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Starting a marathon with a broken ankle: how poor water and sanitation sets children behind

Maximilian Leo Hirn's picture
Children in Koutoukalé, Niger

Have you ever wondered how your life chances are affected by where you were born? Odds of being born at all are already miraculously small, but only one in ten of us is born into the relative security of a high-income country. What if you are born in Niger or in the Democratic Republic of the Congo (DRC)? Before you could even walk or talk, your challenges would be daunting. That's because, despite progress, deaths of children under five years old are more than twenty times higher than in the EU and nearly ten times higher than in China.

Even if you survived, you would confront another major risk to your development: malnutrition. In Niger and DRC, almost one out of every two children is stunted. Stunting has significant and long-lasting negative effects on early childhood development, impeding physiological and mental development, and making small children more vulnerable to disease. Starting off in life stunted is akin to starting a marathon with a broken ankle.

Gender equality hits the highway in Northern Brazil

Satoshi Ogita's picture


Young women, some still girls, await long-haul truck drivers that stop by a gas station in the State of Tocantins, located in the North region of Brazil. Here, impoverished women and girls look to get extra cash in exchange for sex, a phenomenon seen on a daily basis in small towns along the federal highway BR-153. The high dropout rate of girls and gender-based violence are commonplace there. While better road infrastructure brings more economic opportunities to the region, higher road traffic and activity can also increase social risks like gender-based violence.   
 
A World Bank’s multisectoral project in Tocantins seeks to improve efficiency of road transport, in particular, state and rural road network, and to support institutional strengthening in the following five sectors: public administration, agriculture, tourism, environment, and education. While the project does not include any roadwork specifically on the highway BR-153, it aims at reducing existing risk of gender-based violence along the highway as part of the education component of the project.  
 
Schools play an important role in building respectful relations between girls and boys, challenging gender-based stereotypes and combatting discrimination that contributes to violence against women and girls. Accordingly, based on the level of the dropout rate and violence statistics, six high schools along BR-153 were selected to host a pilot initiative to improve awareness of gender-based violence and in the area.

Engaging communities in the Golden 1,000 Days in Nepal

Kaori Oshima's picture
Field survey team in Nepal
A field survey team for the qualitative study holding a focus group discussion with women in one of the SHD project communities. Photo credit: World Bank

In Nepali, “Sunaula Hazar Din” means, “Golden 1000 Days” – which is a critical window of opportunity between conception and the age of two years that, with good health and nutrition, can mitigate the risks of malnutrition that hamper a child’s long-term physical and cognitive development.

Sunaula Hazar Din (SHD) is also the local nickname of the Government of Nepal’s recently completed “Community Action for Nutrition Project”, implemented by the Ministry of Federal Affairs and Local Development and  financially supported by the World Bank from 2012 to 2017. The project aimed to improve practices that contribute to reduced under-nutrition of women of reproductive age and children under the age of two and to provide emergency nutrition and sanitation response to vulnerable populations in earthquake affected areas.

The project used a “Rapid Results Approach (RRA)”, where target communities formed groups of nine members that would collectively select and work on an activity to address malnutrition for 100 days. RRA focused especially on the “1000 days” households– namely, households with children under 2 years and pregnant and/or lactating women and also had community -wide interventions targeted to address malnutrition.  

To better understand the local dynamics around the SHD design and activities, a qualitative study was conducted, with support from the South Asia Food and Nutrition Security Initiative (SAFANSI).

The study team gathered the voices of various stakeholders, including the community members, facilitators, and the village and district-level authorities. Listening to the voices of these stakeholders makes development practitioners and project teams recognize how participatory designs may work as expected – or not – in a specific context.

The economic impact of the Syrian conflict: Estimate it yourself

Shanta Devarajan's picture
Homs, Syria - ART Production | Shutterstock.com

Everyone agrees that conflicts impose huge costs on economies, including massive destruction of infrastructure and housing, disruption of trade, transport and production, not to mention the loss of lives and widespread human suffering. Yet quantitative estimates of these costs are hard to come by.     

Beyond nutrition, investing in livestock can also deliver on health

Franck Berthe's picture
Scenes from Al Nnuhoud Livestock Market, North Kordofan where livestock is brought
and traded from places nearby.
Photo: Salahaldeen Nadir / World Bank



When the United Nations negotiators recently met in New York to track progress on the Sustainable Development Goals (SDGSs), a number of side events to the High-Level Political Forum were organized to emphasize the crucial role of agriculture. I attended a couple of these events and took the opportunity to illustrate why investments in livestock will pay dividends for sustainable development, and more particularly for health. 

