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South Asia

2014 India DM Finalist Story: iKure - Paving the Way to Accessible and Affordable Healthcare through Software Development

Carolyn Marie Florey's picture

We traveled down a bumpy, dirt road in the rural areas of West Bengal towards a village called Bolpur. Three hours after leaving Kolkata, the car pulled up to an unassuming concrete building. The health care worker who accompanied us for this ride jumped out enthusiastically and immediately spoke into her megaphone. “Not feeling well?” she called out to the village, “Need a quick check up? Come and visit us for the next hour and a half.” Here, in a small village, at an unassuming building, we had found ourselves at an iKure spot camp.

iKure -  a Kolkata-based social enterprise dedicated to bringing affordable health care to India’s poorest populations -  has created these spot camps as an integral part of their inventive model for a network of health clinics in India’s rural areas. In addition to providing access to doctors and medicine prescriptions, they provide the necessary outreach to tell villagers about where and when the clinics are and how they can access medical consultations and medicine.

The End of the Population Pyramid

Wolfgang Fengler's picture

This is a surfer’s dream: catching a great wave, far from the shore, and riding it for long beautiful moments as it stretches further and further gathering momentum until the very end, when it breaks right at the beach. This is how my generation, born in the 1970s (when the Beach Boys released their iconic Surf’s Up album), should feel, as we are riding on a “global demographic wave” which keeps extending further and further.
 

Kafala neither guarantees nor cares: guest workers in the Gulf

Zahid Hussain's picture

Thomas Sennett / World Bank
Guest workers have played an integral role in the Gulf since the 1970s where the demographic changes accompanying these labor flows occurred at an extraordinarily rapid pace. The region’s aggregate population has increased more than tenfold in a little over half a century, but in no other region of the world do citizens comprise such a small proportion of the population. While this ‘demographic imbalance’ makes the Gulf unique, what differentiates it is not its economic and demographic expansion through migration but the degree to which the region’s governments have excluded foreign workers from being integrated into the national polity. This exclusion of foreign workers is a result of a conscious policy.
 
Labor migration to Gulf Cooperation Council (GCC) countries are mostly governed under a sponsorship system known as Kafala.  Migrant workers require a national sponsor (called Kafeel) and are only allowed to work for the visa sponsoring firm. The workers must obtain a no-objection certificate from the sponsor to resign and have to leave the country upon termination of the usual 2 to 3 years’ contract before being allowed to commence a new contract under a new sponsor. Tied to the sponsor, the migrants become immobile within the internal labor market for the duration of the contract. Consequently the sponsors benefit from non-competitive environments where they extract substantial economic rents from migrant workers at the expense of inducing significant inefficiencies in production.
 
The Kafeels pay workers an income above the wage in their country of origin and obtain economic rents equal to the difference between such earnings and the net marginal return from employing the migrant worker. Migrant workers are paid the initial nominal wage throughout the entire contractual period. They are even made to accept lower wages than contracted initially. Immobilized by labor restrictions, workers cannot command a higher wage even when there is demand for their services by rival firms willing to hire them in order to avoid the cost of hiring from abroad.  Kafeels have also found other ways of extracting rents in recent decades by indulging in visa trading.  They allow their names to be used to sponsor foreign workers in exchange for monetary gains.
 
Arguably, rents per-se should not directly create adverse effects because they are essentially redistributive transfers. Earnings paid to migrants are sufficient to motivate them to migrate. The migrants do not leave. But this view is over-simplistic. The combination of short contracts, flat wages, and lack of internal mobility kills the incentives for migrant workers to exercise higher effort levels in production and engage in activities that enhance their human capital.  Any productivity gain would go to the sponsor in the form of rents. The system provides incentives to entrepreneurs to concentrate on low-skills, labor-intensive activities where the extraction of economic rents is easier. Such sponsor-worker behavior explains for instance why despite the massive investments in Dubai, the economy-wide efficiency levels (average labor productivity) have not improved in the last two decades while in Hong Kong, they doubled and in Singapore quadrupled.

Rana Plaza One Year On

Ellen Goldstein's picture

Lessons on Governance from Bangladesh’s Garment Industry


One year ago today, in the outskirts of Bangladesh’s capital city, an eight-story garment factory collapsed of its own weight, killing 1,130 young workers and injuring thousands more.  The ghastly photos of bodies trapped in the Rana Plaza wreckage provoked outrage in the wealthy world, targeted largely at global retailers who purchased garments there.  North American and European consumers called for measures to ensure safe conditions and humane treatment for Bangladeshi garment workers, mostly young women from poor families in remote rural areas.  Many called for a boycott of the big-box retailers and of the Bangladeshi products they sell.

I had just moved from Bangladesh to Europe at the time, and my advice to friends who asked was: “Go ahead and buy those skinny jeans or that tank top if you want.  It’s the right thing to do for Bangladesh and its young workers.”

How Can You Build Trust between Communities and the Government in Afghanistan?

Miki Terasawa's picture



Learning from a Social Accountability Pilot in the Mining Sector

 
The Aynak copper mine in the Mohammad Agha district in Logar province is being developed as one of “resource corridors.” These corridors will connect communities with the benefits of mineral resources and infrastructure which will provide over 10,000 estimated jobs and economic growth in Afghanistan.
 
In facilitating community participation to make the most of the potential growth opportunity, the World Bank supported the Ministry of Mines and Petroleum (MoMP) pilot a small social accountability project in Aynak, to bridge trust between MoMP and affected communities by making a grievance redress mechanism (GRM) work. GRM is a feedback mechanism based on two-way communication, in which the government takes action or shares information based on community feedback.  
 
