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51. Does women’s empowerment affect the health of children? The case of Mozambique

Author:
Joseph Deutsch and Jacques Silber
Publication Date:
12-2017
Content Type:
Working Paper
Institution:
United Nations University
Abstract:
In developing countries, women’s decisions concerning their children’s health depend on ‘empowerment’ concerning decision-making, husband/partner’s use of violence, woman’s attitude towards this violence, available information, and resources. We derive an empowerment indicator using the ‘fuzzy sets’ and Alkire and Foster approaches to multidimensional poverty measurement. The health of children is a latent variable; their height and weight are observed health indicators. We apply the ‘MIMIC’ approach to the 2009 Mozambique Demographic and Health Survey. Children’s health is better when the woman opposes her partner’s violence, the higher her education and body mass index, among female children, and in urban areas.
Topic:
Demographics, Health, Poverty, Children, Women, and Empowerment
Political Geography:
Africa and Mozambique

52. Multidimensional poverty and wellbeing in Mozambique

Author:
Ricardo Santos and Vincenzo Salvucci
Publication Date:
02-2017
Content Type:
Policy Brief
Institution:
United Nations University
Abstract:
Poverty is a multidimensional phenomenon involving things other than consumption — such as access to and quality of health and education, housing, possession of durable goods, freedom, and many other factors. The consumption and multidimensional poverty approaches are complementary: it is possible for example that a family has consumption levels below the poverty line but lives in a good quality home, its members have a good level of education, and vice versa.
Topic:
Education, Health, Poverty, Survey, and Housing
Political Geography:
Africa and Mozambique

53. Ebola Response in Cities: Learning for Future Public Health Crises

Author:
Leah Campbell
Publication Date:
06-2017
Content Type:
Special Report
Institution:
ALNAP: Active Learning Network for Accountability and Performance
Abstract:
The 2014/15 West African Ebola Virus Disease (EVD) outbreak was the ‘largest, most severe and most complex Ebola epidemic the world has ever seen’ (WHO, 2014b). It was the first time the disease had affected an urban centre. The 23 prior outbreaks of EVD in Africa had all been largely rural, and the largest outbreak, in Gulu, Uganda, had infected only 425 people. As such, there was no expectation or experience of a massive urban outbreak. While the unprecedented ‘urban-ness’ of this EVD outbreak did not go unnoticed, particularly by the media, overall this recognition did not result in an urban-appropriate response. As part of a learning initiative spanning across the EVD epidemic in West Africa, this paper aims to share reflections and learning about the urban nature of the EVD outbreak. In doing so, it aims to improve future urban public health responses. It builds on existing learning around the EVD response, focusing on urban issues as a noted gap in the key literature on the response thus far.
Topic:
Development, Health, Humanitarian Aid, Ebola, Urban, Disaster Management, and Epidemic
Political Geography:
Africa, Liberia, Sierra Leone, and Guinea

54. Getting Sick in Africa

Author:
Bob Baker
Publication Date:
03-2016
Content Type:
Journal Article
Journal:
American Diplomacy
Institution:
American Diplomacy
Abstract:
Malaria was like having a pain X-ray of all your bones, but after a fever bout, shaking chills diverted attention from your aching bones. I had taken all the anti-malaria pills but had evidently bumped into a new strain upcountry in Mali, West Africa. Catching bugs was also easy in Liberia, and Congo.
Topic:
Diplomacy, Health, Memoir, and Peace Corps
Political Geography:
Africa, Mali, and United States of America

55. Africa’s Great Hunger Handicap

Author:
Mark Wentling
Publication Date:
10-2016
Content Type:
Journal Article
Journal:
American Diplomacy
Institution:
American Diplomacy
Abstract:
Africa’s hunger problem is a long standing one that has been exacerbated by a rapid population growth rate that has outstripped the continent’s ability to feed itself. A number of countries in Africa are now experiencing structural food deficits. The population of Africa currently stands at nearly 1.2 billion, twice what it was in 1985, and it is projected to double again by 2050, surpassing the populations of both China and India by 2023. At the current population growth rate, Africans will represent half the world’s population by 2035.
Topic:
Foreign Policy, Development, Health, and Hunger
Political Geography:
Africa and United States of America

