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  • Reply to: Were the poor left behind by the health MDGs?   5 hours 11 min ago
    Thanks, Charles.

    Yes, indeed, health outcomes reflect all caregiver-delivered "interventions" and proximate determinants, including ones that aren't medical. And yes these and medical interventions will in turn be influenced by income, education, and other underlying determinants. Since "social determinants" could include nonmedical proximate determinants, underlying determinants, or both, it's not clear how the term helps us explain the puzzle, namely why progress on underlying determinants has apparently resulted in propoor progress on monitored interventions but not apparently on other proximate determinants. If income inequality did rise, why didn't it lead to prorich progress on, say, SBAs? Or immunization? Or antenatal care?

    Cheers,

    Adam
  • Reply to: Were the poor left behind by the health MDGs?   6 hours 6 min ago

    It could also be that health outcomes are not just, or only, dependent on health or healthcare related services. Rising economic inequality, and inadequate attention to the social determinants of health, could well be the explanation for the divergence between healthcare interventions and healthcare outcomes. That is why we need a more holistic approach in the post-2015 agenda.

  • Reply to: The Infrastructure Opportunity   9 hours 29 min ago

    When all is said about public infrastructure opportunities, long-term productivity is about finding common cause, building effective consensus (especially among decision makers), and the efficient transformation of resources into wholesale solutions that make a real difference. The WB is right to suggest that continuity among stakeholders can help derive greater productivity where isolated or fragmented interests have been the norm historically.

  • Reply to: The Infrastructure Opportunity   10 hours 40 min ago

    The infrastructure public budget has been continuously restrained everywhere due to fiscal constraints. This policy is translated to infrastructure in lack of maintenance and reinvestment. Private financing was considered to be a way to solve general infrastructure investments, but it showed to be suitable only for developped markets (high traffic roads, IT, main airports and ports,etc.) but not suitable for solving small towns or rural infrastructure.
    In this scope, Governments are forced to focus on emergency and maintenance driven by demand.
    The economies of scale of infrastructure are lost, preventive measures are not posible, and planning does not make much sense if planning results are imposible to pass from paper to execution

  • Reply to: The Infrastructure Opportunity   12 hours 46 min ago

    It is true that sustainable infrastructure development saves lives through its crucial role to mitigate man made and natural disasters.The human suffering we are witnessing in African countries could have been minimized/mitigated, had adequate transport infrastructure been in place that can help the host govrnements and international communities to reach the unreachable people in the remote areas.