income single mothers have transitioned into the labor market. In this article, the authors examine how the work conditions of mothers leaving welfare for employment are associated with the emotional well-being of 372 children ages 5 to 15 years. The authors examine the cumulative incidence, over a 5-year period, of maternal non-family-friendly work conditions, including long work hours, erratic work schedules, nonday shifts, and lengthy commute times, in association with children's internalizing and externalizing behavior problems and levels of positive behavior. The authors found that mothers' lengthy commute times are associated with higher levels of internalizing problem behaviors and lower levels of positive behaviors.

Microcredit and Domestic Violence in Bangladesh: An Exploration of Selection Bias Influences

Abstract: This article explores the relationship between women's participation in microcredit groups and domestic violence in Bangladesh. Several recent studies have raised concern about microcredit programs by reporting higher levels of violence among women who are members. These results, however, may be attributable to selection bias because members might differ from nonmembers in ways that make them more susceptible to violence to begin with. Using a sample of currently married women from the 2007 Bangladesh Demographic Health Survey (BDHS) (N = 4,195), we use propensity score matching (PSM) as a way of exploring selection bias in this relationship. Results suggest that the previously seen strong positive association between membership and violence does not hold when an appropriate comparison group, generated using PSM, is used in the analyses. Additional analyses also suggest that levels of violence do not differ significantly between members and nonmembers and instead could depend on context-specific factors related to poverty. Members for whom a match is not found report considerably higher levels of violence relative to nonmembers in the unmatched group. The background characteristics of members and nonmembers who do not match suggest that they are more likely to be younger and from relatively well-to-do households.

Family Planning Vouchers in Low and Middle Income Countries: A Systematic Review.

Abstract: Family planning (FP) vouchers have targeted subsidies to disadvantaged populations for quality reproductive health services since the 1960s. To summarize the effect of FP voucher programs in low- and middle-income countries, a systematic review was conducted, screening studies from 33 databases through three phases: keyword search, title and abstract review, and full text review. Sixteen articles were selected including randomized control trials, controlled before-and-after, interrupted time series analyses, cohort, and before-and-after studies. Twenty-three study outcomes were clustered around contraceptive uptake, with study outcomes including fertility in the early studies and equity and discontinuation in more recent publications. Research gaps include measures of FP quality, unintended outcomes, clients' qualitative experiences, FP voucher integration with health systems, and issues related to scale-up of the voucher approach.

