Syndicate content

Health

Nepal hotline helps women suffering violence

Annette Dixon's picture
Women in Nepal
Violence against women remains a pervasive issue in Nepal. There's now a
24/7 helpline to support victims. 

On my visit to Kathmandu in January, I visited the Khabar Garaun 1145 (Inform Us) helpline set up to support survivors of Gender Based Violence (GBV).

In a small room, two operators respond tirelessly to callers as part of a 24 hour, seven days a week service. They assess callers’ needs, and refer them to receive legal aid, psycho-social support, child support and shelter. Each entry, whether it comes in by phone, email or text message, is carefully recorded through an online system, that eases the task of tracking and referring cases. The referrals connect them to response service providers including the Nepal Police, One-Stop Crisis Management Centers run by the Ministry of Health, and Non-Governmental Organizations.   

Since its launch by the National Women Commission (NWC) in December 2017, the helpline has received 1,938 calls from women seeking assistance to deal with GBV, with 180 cases being registered. Cases are registered only after a preliminary assessment is conducted, and immediate necessary support provided. It is heartening that so many survivors are coming forward to report cases. But the numbers are clearly alarming.  

Launching the NWC helpline
Launching the NWC helpline. Photo Credit: Richa Bhattarai/World Bank

There are various social restrictions that prevent women from speaking out and reporting incidents of gross injustice. With the introduction of the Khabar Garaun 1145 helpline, we hope that GBV survivors can find shelter, legal, psycho-social and remedial measures quickly and effectively. In fact, this is pioneering work by a government agency that can be a model for other countries, an innovation to note as we mark International Women’s Day. But it also illustrates the disturbing extent of GBV in Nepal, which is a leading cause of death for adult women. We need to eliminate GBV because it has devastating consequences on individuals, families and communities, along with large economic and social costs.   

Recently, an incident of a gang rape of a 21-year old woman was reported to the helpline. As follow up, the NWC counselor personally visited the survivor and traumatized family members and provided psychosocial and legal counseling, before referring the case. The survivor's husband was grateful for the support NWC provided – from counseling to collecting evidence and strengthening the case that resulted in a verdict to arrest perpetrators. “When our entire world seemed to collapse, this support helped restore a little of our faith in humanity,” he said. This is the kind of concrete support that is needed for women across the world. 

It’s time to #PressForProgress for Sri Lanka’s women!

Idah Z. Pswarayi-Riddihough's picture
 
Starting today, March 8, we at the World Bank are embarking on a year-long effort to rally the government, our development partners, the private sector and the public to see how we can really deliver results for Sri Lanka’s women.
Starting today, March 8, we at the World Bank are embarking on a year-long effort to rally the government, our development partners, the private sector and the public to see how we can really deliver results for Sri Lanka’s women.    

International Women’s Day is always an important marker in my calendar and this year’s theme #PressForProgress couldn’t be more exciting.
 
Starting today, March 8, we at the World Bank are embarking on a year-long effort to rally the government, our development partners, the private sector and the public to see how we can really deliver results for Sri Lanka’s women.    
 
What’s the urgency?
 
Simply put, Sri Lanka is trailing behind many countries in its development bracket when it comes to working women. 
 
Did you know that 214,298 women over the age of 15 are unemployed in Sri Lanka today?  Sri Lanka’s female labor force participation or FLFP rate has stubbornly remained in the mid-thirties for the last two decades; out of an estimated 7.3 million people who are considered ‘economically inactive’ 73.8 percent are women, while just 26.2 percent are men.
 
It is clear this challenge is too great for any ministry, development partner or corporate office.
 
But why do Sri Lankan women need to get to work?
 
Because this country’s prosperity depends on it!  Sri Lanka is getting older before getting rich. Without a labor force the country cannot be competitive nor can it deliver on basic services that require revenue to be generated.
 
So, the question is, what will it take to really deliver change for Sri Lanka’s women? What are the challenges? How can we help motivate those able to energize change that will benefit women?    
 
The World Bank is ready to join the government, private sector, development partners and the citizens of Sri Lanka in supporting tangible initiatives which address the realities on the ground. We are going to advocate widely.
 
So, let’s start with a few important announcements. We want to learn from you. Tell us where we should start, and what specific issues need attention. We want to know what your challenges are, and who inspires you most.

