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Financial incentives in health: the magic bullet we were hoping for?

Adam Wagstaff's picture

After years of bad news from developing countries about high rates of health worker absenteeism, and low rates of delivery of key health interventions, along came what seemed like a magic bullet: financial incentives. Rather than paying providers whether or not they show up to work, and whether or not they deliver key interventions, doesn’t it make sense to pay them—at least in part—according to what they do? And if, after doing their cost-benefit calculations, women decide not to have their baby delivered in a health facility, not to get antenatal care, and not take their child to be immunized, then doesn’t it make sense to try to change the benefit-cost ratio by paying them to do so?

Part of the #Youthbiz movement? Share your story!

Valerie Lorena's picture

Also available in: Français | العربية

A boat trip from Port Elizabeth to Kingstown, in the Caribbean country of Saint Vincent and the Grenadines, is a one-hour trip that locals take several times a day. It was during one of these journeys that the boat of Kamara Jerome, a young Vincentian fisherman, ran out of gas six miles from Bequia City in what is termed locally as the "Bequia Channel." While waiting for help with strong wind gusts and the sun on his head, the idea of developing a boat that would run with wind and solar energy was born. Soon after, the idea became a prototype; a boat using green technology was on the water making 20-year-old Jerome a winner of international innovation competitions and a role model to other Caribbean youth. 
In Mexico, young engineer Daniel Gomez runs a multimillion bio-diesel company originally conceived as a research project for his high school chemistry class. Gomez and his partners - Guillermo Colunga, Antonio Lopez, and Mauricio Pareja - founded SOLBEN (Solutions in bio-energy in Spanish) in their early twenties. 
Although Daniel and Kamara have different educational backgrounds, they do share one important skill, the ability to identify a problem, develop an innovative solution, and take it to the market. In other words, being an entrepreneur, an alternative to be economically active, that seems to work and not only for a few.

The case for inclusive green growth

Sri Mulyani Indrawati's picture
Women fishers in Ghana. (Andrea Borgarello/World Bank - TerrAfrica)

Over the last 20 years, economic growth has helped to lift almost a billion people out of extreme poverty. But 1 billion people are still extremely poor. 1.1 billion live without electricity and 2.5 billion people without access to sanitation. For them, growth has not been inclusive enough.

In addition, growth has come at the expense of the environment. While environmental degradation affects everyone, the poor are more vulnerable to violent weather, floods, and a changing climate.

Development experts, policymakers, and institutions like the World Bank have learned a major lesson: If we want to succeed in ending poverty, growth needs to be inclusive and sustainable.

Now is the time to strengthen disaster risk reduction in East Asia and the Pacific

Axel van Trotsenburg's picture
In PDF: Korean | Khmer

Every time I learn of another natural disaster – the people killed and injured, homes destroyed, livelihoods lost – I know we must act to reduce the tragic impact instead of waiting for the next disaster strikes.

We have that chance with this year’s World Conference on Disaster Risk Reduction in Sendai, which seeks to finalize the successor to the Hyogo Framework for Action (HFA2) that guides policymakers and international stakeholders in managing disaster risk. The conference is an opportunity to set new milestones in disaster risk reduction and fighting poverty.

The cost of natural disasters already is high – 2.5 million people and $4 trillion lost over the past 30 years with a corresponding blow to development efforts.

In Asia, rapid urbanization combined with poor planning dramatically increases the exposure of cities, particularly those along densely populated coasts and river basins. Typhoon Haiyan, which killed more than 7,350 people in the Philippines in 2013, directly contributed to a 1.2 percent rise in poverty.

Despite expectations, cities in East Asia are becoming denser

Chandan Deuskar's picture
When we think of urban expansion in the 21st century, we often think of ‘sprawl’, a term that calls to mind low-density, car-oriented suburban growth, perhaps made up of single-family homes. Past studies have suggested that historically, cities around the world are becoming less dense as they grow, which has prompted worries about the environmental impacts of excess land consumption and automobile dependency. A widely cited rule of thumb is that as the population of a city doubles, its built area triples. But our new study on urban expansion in East Asia has yielded some surprising findings that are making us rethink this assumption of declining urban densities everywhere.

Tracking Urbanization: How big data can drive policies to make cities work for the poor

Axel van Trotsenburg's picture

Every minute, dozens of people in East Asia move from the countryside to the city.
The massive population shift is creating some of the world’s biggest mega-cities including Tokyo, Shanghai, Jakarta, Seoul and Manila, as well as hundreds of medium and smaller urban areas.

This transformation touches on every aspect of life and livelihoods, from access to clean water to high-speed trains that transport millions of people in and out of cities during rush hour each weekday.

Why Choosing the Preferred Sanitation Solution Should Be More Like Grocery Shopping

Guy Hutton's picture

When we go to the supermarket, our decision-making is considerably aided by having the price, ingredients and source of goods clearly labeled. This allows us to rapidly compare the characteristics, perceived benefits, and price of different products to make what is usually an informed and instantaneous purchase decision. 

When it comes to making investment choices for public programs, we do not traditionally have the same luxury of information. The full benefits and costs of those interventions, including the long-term costs to maintain and operate a service, are rarely understood or taken into account in the decision. As a result, public decisions are usually made based on the most visible costs (capital investment required from the public budget), historical choices and the political process. 

Bangladesh and Cambodia Collaborate on Higher Education Development

Shiro Nakata's picture
The Cambodian Delegation Visiting the Veterinary and Animals Science University in Chittagong on September 2, 2014

Global partnerships often inspire higher education development. Partnerships were traditionally formed between universities in developed and developing countries. Increasingly important, however, are university partnerships across emerging economies where the common challenges of increasing access and ensuring quality are shared. Tested solutions and good practices may be applicable to address similar challenges in another country. Against this backdrop, there has been a close cross-country collaboration between the Higher Education Quality and Capacity Improvement Project (HEQCIP) in Cambodia and the Higher Education Quality Enhancement Project (HEQEP) in Bangladesh since 2010. Inspired by the success stories of HEQEP in recent years, a Cambodian delegation working for HEQCIP visited Bangladesh from August 30 to September 4, 2014 to learn from the experience of the HEQEP, which has had a few years head-start on implementing a competitive research grant program for universities.

Do we have any idea how to get kids into school?

Donald Baum's picture
 Arne Hoel/ World Bank
In the seven years between 2000 and 2007, the world undertook a massive push to increase enrollments for all children in primary school. This organized effort was successful in reducing the worldwide number of out-of-school children by 40%. Surely, for many, the hope (and even the expectation) at that time was for a fast-approaching elimination of this global dilemma.
So, what of our progress in the last seven years?

Tariffs for Standards?

Hassan Zaman's picture

Bangladesh Duty- and quota-free access for exports to global markets is something developing country trade negotiators have demanded for years.  Few other “stroke-of-the-pen” measures could boost employment and reduce poverty in low income countries in such large numbers. For instance  if the US removed tariffs on Bangladeshi garments – which average around 13%, but for some items are as high as 33% – then exports to the US could rise by  $1.5 billion from the FY13 level of $5 billion, in turn generating employment for at least an additional half a million, primarily female, workers.[1]  Examples of other countries facing US tariffs include Cambodia (12.8% average tariff rate on its exports to the US), India (4.01%), Indonesia (5.73%), and Vietnam (7.41%). Progress in trade facilitation would likely have even greater pay-offs to growth and employment, but these require structural reforms and investments, while the decision to remove tariffs is a simpler, “stroke-of-the-pen” measure.