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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:

Improving access to drugs: Fitting the solution to the problem

Shanta Devarajan's picture

Patricio Marquez’s post correctly  identifies lack of access  to quality medicines as one of the  constraints to poor people’s health in Africa.    But the  solutions he recommends—more public money for “essential drugs benefits”, building  resilient institutions,  and providing  physicians  with better  scientific information  and guidelines  about  drug  prescriptions—are   unlikely   by    themselves  to   improve poor   people’s   health  outcomes.

More public money.  Patricio notes that out-of-pocket expenditures are about 40 percent of total health expenditures and most of this is spent on outpatient drugs.  He assumes the reason is that countries have not adopted a program of essential drugs benefits, and the reason for the latter is lack of public resources.  But consider the following facts. 

How can we improve access and get more value from drug expenditures in Africa?

Patricio V. Marquez's picture

Medicines are key inputs for quality medical care and the prevention of disease, and when administered appropriately, as evidence from Sub-Saharan African countries shows, they can contribute significantly to reducing death rates due to conditions such as HIV/AIDS, tuberculosis, and malaria.
 
But it is also obvious that not everybody in these countries, particularly the poor, enjoys this benefit, since limited access to essential drugs remains a key challenge in most health systems.  High out-of-pocket expenditures, typically more than 40% of total health expenditures in some countries (a large portion for outpatient drugs), also place a heavy burden on poor families with chronically ill members who require daily drug intake.

Tanzania: Water is life, but access remains a problem

Jacques Morisset'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.

There is no doubt about the importance of water to human existence. People need clean water to survive and stay healthy. Lack of clean water contributes to the high mortality rates in children around the world. Water is also critical to a country’s development as it is needed not only for agricultural productivity but also for industrial production. Yet access to water remains a major challenge in many countries. Tanzania has been blessed, both on the surface and below ground, with three times more renewable water resources than Kenya and 37 per cent more than Uganda.

Despite the vast amounts of fresh water available, many Tanzanians are still faced with water shortages due to insufficient capacity to access and store  it both in rural and urban areas. Few households have access to clean drinking water from a piped source. Only a small fraction of rural households can access water to irrigate their farms. The following statistics illustrate the magnitude of the problem:

African Debt since Debt Relief: How Clean is the Slate?

Mark Roland Thomas's picture

This blog post was co-authored with Dino Merotto, Tihomir Stucka, and Tau Huang. 

The benefits of debt relief have persisted, although some countries may now be borrowing too quickly.

Remember Jubilee 2000 and the HIPC Initiative? Remember the “Drop the Debt” and “One” movements in 2005? Live 8? Bono on the White House Lawn?  Those white “make poverty history” wristbands?

Seven years on, debt is now making headlines in the rich countries.  In Europe and the US the news is of sovereign debt downgrades amid speculation about capacity to rollover debts, and countries’ long-term fiscal capacity to repay. 

Country policy and institutional assessment: How well are African countries doing?

Punam Chuhan-Pole's picture

Every year, the World Bank’s country teams and sector experts assess the quality of IDA countries’ policy and institutional framework across 16 dimensions to measure their strenght and track progess.  

The latest country policy and institutional assessment (CPIA) results show that despite difficult global economic conditions, the quality of policies and institutions in a majority of Sub-Saharan African countries remained stable or improved in 2011.

DOWNLOAD the indicators here: www.worldbank.org/Africa/CPIA

For several countries the policy environment is the best in recent years. Of the 38 African countries with CPIA scores, 13 saw an improvement in the 2011 overall score by at least 0.1. Twenty countries saw no change, and five witnessed a decline of 0.1 or more. The overall CPIA score for the region was unchanged at 3.2.  

In short, despite a challenging global economic environment, African countries continued to pursue policies aligned with growth and poverty reduction. 

What will it take to end poverty in Africa?

Shanta Devarajan's picture

My colleague Jim Kim has launched a social media campaign on what it will take to end global poverty (please send your solutions via twitter to #ittakes.) I was reminded of a blog post I did about four years ago entitled “Ending poverty in Africa and elsewhere”. 

My answer then and now is:  Overcome government failure.  By “government failure,” I don’t mean that governments are evil or even that they are incompetent or ill-intentioned.  Analogous to “market failure,” government failure refers to a situation where the particular incentives in government lead to a situation that is worse than what was intended with the intervention.  

For instance, governments finance and provide primary education so that poor children can have access to learning.  But if teachers are paid regardless of whether they show up for work, and politicians rely on teachers to run their political campaigns, the result is absentee teachers and poor children who don’t know how to read or write—precisely the opposite of what was intended.  We see similar government failures in health care, water supply, sanitation, electricity, transport, labor markets and trade policy.

Africa’s Learning Crisis

Shanta Devarajan's picture

Hardly a week goes by without someone pointing out that, despite being enrolled in school, many of Africa’s primary school-age children don’t seem to be learning very much. 

Today’s salvo is from the Brookings Institution’s Center for Universal Education, whose Africa Learning Barometer estimates that 61 million children (half of the primary school-age population) “will reach their adolescent years without being able to read, write or perform basic numeracy tasks.”  

Last week, my colleagues Elizabeth King and Ritva Reinikka called on Africa’s education system to “put learning first for all students.”  We have documented disappointing learning outcomes in Tanzania on this blog.  Despite being a middle-income country and having substantially increased public spending on education, South Africa’s performance in standardized tests is below the average for African countries.

Kenya’s education dividend

Wolfgang Fengler's picture

Despite positive news and the talk of an African “renaissance,” many still doubt whether the continent is ready for take-off. Rapid population growth and the resulting “youth bulge” remain major concerns in a context of widespread un(der)employment. How can a country like Kenya create one million jobs each year, just to accommodate new entrants into the labor force? 

 

But young people don’t just need jobs, they also create them. Therefore, what matters most is to make sure that the education system delivers the skills needed in emerging economies, and incubates entrepreneurs. In turn, as people become more educated and healthier, they will have fewer children. This is already happening: As Kenya continues to welcome about a million new citizens each year, family size is slowly declining. 

Why are Kenyans still brilliant runners but disappointing footballers?

Wolfgang Fengler's picture

 When Churchill was asked for the secret of his long and healthy life, he famously quipped: “No sport!” (that was Winston, not Kenya’s beloved entertainer). The British PM would have been a poor ambassador for the London Olympics, which just ended in great fanfare.

Today, many would challenge his perspective. Obesity is a massive problem in rich societies and rapidly becoming one in emerging economies too. As a result, heart disease and diabetes are also on the rise.

But for me, sport means so much more than just personal fitness. I practiced Judo competitively as a child, which helped me to stay focused, taught me important life skills –especially teamwork— and formed friendships that have lasted until this day. My passion for sport has been reenergized in Kenya, where you can be outdoors all day long and all year round… much better than sitting in front of the TV (football games excepted).

But at the macro level, is sport also contributing to national development? Does it help or hurt in building a nation and growing an economy?

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