The previous post in this blog discussed the positive dynamic effects of conditional cash transfer (CCT) programs in Mexico and Nicaragua – in particular on asset accumulation and the incidence of entrepreneurship by the rural poor.
Le 11 juillet, lors de la Journée mondiale de la population, des acteurs mondiaux de premier plan dans le domaine de la santé se réunissent à Londres pour tenter de mettre la priorité sur l’enjeu de la planification familiale. Cet enjeu est au cœur des travaux du personnel de la Banque mondiale chargé des questions de santé en Asie du Sud, qui s’emploie à trouver les moyens qui lui permettront d’aider plus efficacement les femmes et les familles à espacer les naissances et à éviter les grossesses non désirées.
Même si les pays d’Asie du Sud ont progressé dans l’élargissement de l’accès à la contraception moderne et dans le recul global de la natalité, la région accuse la deuxième plus forte mortalité maternelle du monde. Dans ces pays, les ménages pauvres, marginalisés et non instruits n’ont pas accès aux services de santé génésique dont ils ont besoin, et notamment à la planification familiale.
En Inde, au Népal et au Pakistan en particulier, les taux de fécondité et d’utilisation de contraceptifs diffèrent considérablement d’une catégorie socioéconomique à l’autre : en Inde, alors que le taux de fécondité n’est que de 1,8 chez les femmes les plus aisées, il se maintient à 3,9 parmi les plus démunies. Au Népal, les femmes instruites ont, en moyenne, 1,9 enfant, contre 3,7 pour les femmes non instruites. Au Pakistan, la prévalence de la contraception atteint aujourd’hui 32 % chez les couples riches et seulement 12 % chez les couples pauvres. En Inde, dans l’État du Meghalaya, 36 % des couples désireux de recourir à la planification familiale n’ont pas accès à une contraception efficace.
El 11 de julio, Día Mundial de la Población, mientras los líderes mundiales de la salud se reúnen en Londres para debatir sobre el otorgamiento de una mayor prioridad a la planificación familiar, el personal del Banco Mundial que trabaja en el sector de salud en Asia meridional estará pensando en cómo respaldar más eficazmente a las mujeres y las familias de esta región para espaciar los nacimientos y evitar los embarazos no deseados.
Aunque los países de Asia meridional lograron aumentar el acceso a la planificación familiar moderna y reducir los índices totales de fecundidad, la región sigue teniendo la segunda tasa más elevada de mortalidad materna. Los hogares pobres, marginados y sin educación no cuentan con los servicios de salud reproductiva que necesitan, incluida la planificación familiar.
En India, Nepal y Pakistán, en particular, las diferencias en la fertilidad y el uso de anticonceptivos entre los grupos socioeconómicos son sorprendentes: en India, la tasa de fecundidad en la parte más rica de la población es de 1,8, mientras que sigue siendo de 3,9 entre los más pobres; en Nepal, las mujeres con educación tienen en promedio 1,9 hijos, mientras que las menos educadas tienen un promedio de 3,7; en Pakistán, la prevalencia de anticonceptivos es del 32% en las parejas más ricas y de apenas el 12% entre las parejas pobres, y en el estado indio de Meghalaya, el 36% de las parejas que quiere practicar la planificación familiar carece de acceso a métodos anticonceptivos eficaces.
We’ve got something to smile about this week at the World Bank: Our baby Maya, who has shown us the importance of having a strong health system and access to quality maternal and child health care, has reached her second birthday!
To mark this special occasion, we’re launching a new video about the things that helped Maya achieve this milestone, including access to family planning and proper nutrition. These are two key services provided by well-functioning health systems that create healthy futures for mothers and their children—along with other affordable services, trained health workers, clean water, vaccines, well-equipped clinics, and many other moving parts.
The video—the second in a series that began with Maya’s birth—comes as the global health community holds a summit on family planning this week in London. I hope Maya’s story underscores what a difference access to effective family planning can make. By giving women the means to space the births of their children by three years, for example, deaths of children under-five would decrease by 35%.
On July 11, World Population Day, while global health leaders meet in London to discuss giving greater priority to family planning, World Bank health staff in South Asia will be thinking about how to more effectively support women and families in this region to space births and avoid unwanted pregnancies.
