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Africa

When elephants fight, it is the grass that suffers

Mark Moseley's picture


Photo: shplendid | Flickr Creative Commons

Talk of trade tariffs and heightened geopolitical tensions are dominating news headlines recently. As developed economies consider escalating protectionist policies, it’s easy to forget about the situation many emerging markets face.

As outlined in the World Bank’s Global Economic Prospects report released in June this year, protectionist policies would affect emerging market and developing economies (EMDEs) more severely than advanced economies. And this is at a time where increased investment and spending in EMDEs, including in infrastructure, is sorely needed.

How innovative financing can support entrepreneurship and sustainable livelihoods

Michelle Kaffenberger's picture
A fruit and vegetable stand in Kampala. Photo: Arne Hoel / World Bank

According to The Africa Competitiveness Report 2017, Africa is forecasted to produce just 100 million new jobs by 2035, while the working age population is projected to grow by more than 450 million. The fastest population growth will occur in the 15 to 35-year-old demographic.  This growing working-age population presents both an opportunity and a potential risk to Africa’s future prosperity. To ensure these new workers engage in productive livelihoods and prevent significant increases in extreme poverty and civil unrest, governments will need to enable job creation, including scaling cost-effective livelihood development programs targeting the extreme poor. Described below is a cost-effective approach which is yielding promising results and scaling through results-based financing.

Why are people dying following surgery in Africa?

Bruce Biccard's picture

Surgery is a core component of health. It is a cost-effective intervention1 which is important for global health.2 However, to fully realize the health benefits of surgery, it needs to be safe. In the African continent—with a population of 1.2 billion people—it is estimated that approximately 95% do not have access to safe and affordable surgery. The Lancet Commission on Global Surgery has established six indicators to indicate the success of providing access to safe and affordable surgery.3 Four of them are included in the World Bank’s World Development Indicators (WDI) database. The perioperative mortality rate (POMR)—the number of in-hospital deaths from any cause in patients who have undergone a procedure done in an operating theatre, divided by the total number of procedures—is one of the indicators the success in achieving safe surgery, yet it is not included in the WDI as the data is sparse, including the one from Africa. The recent publication of the African Surgical Outcomes Study (ASOS) has cast an important light on the POMR in Africa.4

ASOS has shown that for patients in Africa fortunate enough to access surgical care, the patient outcomes following surgery are relatively poor. ASOS demonstrated that African surgical patients were twice as likely to die following surgery when compared to the global average, despite a similar complication rate to the global average (Table 1). This is despite the fact that surgical patients in Africa are relatively healthy when compared with similar international surgical patient cohorts,5 and one would thus expect them to do well postoperatively. Therefore, if the data from ASOS had been risk-adjusted for patient comorbidities, it is likely that the mortality following surgery in Africa is more than twice the global average. The results from ASOS are compelling as they provide comprehensive data on surgical outcomes in Africa, from 25 countries, 247 hospitals, and over 11,000 patients.

Table 1. Mortality, complications and ‘failure to rescue’ following surgery

Source: ISOS International Surgical Outcomes Study ASOS African Surgical Outcomes Study4
  ISOS
(elective surgery)
ASOS
(elective surgery)
ASOS
(elective and emergency surgery)
Mortality 207/44 814 (0.5%) 48/4792 (1.0%) 239/11193 (2.1%)
Complications 7508/44814 (16.8%) 624/4658 (13.4%) 1977/10885 (18.2%)
Death following complication
(failure to rescue)
207/7508 (2.8%) 30/620 (4.8%) 188/1970 (9.5%)

Leveraging the power of "grit" across continental boundaries

Rentsenkhand “Handaa” Enkh-Amgalan's picture
Also available in: Français | Mongolian
©2014 David Waldorf/World Bank  


For several years during my childhood, I helped my mother plant vegetables and harvest crops on an urban farm in the distant suburbs of Ulaanbaatar, the capital city of Mongolia. Growing up working on the farm with my siblings and observing my mother work diligently towards the goal of full harvest made me realize what a challenging yet fulfilling journey it is to be a female farmer in a developing country. My mother refused to yield when confronted with adversity--Mongolia’s harsh climate, crop theft, as well as a lack of necessary inputs, labor, and agricultural services- all while taking care of her four children and handling chores.

Kenya's PPP deal information: now open to the public!