Landslides, dumpsites, and waste pickers

Silpa Kaza's picture
Photo: alionabirukova / Shutterstock
Editorial credit: alionabirukova / Shutterstock.com

Last week, the world came to attention when the famous Hulene dumpsite in Maputo, Mozambique collapsed under heavy rains, killing at least 16 people.
 
Buried under piles of waste were homes and people from one of the most impoverished settlements in Mozambique. Many members of this community made a living collecting and selling recyclables from the dumpsite, which had served as the final disposal site for greater Maputo since the 1960s.
 
Sadly, this tragedy did not stand alone.
 
In 2017, landslides at waste dumps occurred at a shocking frequency, accounting for over 150 deaths and relocation of several hundreds in Colombo, Sri Lanka; Addis Ababa, Ethiopia; Conakry, Guinea; and Delhi, India.
 
Sixty million people live near the world’s 50 largest dumpsites, most in low and lower middle-income countries, though thousands of other risky sites also exist around the globe. Fifteen million people make a living scavenging waste and are of the population disproportionately affected when poorly or unplanned disposal sites fail to function in the midst of ever-growing refuse and inclement weather. Those most vulnerable to the landslides of dumps are those living on or by these waste disposal sites. They are the ones who often power their cities’ recycling system.

From marginalization to inclusion: The story of the waste pickers in the West Bank

Amal Faltas's picture

About a decade ago, we started a project to improve solid waste management for waste pickers like Ibrahim and the 840,000 people in the southern West Bank governorates of Bethlehem and Hebron. One of the project components included the closure of the Yatta dumpsite, where illegally dumped and burned household waste was reaching a very unsanitary and hazardous level. 

But here came the challenge. 

While the closure of the dumpsite would mean putting an end to a serious environmental and public health problem, it was terrible news for the waste pickers and their families. It meant that the livelihoods of those families would come to an end. 

Why doctors leave their posts – problem-solving irregularities in the health sector with healthcare workers in Bangladesh

Mushtaq Khan's picture

It’s not often you get together the very people working on the frontline to sit down together and discuss why and how irregular practices occur in their sector – and what can be done about them. But that’s just what we did with a group of frontline health workers at a workshop in Bangladesh’s capital Dhaka in December 2017. We wanted to understand why corrupt and irregular practices occur in the health sector - what are the underlying incentives and processes? And what are some feasible and impactful ways to change these practices?

Many developing countries, including the three where our research consortium, the Anti-Corruption Evidence research consortium is working, Bangladesh, Nigeria and Tanzania, struggle to provide free or low-cost healthcare to all their citizens. Instead, citizens are often forced to buy services from the private sector at higher fees or worse, approach untrained or traditional healers. There is agreement in the literature that a large proportion of these inefficiencies occur due to corrupt practices (though there’s an active debate about whether using the c-word is helpful in this debate, which is why we talked about ‘irregularities’ during this workshop). Many of these practices are related to the way societies in developing countries are organized around patron-client relations, where tax resources are insufficient, and resources, jobs and promotions require lobbying powerful politicians.

How to attract and motivate passionate public service providers

David Evans's picture

In Gaile Parkin's novel Baking Cakes in Kigali, two women living in Kigali, Rwanda – Angel and Sophie – argue over the salary paid to a development worker: "Perhaps these big organisations needed to pay big salaries if they wanted to attract the right kind of people; but Sophie had said that they were the wrong kind of people if they would not do the work for less. Ultimately they had concluded that the desire to make the world a better place was not something that belonged in a person's pocket. No, it belonged in a person's heart."
 
It's not a leap to believe – like Angel and Sophie – that teachers should want to help students learn, health workers who want help people heal, and other workers in service delivery should want to deliver that service. But how do you attract and motivate those passionate public servants? Here is some recent research that sheds light on the topic.
 

Can cash transfers solve Bangladesh’s malnutrition?

Rubaba Anwar's picture
Silvi and her mother arrive with Silvi’s birth certificate to enroll into Jawtno. a cash transfer program aimed to help 600,000 poor families in Bangladesh access prenatal and child care.
Silvi and her mother arrive with Silvi’s birth certificate to enroll into Jawtno. a cash transfer program that aims to help 600,000 poor families in Bangladesh access prenatal and child care. Credit: World Bank


Silvi is eight months old. She lives in a remote village in one of the poorest regions of Bangladesh.
 
