Although Sub-Saharan Africa has some of the worst nutrition indicators in the world, nutrition remains a low priority on the policy agendas of many African governments. This despite the fact that proven interventions are known and available and that investment in them is considered a cost-effective strategy for poverty reduction. This case study is one in a series seeking to understand (1) what keeps African governments from committing fully to reducing malnutrition, and (2) what is required for full commitment. It documents how the Ghanaian government has addressed the issue of malnutrition since Independence, examines what political and institutional factors have prevented full commitment, and identifies what conditions have moved the nutrition agenda forward at different points in time. The primary objective of this study as well as the series as a whole is to help African governments, development partners, and nutrition and health practitioners identify, understand and address the political and institutional obstacles preventing sustainable progress in nutrition.
This report is a part of larger welfare and social policy work agenda which the Turkish State Planning Organization and the World Bank are carrying out collaboratively. The work agenda includes the preparation of a number of conceptualized, and in part of co-authored, analytical studies on topics ranging from examines the equity determinants to investigating the links between poverty, employment creation, and growth. Further, the work agenda comprises a number of human development dialogues for which we are inviting international experts and practioners to share their experiences about social policy reforms with the Turkish government and the wider academic and non-governmental public. This report examines life chances. Life chances for today Turkish people, most importantly future generation, today's children. The results presented in this report show that life chances differ in important dimensions today, and that Turkey could immensely improve its human and economic development potential by maximizing such opportunities.
Capítulos en libros ; INTRODUCCIÓN: El baño es un cuidado esencial y básico para mantener la salud del recién nacido. OBJETIVOS: Determinar el conocimiento y la satisfacción de los padres/madres con el aprendizaje del baño del recién nacido recibido en atención primaria y especializada. MÉTODO: Ámbito: Atención Primaria de la Comunidad de Madrid. Diseño: Estudio descriptivo transversal. Sujetos participantes: Puérperas y Parejas que asisten a las consultas de atención primaria de matrona que cumplieran criterios de inclusión (ingreso hospitalario postparto superior a las 48 horas, tener buena comprensión del castellano y aceptar participar en el estudio). El tamaño de la muestra se determinó por estudio piloto en el que para la variable principal se estimó una variabilidad de 0,83 por lo que se eligió un tamaño de muestra de 200 participantes más un 10% de pérdidas, lo que da una muestra de N=220. El Índice de Confianza del 95% para un promedio, tendría una amplitud de +/- 0,087 puntos. Periodo de estudio: octubre 2017 a abril 2018. Instrumento: cuestionario de elaboración propia previamente validado de 27 variables agrupadas en 4 dimensiones: elementos de contexto, conocimiento teórico, conocimiento práctico, opinión y satisfacción. La aplicación se realizó en la consulta de la matrona de atención primaria en la primera semana de postparto. Análisis de datos: descriptivo y de técnicas de contraste para evaluar la asociación de las variables según los distintos niveles de medición (Coeficiente de correlación de Pearson, Χ2, t de Student y U de Mann-Whitney). Paquete estadístico SPSS v.20. Nivel de significación estadística p< 0.05. Consideraciones éticas: Se contemplan las directrices de la legislación vigente. RESULTADOS. De las 280 puérperas atendidas se ha aplicado el cuestionario a 220 puérperas y sus parejas que cumplen criterios de inclusión. De los elementos de contexto la edad media de los participantes fue de 36 años (D.S 5). Todos los participantes (madres/padres), tenían estudios (100%). La situación laboral fue de trabajo en el 86%. Para el 58% era su primer hijo. Conocimiento teórico: El conocimiento del baño del recién nacido de los padres se adquiere en un 84% a través del programa de Educación para la Maternidad/Paternidad y por experiencia previa en un 63%. Conocimiento práctico: Los recursos básicos que las madres/parejas precisan para el baño son: jabón y toalla (73%) y un 15% añade la esponja. Opinión: Las madres/parejas opinan que el primer baño lo deben realizar los padres en el hospital supervisados por un profesional (54%). Satisfacción: la satisfacción de las madres/parejas con el conocimiento del baño del recién nacido en una escala de 0 a 10 es superior a 8 en el 68% de los casos. DISCUSIÓN. Este trabajo se encuadra en la recomendación internacional de empoderar a los padres en los cuidados del recién nacido para disminuir la morbimortalidad infantil que promueve la Organización de la Salud en sus objetivos 2020. Los resultados del trabajo están en línea con los resultados del estudio de López (2014) en cuanto a conocimiento teórico, práctico y