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Insuring India: States learn about health insurance from each other

Owen Smith's picture

India faces many challenges on the road to Universal Health Coverage (UHC).  Almost two-thirds of total health spending is paid out-of-pocket by households, placing India among the top 10 countries in the world in this regard.  Recent global estimates that aim to measure country progress towards UHC also highlight India’s gaps in terms of service coverage. 



So how does a country achieve UHC? One possible answer might be to discuss broad health system paradigms, but quite another would be to talk about the nuts and bolts of implementing a specific program.  While the choice between paradigms is made, at most, once in a decade, figuring out how to implement a program happens every day.  For this, practitioner-to-practitioner learning is one of the best ways to help implementers make real progress on the road to UHC. 

Rebuilding houses and livelihoods in post-earthquake Nepal

Mio Takada's picture
When the 2015 earthquake hit Nepal, Fulmati Mijar lost her home and livelihood. Now, she has turned her life around, learned carpentry and quake-resistant techniques, and started a business
When the 2015 earthquake hit Nepal, Fulmati Mijar lost her home and livelihood. Now, she has turned her life around, learned carpentry and quake-resistant techniques, and started a business. Credit: World Bank.

 
Fulmati Mijar, a mother of three living in Nuwakot district in Nepal, used to earn her living from daily wage labor along with her husband.
 
On April 25, 2015, their lives took a turn for the worse when a magnitude 7.8 earthquake struck Nepal, killing 8,790 people and affecting 8 million more—or nearly a third of the country’s population.
 
The catastrophe destroyed Fulmati’s house and made her family more vulnerable.
 
Yet, it did not dent her resolve.
 
When housing reconstruction started through the Earthquake Housing Reconstruction Project (EHRP), Fulmari joined her village’s Community Organization (CO), supported by the Poverty Alleviation Fund (PAF) and learned carpentry and earthquake-resistant techniques for housing reconstruction.
 
She initially received a NPR18,000 ($176) loan to invest in a small furniture enterprise. With the funds, her family started making windows, doors, and kitchen racks, which were in high demand. After repaying the loan, she received another loan to upgrade their furniture enterprise, where today she and her family make their living.
 
At the time of the 2015 earthquake, full recovery was estimated to cost $8.2 billion, with the housing recovery component amounting to $3.8 billion. The World Bank immediately pledged $500 million to support the emergency response. During the reconstruction phase, the most urgent—and largest—need was to rebuild nearly 750,000 houses.
 
More than two years since the earthquake, restoring lost or affected livelihoods has become more important.

What does risk management have to do with Sri Lankan families?

Ralph van Doorn's picture
While the number of Sri Lankans living under the poverty line has decreased tremendously, many still live right above it and can fall back into extreme poverty if they experience a shock such as a natural disaster. Photo Credit: Lakshman Nadaraja 


Imagine there is a small fire in your house: someone forgot to put out a cigarette stub and accidentally set your rubbish bin on fire. You will need just one bucket of water to put it out.
 
But up the ante, and it is no longer possible for an individual to handle it. For instance, if your entire house was on fire, you would need to call your local fire station for help.
 
Now, go up one more level. You live in a thickly wooded part of a district like Badulla, and a forest fire covering hundreds of acres is threatening homes and businesses—then it would take the resources of the country, and maybe even aid and support from international allies, to battle the fire and help people recover.
 
I am telling you this story to illustrate how there are levels of risks—and responses—to consider when discussing a subject like integrated risk management.
 
As part of our work on the recently released Sri Lanka Development Update (SLDU) we considered the risks and opportunities facing Sri Lanka, beginning from the smallest unit of the household and building up to the country, as represented by the public sector.
 
There’s been a lot of talk about the macro-economy and national level reforms and policy initiatives. However, in this blog I wanted to focus on your families. What does integrated risk management mean for households?
 