A Treatise on the Family

Abstract: A Treatise on the Family. G. S. Becker. Cambridge, MA: Harvard University Press. 1981. Gary Becker is one of the most famous and influential economists of the second half of the 20th century, a fervent contributor to and expounder of the University of Chicago free-market philosophy, and winner of the 1992 Nobel Prize in economics. Although any book with the word "treatise" in its title is clearly intended to have an impact, one coming from someone as brilliant and controversial as Becker certainly had such a lofty goal. It has received many article-length reviews in several disciplines (Ben-Porath, 1982; Bergmann, 1995; Foster, 1993; Hannan, 1982), which is one measure of its scholarly importance, and yet its impact is, I think, less than it may have initially appeared, especially for scholars with substantive interests in the family. This book is, its title notwithstanding, more about economics and the economic approach to behavior than about the family. In the first sentence of the preface, Becker writes "In this book, I develop an economic or rational choice approach to the family." Lest anyone accuse him of focusing on traditional (i.e., material) economics topics, such as family income, poverty, and labor supply, he immediately emphasizes that those topics are not his focus. "My intent is more ambitious: to analyze marriage, births, divorce, division of labor in households, prestige, and other non-material behavior with the tools and framework developed for material behavior." Indeed, the book includes chapters on many of these issues. One chapter examines the principles of the efficient division of labor in households, three analyze marriage and divorce, three analyze various child-related issues (fertility and intergenerational mobility), and others focus on broader family issues, such as intrafamily resource allocation. His analysis is not, he believes, constrained by time or place. His intention is "to present a comprehensive analysis that is applicable, at least in part, to families in the past as well as the present, in primitive as well as modern societies, and in Eastern as well as Western cultures." His tone is profoundly conservative and utterly skeptical of any constructive role for government programs. There is a clear sense of how much better things were in the old days of a genderbased division of labor and low market-work rates for married women. Indeed, Becker is ready and able to show in Chapter 2 that such a state of affairs was efficient and induced not by market or societal discrimination (although he allows that it might exist) but by small underlying household productivity differences that arise primarily from what he refers to as "complementarities" between caring for young children while carrying another to term. Most family scholars would probably find that an unconvincingly simple explanation for a profound and complex phenomenon. What, then, is the salient contribution of Treatise on the Family? It is not literally the idea that economics could be applied to the nonmarket sector and to family life because Becker had already established that with considerable success and influence. At its core, microeconomics is simple, characterized by a belief in the importance of prices and markets, the role of self-interested or rational behavior, and, somewhat less centrally, the stability of preferences. It was Becker's singular and invaluable contribution to appreciate that the behaviors potentially amenable to the economic approach were not limited to phenomenon with explicit monetary prices and formal markets. Indeed, during the late 1950s and throughout the 1960s, he did undeniably important and pioneering work extending the domain of economics to such topics as labor market discrimination, fertility, crime, human capital, household production, and the allocation of time. Nor is Becker's contribution the detailed analyses themselves. Many of them are, frankly, odd, idiosyncratic, and off-putting. …

Micro-credit initiatives for equitable and sustainable development : who pays?; a case study of the Grameen Bank Program in rural Bangladesh

Abstract: Abstract There is a growing acknowledgement that micro-credit programs have potential for equitable and sustainable development. However, my anthropological research on the micro-credit program of the Grameen Bank shows that bank workers are expected to increase disbursement of loans among their members and press for high recovery rates to earn profit necessary for economic viability of the institution. To ensure timely repayment in the loan centers bank workers and borrowing peers inflict an intense pressure on women clients. In the study community many borrowers maintain their regular payment schedules through a process of loan recycling that considerably increases the debt-liability on the individual households, increases tension and frustration among household members, produces new forms of dominance over women and increases violence in society.

Defining and conceptualizing workplace flexibility

Abstract: We first compare and contrast current conceptualizations of workplace flexibility in order to arrive at a definition in harmony with its contemporary use: ‘the ability of workers to make choices influencing when, where, and for how long they engage in work-related tasks’. Next, we situate workplace flexibility in its theoretical contexts to provide researchers with a clearer understanding of what workplace flexibility is, what its mechanisms of operation are, and why it may be related to other concepts. Finally, we present a conceptual framework of antecedents and consequences of workplace flexibility, including illustrative examples of several basic associations from the peer-reviewed literature.

FURSTENBERG, Frank F. Jr., Thomas D. COOK, Jacquelynne ECCLES, Glen H. ELDER, Jr., and Arnold SAMEROFF, MANAGING TO MAKE IT: Urban Families and Adolescent Success