56. Barriers to Healthcare-Seeking among Caretakers of Children under fve in Uganda

Author:
Moses Mukundane, Annet Nannungi, Dennis Bataringaya, Patrick Ssesanga, Frederick Golooba-Mutebi, and Winstons W. Muhwezi
Publication Date:
01-2016
Content Type:
Research Paper
Institution:
Advocates Coalition for Development and Environment (ACODE)
Abstract:
Uganda has made commendable achievements in human development and poverty reduction as part of efforts to achieve Millennium Development benchmarks. Despite the efforts, the country’s under-fve mortality statistics remain high, underscoring the serious challenges that the government faces in its efforts to ensure the survival of children under 5 years of age. The fourth Millennium Development Goal required a two-thirds reduction in child mortality, which implied a decrease in under-fve mortality rate from 156 in early 1990s to 56 per 1,000 live births by 2015. By 2015, the child mortality rate had reduced to 90 per 1,000 live births implying a signifcant stride made in its reduction over the several years. Nevertheless, the rate was still high and the country missed hitting the target of MDG-4 (The Republic of Uganda, 2015; Uganda Bureau of Statistics (UBOS) & ICF International Inc, 2012).
Topic:
Development, Health, Poverty, and Children
Political Geography:
Uganda and Africa

57. Why Are Indian Children So Short?

Author:
Seema Jayachandran and Rohini Pande
Publication Date:
04-2015
Content Type:
Working Paper
Institution:
The John F. Kennedy School of Government at Harvard University
Abstract:
India's child stunting rate is among the highest in the world, exceeding that of many poorer African countries. In this paper, we analyze data for over 174,000 Indian and Sub-Saharan African children to show that Indian firstborns are taller than African firstborns; the Indian height disadvantage emerges with the second child and then increases with birth order. This pattern persists when we compare height between siblings, and also holds for health inputs such as vaccinations. Three patterns in the data indicate that India's culture of eldest son preference plays a key role in explaining the steeper birth order gradient among Indian children and, consequently, the overall height deficit. First, the Indian firstborn height advantage only exists for sons. Second, an Indian son with an older sibling is taller than his African counterpart if and only if he is the eldest son. Third, the India-Africa height deficit is largest for daughters with no older brothers, which reflects that fact that their families are those most likely to exceed their desired fertility in order to have a son.
Topic:
Health, Poverty, Children, and International Development
Political Geography:
Africa, South Asia, and India

58. Decentralized Local Health Services in Tanzania: Are Health Resources Reaching Primary Health Facilities, or Are They Getting Stuck at the District Level?

Author:
Jameson Boex, Luke Fuller, and Ammar A. Malik
Publication Date:
04-2015
Content Type:
Research Paper
Institution:
Urban Institute
Abstract:
This study analyzes local health finances in Tanzania by considering the extent to which public health resources in Tanzania flow from the district government level to primary health facilities, or whether these resources get stuck at the district level. Our analysis of health expenditures in six rural Local Government Authorities suggests that less than half of local health funding reaches the front-line dispensaries that provide the vast majority of local health services. The structure of the local health system appears to favor top-down interventions and control, rather than empowering local facilities to improve local health outcomes.
Topic:
Health, Health Care Policy, International Development, and Cities
Political Geography:
Africa and Tanzania

59. Are Policy Reforms Enough to Improve Satisfaction with Health Care? Evidence from Benin

Author:
Richard Houessou
Publication Date:
11-2015
Content Type:
Policy Brief
Institution:
Afrobarometer
Abstract:
In 2009, the government of Benin embarked on a series of policy initiatives to increase public access to health services, especially for pregnant women, children under age 5, and the poor. While health coverage rates remained steady, attendance at health services increased sharply, and at first, public satisfaction with the government’s performance in improving basic health services increased as well. However, by 2014, public approval of the government’s efforts had dropped sharply. What explains this decrease in public satisfaction, despite the policy reforms? This paper uses Afrobarometer survey findings and other data to examine mechanisms that might contribute to dissatisfaction at the grass roots with how government is handling health services. Its finding that citizens’ negative experiences while visiting public clinics or hospitals are the main factor driving down public assessments of government performance in this area should alert policy makers that they must put in place more than policy reforms in order to satisfy public demand for high-quality basic health services.
Topic:
Health, Governance, Health Care Policy, and Social Services
Political Geography:
Africa and Benin

60. The Face of African Infrastructure: Service Availability and Citizens' Demands

Author:
Vijaya Ramachandran, Benjamin Leo, and Robert Morello
Publication Date:
02-2015
Content Type:
Working Paper
Institution:
Center for Global Development
Abstract:
The need for infrastructure improvements is a top-tier economic, political, and social issue in nearly every African country. Although the academic and policy literature is extensive in terms of estimating the impact of infrastructure deficits on economic and social indicators, very few studies have examined citizen demands for infrastructure. In this paper, we draw upon survey data to move beyond topline estimates of national infrastructure access rates towards a more nuanced understanding of service availability and citizen demands at the regional, national, and sub-national level. We find a predictable pattern of infrastructure services across income levels—lower income countries have fewer services. The survey data also allows us to observe the sequencing of infrastructure services. On the demand side, survey respondents are most concerned with jobs and income-related issues, as well as with the availability of infrastructure: specifically transportation and sanitation. These priorities transcend demographic factors, including gender and location (urban/rural).
Topic:
Health
Political Geography:
Africa