While the countries of South Asia have made progress in increasing access to modern family planning, and reducing total fertility rates, the region still accounts for the second highest burden of maternal deaths. Poor, marginalized and uneducated households do not have access to the reproductive health services they need, including family planning.
In India, Nepal and Pakistan in particular, the differences in fertility and use of contraception across socioeconomic groups are striking: In India, the fertility rate among the wealthiest part of the population is only 1.8, while it remains 3.9 among the poorest. In Nepal, educated women have on average 1.9 children while the least educated have an average of 3.7.In Pakistan, contraceptive prevalence is 32% among wealthier couples and yet only 12% among poor couples. In the Indian state of Meghalaya, 36% of couples who want to practice family planning lack access to effective contraception.
In a landmark decision, the U.S. Supreme Court today upheld the main provisions of President Obama’s Affordable Care Act, including the individual mandate (i.e., everyone must buy health insurance). It represents a major step towards universal coverage for health care in the U.S., something that many countries around the world are striving to achieve.
For those interested in gaining a better understanding of this complex legislation, you can do no better than to start with a graphic novel about the law written by Jonathan Gruber, a professor at MIT and one of the main architects of the Affordable Care Act (and, for that matter, of the Massachusetts health reform that it closely resembles). It’s a great introduction to the policy issues surrounding market failure in health insurance, without having to wade through a dry textbook or World Bank report.
Malnutrition in South Asia is the worst in the world (yes, worse than that of sub-Saharan Africa). It undermines the efforts of countries to reduce poverty, increase educational attainment and productivity, expand innovation and entrepreneurship, and reduce maternal and child mortality. It’s also why, for the past two years, 21 organizations from India, Nepal, Afghanistan, Pakistan, Sri Lanka and Bangladesh have implemented community-based innovations for improving infant and young child nutrition, financed by a unique World Bank small grants initiative known as the Development Marketplace.
It is common to hear officials from countries and international agencies talk about the multiple challenges that impede intersectoral work for health. The concern is valid: while ministries of health and related institutions are organized and funded to improve the “health” of the population, other ministries do not have such a mandate. In most cases, this has led to a certain paralysis characterized by lofty aspirations in the health sector about the potential benefits of intersectoral action, but with little collaboration and action involving other sectors.
La semaine dernière, l’Inde, l’Éthiopie et les États-Unis organisés un Sommet pour des actions concrètes en faveur de la survie de l’enfant, avec la participation de représentants venus du monde entier. Cet événement est à la fois opportun et fondamental : l’enjeu est de renforcer davantage les engagements pris sur le plan national et international ainsi que la responsabilité des pays dans la réalisation du quatrième objectif du Millénaire pour le développement (OMD), qui vise à réduire la mortalité infantile. Si de nombreux progrès ont été accomplis dans ce domaine, il est des pays qui risquent de ne pas remplir cet objectif à l'horizon 2015 et qui ont le plus besoin de notre soutien et de notre coopération.
La semana pasada, los Gobiernos de India, Etiopía y Estados Unidos organizaron una Cumbre de Llamamiento a la Acción para la Supervivencia Infantil, con la participación de líderes mundiales y nacionales. Se trata de un evento oportuno y fundamental, destinado a fortalecer aún más el compromiso mundial y de los países y la responsabilidad de estos en el logro del objetivo de desarrollo del milenio (ODM) 4: reducir la mortalidad infantil. Aunque hemos observado una mejora sustancial en esta meta, los países que requie renmás de nuestro apoyo y asociación podrían no alcanzarla para 2015.
People, Spaces, Deliberation bloggers present exceptional campaign art from all over the world. These examples are meant to inspire.
This week, the governments of India, Ethiopia and the United States will host a Child Survival Call to Action summit, with the participation of country and global leaders. This is a timely and critical event, aimed at further strengthening global and country commitment and country accountability for MDG4, to reduce child mortality. Though we’ve seen substantial improvement on this goal, the countries that need our support and partnership most may not reach it by 2015.
Start-up eHealth innovations are popping up all over Africa, providing a glimpse of how ICTs can transform the delivery and governance of health services in the region. Many of these pilots show promise, but their rapid growth also poses challenges: At an eHealth conference held in Nairobi in May and co-organized by the World Bank, health professionals and development partners discussed how to identify the best of these evolving tools and bring them to scale.