Her mother Maya often reflects on her pregnancy and worries about her daughter’s wellbeing as she recalls her morning sickness, the uncertain and painful birth, and the long nights at Silvi’s side as the baby lay wide awake wailing, fighting one illness after the other.
 
She remembers, too, the thrills of hearing Silvi giggle at the sound of her rattle, and when she began to crawl.
 
Despite the little joys that her baby brings to Maya, Silvi’s early childhood was marked with apprehension: Shouldn’t she be a little heavier? When will she learn to walk? Will she be healthy and intelligent enough to earn a decent living when she grows up? Or would she be handed down her parents’ poverty and get married like Maya had to, at only sixteen?
 
But with the right kind of support, Silvi can have a chance at a better life and bring her family out of poverty.
 
Growing evidence has shown that adequate nutrition before birth and the two years after – or in the first 1,000-days – has lasting effects on a child’s intelligence and brain development.
 
When they’re properly fed and exposed to learning, children can reach their full potential and break the poverty trap.
 
Thus, investing in early childhood nutrition and cognitive development (CNCD) is critical to curbing poverty in a country like Bangladesh, where 36 percent of children below the age of 5 are stunted —or too short for their age--, low birth weight is prevalent, and maternal nutrition remains poor.
 
Sadly, poor families like Maya’s are not utilizing services available to them.  

Edutainment changes the way we do development

Arianna Legovini's picture


Improving people’s lives is more than offering services. It requires people to be active participants in development, demanding services and products that add value to their lives and engaging in behaviors that are conducive to increasing their own welfare. Health prevention is a case in point.

At our HIV Impact Evaluation Workshop in Cape Town, South Africa in 2009, I listened to Nancy Padian, a medical researcher at the Women’s Global Health Imperative, presenting a systematic review of random control trials testing the effectiveness of HIV prevention campaigns.

The study she presented explained how three dozen HIV prevention campaigns had failed to change sexual behavior and reduce HIV incidence.

The presentation gave us pause. The review dismissed the communication campaigns as an ineffective means to change behavior and slow down the HIV epidemic.

A closer look revealed that the campaigns lacked inspiring narratives, and were communicated through outdated and uninteresting outlets such as billboards and leaflets.

The question we asked ourselves was: Can we do this differently?

Youth volunteers in Yemen provide hope during conflict

Khalid Moheyddeen's picture


Even before the protractive conflict, implementing development projects in some of the most remote and disadvantaged districts in a number of Yemeni governorates faced significant challenges. To address these challenges, and overcome some of the problems related to access to these remote areas, Yemen’s Social Fund for Development (SFD) devised a program in 2004 to attract youth interested in volunteering to promote development. In its first phase, this program — known as “Rural Advocates Working for Development (RAWFD)” — targeted a number of male and female students from these remote areas and provided them with a development-related program while they are attending universities in major cities. After graduation, these young graduates made a big difference in facilitating SFD operations and activities of other national and international organizations in their home areas. 

Surgical care – an overlooked entity in health systems

Emi Suzuki's picture

Five billion peopletwo thirds of world populationlack access to safe and affordable surgical, anesthesia and obstetric (SAO) care while a third of the global burden of disease requires surgical and/or anesthesia decision-making or treatment. Treating the sick very often requires surgery and anesthesia. Despite such huge burden of disease, safe and affordable SAO care is often overlooked.

Why? It may be because surgery and anesthesia are not disease entities. They are treatment modalities that address the breadth of human disease — infections, non-communicable, maternal, child, geriatric and trauma-related disease and injuries, and international development agencies have been focusing on vertical disease-based programs.

Prior to 2015, global data on surgery, anesthesia and obstetric care was virtually nonexistent. With the idea that “We can’t manage what we don’t measure”, the Lancet Commission on Global Surgery developed six Surgical, Obstetric and Anesthesia (SAO) indicators (discussed here) and collected data for them. The analysis of these data show large gaps in SAO care across countries by income groups.

There are 70-times as many surgical workers per 100,000 people in high-income countries compared with low-income countries

The SAO or “surgical” workforce is extremely small in low-income countries (1 SAOs per 100,000 population) and lower middle-income countries (10 SAOs per 100,000 population) whereas there are 69 SAOs per 100,000 population in high-income countries. The discrepancy between high-income countries and low- and middle-income countries is even greater for surgical workforce density than that of physician density.


Pages