satisfacción. Con respecto a este estudio, la formación por la educación prenatal se ha incrementado significativamente de 49% a 84% (p< 0.05), frente a la formación hospitalaria que ha disminuido de 38% a 36%. Una de las limitaciones del estudio es la circunscripción de la muestra a un área de salud de una Comunidad, lo que es muy útil para los profesionales del distrito sanitario y para diseñar estrategias de mejora, pero los resultados no son extrapolables a toda la población. Se coincide con la recomendación internacional de seguir trabajando por el cuidado de la piel del recién nacido. IMPLICACIONES PARA LA PRÁCTICA. El estudio permite determinar el conocimiento y la satisfacción de las madres/parejas con el aprendizaje de un cuidado básico y esencial del recién nacido: el baño. Ello permite, en primer lugar, generar un espacio de reflexión ; INTRODUCTION: The bathroom is an essential and basic care to maintain the health of the newly born. OBJECTIVES: To determine the knowledge and satisfaction of parents with the Newborn bath learning received in primary and specialized care. METHOD: Scope: Primary Care of the Community of Madrid. Design: Cross-sectional descriptive study. Participating subjects: Puerperas and Couples attending the primary care consultations of midwife who met inclusion criteria (postpartum hospital admission greater than 48 hours, have a good understanding of Spanish and agree to participate in the study). The size of the Sample was determined by pilot study in which for the main variable an estimated variability of 0.83, so a sample size of 200 participants was chosen plus 10% of losses, which gives a sample of N = 220. The 95% Confidence Index for an average, It would have an amplitude of +/- 0.087 points. Study period: October 2017 to April 2018. Instrument: self-validated questionnaire previously validated of 27 grouped variables in 4 dimensions: context elements, theoretical knowledge, practical knowledge, opinion and satisfaction. The application was made in the consultation of the primary care midwife in the First week of postpartum. Data analysis: descriptive and contrast techniques for evaluate the association of the variables according to the different levels of measurement (Coefficient of Pearson's correlation, Χ2, Student's t and Mann-Whitney's U). SPSS statistical package v.20. Level of statistical significance p <0.05. Ethical considerations: The guidelines are contemplated of current legislation. RESULTS Of the 280 puerperal women treated, the questionnaire to 220 puerperal women and their partners that meet inclusion criteria. Of the elements in context the average age of the participants was 36 years (D.S 5). All participants (mothers / fathers), had studies (100%). The employment situation was work in 86%. For him 58% was his first child. Theoretical knowledge: Knowledge of the newborn's bath of the parents are acquired by 84% through the Maternity / Paternity Education program and by previous experience in 63%. Practical knowledge: The basic resources that Mothers / couples needed for bathing are: soap and towel (73%) and 15% add the sponge. Opinion: Mothers / couples think that the first bath should be done by the parents in the hospital supervised by a professional (54%). Satisfaction: the satisfaction of mothers / couples with the Newborn bath knowledge on a scale of 0 to 10 is greater than 8 in 68% of cases. DISCUSSION. This work is part of the international recommendation to empower parents in the care of the newborn to reduce infant morbidity and mortality that promotes the Health Organization in its 2020 goals. The results of the work are in in line with the results of the López study (2014) in terms of theoretical, practical and satisfaction. With regard to this study, training for prenatal education has been significantly increased from 49% to 84% (p <0.05), compared to hospital training that It has decreased from 38% to 36%. One of the limitations of the study is the circumscription of the shows a health area of a Community, which is very useful for district professionals health and to design improvement strategies, but the results are not extrapolated to all the population. It coincides with the international recommendation to continue working for the care of The skin of the newborn. IMPLICATIONS FOR PRACTICE. The study allows to determine the knowledge and satisfaction of mothers / couples with learning basic care and Newborn essential: the bathroom. This allows, first, to generate a space for reflection ; info:eu-repo/semantics/publishedVersion
Spatial inequality is an important feature of many developing countries that seems to increase with economic growth and development. At the same time, there seems to be little consensus on the causes of spatial inequality and on a list of effective policy instruments that may foster or reduce spatial inequality. This paper examines the theoretical and empirical literature on spatial inequality to learn what we know and do not know about the causes of spatial inequality, to investigate what policies may or may not ameliorate spatial inequality, and to determine whether policy makers can identify and implement policies that promote or reduce spatial inequality.