61. Increasing Anti-Malaria Bednets Uptake Using Information and Distribution Strategies: Evidence from a Randomized Experiment in Senegal

Author:
Jacopo Bonan, Philippe LeMay-Boucher, Douglas Scott, and Michel Tenikue
Publication Date:
05-2015
Content Type:
Working Paper
Institution:
Kellogg Institute for International Studies
Abstract:
This paper studies the effects of information about malaria and of bednet distribution strategies on the demand for anti-malaria bednets, using a randomized experiment in the city of Thiès in Senegal. We offer two orthogonal treatments to a random sample of households. The first is a sale treatment and consists of 1) an offer to purchase on the spot a bednet at a subsidized price or 2) an offer to purchase a bednet at the same subsidized price with a voucher valid for seven days. The second is an information treatment that consists of a ten-minute information session on malaria-related issues. We find that information has no significant effect on the demand for bednets and that receiving a voucher increases purchasing by 20%. Our results suggest that selling bednets at a subsidized price and allowing for some flexibility with a short period of seven days increases purchase compared to the on-the-spot sale approach.
Topic:
Health, Human Welfare, Humanitarian Aid, and Health Care Policy
Political Geography:
Africa

62. Family Planning and Linkages with U.S. Health and Development Goals

Author:
Janet Fleischman and Alisha Kramer
Publication Date:
04-2014
Content Type:
Working Paper
Institution:
Center for Strategic and International Studies
Abstract:
For decades, the United States has been the global leader in supporting voluntary family planning services around the world. The benefits of family planning are numerous, not only for women's health, but also for increasing child survival, nutrition, education, and economic development, as well as preventing mother-to-child transmission of HIV. For these reasons, family planning is a core component of sustainable development.
Topic:
Health, Foreign Aid, and Health Care Policy
Political Geography:
Africa and United States

63. Investing for the Few: The IFC's Health in Africa initiative

Author:
Anna Marriott and Jessica Hamer
Publication Date:
09-2014
Content Type:
Policy Brief
Institution:
Oxfam Publishing
Abstract:
World Bank Group President Jim Yong Kim has publicly stated that achieving universal health coverage (UHC) and equity in health are central to reaching the two new overarching World Bank Group goals to end extreme poverty by 2030 and boost shared prosperity. Jim Kim has also rightly emphasized the need to close the gap in access to quality health services for the poorest 40 percent of the population and to eliminate point-of-service payments that impoverish people in every country.
Topic:
Government, Health, Foreign Direct Investment, World Bank, and Health Care Policy
Political Geography:
Africa

64. Turning the Tide on Ebola: Scaling up public health campaigns before it's too late

Author:
Debbie Hillier
Publication Date:
10-2014
Content Type:
Policy Brief
Institution:
Oxfam Publishing
Abstract:
The current Ebola outbreak in West Africa is totally unprecedented. The accelerating number of cases, the poor health infrastructure in affected countries, the short supply of skills, knowledge and personnel, and the fear surrounding this disease are providing a huge challenge to affected governments and the international community as they battle to bring the epidemic under control.
Topic:
International Relations, Security, Health, Humanitarian Aid, Foreign Aid, Health Care Policy, and Ebola
Political Geography:
Africa and West Africa

65. Improving Maternal, Neonatal, and Child Health in Ghana

Author:
Katherine E. Bliss and Cathryn Streifel
Publication Date:
11-2014
Content Type:
Working Paper
Institution:
Center for Strategic and International Studies
Abstract:
In June 2014, a small team from the CSIS Global Health Policy Center traveled to Ghana to examine U.S. bilateral support for maternal, neonatal, and child health (MNCH). The purpose of the trip was to plan a return visit with a delegation of U.S. congressional staff in August 2014. Ghana's mixed progress toward meeting Millennium Development Goals (MDG) 4 and 5 related to maternal and child health; its strong relationship on immunizations with Gavi, the Vaccine Alliance; and its longstanding partnership on health with the United States were all reasons we decided to examine the country's MNCH situation. By late July, the acceleration of the Ebola outbreak in West Africa led us to postpone the trip until emergency preparations are not a major focus of the Ghanaian government, the United States, and other partners. Considering the fruitful meetings we had in June, we have captured here some of our initial impressions, observations, and recommendations.
Topic:
Health, Infectious Diseases, and Foreign Aid
Political Geography:
Africa, United States, and Ghana