Abstract: FURSTENBERG, Frank F Jr., Thomas D. COOK, Jacquelynne ECCLES, Glen H. ELDER, Jr., and Arnold SAMEROFF, MANAGING TO MAKE IT: Urban Families and Adolescent Success. Chicago, IL: The University of Chicago Press, 1999, 305 pp., $ 32.50 hardcover / $17.00 softcover. When five academics get together to write a book, one might expect that it would never be published: it would take forever for them to agree on anything. This book on families and neighborhoods, however, shows the positive benefits of such collaboration. Very well written and methodologically sound, it provides the reader with plenty of quantitative information, peppered with illustrative examples from in-depth qualitative interviews. The central theme of the book is how parents, especially poor and working class parents, manage the resources available to them to protect their children and promote their chances of success. The book is centered on research conducted in the inter city neighborhood of Philadelphia in the early 1990s and is divided into ten chapters, each of which covers an important aspect of studying the family. The first chapter of the book outlines the authors' theoretical perspective. Chapter two describes how the areas studied were selected and provides details of the sample. Chapter three explores the measurements of adolescent success for the subjects of this study. Chapter four looks at parental management strategies. Parents employ preventative strategies to manage risk in order to protect their children from harm. At the same time, parents seek opportunities to develop and promote their children's abilities. Neighborhoods have significant effects on the use of preventative measures, such as monitoring and discipline. Parents in low-resource neighborhoods are faced with greater levels of risk for their children, so they are forced to put more emphasis on risk management in order to protect their children. This in turn has an effect on the ability of adolescents in these areas to develop their sense of autonomy. Chapter five explores how parenting efforts affect behaviors of disadvantaged adolescents. Chapter six addresses an additional consideration of the impact of parenting on adolescent competence by questioning the effect of parental and household resources on adolescent wellbeing. Chapter seven explores how neighborhood characteristics are related to family management and consequently adolescent success. Chapter eight addresses issues of how to identify high-risk environments and family management practices that may mitigate the consequences of unfavorable conditions on the success of adolescents - referred to as a `risk-and-resiliency' framework. It is suggested that the adolescent period of an individual's life is frequently marked by opportunities to improve skills and may also be fraught with setbacks. Evidence in prior chapters of the book suggests that the advantages and disadvantages experienced by youths and families tend to accumulate over time, ensuring a level of continuity in life experiences. …

Factors associated with HIV testing among young men who have sex with men in Myanmar: A cross-sectional study

Abstract: Introduction In Myanmar, men who have sex with men (MSM) experience high risk of HIV infection. However, access to HIV testing and prevention services remains a challenge among this marginalized population. The objective of this study was to estimate population prevalence and correlates of prior HIV testing among young MSM (YMSM) and informs the development of HIV testing and intervention programmes that respond to the specific needs of this population. Methods Five hundred and eighty-five YMSM aged 18 to 24 years were recruited using respondent-driven sampling (RDS) in a cross-sectional survey conducted in six townships of Myanmar. RDS-adjusted population estimates were calculated to estimate prevalence of HIV testing; RDS-weighted logistic regression was used to examine correlates of HIV testing in the past 6 months and in a lifetime. Results There were 12 participants who reported receiving a HIV-positive test; of those, five were tested in the past 6 months. The RDS-weighted prevalence estimates of lifetime (any prior) HIV testing was 60.6% (95% CI: 53.3% to 66.4%) and of recent (≤ 6 months) HIV testing was 50.1% (95% CI: 44.1% to 55.5%). In multivariable analysis, sexual identity was associated with lifetime but not recent HIV testing. Lifetime and recent HIV testing were associated with having three or more male sexual partners in the past 12 months (adjusted ORs (aORs) = 2.28, 95% CIs: 1.21 to 4.32 and 2.69, 95% CI: 1.59 to 4.56), having good HIV-related knowledge (aORs = 1.96, 95% CIs: 1.11 to 3.44 and 1.77, 95% CI: 1.08 to 2.89), reporting high HIV testing self-efficacy (aORs = 13.5, 95% CIs: 6.0 to 30.1 and 9.81, 95% CI: 4.27 to 22.6) and having access to and use of non-HIV health-related services in the past 12 months (aORs = 13.2, 95% CIs: 6.85 to 25.6 and 7.15, 95% CI: 4.08 to 12.5) respectively. Conclusions HIV testing coverage among YMSM aged 18 to 24 years old in Myanmar is still suboptimal. Integrated HIV testing and prevention services in existing health service provision systems with tailored HIV information and education programmes targeting YMSM to improve HIV-related knowledge and self-efficacy may help to promote regular HIV testing behaviour and contribute to sustainable control of the HIV epidemic among this marginalized population in Myanmar.