Talking to a Sri Lankan friend about his 80-year old mother, who has been living alone ever since his father passed away 4 years back, brought back memories of my own mother who passed away at the age of 76 in 2008. As my Sri Lankan friend was worried about his mother’s living arrangements (he is happy to have her move in with him, but she prefers to stay alone in the house that has been her home for 46 years), I began to muse about my own father who lives alone at 85 years. He is in reasonable health for his age, and is largely independent, except that he needs oxygen support every night while sleeping as his lungs have lost significant capacity due to fibrosis, and his eyesight has deteriorated considerably. I was feeling guilty for not taking care of him in his old age. Again, it is his decision not to move in with any of his children, as he wants to stay in the apartment which he is familiar with and to be ‘independent’. We have appointed a care-taker who stays with him all day, while my sister and brother-in-law who live just a kilometer away give him company in the nights. Still the guilt feeling is no less.
The United Nations hosted the Millennium Development Goals (MDG) Summit in New York City last month, with the participation of over 120 global leaders from both developed countries and emerging markets. This year’s summit was an especially momentous occasion since it marks 10 years since the Goals were set into motion and begins the 5 year countdown to 2015 when the goals are to be met.
At the awards ceremony on September 19th, both Bangladesh and Nepal received MDG country awards for advancements towards the development goals in health indicators with India receiving a nomination for greatly increasing access to education.
We asked South Asia's Human Development Director, Michal Rutkowski about these achievements.
Starting with water and sanitation interventions and then trying to gauge the health impact can actually take us away from our desired goal of securing health improvements. Reversing this approach to start with health impact (first) and then determine causality (second) may create a more effective framework to optimize the trade-offs between water, sanitation and a range of other interventions!
The water and sanitation sector has been subject to numerous health impact studies. These are complex undertakings that require careful intervention and control conditions, extensive and carefully managed data sets, considerable time and money. Even in the best cases, quantifying the health impact of water and sanitation interventions is plagued by the high levels of uncertainty that surround the confounding variables. Furthermore, such studies do not quantify the relative health impact of choosing to invest in water and sanitation rather than breast feeding, or female literacy, or any other intervention. Even worse, such studies can draw a positive correlation between an intervention and the health impact … while the overall health for the particular target population has decreased. In such a scenario, it could be legitimately argued that investing in water and sanitation (and not female literacy) was the wrong choice - if the goal was a positive impact on health.
Pakistan’s deadly floods have affected more than 14 million people, with some estimates putting the figure considerably higher. The affected area covers 132,421 km, including 1.4 million acres of cropped land. Continuing rains have caused additional flooding and hindered relief activities.
The blog I have posted reflects my personal views and not those of the World Bank or its affiliates. It is unfortunate that some parties have sought to interpret what I written as the official views of the World Bank. The blog platform is intended to generate a healthy discussion. The comments that the blog attracted shows differing opinions on the subject of public and private roles in health care.
- South Asia
- Social Development
- Public Sector and Governance
- Private Sector Development
- Financial Sector
- Communities and Human Settlements
- Tamil Nadu Health
- public-private partnerships
- public health
- Primary Health Centers
- National Rural Health Mission (NRHM)
- National Health Insurace
- health care
In 2008, I sat with a focus group of about 15 women in a rural village of Bagerhat district in southern Bangladesh. I and some colleagues had visited their village the day before and saw their desperate living conditions and the family conflicts that erupted because of it. This village, and many others, had been hit by cyclone Sidr four months earlier.
We asked the women about their aspirations; they responded with blank stares. But after just two hours of discussion, these women had absorbed and understood the importance of savings, of credit, of good governance, and how they could rebuild (and improve) their lives and livelihoods. At the end of the meeting, one woman told us, “We came here because we thought you would give us food, but we’re not hungry anymore. We have hope.”
The women in Bagerhat and 7 other districts are part of the Social Investment Program Project (SIPP), which has been working in Bangladesh since 2004, when it started as a US$18 million pilot, to introduce community driven development to the country’s rural communities.
Nepal has faced seven avian influenza outbreaks in animals since early-February this year. In the Central, Southern and Eastern Regions, these outbreaks were quickly spotted by field monitors and successfully contained by Rapid Response Teams, thanks to the Avian Influenza Control Project (AICP).
The project is helping the Government of Nepal to prepare, prevent and control avian influenza outbreaks together with our partner organizations, including USAID, FAO, OiE, WHO and UNICEF. Implemented jointly by the Departments of Livestock Services and Health Services, the project is strengthening surveillance, diagnostic capacity, and prevention and containment activities, improving bio-security in poultry production and trade, and raising awareness through communication activities.
The International Organization for Migration (IOM) presented their Final Report on The Bangladesh Household Remittance Survey 2009 in a workshop held in Dhaka on May 12, 2010. This survey collected data from a nationally representative sample of 10,926 migrant households. The findings of the survey confirm most of what we know about migration and remittance based on smaller surveys and anecdotal evidence. In particular, the findings are in line with the ones from the World Bank Survey (2007), which was smaller in scope.
I summarize below what appears to me as some emerging stylized facts about the profile of Bangladeshi migrants and their remittance behavior.
Migrants tend to be young (32 years old on average) married males who have at least completed primary education (over 75 percent). They go to the Middle-East (nearly 73 percent) and Asia (22) with the help of relatives (55 percent) and intermediaries (45 percent) after obtaining a low skilled or semi skilled job contract (79 percent) for which they had to wait for about 6 months.
I had the opportunity to be a part of the launch of "Economic Challenges to Make South Asia Free from Poverty and Deprivation" in Washington and was truly inspired by the talent and knowledge of the students and the ideas and enthusiasm generated by the event across the region.
The event, coordinated across the region through video conference was moderated by Economic Adviser Shekhar Shah, who authored the foreward, and was exceptionally encouraging of the students and the issues discussed in the volume and organized by Hema Balasubramanian who heads the Public Information Center in New Delhi.
The unique student initiative that created the book, South Asia Economics Students’ Meet (SAESM), edited by Meeta Kumar and Mihir Pandey promotes budding economists to foster intellectual discourse with other students from the region. The annual conference, since 2004, has provided an opportunity for exceptional economic students to write, present, and share their academic papers on economic issues critical to the region.
…that too many children have died?
I adapt this from Dylan’s famous 1962 lyrics, but it is nowhere more true than for Adivasis or tribal peoples (called Scheduled Tribes) in India.
Come monsoon, the Indian media is rife with stories of child deaths in tribal areas, frequently reported as “malnutrition deaths”. Kalahandi district in Orissa for instance, had been a metaphor for starvation due to press reports dating back to the 1980s. Melghat area in Maharashtra has similarly surfaced in the press especially during the monsoon when migrant Adivasis return to their villages and to empty food stocks in the home. This is followed by public outrage, sometimes by public interest litigation and often a haggling over numbers.
We recently published a working paper that looks at child mortality among India’s adivasis – the starkest manifestation of their deprivation. We find that an average Indian child has a 25 percent lower likelihood of dying under the age of five compared to an adivasi child. In rural areas, where the majority of adivasi children live, they made up about 11 percent of all births but 23 percent of all deaths in the five years preceding the National Family Heath Survey 2005. While there has been progress in child survival over the years, and much greater vigilance, which often leads to these stories surfacing in the media at all, the fact remains that children in tribal areas are at much greater risk of dying than those in other areas.