66. Insecticide Resistance and Malaria A Threat Decades in the Making

Author:
William G. Brogdon, Anthony Fiore, S.P. Kachur, Laurence Slutsker, and Robert A. Wirtz
Publication Date:
12-2014
Content Type:
Working Paper
Institution:
Center for Strategic and International Studies
Abstract:
Insecticide (DDT) use to control malaria was first employed successfully in the antimalaria program in Greece in 1947. By 1951, DDT success in controlling malaria was reported in 22 countries. However, that year also saw the first report of DDT resistance, in Anopheles sacharovi in Greece. By 1954, resistance to DDT among mosquitos was known to be a global problem, documented in Europe, the Americas, Africa, and Asia. The World Health Organization–led Global Malaria Eradication Program (GMEP) began in 1955, when resistance was already pronounced worldwide. Scientists did not identify the underlying biochemical mechanism contributing to insecticide resistance until 1958. By then, insecticide resistance was recognized by many to be a major contributor to the ultimate dismantling of GMEP, given the limited capabilities and knowledge of the time. Consequently, the global focus shifted from malaria “eradication” to malaria “control” in the late 1960s.
Topic:
Environment, Health, and Infectious Diseases
Political Geography:
Africa, Greece, and Asia

67. Transformative Tools for Malaria Elimination

Author:
PATH Malaria Center of Excellence
Publication Date:
12-2014
Content Type:
Working Paper
Institution:
Center for Strategic and International Studies
Abstract:
Over the past 15 years, malaria has gained increased attention and action from the public health community, with researchers, global and national funders, and, most importantly, national governments and communities in endemic areas. Renewed efforts to fight the disease have resulted in an unprecedented 50 percent reduction in malaria deaths in African children since 2000. This progress has been achieved in large part because effective, efficient, and affordable tools emerged as a result of earlier investments in research and development.
Topic:
Health, Human Welfare, Humanitarian Aid, International Cooperation, and Infectious Diseases
Political Geography:
Africa

68. To Charge or Not to Charge: Evidence from a Health Products Experiment in Uganda

Author:
Dean Karlan, Pia Raffler, Greg Fischer, and Margaret McConnell
Publication Date:
11-2014
Content Type:
Working Paper
Institution:
Center for Global Development
Abstract:
In a field experiment in Uganda, we find that demand after a free distribution of three health products is lower than after a sale distribution. This contrasts with work on insecticide-treated bed nets, highlighting the importance of product characteristics in determining pricing policy. We put forward a model to illustrate the potential tension between two important factors, learning and anchoring, and then test this model with three products selected specifically for their variation in the scope for learning. We find the rank order of shifts in demand matches with the theoretical prediction, although the differences are not statistically significant.
Topic:
Development and Health
Political Geography:
Uganda and Africa

69. Ebola and the Private Sector: Bolstering the response and West African economies

Publication Date:
12-2014
Content Type:
Working Paper
Institution:
Oxfam Publishing
Abstract:
The current Ebola outbreak in West Africa is unprecedented. The increasing number of cases, the poor health infrastructure, the shortage of skills, knowledge and personnel, and the fear surrounding the disease are proving a huge challenge to affected governments and to the international community as they battle to bring the epidemic under control.
Topic:
Disaster Relief, Health, Human Welfare, and Infectious Diseases
Political Geography:
Africa and West Africa

70. Seven Million Lives Saved: Under-5 Mortality Since the Launch of the Millennium Development Goals

Author:
John McArthur
Publication Date:
09-2014
Content Type:
Working Paper
Institution:
The Brookings Institution
Abstract:
To what extent have developing countries' patterns in reducing under-5 mortality rates (U5MR) changed since the advent of the Millennium Development Goals (MDGs)? This paper investigates that question across multiple time horizons, with attention to the fact that countries' progress had already begun to accelerate during the late 1990s compared to the early 1990s. The paper gives special consideration to countries the MDGs were primarily intended to support, including initially “Off Track” and low-income countries. Although only 21 percent of originally Off Track countries and 34 percent of originally low-income countries are now on a path to achieve the MDG target by 2015, at least 80 percent of each group has seen accelerated progress since 2001. Approximately 90 percent of countries in sub-Saharan Africa have accelerated. Most importantly, regression analysis indicates that cross-country trends since 2000 differ considerably from previous decades. The years since the launch of the MDGs include the first extended period in at least four decades during which rates of U5MR decline have not been negatively correlated with U5MR levels. Compared to a conservative counterfactual trend from 1996 to 2001, at least 7.5 million additional children's lives are estimated to have been saved between 2002 and 2013. The results suggest that much of the greatest structural progress has been achieved by countries not likely to achieve the formal MDG targets, even if their progress might be linked to the pursuit of those targets. Implications are considered for setting U5MR targets through to 2030.
Topic:
Development, Health, Human Welfare, and Health Care Policy
Political Geography:
Africa