The Aynak mine development directly affected 62 families in two villages who had to be relocated. The MoMP prepared a resettlement action plan (RAP), which laid out compensation for these affected families and outlined the GRM, including setting up of the district-level grievance handling committee to address resettlement related complaints. Initially, there was no representation in the committee from two communities, and they were not clear on their roles.
 
The social accountability pilot supported community mobilization, training on entitlements and GRM, and election of Community Development Council (CDC), following the procedure set by the National Solidary Project (NSP) implemented by the Ministry of Rural Rehabilitation and Development. These activities were facilitated by a civil society organization (CSO), the International Rescue Committee (IRC), which had a long-established presence in Mohammad Agha district and was also a NSP facilitating partner in the district. 

Advancing Climate and Disaster Resilience in Sri Lanka

Suranga Kahandawa's picture


The 2004 Indian Ocean Tsunami – Triggering engagement in Disaster Risk Management (DRM)

 
In 2004 December, Sri Lanka faced the worst disaster in its history - the Indian Ocean Tsunami. More than 35,000 people lost their lives and around 5,000 people went missing. At the time of the Tsunami, Sri Lanka did not have a proper legal and institutional mechanism to manage disaster risk. In the aftermath of the catastrophe, the Government made very serious efforts to establish a mechanism to avoid dramatic loss of life in future disaster events.
 
Subsequently, the Disaster Management Act was passed and the National Council for Disaster Management, chaired by the President, was established.  A Ministry of Disaster Management (MoDM) was created and charged with the disaster risk management (DRM) portfolio and the Disaster Management Centre (DMC) was established July 2005 to implement DRM programs across the country.
 
With these mechanisms in place, the Government began strengthening disaster preparedness, especially for tsunamis. Three pieces were put in place including: i) development of a tsunami early warning system; ii) implementation of awareness raising programs, from the grassroots to national levels; and, iii) regular evacuation drills were conducted in all coastal villages. The system has proven successful as the DMC issued Tsunami evacuation warnings in September 2007 and April 2014, which resulted in the safe evacuation of coastal communities.

Nepal's Paradox: When Good is Not Good Enough

Johannes Zutt's picture

Nepal needs to fix its budget process, remove hurdles to infrastructure development and cut down excess liquidiity.



At first glance Nepal’s economic fundamentals appear sound. Economic growth this year is expected to recover to 4.5%, after a lackluster FY13. On the fiscal and external fronts, indicators are well in the green. This year again, Nepal is likely to be the only country in South Asia to post a budget surplus (0.3% of GDP). Continued growth in revenue mobilization and higher grants will more than make up for the increase in government spending. In FY14, public debt is expected to fall below 30% of GDP, and Nepal’s risk of debt distress may fall from a “moderate” rating to “low”.

Unlike other South Asian countries, Nepal has remained largely unscathed by global monetary tightening, reflecting its limited integration into global financial markets as well as its healthy external balances. Nepali analysts often highlight the growing trade deficit as a cause for concern, but remittances (projected at over 30% of GDP) should push the current account to a comfortable surplus position of 2.4% of GDP.

The only apparent dark spot is inflation, which remains stubbornly high. With inflation close to double digits in January (year-over-year), it appears unlikely that the NRB’s target of 8.5% will be reached.

In short, Nepal appears to be doing well.  Many European countries today can only dream of posting similar growth, fiscal or debt numbers. So what is the problem?

Why should Governments Spend on Sanitation?

Shanta Devarajan's picture

A puzzle:  Sanitation is one of the most productive investments a government can make.  There is now rigorous empirical evidence that improved sanitation systems reduce the incidence of diarrhea among children.  Diarrhea, in turn, harms children’s nutritional status  (by affecting their ability to retain nutrients).  And inadequate nutrition (stunting, etc.) affects children’s cognitive skills, lifetime health and earnings.  In short, the benefits of sanitation investment are huge.  Cost-benefit analyses show rates of return of 17-55 percent, or benefit/cost ratios between 2 and 8.

But if the benefits are so high (relative to costs), why aren’t we seeing massive investments in sanitation?  Why are there 470 million people in East Asia, 600 million in Africa and a billion people in South Asia lacking access to sanitation?  Why are there more cellphones than toilets in Africa?

Enhancing Service Delivery in Conflict Contexts: Lessons from South Asia

Maria Correia's picture



More than 1.5 billion people today reside in countries affected by violence and conflict, most - if not all - of which also suffer from inadequate and poor access to basic services. By 2030, it is estimated that about 40 percent of the world’s poor will be living in such environments, where each consecutive year of organized violence will continue to slow down poverty reduction by nearly one percentage point.
 
A large portion of this group presently resides in conflict-affected parts of South Asia, a region that is home to 24 percent of the world’s population and about half the world’s poor.
 
Despite such challenging circumstances, research shows that in many settings, development aid is indeed working - albeit with frustrating inconsistency. 
 
The 2011 World Development Report recognizes the strong link between security and development outcomes in fragile and conflict-affected contexts. However, what the evidence is yet to show us is how exactly do you get the job done right?

Can Computers Outperform Humans?

Wolfgang Fengler's picture

The epic battle of man against machine has been fought on many occasions. One of the most memorable encounters was the chess game between IBM’s Deep Blue and Gary Kasparov. Deep Blue was the first computer to beat a reigning chess champion in 1996 (the machine still lost 2 to 4 after six games). A year later, at their “rematch”, the machine won on the overall score: 3.5 to 2.5.

However, it is surprising that, 18 years later, we still have not figured out the ultimate winning strategy in chess. Any game with limited combinations and full disclosure of information must have ‘safe strategies’ and can be ‘solved’ (as has happened with the game checkers in 2007). The solution, in chess, would from what we know today involve strategies whereby the white player would win or the black player would force a draw. Yet no human or super computer to date has managed to solve chess’ mathematical puzzle.  How much more computing power do we need to succeed?


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