The Latin America and Caribbean (LAC) region is making progress in opening the doors of development to all. But it still has a long way to go. At the current pace, it would take, on average, a generation for the region to achieve universal access to the basic services that make for human opportunity. Intra-county regional disparities are large, and barely converging.This book assesses the status and evolution of human opportunity in LAC. It builds on the 2008 publication, "Measuring Inequality of Opportunity," in several directions. First, it uses newly-available data to expand the set of oppo
This report summarizes the results and lessons learned from the Technical Assistance (TA) Support to Rural Sanitation Scale Up under the Philippine National Sustainable Sanitation Plan. The TA was carried out by the World Bank's Water and Sanitation Program from July 2012 to March 2016, and is part of a larger programmatic assistance by the Bank to the Government of the Philippines in framing relevant institutional and financial reforms by key sector agencies and in strengthening the government's capacity to accelerate delivery of basic water and sanitation services particularly to the poor. This synthesis report provides recommendations to consolidate and accelerate the scaling up rural sanitation initiative focusing on priorities for World Bank engagement and alignment with the incoming government's overall strategic direction.
Latin America and the Caribbean (LCR) will be center stage in the global development debate as leaders from around the world convene in Lima, Peru for the annual meetings of the World Bank Group and International Monetary Fund. Critical progress in poverty reduction has been made in the region over the last decade. The region's bottom 40 percent of the population saw growth eclipsing that seen by the group in every other region in the world. However, a global slowdown in economic growth and activity challenges these positive strides. The stories in this report embody concrete successes of countries working together with the World Bank. Innovative development approaches were designed and implemented. Individuals, communities, countries, and even regions benefited from better health, education, governance, disaster risk management, and more.
After stagnating for much of its postcolonial history, economic performance in Sub?Saharan Africa has markedly improved. Since 1995, average economic growth has been close to 5 percent per year. Has Africa finally turned the corner? This paper analyzes growth accelerations and decelerations-that is, country level deviations from long?run trend growth. Seen from this perspective, Africa's record of slow and volatile growth reflects a pattern of offsetting accelerations and declines, and much of the improvement in economic performance in Africa post 1995 turns out to be due to a substantial reduction in the frequency and severity of growth decelerations. The fall in economic declines since 1995 is largely due to better macroeconomic policies, but changes in such 'growth determinants' as investment, export diversification, and productivity have not accompanied the growth boom. Lack of change in these variables and the significant role played by natural resources in sparking growth accelerations suggest that Africa's growth recovery was fragile, even before the recent global economic crisis. The paper concludes by setting out four elements of a strategy that can help move Africa from fewer mistakes to sustained growth: managing natural resources better, pushing nontraditional exports, building the African private sector, and creating new skills.
After stagnating for much of its postcolonial history, economic performance in Sub?Saharan Africa has markedly improved. Since 1995, average economic growth has been close to 5 percent per year. Has Africa finally turned the corner? This paper analyzes growth accelerations and decelerations-that is, country level deviations from long?run trend growth. Seen from this perspective, Africa's record of slow and volatile growth reflects a pattern of offsetting accelerations and declines, and much of the improvement in economic performance in Africa post 1995 turns out to be due to a substantial reduction in the frequency and severity of growth decelerations. The fall in economic declines since 1995 is largely due to better macroeconomic policies, but changes in such 'growth determinants' as investment, export diversification, and productivity have not accompanied the growth boom. Lack of change in these variables and the significant role played by natural resources in sparking growth accelerations suggest that Africa's growth recovery was fragile, even before the recent global economic crisis. The paper concludes by setting out four elements of a strategy that can help move Africa from fewer mistakes to sustained growth: managing natural resources better, pushing nontraditional exports, building the African private sector, and creating new skills.
Rapid growth since 1980 has transformed India from the world's 50th ranked economy in nominal U.S. dollars to the 10th largest in 2005. The growth of per capita income has helped reduce poverty. At the same time, evidence suggests that income inequality is rising and that the gap in average per capita income between the rich and poor states is growing. This paper reviews India's long term growth experience with a view to understanding the determinants of growth and the underlying political economy. The paper looks specifically at the political economy of India's growth transformation from a low-growth environment (pre-1980s) to a rapid-growth environment (post 1980s) and asks how sustainable is this transformation in view of concerns about regional disparity and income inequality. The paper concludes that the pledge that India's post-independence leadership had undertaken to abolish mass poverty remains only partially redeemed. Half the battle still lies ahead. Many more would like the fruits of the economic boom to come to them. The greatest challenge for India's policy makers today is to balance the growth momentum with inclusionary policies.