The poorest Sri Lankan families are vulnerable to shocks

Bangladesh is thinking big by thinking blue

Pawan Patil's picture


Maintaining and restoring ocean ecosystems – or ‘ocean health’ – is synonymous with growing ‘ocean wealth,’ according to a soon-to-be published report by the World Bank and European Union. With rapid population growth, limited land and fewer terrestrial resources to house, feed and provide citizens with their energy needs, coastal nations across South Asia are looking seaward. In doing so, countries are clueing in on the fact that sustainably managing and developing ocean spaces is critical to a nation’s economic advancement.

Thinking Blue - thinking how best to sustainably tap ocean spaces as new sources of sustainable growth and transition to a blue economy - is new, although South Asian nations have used the sea for food and trade for centuries. 

Five years ago, the term ‘blue economy’ had nothing to do with oceans; few had an inkling of its emerging importance.

In late 2017, at the Second International Blue Economy Dialogue hosted by the Government of Bangladesh in Dhaka, interest in what the blue economy is and why it matters is at an all-time high and rising. Perhaps this not surprising. 

The quest for a well-resourced holiday meal

Idah Z. Pswarayi-Riddihough's picture



Holidays for me have always been about family and food. A time to relax, catch-up with loved ones and eat good food.  When it’s our turn to cook, my husband and I take time to plan the menu. A central part of our meals are vegetables and fresh fruits but we have also learnt over the years that a good meal needs fresh ingredients, all procured as close to the preparation of the meal as possible. 
 
Sri Lanka has not disappointed in its array of fruits and vegetables. I am still discovering the names of many; some of which I will never be able to pronounce for sure. Despite that, I love eating them! 
 
Amongst my favourites are papaya, mangoes and kankun, the last for which I share a passion with my two pet turtles. But getting these vegetables and fruits from the same supplier on a constant basis is a challenge. Even common produce like onions, tomatoes, and cucumbers can be discoloured or squishy – not at all appetizing or conducive for a salad or other such type of fresh dish.
 
The price, of course, is the same whatever the quality. Fresh produce can be expensive, and regularly buying a variety of fruits and vegetables does strain the budgets of many families in Sri Lanka. Needless to say, this shouldn’t be the case in a country with such rich soils and plentiful sunshine.  
 
The question of access to fresh and healthy food goes beyond our holiday tables. According to the World Health Organisation, 1 in 5 premature deaths in Sri Lanka are due to a non-communicable disease (NCD) such as diabetes, cardiovascular disease or cancer.[1] Tobacco use, unhealthy diets, harmful use of alcohol and physical inactivity have all been identified as risk factors.

When technology meets agriculture in Bhutan

Yoichiro Ishihara's picture
Commercial Agriculture is important for Bhutan's Development
Based in eastern Bhutan, Mountain Hazelnuts has developed innovative uses of ICT for its commercial agriculture operations. Photo Credit: Bryan Watts/World Bank

Bhutan is a challenging environment in which to develop commercial agriculture. The country has limited areas for agriculture, and its geography and road conditions make logistics and market access costly.

Therefore, commercial agriculture is critical to increase productivity, which will help create jobs and access to more and better food. This can be achieved not only through focusing on high-value products and investing in traditional infrastructure such as irrigation, but also through using information and communication technology (ICT). Based in eastern Bhutan, Mountain Hazelnuts has developed innovative uses of ICT for its commercial agriculture operations.

Protecting forests in India from disastrous fires

Siddhanta Das's picture

India’s commitment to sustainable development is clearly demonstrated through its innovative and progressive forest policies. The Government’s policy of incentivising state governments to improve their forest cover is evident in the 14th Finance Commission’s allocation of 7.5% of total revenues on the basis of the state’s forest cover. This makes India the implementer of the world’s largest Payment for Environmental Services scheme.

Over the last few years, the forest and tree cover in the country has been steadily increasing, and at present, it stands at 24.16% of the total geographic area. This affirms that sustainable forest management and long-term thinking about natural assets are foundations for strong and sustained growth. This is not to say that there are no challenges. Forest fires are a leading cause of forest degradation in India, and the current pattern of widespread and frequent fires could make it more difficult for India to meet its long-term goal of bringing 33% of its geographical area under forest & tree cover and to achieve its international commitment to create additional carbon sinks of 2.5 billion to 3 billion tons worth of CO2 equivalent by 2030.

