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Sustainable Communities

Poor sanitation is stunting children in Pakistan

Ghazala Mansuri's picture
A nutrition assistant measures 1 year old Gullalay’s mid-upper arm circumference (MUAC) at UNICEF supported nutrition center in Civil Dispensary Kaskoruna, Mardan District, Khyber-Pakhtunkhwa province, Pakistan.
With a stunting rate of 38 percent, Pakistan is still among the group of countries with the highest rates of stunting globally and the pace of decline remains slow and uneven. In Sindh, for example, things have worsened over time, with one in two children now stunted. Credit: UNICEF


More than one in every three children born in Pakistan today is stunted.

Child stunting, measured as low height for age, is associated with numerous health, cognition and productivity risks with potential intergenerational impacts.

With a stunting rate of 38 percent (Demographic & Health Survey 2018), Pakistan is still among the group of countries with the highest rates of stunting globally and the pace of decline remains slow and uneven.

In Sindh, for example, things have worsened over time, with one in two children now stunted!

The policy response to this enormous health crisis has been almost entirely centered on interventions at the household level—reducing open defecation (OD), improving household behaviors like child feeding and care practices and food intake.  

A recent World Bank report, which I co-authored, suggests that a major shift is this policy focus is required for significant progress on child stunting.

The report begins by showing that over the past 15 years Pakistan has made enormous progress in reducing extreme poverty, with the poverty rate falling from 64 percent to just under 25 percent in 2016.

This has improved dietary diversity, even among the poorest, and increased household investment in a range of assets, including toilets within the home.

This has, in turn, led to a major drop in OD, from 29 percent to just 13 percent. Curative care has also expanded, with the mainstreaming of basic health units and the lady health worker program.
 

Protecting Bhutan’s cultural heritage

Dechen Tshering's picture
Cultural heritage is an extremely important aspect of Bhutan and is one of the four pillars of Gross National Happiness, the guiding philosophy of Bhutan’s development


Culture defines the sovereignty and identity of Bhutan and its people.

And the intricate beauty and uniqueness of its traditional architecture are known around the world.

As such, cultural heritage preservation is one of the four pillars of Gross National Happiness, the guiding philosophy of Bhutan’s development, and is embedded in all its national development policies.

In this context, the Royal Government of Bhutan has made it a priority to sustain both tangible and intangible aspects of its culture with dedicated offices under the Department of Culture of Ministry of Home and Cultural Affairs (MOHCA), which work closely with local governments.

This work is critical as Bhutan’s monuments are vulnerable.

The 2009 and 2011 earthquakes damaged hundreds of historic monasteries and fortresses known as dzongs, including the Lhuntse and Trashigang Dzongs (2009) and the Paro Tadzong (2011).

Also, fires triggered some of the worst disasters in Bhutan’s cultural history.

The famous Paro Taktshang, nicknamed the Tiger’s Nest and the Wangduephodrang Dzong were burnt down in 2008 and 2012 respectively.

One of the distinctive characteristics of the Dzongs of Bhutan is their strategic location.

Too often, Dhaka remains inaccessible for people with disabilities

Shigeyuki Sakaki's picture
 World Bank 
Tajkia Mariam Jahan, a wheelchair user from Dhaka, Bangladesh was confined to her home for seven years due to the road environment. The city roads are unwelcoming not only for people in a wheelchair like her but also for persons with all types of disabilities. Credit: World Bank 

An ever-growing urban population with overflowing and at times chaotic vehicular traffic can make life difficult even for the most well-abled pedestrian.

The challenges become higher for a person with a disability.

How can I go out of my home?’ asks Tajkia Mariam Jahan, a wheelchair user from Dhaka, who was confined to her home for seven years due to the road environment.

The city roads are unwelcoming not only for people in a wheelchair like her but also for persons with all types of disabilities.

Hawa Aktar, a woman with hearing impairment, needs clear, visible signs and signals on road crossings and from vehicles. And Bashir Uddin Molla, a student with visual impairment, needs sounds and guidance when she is walking.

None of these facilities are available to people with disabilities living in Dhaka.

Five takeaways for better nutrition in South Asia—and beyond

Felipe F. Dizon's picture
In many developing countries, governments and health authorities face the dilemma of how to feed their growing population while ensuring their food is nutritious. Credit: World Bank

Together with more than 1,500 academics, scientists, and policymakers, we participated last week in the Rice Olympics.
 