In 2010, the Municipality of Cuenca, through its environmental management commission (EMC), and the World Bank, through the environment and natural resources department, started a collaboration targeted towards strengthening EMC's capacity to better manage Cuenca's environmental assets and to provide EMC with hard evidence and data that will serve as departing point for decision-makers towards the formulation of public policy. Two main areas of focus were chosen: (i) costs of environmental degradation for Cuenca; and (ii) climate change impacts and resilience measures for Cuenca. This report describes the findings of the first area of focus. This report tries to capture the main results and to describe the assumptions and input data utilized, through a detailed step-by-step description of an internationally-accepted and validated methodology, an explanation of input data needs, equations used, assumptions made, and alternative calculation streams; and through the demonstration of this methodology as it is applied to the real case of air pollution in Cuenca. Analyses about the cost of environmental degradation are often used as an environmental priority-setting tool, because it gives the estimated socio-economic costs of environmental degradation (air pollution, inadequate water supply, sanitation, hygiene, and others). In this report, the methodology was used only for air pollution; similar studies can be replicated for other areas in order to have a full description of the different sources of pollution and the subsequent costs that Cuenca is subject to. Economic analysis (cost-benefit analysis) can be applied as a useful tool to prioritize among these interventions options with respect to their efficiency and cost effectiveness. Some policy reforms may also require to understand the political economy of reforms, for example, when taxi technology or bus technology of private firms is to be changed.
The authorities' determined implementation of stabilization measures over the past year has helped to avert a macroeconomic crisis. If the deterioration of the macroeconomic environment in 2010-11 was rapid, the improvement in the situation in the past twelve months has been equally swift. Regaining macroeconomic stability has been costly, but not stabilizing the economy would have led to even bigger losses. Real gross domestic product (GDP) growth has decelerated from 6.8 percent in 2010 to 5.9 percent in 2011, and further to 4 percent in the first quarter of 2012 as higher prices has lowered domestic demand, affecting sectors such as construction, manufacturing and utilities. Industrial production has slowed, inventory for key industrial products has accumulated, and a number of small and medium enterprises have either closed, been liquidated or temporarily suspended their operations. While the stabilization efforts may have contributed to a cyclical slowdown, Vietnam's trend growth rate has been on a downward path for the last 5-6 years, largely on account of the slow pace of structural reforms. Inefficiencies in state-owned enterprises, banks and public investments have been a drag on the country's long-term growth potential. With gains from macroeconomic stabilization still recent and fragile, especially in an external environment that is fraught with uncertainty, the government needs to be careful not to shift to an expansionary stance prematurely.
The objective of this study is to identify lessons for improving cookstoves in Bangladesh through an evaluation of existing programs, the international experience on improved stoves, and the lessons from successes in the sanitation sector. Bangladesh's new renewable energy policy endorses creating a better environment for renewable energy technologies and promoting market development for improved cookstoves (Government of Bangladesh 2009). This study supports this policy direction by examining possible strategies to move forward the development of markets for improved stoves in Bangladesh. The study consists of several components: a national review of household energy programs; an evaluation of national sanitation programs; and an examination of improved cookstove programs from around the world, including China, Guatemala, Haiti, Mongolia, Nepal, and Uganda. The study is based on published literature, consultations with organizations throughout Bangladesh, site visits, and structured discussions with beneficiaries and other stakeholders.
The FOAM (Focus on Opportunity, Ability, and Motivation) is a framework designed to help in the development, monitoring, and evaluation of handwashing behavior change programs. FOAM was developed for use in resource-poor settings, but it can also be adapted for other socioeconomic environments. This working paper is intended for use by program managers implementing handwashing behavior change initiatives, as well as multilateral and bilateral agencies, academic institutions, and government and nongovernmental organizations (NGOs) working in water and sanitation.
Despite its challenging circumstances, Bangladesh has proven to be remarkably resilient and achieved significant human development gains. The country partnership framework (CPF) will refocus the World Bank Group's (WBG's) strategic direction on removing stubborn impediments to job creation and growth. The CPF will build on a well-performing portfolio, particularly in human development, identified by the systematic country diagnostic (SCD) as foundational priorities which are important prerequisites to sustained growth. Engagements from the previous strategy that promote inclusive growth - notably in health, education, and social protection, as well as in revenue mobilization, financial sector support, and the business environment - will continue. The CPF will also give greater prominence to policy reforms and make policy dialogue an integral building block in the country program. The CPF considers three selectivity criteria: (i) consistency with the government's seventh five year plan to ensure strong country ownership; (ii) alignment with policy priorities identified in the SCD, in particular the five transformational priorities to achieve the greatest impact on poverty reduction and shared prosperity; and (iii) the WBG comparative advantage, taking into account the knowledge and financing support provided by other development partners. The activities in the CPF are structured around three focus areas consistent with the South Asia regional strategy - growth, social inclusion, and climate and environmental management.
