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Health

The Last Mile, at Last?

Onno Ruhl's picture

Onno visiting a medical dispensary in Okhla, Delhi, IndiaIt looked like an ordinary little drugstore. A reasonable supply of medication on the right, and man behind a small desk in the middle.

But what was on the desk was not ordinary: a netbook laptop and a fingerprint scanner. And on the left were boxes, all the same medication, with names written on them. “Try it,” Neema said. “Scan your finger.” I did and the screen turned yellow. “You have never been here yet” said Neema, “I cannot give you any medication.”  

Bird Flu and Public Health Systems: Lessons of History

Patricio V. Marquez's picture

(image: Wikipedia Commons)

 

Here we go again!  In the last couple of weeks there has been a lot of media buzz about the outbreak of H7N9, a new deadly bird flu virus in China, centered in Shanghai and surrounding provinces and now reported in Beijing.  This outbreak follows the global panic and economic and travel disruptions caused by the severe acute respiratory syndrome, or SARS, in 2003 and the H5N1 avian influenza outbreak in 2006. 

Reconciling the two “sciences of delivery”

Adam Wagstaff's picture

Last week on Let’s Talk Development, I asked what the term “science of delivery” (SOD) means. I suggested that SOD is about moving from thinking about “what to deliver” to “how to deliver”.  We know, for example, the interventions that cut child mortality (bednets, vaccinations, breastfeeding, etc.) but these interventions reach too few children, and the trick is to get them delivered to more. Much of the Bank’s analytic work, policy dialogue and lending work has focused precisely on how to reform policies and programs to ensure the interventions that are needed to improve development outcomes actually reach people. Much of this work merits the term “science” – it makes use of an explicit “theory of change” in the form of a results framework that reflects the latest social science, and builds on rigorous empirical evidence that compares actual outcomes with an explicit and plausible counterfactual.

Toilets: There’s an App for That

Jose Luis Irigoyen's picture

It’s no secret that the rapid rise in access to mobile phones has created a new vehicle for the delivery of information and services, particularly for people at the base of the pyramid – or those who live on less than $1.25 a day. The challenge we, as development practitioners, face is understanding how to leverage mobile phones in ways that empower citizens as agents of change who can influence and drive development processes in their communities.

Nutrition: Cornerstone of the Post-2015 Agenda

Leslie Elder's picture

Last week marked the start of the final 1,000 days to the end of the Millennium Development Goals (MDGs). As the international community discusses achievements and challenges of the MDGs since the year 2000, discussions are also intensifying around the post-2015 development agenda. Many call nutrition the “forgotten” Millennium Development Goal, given continued low levels of development assistance resources in support of nutrition and the lack of progress on child underweight (MDG1c). But if we look to the future, what do international experts have to say about how nutrition should be included in the post-2015 development agenda? 

User fees and abuser fees

Shanta Devarajan's picture

If user fees for health have been so vilified (including in comments on this blog), why are we bringing the subject up again?  Because new evidence calls into question the prevailing view, namely that removing user fees leads to: (i) increased use of health services and hence to (ii) improved health outcomes.  Confirming (i), the recent literature shows that (ii) does not always follow.

Principles

Raising the price of a good or service has two effects: it reduces demand and increases supply.  In the case of user fees for health, it was thought that paying for a service also makes people use it more appropriately (you don’t go to the doctor for minor ailments) and value it more than if they obtained it for free. 

So what exactly is the “science of delivery”?

Adam Wagstaff's picture

The World Bank’s president, Jim Kim, has now made two major speeches outlining his vision for the institution – one at the Annual Meetings the other at Georgetown University on April 2 ahead of the upcoming Spring Meetings.

Several themes are emerging. Two are easy to grasp and likely to resonate strongly with Bank staff and stakeholders: “ending poverty” and “boosting shared prosperity”. For years the Bank has seen fighting poverty as its mission. It has made major contributions in the areas of measuring and monitoring poverty – Bank staff have authored many of the world’s most-cited publications with poverty in the title. The Bank’s work at the country level has always had a strong anti-poverty focus. “Ending” poverty – rather than merely “fighting” it – is a natural next step. The idea of “boosting shared prosperity” also resonates. While economic growth is still seen as the principal driver of poverty-reduction, the goal has always been pro-poor growth – a concept that links naturally to the idea of “shared prosperity”.

Back from the Cold: Russia Confronts Tobacco

Patricio V. Marquez's picture

image Wikimedia Commons

You might have missed it over the winter, but Russia achieved an important public health milestone that deserves applause: It enacted a national law that bans smoking in public places and restricts cigarette sales, joining a growing number of countries in making tobacco control a health priority.

The policy victory was a long time coming.

Ending Open Defecation, Not by Evidence Alone

Jaehyang So's picture

Open defecation – going outside without using a toilet or latrine – is one of the most important threats to child health and human capital, period; ending it must be a policy priority.

Should inequality be reflected in the new international development goals?

Adam Wagstaff's picture

The last few months have been a busy time for inequality. And over the last few days the poor thing got busier still. Inequality is now dancing on two stages. It must be really quite dizzy.

We need an inequality goal. No we don’t. Yes we do

One of the two stages is the post-2015 development goals. At some point, someone seems to have decided that reducing inequality needs to be an explicit commitment in the post-2105 goals. The UN System Task Team on the Post-2015 UN Development Agenda wrote a report on inequality and argued that “addressing inequalities is in everyone’s best interest.” Another report by Claire Melamed of Britain’s Overseas Development Institute argued that “equity, or inequality, needs to be somehow integrated into any new framework.” Last week a group of 90 academics wrote an open letter to the High Level Panel on the Post 2015 Development Agenda demanding that inequality be put at the heart of any new framework.


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