Miscellaneous Knowledge Notes
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Publication
WASH for Human Development: Can Scaling Up Water Supply, Sanitation, and Hygiene Interventions Help Children Grow in Tanzania?
(World Bank, Washington, DC, 2017-09)In Tanzania, chronic undernutrition is at 35 percent among children under five. This makes the country home to the third highest population of children with chronic undernutrition in Sub-Saharan Africa, just after Ethiopia and the Democratic Republic of Congo. This brief provides an overview of the trends in undernutrition, as indicated by stunted growth, over time and by subgroups of gender, age in months, rurality, geography, and poverty. It also provides a geo-spatial stunting map which shows 1km x 1km pixel-level estimations of stunting rates. Using the UNICEF Synergies Approach (1990) and drawing on existing scientific literature, the brief then outlines the theory behind different pathways to chronic undernutrition through inadequate food, care, environment, and health services. Further econometric analysis has been conducted on the DHS 2016 data using Shapley decomposition, to identify the relative contributions of various determinants including water supply, sanitation, and hygiene (WASH) variables in determining stunting rates, and hence chronic undernutrition in the Tanzania. The relative contributions of other factors such as poverty, the child’s characteristics, mother’s characteristics and location are also highlighted. Finally, it provides operational and policy implications along the lines of multisectoral and nutrition-sensitive approaches for intervention design to reduce stunting in Tanzania. -
Publication
Health Impact and Effectiveness of Distribution Models for Plastic Latrine Slabs in Kenya
(World Bank, Washington, DC, 2017-03)Lack of sanitation is a huge development challenge in Kenya, but also a potentially sizeable market opportunity. The World Bank and IFCs ‘Selling Sanitation’ project worked with large plastics manufacturing firms in Nairobi to design, test, and support market development and distribution of a range of plastic latrine slabs. The products were designed from the consumer’s perspective using the Human-Centered Design approach and priced well below the cost of the prevailing concrete slab. This research brief summarizes baseline findings and monitoring results from an impact evaluation of the plastic latrine slab, evaluating its health impact and the effectiveness of niche distribution and financing mechanisms for reaching base-of-the-pyramid households. Baseline findings show that children in the study area suffer from high rates of diarrhea and many are underweight, but worm infections are rare. The majority of households at baseline had unimproved pit latrines with either no slab (49%), or a mud slab, and overall sanitation and environmental hygiene conditions are poor. Feedback on the plastic slab from monitoring visits is overwhelmingly positive, with respondents citing ease of cleaning, safety for children, and prestige. However several barriers to adoption were noted. Most participants perceive the slab as unaffordable for the target beneficiaries, while a lack of adequate follow-up and marketing from sales agents, and limited availability of the product in remote, rural villages are major obstacles to generating demand for the slab. Additional public sector resources will be needed to further support the development of distribution channels and financing mechanisms to reduce the price for base-of-the-pyramid households and increase adoption of the slab among target beneficiaries. -
Publication
Ending AIDS in Johannesburg: An Analysis of the Status and Scale-Up Towards HIV Treatment and Prevention Targets
(World Bank, Washington, DC, 2016-10)Johannesburg, one of South Africa’s metropolitan municipalities and one of the 52 health districts has more people living with HIV (PLHIV) than any other city worldwide at ~600,000. This brief provides the key results of a modeling analysis estimating what it would take in terms of programmatic targets and costs for Johannesburg to meet the Fast-Track targets and demonstrate the impact that this would have. The Optima HIV epidemic and resource allocation model was used, distinguishing 26 sub-populations and populated with the available demographic, epidemiological, behavioral, programmatic and financial data. The analysis demonstrated that Johannesburg has rapidly expanded HIV diagnosis and treatment between 2010 and 2015, reaching 267,236 PLHIV with the ART program in 2015. In 2015, an estimated 70 percent knew about their positive status, about 64 percent of diagnosed PLHIV accessed treatment, and about 54 percent of them were known to be virally suppressed. The analysis suggested that the health impact of successfully scaling-up HIV testing, treatment and ART adherence to the 2020 and 2030 Sustainable Development Goals target levels is very large in Johannesburg. The increase in PLHIV on treatment will result in reductions in new HIV infections (an estimated cumulative difference of ~327 thousand infections from 2016-30). It will also results in reductions in HIV-related deaths (a cumulative difference of ~104 thousand deaths from 2016-30). -
Publication
Strengthening Regional Collaboration and Integration
(World Bank, Washington, DC, 2016-04)West Africa’s coastal area is critical to the region, home to a third of its people and the source of about half of its gross domestic product (GDP). Because most of it is composed of mangroves and sand formations, the area’s coastline is also highly vulnerable to erosion caused by coastal currents and storm surges. Erosion is evident from Mauritania to Gabon - and the rates of erosion are increasing. Around the port of Lome, for example, Togo’s coastline is estimated to have receded by as much as 12 to 15 meters a year. Regional integration will improve the sustainability of shared coastal waters, the protection of environmental services, and the livelihoods that rely on coastal ecosystems. Cooperation will also contribute to the development of regional principles or guidelines for coastal infrastructure investments. -
Publication
The Effects of Climate Change on Coastal Erosion in West Africa
(World Bank, Washington, DC, 2015-11)The effects of climate change, from changing precipitation patterns to rising seas, will exacerbate the coastal erosion already affecting West Africa, increasing the exposure and vulnerability of the people and assets located there. Given the importance of the coastal zone to the region as a whole, it is critical that policy makers consider the effects of future climate change in the decisions they make today. Regional cooperation is challenging, but it has been successful in many places, particularly where the issue addressed presented an existential challenge to the coun¬tries affected. Efforts to build trust and coordinate efforts will help policy makers protect the lives and livelihoods of the people in the region and allow their countries to build on the development gains made in recent years rather than see them rolled back as a result of climate change. -
Publication
Managing Coastal Risks in West Africa
(World Bank, Washington, DC, 2015-01)Coastal erosion is a naturally occurring process that is accelerated by human impacts. Artificial stabilization of the shoreline, the deterioration of natural formations, the construction of infrastructure, the extraction of materials, and the proliferation of dams deprive fragile coastal areas of important sediment deposits, which leads to erosion. Degradation of the shoreline reduces the natural protection of coastal areas to storm surges, which, together with heavy precipitation, exposes low-lying areas to flooding. Given the trans boundary nature of the region’s ecosystems, the potential downstream effects of infrastructure, and the importance of the coastline for all sectors, optimal solutions to reduce the risk along West Africa’s coasts can be reached only through multi sectoral action and multinational cooperation. Every national and regional development plan in West Africa should take coastal risks and adaption to climate change into consideration.