The event—formally known as the International Rice Congress (IRC)—provides a unique window on the latest innovations and policies about the globe’s most important staple crop.
 
For many, rice may not seem worth the cost of a conference trip. Yet, half of the world’s population depend on it as their main supply of nutrients and energy.  
 
Rice isn’t just a crop,” said Rajan Garjaria, Executive Vice President for Business Platforms at Corteva Agriscience. “It’s a way of life. A place can be made or broken, based on their rice crop.
 
The Congress discussed a breadth of topics, but what stood out the most is that rice can be instrumental in making people healthier and in sustaining the planet.
 
The South Asia Food and Nutrition Security Initiative (SAFANSI), a World Bank partnership that aims to improve food and nutrition security across the region, participated in the Symposium on Sustainable Food Systems and Diets and presented its latest research on linkages among food prices, diet quality, and nutrition security.  
 
Overall, the event underscored how governments and health authorities in many developing countries face the dilemma of how to feed their growing population while ensuring their food is nutritious and discussed relevant strategies to transform nutrition security challenges into opportunities.

Afghanistan: Learning from a decade of progress and loss

Shubham Chaudhuri's picture
Also available in: دری | پښتو
Afghanistan: Learning from a decade of progress and loss


In Afghanistan, the past decade saw remarkable progress, as well as reversals and lost opportunities.

The overall macroeconomic and security context in Afghanistan since 2007 can be broken into two distinct phases, pre- and post- the 2014 security transition, when international troops handed over security responsibilities to the Afghan National Security Forces (ANSF).
 
The pre-transition phase was marked by higher economic growth (GDP per capita grew 63 percent relative to its 2007 value) and a relatively stable security situation.

Since 2014, growth has stagnated, falling below rates of population growth, and the security situation continues to deteriorate. With the withdrawal of most international troops and the steady decline in aid (both security and civilian aid) since 2012, the economy witnessed an enormous shock to demand, from which it is still struggling to recover.

Similarly, welfare can be characterized into two distinct phases.

Building up Bhutan’s resilience to disasters and climate change

Dechen Tshering's picture
Building Bhutans Resilience
Despite progress, Bhutan still has ways to go to understand and adapt to the impacts of climate change. And with the effects of climate change intensifying, the frequency of significant hydro-meteorological hazards are expected to increase. Photo Credit: Zachary Collier


The 2016 monsoon was much heavier than usual affecting almost all of Bhutan, especially in the south.
 
Landslides damaged most of the country’s major highways and smaller roads. Bridges were washed away, isolating communities.
 
The Phuentsholing -Thimphu highway which carries food and fuel from India to half of Bhutan was hit in several locations, and the Kamji bridge partially collapsed, setting residents of the capital city and nearby districts into panic for fear of food and fuel shortages.
 
Overall the floods drove down Bhutan’s gross domestic product by 0.36 percent.

While not as destructive as the 2016 monsoon, flash floods, and landslides are becoming a yearly occurrence along Bhutan’s roads.

How can Sri Lanka better protect its people against disasters?

Thomas Walker's picture
A recent World Bank report indicates that nine out of 10 of Sri Lankans may live in climate hotspots—or areas highly prone to floods or droughts—by 2050
A recent World Bank report indicates that nine out of 10 of Sri Lankans may live in climate hotspots—or areas highly prone to floods or droughts—by 2050

Sri Lanka has a long history of coping with weather impacts.  

About two thousand years ago, the country built one of the world’s first irrigation system to control its water supply.

This feat of engineering, which boasted hundreds of kilometers of channels, tanks, and innovative valve pits, helped the great kingdoms of Anuradhapura and Polonnaruwa flourish into sophisticated societies and protect their people against hunger.

Not unlike these early civilizations, modern social protection programs have sheltered those affected by disaster through financial assistance and other forms of support.

Today, building resilience to natural disasters and other shocks is more critical than ever.

Since 1980, the frequency of natural disasters worldwide has increased by 250 percent, and the number of affected people has more than doubled.

Sri Lanka is no exception. The country ranked fourth most vulnerable to climate change in 2016.

Further to that, a recent World Bank report indicates that nine out of 10 of Sri Lankans may live in climate hotspots—or areas highly prone to floods or droughts—by 2050.

The losses caused by significant shocks like natural disasters have long-lasting consequences.

Children, especially, can suffer permanent damages if they are not educated or fed correctly in their critical early years.  

And the loss of assets, livestock, and crops can severely hurt small business owners and farmers and further discourage them from investing.

