Data compiled over the past two decades has found that all four major non-communicable diseases (NCDs) in Tonga are on the rise – diabetes, cardiovascular disease, cancer, and respiratory diseases. According to the latest WHO data, NCDs accounted for four out of five leading causes of deaths in Tonga, which is among the highest in the Pacific.
The increase in risky behaviors such as smoking, poor diet, harmful alcohol intake, and physical inactivity are acknowledged as the major contributing factors to the rise in NCDs in Tonga. Almost one in two men smoke, and smoking appears to be increasing among young women in Tonga. These are all strongly linked to ‘unhealthy environments’, and require complementary policies, regulations and legislation interventions.
Koshi is 4 days old. She was born in a small village near Hyderabad (Sindh, Pakistan) and is one of four siblings – all girls, all under the age of 10. Her parents were hoping that this time it would be a boy, but perhaps better luck next time? Her mother is worried that if she doesn’t give birth to a boy, she will be stigmatized. Family planning is out of the question – not that she and her husband have even discussed this. She worries about her girls’ well-being too. They are underweight and get sick a lot. She wants them to grow up healthy and get an education. Koshi’s father is worried about them too. He is a tenant farmer with a meager income. He already struggles to provide the basic necessities – food, clothing, shelter. Even if they marry young, how will he arrange their dowries? Of course this is only if Koshi and her sisters live long enough.
Koshi’s chances of survival are slim.[ii] The situation in Sindh is worse than the national average, and the risk of deaths is higher in its rural areas where access to healthcare and other social services is more limited.
Having a primary health center near the village and local lady health workers for example will improve the girls’ chances of access to healthcare and childhood immunization – necessary for protection against diseases such as measles, polio, and diphtheria that still take a heavy toll on children’s lives. It also improves the mother’s access to skilled birth attendance. .[iv]
More than one billion people globally – about 15% of the world’s population – are estimated to have a disability. Most of them live in developing countries. This number is expected to increase as aging, war and conflict, natural disasters, forced displacement, and other factors continue to affect the prevalence of disability.
They encounter attitudinal and environmental barriers that hinder their full and effective participation in society on an equal basis with others.
and ensures their participation in all stages of development programs. With a focus on social inclusion, disability-inclusive development is directly responsive to the World Bank’s twin goals of ending extreme poverty and boosting shared prosperity.
Disability Inclusion and Accountability Framework
with significant strides in operations and analytical work.
This has culminated in World Bank’s first Disability Inclusion and Accountability Framework, which offers a roadmap for:
- Including disability in the World Bank’s policies, operations, and analytical work; and
- Building internal capacity for supporting clients in implementing disability-inclusive development programs.
The Framework has been launched today on the occasion of the 11th Conference of States Parties to the Convention on the Rights of Persons with Disabilities at the United Nations, the premier international gathering of governments, development practitioners, and civil society working on disability inclusion.
How will the Framework support development work?
The Framework provides four main principles for guiding the World Bank’s engagement with persons with disabilities:
- Nondiscrimination and equality
- Inclusion and participation
- Partnership and collaboration
The appendices to this Framework highlight key areas of engagement for a significant impact on the inclusion, empowerment, and full participation of persons with disabilities.
These areas include transport, urban development, disaster risk management, education, social protection, jobs and employment, information and communication technology, water sector operations, and health care.
The Framework is a living document that will be reviewed periodically and strengthened with new focus areas and evidence to reflect ongoing developments.
We invite you to download the Disability Inclusion and Accountability Framework. We hope you find it useful for your work to build inclusive, resilient, and sustainable cities and communities for all.
When the door closed behind her, Maria’s world seemed to collapse. The mother of a girl and two boys had just learned that her eldest son, the teenager who became the pillar of the family after their father died, was not only in a deep depression and increasingly using alcohol but he was gay. She had noticed him becoming moodier and even heard he received a warning at his job for not showing up, something totally unlike him at all. She felt helpless but knew his depression had to stay hidden from the rest of the family and the neighbors as mental health problems brought with them social stigma. But she was most afraid someone would find out he was gay, causing the family to be ostracized and endangering the future of the other children.
What is there not to like about the Sustainable Development Goals? The 17 goals and 169 targets are nothing if not a smorgasbord of worthy ambition. But the sheer breadth and scope of the SDGs, allied to the 2030 target date, can make it difficult for governments to prioritise. It can also make it difficult for citizens to hold their governments to account. Cynics might suggest that’s why so many governments signed up for an SDG pledge that few of them have any intention of delivering.
For those of us who are more interested in achieving change than indulging in cynicism, the challenge is to identify pathways for translating rhetorical commitments into practical outcomes. If I had to select just one morsel of accountability from the SDG feast it would be this sentence tucked away in the preamble: “We wish to see the Goals and targets met…. for all segments of society. And we will endeavour to reach the furthest behind first.”
It’s tough to think of a more elevated test of fairness. The SDGs establish bold targets for eliminating extreme deprivation. But they also signal an intent to combine national progress towards those targets with ‘social convergence’, or a decline in the disparities separating the most marginalised from the rest of society. This is a marked departure from Millennium Development Goals (MDGs), which focused attention on national average progress. As the findings from an excellent 2015 paper by Adam Wagstaff and Caryn Bredenkamp noted national progress in child survival and nutrition masked widening inequalities in a majority of countries, notably in sub-Saharan Africa.
While it might be hasty to suggest we have collectively moved beyond the legacy of panic and neglect behavior, I am hopeful that the multiple global and country level efforts to strengthen pandemic readiness emerging since the deadly West Africa Ebola outbreak of 2014 might be starting to bear fruit.
Blog reader: “Dan! The government is one big system. Why didn’t your blog on the latest research on the quality of governance take this into account?”
Dan (Rogger): “Well, typically frontier papers in the field don’t frame their work as ‘modeling the system’ [which do?] However, Martin Williams at the Blavatnik School of Government hosted a conference last week on ‘Systems of Public Service Delivery in Developing Countries’ that directly aims to discuss how research can take into account the systemic elements of governance.
Today we mark World No Tobacco Day and this year the focus is on “Tobacco and Heart Disease.” The goal is to highlight the important and often overlooked role of smoking cigarettes as a leading cardiovascular disease (CVD) risk factor.
However, after promoting cleaner buses in Mexico for five years, we have seen firsthand that financial incentives alone are not enough. Specifically, there are three main obstacles that impede the expansion of cleaner bus fleets, and should be addressed appropriately.
New technologies and risk aversion
In general, private bus operators tend to be very risk averse when it comes to experimenting with new vehicle technologies. This is not exactly surprising: according to our own calculations from different projects in Latin America, variables related to vehicle performance—like fuel and maintenance—make up over 2/3 of costs over the life cycle of a conventional diesel bus. In that context, operators who are not familiar with the performance of new vehicle technologies can understandably perceive the transition to a cleaner fleet as a huge financial gamble.
The problem is partially rooted in institutions, who having imperceptibly supplanted traditional & cultural rites of passage often fail to recognize the extent of the need for robust, wholistic and sustained alternatives. Girls experiencing menarche not only require WASH infrastructure, but meaning; they not only need materials, space and privacy to change and dispose of menstrual products, but an environment free from aspersions, taboo and social restriction.