Adetoun Adetona's picture



The Kenyan government took a big step in improving its business environment with the launch of the Public-Private Partnership (PPP) Disclosure Portal, an online tool that makes all non-confidential information relating to PPP contracts available to the public. The portal, which went live in June, is the result of the government’s work with the World Bank Group to improve transparency and accountability in PPPs since 2016.

As important as the act itself is the timing of the launch. The government recently announced its commitment to eradicate corruption in the public service. The government launched the PPP disclosure portal shortly thereafter—at a time when citizens in Africa are increasingly demanding answers, engaging their governments, and increasing scrutiny in public spending. This reflects positive movement and will hopefully fuel a virtuous cycle where citizens increasingly trust that the government cares about their views, their needs, and their hard-earned money.

Solving Africa’s currency illiquidity problem

David Bee's picture

Some 41 currencies serve the African continent. Many of these are characterised by their illiquid and rarely traded status on the global financial market, as well as their volatility. So for those wishing to do business with Africa, these currencies — as difficult and expensive to source — can pose a real problem.

From the Namibian dollar to the Seychellois rupee, it is vital that organisations are able to source emerging market currencies reliably, on time, and at competitive prices. Yet such necessities often elude those trading with Africa, who view currency concerns as one of the biggest barriers to the development of Africa as an emerging — and therefore high growth — opportunity for international investors.

Introducing two new dashboards in the Health, Nutrition and Population data portal

Haruna Kashiwase's picture

We’re pleased to launch new dashboards in the Health, Nutrition and Population Portal, following the portal’s revamp last year. The renewed HNP portal has two main dashboards covering Population and Health. Both dashboards are designed to be interactive data visualization tools where users can see various population and health indicators. Users can access various charts and maps by selecting specific time, country or region and indicators. We have added new indicators, charts and new health topics such as Universal Health Coverage and Surgery and Anesthesia. Below are some examples of stories gleaned from our dashboards.

India’s population is projected to surpass that of China around 2022

China, with 1.4 billion people, is the most populous country in the world in 2017. However, India, the second most populous country with 1.3 billion people, is projected to surpass China’s population by 2022. China’s total fertility rate (the number of children per woman) has also declined sharply since the 1970s.

Investing in prevention: A new World Bank Group approach to crisis

Kristalina Georgieva's picture
© Riyaad Minty/Creative Commons
© Riyaad Minty/Creative Commons

Benjamin Franklin famously said, “An ounce of prevention is worth a pound of cure.”  This was his message to Philadelphians on how to avoid house fires, at a time when they were causing widespread damage to the city and its people.

His words ring true today, as we face global crises – natural disasters, pandemics, violent conflicts, financial crises, and more – that hit rich and poor countries alike, and have lasting consequences especially for the world’s most vulnerable people. They can take the lives of millions of people and cost the world trillions of dollars in damages and lost potential.

Five new insights on how agriculture can help reduce poverty

Luc Christiaensen's picture
Also available in: Français 
A Cambodian farmer
A Cambodian farmer - Photo: Chor Sokunthea / World Bank

The view that a productive agriculture is critical for employment creation and poverty reduction is now widely shared within the development community. Yet, this has not always been the case. In the run up to the 2008 world food price crisis, many development practitioners, government officials and economists doubted whether agriculture could still play this role, especially in Africa. Agro-pessimism had set in during the 1990s and 2000s, with a decline in policy attention and agricultural investment.  The food price spikes of 2008 brought a realization that more needed to be done to strengthen agriculture in developing countries.

DRC: An Ebola story with a different ending

Jim Yong Kim's picture
© WHO/S.Oka
© WHO/S.Oka

The 9th Ebola outbreak in the Democratic Republic of Congo (DRC) has officially ended today —77 days and 28 deaths after an outbreak was declared on May 8. For the families of those 28 Ebola victims, the declaration comes too late—a loved one was lost to a disease that should be both preventable and treatable. That is always a needless tragedy.
 
Today is also a day to acknowledge that we have taken a momentous step forward in breaking the cycle of panic and neglect when it comes to outbreaks. Only two-and-a-half months ago, another pandemic seemed probable: an Ebola outbreak in three remote provinces, which spread quickly to the urban center of Mbandaka on the busy Congo River, appeared likely to spread rapidly around the country or even the region. 


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