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South Asia

Ask what a mayor can do for you

Maryse Pierre-Louis's picture


For the first time in history, more than half the human population lives in cities, and the vast majority of these people are poor. In Africa and Asia, the urban population is expected to increase between 30-50% between 2000 and 2020. This shift has led to a range of new public health problems, among them road traffic safety. Road crashes are the number 1 killer among those aged 15-29, and the 8th leading cause of death worldwide. The deadly impact from accidents is aggravated by pollution from vehicles, which now contributes to six of the top 10 causes of death globally.

Innovation in India to Expand Health Coverage

Harold Alderman's picture

A number of recent innovations have increased the scope of climate insurance available for rural communities. For example, by using rainfall or forage cover instead of individual assessments, farmers and pastoralists have the option of insuring a portion of their livelihoods. A range of schemes have been attempted to provide a similar level of coverage for out-of-pocket health expenditures to workers in the informal sectors.   

Pour un accès plus équitable à la planification familiale en Asie du Sud

Julie McLaughlin's picture

Le 11 juillet, lors de la Journée mondiale de la population, des acteurs mondiaux de premier plan dans le domaine de la santé se réunissent à Londres pour tenter de mettre la priorité sur l’enjeu de la planification familiale. Cet enjeu est au cœur des travaux du personnel de la Banque mondiale chargé des questions de santé en Asie du Sud, qui s’emploie à trouver les moyens qui lui permettront d’aider plus efficacement les femmes et les familles à espacer les naissances et à éviter les grossesses non désirées.

 

Même si les pays d’Asie du Sud ont progressé dans l’élargissement de l’accès à la contraception moderne et dans le recul global de la natalité, la région accuse la deuxième plus forte mortalité maternelle du monde. Dans ces pays, les ménages pauvres, marginalisés et non instruits n’ont pas accès aux services de santé génésique dont ils ont besoin, et notamment à la planification familiale.

 

En Inde, au Népal et au Pakistan en particulier, les taux de fécondité et d’utilisation de contraceptifs diffèrent considérablement d’une catégorie socioéconomique à l’autre : en Inde, alors que le taux de fécondité n’est que de 1,8 chez les femmes les plus aisées, il se maintient à 3,9 parmi les plus démunies. Au Népal, les femmes instruites ont, en moyenne, 1,9 enfant, contre 3,7 pour les femmes non instruites. Au Pakistan, la prévalence de la contraception atteint aujourd’hui 32 % chez les couples riches et seulement 12 % chez les couples pauvres. En Inde, dans l’État du Meghalaya, 36 % des couples désireux de recourir à la planification familiale n’ont pas accès à une contraception efficace.

Planificación familiar en Asia meridional: Mejorar la igualdad de acceso

Julie McLaughlin's picture

 

El 11 de julio, Día Mundial de la Población, mientras los líderes mundiales de la salud se reúnen en Londres para debatir sobre el otorgamiento de una mayor prioridad a la planificación familiar, el personal del Banco Mundial que trabaja en el sector de salud en Asia meridional estará pensando en cómo respaldar más eficazmente a las mujeres y las familias de esta región para espaciar los nacimientos y evitar los embarazos no deseados.

 

Aunque los países de Asia meridional lograron aumentar el acceso a la planificación familiar moderna y reducir los índices totales de fecundidad, la región sigue teniendo la segunda tasa más elevada de mortalidad materna. Los hogares pobres, marginados y sin educación no cuentan con los servicios de salud reproductiva que necesitan, incluida la planificación familiar.

 

En India, Nepal y Pakistán, en particular, las diferencias en la fertilidad y el uso de anticonceptivos entre los grupos socioeconómicos son sorprendentes: en India, la tasa de fecundidad en la parte más rica de la población es de 1,8, mientras que sigue siendo de 3,9 entre los más pobres; en Nepal, las mujeres con educación tienen en promedio 1,9 hijos, mientras que las menos educadas tienen un promedio de 3,7; en Pakistán, la prevalencia de anticonceptivos es del 32% en las parejas más ricas y de apenas el 12% entre las parejas pobres, y en el estado indio de Meghalaya, el 36% de las parejas que quiere practicar la planificación familiar carece de acceso a métodos anticonceptivos eficaces.

Family planning in South Asia: Improving equity of access

Julie McLaughlin's picture

On July 11, World Population Day, while global health leaders  meet in London to discuss giving greater priority to family planning, World Bank health staff in South Asia will be thinking about how to more effectively support women and families in this region to space births and avoid unwanted pregnancies. 

 

While the countries of South Asia have made progress in increasing access to modern family planning, and reducing total fertility rates, the region still accounts for the second highest burden of maternal deaths. Poor, marginalized and uneducated households do not have access to the reproductive health services they need, including family planning.

 

In India, Nepal and Pakistan in particular, the differences in fertility and use of contraception across socioeconomic groups are striking: In India, the fertility rate among the wealthiest part of the population is only 1.8, while it remains 3.9 among the poorest. In Nepal, educated women have on average 1.9 children while the least educated have an average of 3.7.In Pakistan, contraceptive prevalence is 32% among wealthier couples and yet only 12% among poor couples. In the Indian state of Meghalaya, 36% of couples who want to practice family planning lack access to effective contraception.

Filling empty stomachs: when enough food is not enough

Leslie Elder's picture

Children having a bowl of soup (credit: Jamie Martin).

Save the Children’s recent report, A Life Free from Hunger: Tackling Child Malnutrition, reminds us that undernutrition is not a new crisis—and that the crisis will deepen if the global community fails to take serious action. If current trends persist, 11.7 million more children will be stunted in Sub-Saharan Africa by 2025, compared to 2010.

 

What can we do? Food is part of the answer, but it’s about the right food, at the right time—not just starchy staple foods that fill empty stomachs. According to Save the Children, more than half of children in some countries are eating diets of just three items: a staple food, a legume, and a vegetable (usually green leaves).

 

Availability of food and access to food are necessary but insufficient to ensure good nutrition. Insidiously, malnutrition (undernutrition) is not hunger, although malnourished children are often hungry. And undernutrition is frequently invisible, but increases the risk of child death; steals children’s growth; decreases cognitive potential, school performance, and adult productivity; and contributes to the development of non-communicable diseases later in life.

Nutrition: the hardware for development

Kees Kostermans's picture

Especially under the present constrained financial environment, the debate among development specialists often shifts toward the core requirements for development. Is it infrastructure (regular electricity, good roads, airports, and bridges)? Is macro-economic stability the top priority (good luck with that one, today!)? Or is it human development (good health, education, and social protection services)? Or is it governance linking it all together and managing the available resources well?

Few issues have come so much to the forefront of the development agenda lately as nutrition. Nowadays multisectoral nutrition programs are being developed with high-level attention from policy makers and development partners. In the World Bank, the South Asia region has made nutrition one of its key priorities to be addressed, as we heard at yesterday’s event.

But more importantly, governments in the region also have recognized nutrition as a key development challenge.