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The Costs of Inaction

Shanta Devarajan's picture

Sudhir Anand and co-authors recently published a fascinating book, The Costs of Inaction, which looks at cost-benefit analysis in a different way. All cost-benefit analysis requires the analyst to specify a counterfactual—how the world would have evolved in the absence of the project of program.  This is critical.  An evaluation in Kenya included increased use of cellphones as an indicator of project success — neglecting the fact that cellphone use in neighboring villages was just as widespread. 

In many cases, the counterfactual could be “doing nothing.”  For a number of important areas such as health and education in Africa, The Costs of Inaction calculates the costs of doing nothing in terms of lives lost or under-educated children. 

Has the African Growth Miracle Already Happened?

Shanta Devarajan's picture

Most of the literature about Africa’s growth, “Africa Rising”, “Lions on the Move”, etc., refer to the present or the future.  An oft-quoted World Bank report said, “Africa could be on the brink of an economic takeoff, much like China was 30 years ago and India 20 years ago.” 

Meanwhile, Alwyn Young has recently published a paper that claims that per-capita consumption on the continent has been growing at 3.4-3.7 percent a year for the last two decades—about three to four times the growth rates documented in other studies. Instead of using national accounts data (which, as we know, suffer from several deficiencies), Alwyn adopts the Demographic and Health Surveys (DHS), which calculate the households’ ownership of assets and other indicators of well-being (ownership of a car or bicycle; material of the house floor; birth, death or illness of a child, etc.). 

What is the best way to save one million lives?

David Evans's picture

Last October, the Government of Nigeria committed to save one million lives by 2015 by increasing access to cost-effective health services and commodities, a bold goal.

Crucially, the Federal Ministry of Health is coupling the scale-up of services and commodities with a focus on knowledge, using rigorous impact evaluation strategically and systematically across their programs (in partnership with the World Bank’s Development Impact Evaluation Unit and the Gates Foundation).  Each evaluation adapts promising evidence from elsewhere in the world to fit the Nigerian context, letting the Government and its partners see which interventions are most effective in saving lives.

Perilous pregnancies: How to improve maternal health in Tanzania?

Isis Gaddis's picture

Let's think together: Every Sunday the World Bank in Tanzania in collaboration with The Citizen wants to stimulate your thinking by sharing data from recent official surveys in Tanzania and ask you a few questions.

Pregnancy and childbirth can be a tremendously exciting time for a family if the expectant mother and her unborn child benefit from quality medical services and the baby is delivered in a safe environment. 

However, it can also be a traumatizing experience if the mother loses her life during childbirth or if the newborn is sick or dies. 

In Tanzania many mothers and mothers-to-be are dying young and unnecessarily as illustrated by the following statistics:

Old and vulnerable: The status of Tanzania’s elders

Jacques Morisset's picture

Let's think together: Every Sunday the World Bank in Tanzania in collaboration with The Citizen  wants to stimulate your thinking by sharing data from recent official surveys in Tanzania and ask you a few questions.

Growing old is almost a universal dream. Over the past two centuries, life expectancy in Western Europe increased from 32 (in 1800) to over 80 years in 2011. This unprecedented leap in human history came as the combination of technological advances in medicine, improved living conditions, and better nutrition, among other factors. However, old age is also often accompanied with a general deterioration in physical capacities, proneness to disease and sickness, and the inability to engage in economic activity. This heightens the risk of poverty and insecurity thereby requiring societies to find mechanisms to support their elderly population.

How does Africa fare? Findings from the Global Burden of Disease Study

Patricio V. Marquez's picture

The Global Burden of Disease Study 2010 (GBD 2010), a systematic effort to assess the global distribution and causes of major diseases, injuries, and health risk factors, was launched last week in London. 

And a special issue of The Lancet has published its results (http://www.thelancet.com/themed/global-burden-of-disease).

What are some of the main findings for Africa that can be drawn from the GBD 2010?

  • Since 1990, the largest gains in life expectancy worldwide occurred in sub-Saharan African countries, especially in Angola, Ethiopia, Niger and Rwanda, where life expectancy increased by 12-15 years for men and women. Overall, male life expectancy increased from 48.8 in 1990 to 53.2 years in 2010 in central sub-Saharan Africa, 50.9 to 59.4 years in eastern sub-Saharan Africa, and 53.0 to 57.9 years in western sub-Saharan Africa. 

Cervical Cancer Undermines Gender Equality in Africa

Patricio V. Marquez's picture

This blog post is co-authored with: Sheila Dutta

The 2012 World Development Report (WDR) “Gender Equality and Development” found that, while many disadvantages faced by women and girls have shrunk thanks to development, major gaps remain.

A significant gap is the excess female mortality in many low- and middle income countries, especially in childhood and during reproductive years. Cervical cancer —a preventable condition that usually results from a viral infection by the human papillomavirus (HPV) that is generally sexually transmitted— is one of the leading causes of premature death and ill health among women in sub-Saharan Africa.  As the figure shows, the Eastern, Western and Southern African regions have the highest incidence rates of cervical cancer in the world.  Rates exceed 50 per 100,000 populations and age-standardized mortality exceeds 40 per 100,000 populations. 

We want jobs, jobs, jobs

Isis Gaddis's picture

Let's think together: Every week the World Bank team in Tanzania wants to stimulate your thinking by sharing data from recent official surveys in Tanzania and ask you a couple of questions. This post is also published in the Tanzanian Newspaper The Citizen every Sunday.

Jobs are at the very heart of living. Families escape poverty when their members secure gainful employment, and societies flourish when labor markets offer a wide range of job opportunities to citizens. And there is more to jobs than just monetary benefits. Not having a job or working under unfavorable conditions is often associated with low individual life satisfaction. Youth unemployment, in particular, can undermine the foundations of social cohesion, especially in fragile countries with a legacy of civil unrest and conflict.

Living a long and healthy life – Africa and Kenya are only starting to catch up

Wolfgang Fengler's picture

Soon after I turned 40, I started experiencing back problems. I asked my brother for advice (he is a medical doctor) but didn’t quite like what I heard. “Sorry brother, our bodies are just not built for us to live much beyond 40…” he told me. If you take human evolution as a reference, he is right.

For the first 59,900 years of our existence (out of a total of 60,000), people used to live only into their 30s, at best. During the 1000 or so years that followed, there were some modest improvements raising life expectancy to 40 years. Things really changed only in the past 100 years on the backdrop of major medical and sanitation breakthroughs.

Invest in nutrition to invest in the future?

Janneke Hartvig Blomberg's picture

Let's think together: Every week the World Bank team in Tanzania wants to stimulate your thinking by sharing data from recent official surveys in Tanzania and ask you a couple of questions. This post is also published in the Tanzanian Newspaper The Citizen every Sunday.

Malnutrition has detrimental effects on a child's physical growth (stunting); it can also result in irreversible damage to their brain and mental development, and it increases their risk to illness and death. The biggest impact of malnutrition is seen in the first 1,000 days of life of a child's life - from the time of conception to the time they reach their second birthday.

For women, malnutrition increases risk during pregnancy and the delivery of low birth weight babies. Malnutrition is a serious issue in Tanzania as shown by the following statistics:

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