Karnataka Becomes India’s First State to Safely Dispose Biomedical Waste at all Public Health Facilities

Suresh Mohammed's picture

What happens when infected needles, syringes, plasters, surgical gloves and intravenous sets are disposed of carelessly? Well, for a start, they spread hepatitis and HIV, not only among the poor rag-pickers who unsuspectingly handle them, but also infect all the waste around, multiplying the hazard manifold.  Then, when the waste is not properly incinerated, it causes further damage, polluting the very air we breathe. Liquids wastes are particularly harmful; they can leach into the soil and contaminate the water supply, with often devastating consequences.

Yet it is heartening to see how a few dedicated individuals can make a difference.
 

Nurses using needle cutter to destroy used syringes

Providing better healthcare in Afghanistan – A view from the field

Fahimuddin Fahim's picture


Although I have extensive project management experience in Daykundi Province, the scale and impact of the System Enhancement for Health Action in Transition (SEHAT) Program is truly inspiring—for example, the 39 centers that deliver the Basic Package of Health Services (BPHS) together serve over 77,000 outpatients per month. In October 2016, these centers managed the delivery of 615 babies, with as many as 69 deliveries in Temran Basic Health Center alone.
 
In fact, when it comes to female health, SEHAT has ensured that there is at least one female staff member in every health center. This has partly been possible because of the successful implementation of community-level education programs, such as the Community Midwifery Education (CME) and Community Health Nursing Education (CHNE). The program has also strengthened community-based health care by setting up health Shuras (councils) in all locations covered by SEHAT and implemented specific controls on qualifications and credentials of health workers.
 
SEHAT is a program of the Ministry of Public Health (MoPH), supported by the International Development Association (IDA), the World Bank Group’s fund for the poorest countries, and the Afghanistan Reconstruction Trust Fund (ARTF), in partnership with multiple donors. An NGO, PU-AMI, was contracted by MoPH between 2013 and June 2017 to deliver BPHS in Daykundi, in line with national health goals outlined by the ministry. These goals include reducing mother and child deaths and improving child health and nutrition. Thus, the program focuses on increasing access, building capacity, strengthening coordination, promoting use of monitoring and evaluation data, and enabling better support for pharmaceutical supplies.

Finger Splints, Coding, Drones and R2D2: The Evolving Face of Technology and Development

Brittany Walters's picture
Launched in October 2016, the drone delivery project made Rwanda the first country in the world
to use the drone technology at the service of saving lives. The drone delivery project is a partnership
between the Government of Rwanda and the California based robotics company, Zipline, Inc.
With the help of these drones, patients no longer have to wait for blood for hours to get to remote
clinics and hospitals. They can now receive blood transfusions in minutes.
Photo: Sarah Farhat / World Bank


Blood-delivering drones? Check. 3D-printer working off grid to print finger splints? Check. Disadvantaged women trained and employed in software-developing? Check. Is this how technology can deliver for development?

Committing to the Early Years, the Foundation for Growth

Marlyse Douala Bell's picture
This page in: French



In 2013, I was confronted by the realization of my country’s situation at a parliamentarian workshop organized by UNICEF where I learned about the different forms of malnutrition that we face. There, I discovered that my country, Cameroon, has an overall stunting prevalence of 32% for children under age five. In other words, one in three children under the age of five is affected. I now know of the devastating effects of malnutrition on the health of families, children and adolescents and consequently on the development of our country. As a parliamentarian, I’ve worked to serve my constituency and set up a community health insurance which helps improve the coverage of vulnerable children and young people. These challenges are our daily reality, but I was surprised to see them highlighted by the President of the World Bank in Washington, DC when I traveled there for the World Bank’s Spring Meetings.  

To build resilient cities, we must treat substandard housing as a life-or-death emergency

Luis Triveno's picture
Also available in: Español | 中文

Resilient housing policies. © World Bank
Why resilient cities need resilient housing.  Download the full version of the slideshow here

The scene is as familiar as it is tragic: A devastating hurricane or earthquake strikes a populated area in a poor country, inflicting a high number of casualties, overwhelming the resources and capacity of rescue teams and hospital emergency rooms. First responders must resort to “triage” – the medical strategy of maximizing the efficient use of existing resources to save lives, while minimizing the number of deaths. 

But if governments could apply triage to substandard housing, medical triage would be a much less frequent occurrence – because in the developing world, it is mainly housing that kills people, not disasters.
 
From the 2017 Global Platform for Disaster Risk Reduction to the 2017 Urban Resilience Summit, practitioners and policymakers have increasingly focused their discussions on how we can boost the resilience of urban areas.

But this is a problem with a well-known solution: Resilient cities require resilient housing.

To make housing more resilient, cities need to focus on two different but complementary angles: upgrading the existing housing stock, where most the poor live, while making sure that new construction is built safe, particularly for natural disasters. After all, if floods or earthquakes do not distinguish between old and new homes, why should policymakers? It is time for resilience to become part of the definition of “decent, affordable, and safe housing.”

 


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