Sadly, natural disasters hit the poor the hardest as they tend to live in disaster-prone areas, work in agriculture, and usually don’t have savings or access to credit.

When a shock hits, wellbeing declines as people cut back on food and other essentials due to their loss of income or the high cost of rebuilding their homes.

And while some people gradually restore their standards of living, some never fully recover and get stuck in poverty.

But the poor aren’t the only ones who need to worry about shocks.

Today, a third of Sri Lankans are just a shock away from falling into poverty.

Our analysis of the 2016 Household Income and Expenditure Survey reveals that a 20 percent sudden decrease in household welfare—or consumption shock—would more than double the poverty rate: almost 1 in 10 Sri Lankans would be poor.

If the shock triggered a 50 percent decrease in consumption, one in three Sri Lankan families would fall into poverty.

Connecting communities through India and Bangladesh's cross-border markets

Nikita Singla's picture


In remote border regions in Bangladesh and India, a government-to-government initiative is changing cross border relations, shifting the focus from smuggling and skirmishes to mutual economic gains and building a coalition for peace and cooperation.

In 2011, Bangladesh and India flagged off the first of their border haats, representing an attempt to recapture once thriving economic and cultural relationships that had been truncated by the creation of national borders.
Border Haats are local markets along the Indo-Bangladesh border that stretches 4100 Kms and runs through densely populated regions.

Conceived as Confidence Building Measures between India and Bangladesh, 4 Border Haats were set up between 2011 and 2015.
  • Balat (Meghalaya) – Sunamgunj (Sylhet)
  • Kalaichar (Meghalaya) – Kurigram (Rangpur)
  • Srinagar (Tripura) – Chagalnaiya (Chittagong)
  • Kamalasagar (Tripura) – Kasba (Chittagong)

Initially only local produce was permitted for trade. But subsequently, the range of items has been broadened to include goods of household consumption.
 

Bringing the People of Bangladesh and India Together Through Border Markets
Overall, border Haats have been strongly welcomed by participants. The positive experience of border haats has prompted both the governments to flag-off six more Border Haats: two in Tripura and four in Meghalaya. More Haats mean more trade, more people to people connect and more trust, one leading to another. This will go a long way in linking marginalized border communities to more mainstreamed trade and development.  


But border haats are not only about trade.

Clean and Green Bangladesh: A goal that can be achieved

Karin Erika Kemper's picture
 

"Think before you do, not after you're done,” says a Bengali proverb that applies to an urgent threat today for Bangladesh—major environmental problems spawned by rapid urbanisation and industrialisation. A decade of strong economic growth helped Bangladesh reach lower middle-income status while sharply decreasing its poverty rate, a remarkable achievement. But like many countries in the world, such progress has come at considerable environmental cost.

According to our just released report, "Country Environmental Analysis", Bangladesh is among the countries most affected by pollution and other environmental health risks. The monetary cost to the Bangladeshi society of environmental degradation in urban areas, measured in terms of foregone labour output was equivalent to about one percent of the Gross Domestic Product (GDP) annually.  If one takes into account the broader welfare impacts of mortality attributed to environmental risks, the economic cost is equivalent to 3.4 percent of the national GDP. Noncompliant industries and inadequate waste management of hazardous and nonhazardous materials are polluting the cities' air as well as surface and ground water. The study also indicated that many rivers around Dhaka are polluted.

Addressing gender-based violence in Nepal

Zainiddin Karaev's picture
 David Waldorf
Nepal has a high incidence of gender-based violence and women remain — by large — the main victims. Credit: David Waldorf

Last month, I visited Nepal to understand the gravity of gender-based violence (GBV) and how victims can seek help and access confidential and quality support services.   
 
Nepal has a high incidence of gender-based violence. And while everyone, regardless of their sex, can be affected, women remain — by large — the main victims.   
 
In 2017, 149 people were killed as a result of GBV in Nepal. 
 
Of these victims, 140 were female, 75 of whom were killed because of domestic violence.  
 
In 2017, out of 680 documented cases, the main perpetrator was a family member or relative in 163 cases of them.  
 
However, such cases are generally unreported due to the stigma attached to GBV. 
 
In this bleak context, it was heartening to hear about an integrated platform that addresses GBV issues and has helped improve response and support to the victims.  
 
With assistance from the World Bank’s State and Peacebuilding Fund (SPF), the government of Nepal has set up a helpline and a network of service providers for GBV victims.
 
Since 2017, these programs have supported over 677 cases. 

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