Health

Mongolia needs better roads, schools and hospitals: so why all this talk about saving for the future?

Монгол хувилбар байгаа

Mongolia’s mining revenues are set to soar in the coming years, but here people talk about the need to save for the future.

Surely building infrastructure, educating young Mongolians, improving healthcare and creating jobs is important? Surely by achieving these development goals Mongolia is providing for the next generation? These are great questions. Mongolia must do these things. But they in turn depend on efforts to prevent boom and bust and provide financial assets for future generations. Saving some of the revenues in good times is part of effective natural resource management.

Let's think together: Every Sunday the World Bank in Tanzania in collaboration with The Citizen wants to stimulate your thinking by sharing data from recent official surveys in Tanzania and ask you a few questions.

Tanzania is ranked the second lowest in terms of access to improved sanitation worldwide out of 171 countries that reported statistics for 2010. The details read as follows:
- Only 1 in 10 Tanzanians has access to an improved sanitation facility, such as a flush toilet connected to a sewage system or septic tank or a covered pit latrine not shared with other households.
- The above access to improved sanitation for Tanzania is well below the average for sub-Saharan Africa (31 percent), and also much lower than in Kenya (32 per cent), Uganda (34 per cent) and Malawi (51 per cent).
- Urban residents are three times more likely to use an improved toilet facility than their rural counterparts (20 per cent vs. 7 per cent).
- A staggering 5.4 million Tanzanians do not have access to any toilet facility, and answer nature’s call in the open. This burden falls most heavily on the poorest quintile.

The World Health Organization’s recent Global Burden of Disease (GBD) Assessment estimates that outdoor air pollution causes 620,000 premature deaths per year in India, a six fold increase since 2000. The main causes are growing emissions of particulate emissions (PM10) from transport and power plants. GBD in this analysis has ranked air pollution as the sixth most dangerous killer in South Asia and fifth leading cause of deaths in India.

Also, according to the WHO, across the G-20 economies, 13 of the 20 most polluted cities are in India and over 50% of the sites studied across India had critical levels of PM10 pollution. A recent rapid survey by Delhi based Center for Science and Environment revealed that almost 75% of respondents considered air pollution as a major cause of concern and as responsible for respiratory illnesses.

As we commemorate World Water Day on March 22, 2013, it is sobering that NASA’s Curiosity rover found convincing evidence that at one time Mars, like Earth today, was awash with water.

In February, the United Nations named 2013 the Year of Quinoa and made the president of Bolivia and the first lady of Peru special ambassadors to the UN’s Food and Agriculture Organization (FAO). The World Bank joined in with a kick-off event and celebration of Bank-funded work that is helping Bolivian quinoa farmers bring their product to market.

The mobile phone is a truly novel device. It comes in just as handy and as easily when we need to communicate about the serious things as to chat about the simpler things in life. Mobiles are not only being used as radios and flashlights but they are also delivering banking and financial services to those who urgently need them.

Increasingly, people around the world, especially in Africa, are paying their school fees, healthcare and utility bills using mobile phones today. Businesses use mobile money phones to pay their staff and suppliers. Poor people who have never entered a bank are using mobile services to send or receive remittances and to save their money.

Has the rise in international food prices since the mid 2000s hurt the poor, or helped them? Until recently, everything we knew about this topic came from simulation analyses rather than survey data. Simulation approaches invariably predict that poverty and food insecurity increases as the result of higher food prices, but there are many reasons why these predictions might not eventuate. On the other hand, standard household surveys yield information only after long lag periods. In light of these constraints, in some of my work I use an indicator of self-assessed food security from the Gallup World Poll (GWP). Since 2005, Gallup has survey men and women in a large number of developing countries and asked them (among other things) whether they have had “any trouble affording sufficient food in the last 12 months?” I take the percentage of respondents who answer yes to this question as a measure of national food insecurity.

In a recent blogpost I asked whether Universal Health Coverage (UHC) is old wine in a new bottle, and if so whether that’s so bad.

I argued that UHC is ultimately about making sure that “everyone – whether rich or poor – gets the care they need without suffering undue financial hardship as a result.” I suggested UHC embraces three important concepts:

• equity: linking care to need, not to ability pay;
• financial protection: making sure that people's use of needed care doesn't leave their family in poverty; and
• quality of care: making sure providers make the right diagnosis, and prescribe a treatment that's appropriate and affordable.

A couple weeks ago, I had the opportunity to participate in the launching of The Lancet’s fourth series on non-communicable disease (NCDs) and development. This was a well-attended event chaired by the Dean of the London School of Hygiene and Tropical Medicine, Prof. Peter Piot.

A new study presented at Conference on Retroviruses and Opportunistic Infections found that a community intervention (a package that improves take-up, provides community engagement, and post-test support)

March 8 is the First International School Meals Day. New evidence suggests that today around 370 million children will eat a meal at school.

The U.S. Department of Agriculture (USDA) has declared March 8 the First International School Meals Day -- a celebration of a worldwide phenomenon. The World Food Programme (WFP) and the World Bank have shown that school feeding has been undertaken in nearly every country in the world.

In the policy discussions related to hunger, malnutrition, poverty and wellbeing, calorie intake is often the focus. Increasingly, however, micronutrient malnutrition appears to be a critical problem in many developing countries. Women and children are most vulnerable to micronutrient malnutrition due to their elevated micronutrient requirements for reproduction and growth. According to some estimates, nearly three billion people (including 56% of the pregnant and 44% of the nonpregnant women) suffer from iron deficiency anemia (IDA), and one-third of the world's population suffer from zinc deficiency. Twenty percent of the maternal deaths in Africa and Asia are due to IDA. One in every three preschool-aged children in the developing countries is malnourished. Undernutrition, coupled with infectious diseases, accounts for an estimated 3.5 million deaths annually. At levels of malnutrition found in South Asia, approximately 5% of GNP is lost each year due to debilitating effects of iron, vitamin A, and iodine deficiencies alone.

“So how are you enjoying living in paradise?” Michael Geerts, the former German ambassador to Kenya asked me the other day. He was posted in Nairobi during the difficult years in the end of the 1990s, and continues to stay in touch with a country he loves dearly. Many colleagues, who once worked in Kenya have bought houses in Nairobi, and plan to retire in the “city under the sun”. But not everybody shares their passion and faith in the country’s future. There are many pessimists who feel that the country is moving in the wrong direction. Kenya, they say, will never rid itself from grand corruption, and crime such as drug trafficking will continue to flourish.

Are they seeing the same country? Maybe both perspectives are right, because Kenya is a country of extremes.

Ministerial meetings aren’t known for their dynamism. As Adam Wagstaff wrote in a recent blog post, these formal interactions sometimes lack the energy—and follow-through—that such high-level gatherings should inspire.

However, this wasn’t the case in late February, when the World Bank and the World Health Organization (WHO) met with 27 finance and health ministers, international partners and civil society organizations in Geneva to discuss countries’ progress toward universal health coverage (UHC). The topic energized attendees, who vowed to continue following the path towards UHC in their countries.