71. Inequality in South Africa: A two part document on the current understanding and dimensions of inequality in health, gender and livelihoods

Author:
Nicola Deghaye, Tamlyn McKenzie, and Petronella Chirawu
Publication Date:
07-2014
Content Type:
Working Paper
Institution:
Oxfam Publishing
Abstract:
Recognising inequality is at the heart of the South African 'development problem', Oxfam commissioned the Health Economics and HIV and AIDS Research Division (HEARD) to produce this report, which is divided into two parts, to enable an understanding of the dimensions of inequality in South Africa and to provide Oxfam with a set of basic measures against which it could measure its success in dealing with inequality.
Topic:
Security, Gender Issues, Health, and Food
Political Geography:
Africa and South Africa

72. Responding to Health Challenges: The Role of Domestic Resource Mobilization

Author:
Samantha Bradshaw and Alan Whiteside
Publication Date:
08-2014
Content Type:
Policy Brief
Institution:
Centre for International Governance Innovation
Abstract:
Over the last decade, tremendous progress has been made in the prevention, care and treatment of HIV/AIDS, TB and malaria globally. The international community has played a key role in this progress and remains committed to the fight, but as implementing countries' economies grow, they are progressively graduating from international support. This could leave national governments, especially health ministers, uncertain about the future of financing available for their national health programs. Without sufficient resources from both domestic and international resources, there is a risk of resurgence of these diseases. If these trends continue, there may not be a "grand convergence" in health by 2035, resulting in enormous economic and social costs.
Topic:
Economics, Health, and Governance
Political Geography:
Africa

73. The Effect of Age on Conditional Fecundability in Nigeria

Author:
Magdalene Agdalene, Akikibofori Akikibofori, and Jacob Sunday
Publication Date:
03-2014
Content Type:
Journal Article
Journal:
Studies of Changing Societies Journal (SCS)
Institution:
Studies of Changing Societies Journal (SCS)
Abstract:
Delaying the start of childbearing raises the issue of fertility postponed versus fertility foregone. One of the limits of previous studies of “How late can you wait? Is it difficult to control sexual activity? Data on the frequency and timing of intercourse within a menstrual cycle are uncommon. We use such data from the Menstrual Cycle Fecundability Study for this study “Can we wait until the early 30s? We model the effect of age on conditional fecundability, i.e. the probability of conception given that the couple is not sterile, simultaneously controlling for the effect of primary sterility and the frequency and timing of Intercourse in each menstrual cycle. Can we wait until the early 30s for a birth? Our evidence is yes (provided you are not already sterile) as the increase in the mean waiting time to conception is very modest and of little practical importance.
Topic:
Health, Children, Women, Aging, and Fertility
Political Geography:
Africa and Nigeria

74. Health, Social Policy, and Inclusive Growth in MENA

Author:
Randa Alami
Publication Date:
04-2014
Content Type:
Working Paper
Institution:
School of Oriental and African Studies - University of London
Abstract:
This paper takes stock of the current status of health sectors in MENA. From the narrow perspective of national aggregate indicators, as with most middle income countries, the region has seen significant achievements. Yet, health sectors face systemic challenges, and suffer from significant and persistent inequities in health outcomes, access, delivery, and distribution of health services. Out of pocket spending levels are amongst the highest in the world, and are driven by: privatisation, poor social protection and insurance coverage, and the inability to respond to the epidemiological transition. Consequently, the financial burden of healthcare forces significant swathes of the population into poverty, or to forgo healthcare altogether. Sectoral policies have been piecemeal and short‐termist, with a clear neglect of public health sectors. These deficiencies are more evident if MENA is benchmarked against many of their peers, or against the international consensus of Universal Health Care (UHC). To achieve inclusive growth, MENA must reverse the disinvestment in public health, and the central importance of health and health equity to development must be reinstated. By the same token, MENA countries must follow UHC centred strategies, which have a good track record in tackling similar challenges in other middle income countries. While part of the difficulties may lie in financing, the lack of political commitment and weak institutional capabilities have also been serious obstacles. Sectoral reforms must target these failures, and governments need to play a more central role in covering the poor and regulating the sector.
Topic:
Health, Privatization, Inequality, Welfare, and Social Services
Political Geography:
Africa, Middle East, and North Africa