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Health

A three-course meal in darkness: An ‘eye-opening’ experience for embracing inclusivity

Annette Akinyi Omolo's picture
During a recent “Dinner in the Dark” social experiment, Kenya’s governors, policy makers and legislators experienced first-hand some of the same challenges as people living with disabilities. Photo: World Bank

 “That tastes like fish.”

“There’s some avocado and tomato in it too!”

“What is that?”

These are some of the exclamations I heard from participants of a recent social experiment dubbed “Dining in the Dark” in Nairobi on November 13th as they ate the first course of their meal.

Building human capital starts with health

Tim Evans's picture
Mothers register their babies while seeking health care at the Primary Health Centre New Karu, in Karu Village, Nigeria on June 19, 2018. Photo © Dominic Chavez/GFF

Health is a foundational investment in a country’s human capital.   Will a child live to celebrate her fifth birthday and be ready to attend school? Will she actually be able to learn and thrive in school? Will she grow to be an adult who can productively contribute to the society in which she lives?  All of this depends on robust health and nutrition, at every stage in her life.

Moving Afghanistan’s Bamyan province forward

Mohammad Tahir Zuhair's picture
View of Bamyan Province, Afghanistan
View of Bamyan city, Bamyan Province. Photo Credit: Rumi Consultancy​/ World Bank

When people think of Afghanistan, what comes to their minds are images of decades of war and insecurity.

True, Afghanistan has suffered a long history of upheaval

But there has been significant progress in rebuilding a strong, independent, and modern nation since 2001.

And in light of our nation’s turbulent history, it is sometimes easy to forget how far Afghanistan has come.

Just two month ago in October, over four million voters cast their ballots in parliamentary elections—with millions more looking forward to voting in the upcoming presidential election in 2019.

Unforgettably, 2018 also brought the unprecedented three-day ceasefire during Eid, a rare glimpse of complete peace that continues to give hope to many of us.

As Governor of Bamyan Province, one of my goals is to present a different image of my country to the world—one of progress and possibility in the face of adversity.

Many people have never heard of Bamyan. Neither do they know its longstanding and well-deserved reputation as one of Afghanistan’ safest provinces.

Our residents take pride in the fact that we haven’t experienced chaos, war, or insurgency against the government in 17 years.

And as Governor, I have witnessed the importance residents put on civil society, which has been vital to implementing successful development projects in the province.

Milk fortification in India: The journey so far

Edward W. Bresnyan's picture
 NDDB
In India alone, 185 million people don’t get enough nutrients. This hidden hunger is especially pervasive among children. as more than 70 percent of India’s children under five are deficient in Vitamin D, and 57 percent of all children in the country lack adequate levels of Vitamin A. Credit: NDDB
Globally, more than two billion people are deficient in key micronutrients, which are essential to their good health.
 
In India alone, 185 million people don’t get enough nutrients.
 
This hidden hunger is especially pervasive among children. More than 70 percent of India’s children under five are deficient in Vitamin D, and 57 percent of all children in the country lack adequate levels of Vitamin A. 
 
These deficiencies have contributed to high levels of stunting, wasting and underweight children.
 UNICEF 
Global micronutrient deficiency (as a percentage of the population). Two billion people in the world lack key micronutrients such as Vitamin A or iron. South Asia has the most critical malnutrition levels. Source: UNICEF 


Micronutrient availability can make or break a balanced diet
 
If accessible and affordable, nutritional supplements taken in the form of capsules or tablets can mitigate the symptoms of hidden hunger. But they can become toxic if consumed in large amounts.  
 
Unlike supplements, food fortification is a simple, preventive and low-cost approach to curb micronutrient deficiencies.
 
But except for mandatory iodine fortification of salt, India lags in adopting food fortification as a scalable public health intervention.  
 
This is a missed opportunity as a glass of fortified milk (320g) can provide approximately 34 percent of the recommended daily allowance of Vitamin A and 47 percent of Vitamin D.
 
In 2016, the Food Safety and Standards Authority of India released standards for the fortification of five staple food items: rice, wheat, salt, oil, and milk. Further to that, regulations are now in place to fortify milk variants such as low fat, skimmed, and whole milk with Vitamin A and D.   
 
But despite its significant health benefits, and while established for more than three decades by companies such as Mother Dairy, a subsidiary of the National Dairy Development Board (NDDB), milk fortification is not yet common practice across the Indian milk industry.
 
To fill that gap, NDDB partnered in 2017 with the South Asia Food and Nutrition Security Initiative (SAFANSI), the World Bank, and The India Nutrition Initiative, Tata Trusts to explore the possibilities of large-scale milk fortification in India.
 
Over the last twelve months, this collaboration has enabled ten milk federations, dairy producer companies, and milk unions across the country to pilot milk fortification for their consumers. Fifteen others have initiated the process.

All hands on deck: Halting the vicious circle of stunting in Sub-Saharan Africa

Emmanuel Skoufias's picture
Betty teaches mothers with small children about nutrition, Uganda. Photo: © Stephan Gladieu / World Bank

In a large, complex, or urgent situation, the command goes out: “All hands on deck!”

Sub-Saharan Africa faces such a clarion call now. It is the only region in the world with a growing number of children under the age of five who have stunted growth, meaning they are too short for their age. Although the number of children affected by stunting globally has decreased drastically since 1990, Africa is the only region that has seen an increase in the number of children stunted despite a decrease in the prevalence of stunting.

Do Knowledge and Income Have Synergistic and Distributional Effects on Preventing Child Undernutrition? Guest Post by Seollee Park

Development Impact Guest Blogger's picture

This is the eighth in this year's series of posts by PhD students on the job market.

High rates of stunting in many developing countries pose important health threats to young children and lead to adverse later-life outcomes. Many nutrition-specific interventions that target a single dimension of causes of child undernutrition have often found limited effects. This generates the question as to whether interventions that address multidimensional and nutrition-sensitive causes of undernutrition, such as lack of knowledge and income, are more effective in bringing about healthy child development.

Antimicrobial resistance is a priority issue for all people

Juergen Voegele's picture
Bogota, Colombia. Photo credit: Dominic Chavez/World Bank

If, like most people, you think antimicrobial resistance is something that only doctors and scientists need to worry about, you should probably think again.
 
We humans have co-evolved with microbes for millions of years.  Our bodies have provided a safe environment for thousands of species of microbes to flourish and in return microbes have provided us with many benefits – like protection against “bad” organisms and regulation of many of our physiological processes.  We now know that a healthy, balanced microbiome is essential to human wellbeing.

How Russia can further improve its tobacco taxation efforts to boost health and life expectancy

Patricio V. Marquez's picture

Over the past 10 years Russia has made great progress in increasing the life expectancy of its people. Back in the mid-2000s, we documented the dramatic decrease in life expectancy in the post-Soviet period in the report “Dying Too Young,” due especially to high mortality among working-age men. Behavioral risk factors, such high rates of cigarette smoking and alcohol abuse, economic and social dislocation, a shift in the predominant diseases and the deterioration of the health care system, including access to it, all contributed to premature death and a dramatic shrinking of the Russian population that hadn’t been seen since World War II. 

Yemen: Where humanitarian and development efforts meet

Raja Bentaouet Kattan's picture



The poorest country in the Middle East and North Africa even prior to the conflict, Yemen has through violence and subsequent economic freefall landed at the epicenter of a series of interrelated emergencies that the United Nations describes as the “world’s worst humanitarian crisis.” This is the first of a three-part blog series on the Bank’s response in Yemen.

In July of this year, I assumed the role of Country Manager for Yemen. Much has happened in my first 100 days as CM. 

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.
 


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