Recognizing the challenge of forest fires in India, the Ministry of Environment, Forest and Climate Change and the World Bank co-organized an international workshop on Forest Fire Prevention and Management from November 1 to 3, 2017. The discussion benefitted from the perspectives of government officials from India, researchers, experts and representatives from Australia, Belarus, Canada, Mexico, Nepal, the United States of America, and the Food and Agriculture Organization of the United Nations. This workshop served as an opportunity for knowledge exchange to help India devise a robust strategy to tackle the challenge of forest fires. It was also an opportunity for Indian states to share good practices with each other, and with countries from around the world, and to learn from other countries.

More qualified procurement personnel will strengthen Afghanistan’s reform efforts

Anand Kumar Srivastava's picture
Also available in: دری | پښتو
With support from the Afghanistan Reconstruction Trust Fund, the Afghan government is taking steps to professionalize procurement and improve capability in ministries and other government institutions.
With support from the Afghanistan Reconstruction Trust Fund (ARTF), the Afghan government is taking steps to professionalize procurement to improve the capability of ministries and other government institutions. Photo Credit: NPA/World Bank

Recruiting the right people for the right jobs is the drive behind the first mass recruitment carried out by the Government of Afghanistan to improve public services. The process is currently underway as part of the government’s civil service and procurement reforms to improve capacity in ministries. Almost 700 highly qualified women and men are expected to be recruited by the end of 2017.

The ongoing recruitment, led by the Independent Administrative Reform and Civil Service Commission (IARCSC), is in tune with the government’s efforts to professionalize procurement and improve capability in ministries and other government institutions.
 
Candidates are undergoing a rigorous selection process, including a mass examination, which saw about 7,800 people take the exam. IARCSC is working closely on this initiative with the National Procurement Authority (NPA), which is providing technical support, and the Ministry of Higher Education, which is facilitating the examination process.

Building safer houses in Northern India

Hyunjee Oh's picture
The State of Uttarakhand is endowed with vast natural resources, and is one of the most frequented pilgrimage/ tourist destinations in India. However, the State also has a very fragile terrain that is also highly prone to earthquakes.
The State of Uttarakhand is endowed with vast natural resources, and is one of the most frequented pilgrimage and tourist destinations in India. However, the State also has a very fragile terrain that is also highly prone to earthquakes. Credit: GFDRR/ World Bank
This blog is part of a series exploring the housing reconstruction progress in Uttarakhand, India.
 
In June 2013, a heavy deluge caused devastating floods and landslides in the state of Uttarakhand located in the Himalayan foothills. The disaster – the worst in the country since the 2003 tsunami—hit more than 4,200 villages, damaged 2,500 houses, and killed 4,000 people.
 
Since 2013, the Government of Uttarakhand with support from the World Bank and the Global Facility for Disaster Reduction and Recovery (GFDRR) has helped the people of Uttarakhand restore their homes, build better roads, and better manage future disaster risks through the Uttarakhand Disaster Recovery Project (UDRP).
 
Central to the project is rebuilding 2,382 houses that are more resilient to disasters. The project has promoted an owner-driven housing reconstruction model, whereby beneficiaries rebuild their houses on their own with technical and social support from a local NGO, using guidelines issued by the project for disaster resilient housing.
 
Watch how we’ve helped build safer houses for the people in Uttarakhand:
 
Building Safer Houses in Northern India

 

Challenges and opportunities of urbanization in India

Divya Gupta's picture

India’s leading urban thinkers and practitioners gathered earlier this month, on November 1, 2017, in New Delhi to discuss “Challenges and Opportunities of Urbanization in India,” at a Roundtable Discussion organized by the World Bank Group. The event was chaired by Ede Ijjasz-Vasquez, Senior Director, Global Practice for Urban, Social, Rural and Resilience, World Bank.


 
“India's urban trajectory will be globally important,” said Vasquez in opening remarks, underscoring the strong link between the country’s economic trajectory and how it urbanizes, particularly over the next two decades. “It’s progress on poverty elimination, efficiency and growth of the economy, health of urban residents, climate emissions will all have a very important bearing, not just for India, but globally.”

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