Growing up in India, mosquito nets were an essential part of life. I slept under them as a child in Bangalore, with their ropes tied to bedposts, doors, closets, window grills—anything that would offer support at the right height. It was like pitching a tent every night, and the occasional dramatic collapse would result in much helpless laughter. Later, going to college on the banks of the slow-flowing Koovam river in Madras (now Chennai), I tucked myself under a net in my dormitory at about 6 p.m. to avoid the twilight assault of mosquitos from the water. In fact, particularly after a bad attack of malaria when I was a child, a lot of my life was lived perforce under a mosquito net, until electric repellent gadgets reached the market and nets somewhat lost their popularity.
Recently, sitting in Halima Ibrahim’s house in Majengo, a neighborhood in the coastal city of Mombasa, and talking about the new mosquito nets her family had just received from the Kenyan government, I felt instantly at home in her tiny living room. It was packed from corner to corner with family and friends, all brimming with opinions about nets old and new. Everybody talked about malaria and what a problem the disease was in the community. The nets that had just been distributed to them free of cost would make a huge difference, they said, protecting them from being bitten by mosquitos, and saving them considerable expense. Many of the families on the street simply could not afford to buy durable and effective nets at the prices they commanded in the local market.
The Sanitation Hackathon & App Challenge three grand prize winners, mSchool, Taarifa, and SunClean, flew over from their home countries, Senegal, Tanzania, England, and Indonesia to attend the awards ceremony in Washington, DC. With a 64inch touchscreen provided by Microsoft, the teams showcased their apps to sanitation sector specialists at the WB-IMF side event on Investing in Sanitation.
VillageReach is a non-profit social enterprise whose mission is to save lives and improve well-being in developing countries by increasing last-mile access to healthcare and filling gaps in essential supporting infrastructure, especially for remote, underserved rural communities. VillageReach received the Development Marketplace award in 2003 and also participated on the Development Marketplace Investment Platform program with its vaccination program in Mozambique.
This program focuses on improving the performance of the health system in Mozambique through the use of dedicated distribution channels for vaccines and other medical commodities to community health centers. The program’s key objective is to achieve high vaccination rates and low vaccination dropout rates, as well as to increase the overall knowledge and trust in the use of local health services. The key feature of the program is to achieve systemic change in the performance of the Mozambique Ministry of Health by building its capacity and expanding the dedicated logistics system, which would result in VillageReach decreasing its role over time as greater capacity is built.
I’m consistently astonished by how little we know about the important stuff in development. Take the Millennium Development Goals – the basis for innumerable aid debates, campaigns, and negotiations. A large chunk of the MDG agenda concerns the size and quality of public spending – on health, education, water, sanitation etc. So obviously, the first thing we need is to know how much governments are spending on these things, right?
Well no actually, because we don’t have those numbers. Until now. Oxfam has teamed up with an influential and well-connected NGO, Development Finance International, which advises developing country governments around the world. Working with a network of government officials, DFI has pulled together and analysed the budgets of 52 low and middle income countries (With another 34 to follow). The result is a new database, called Government Spending Watch, (summary of overall project here) and a report ‘Progress at Risk’, previewed in Washington last Friday in a joint DFI/Oxfam America event to coincide with the IMF and World Bank Spring meetings. The full report won’t be ready ‘til May, but an initial draft exec sum is available, and here’s what it says.
It 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.”
(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.
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.
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.
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?
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.
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.