Miscellaneous Knowledge Notes

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http://hdl.handle.net/10986/9388

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Combating Malnutrition: Can Group Procurement be Equitable? Results from a Food Security Program in Rural Bihar

(World Bank, Washington, DC, 2019-10) Christian, P.

India has among the highest rates of child malnutrition worldwide, with Bihar one of the worst affected states. With the intent of combating food insecurity, the Government of India (GoI) and the state Government of Bihar (GoB) offer a Food Security Fund (FSF) via the Bihar Rural Livelihoods Promotion Society. The program has proved successful in giving rural women agency to ensure food security for themselves and their families. The scheme is most effective in reaching the poorest households when local committees procure the most affordable grains.
Innovations and Tools in Child Growth Measurement and Data Visualization

(World Bank, Washington, DC, 2019-06-30) World Bank Group

Despite global efforts to address malnutrition, the numbers of children under five who are not growing properly are alarming: 150.8 million (22.2 percent) are stunted (too short for their age), 50.5 million (7.5 percent) are wasted (too thin for their height), and 38.3 million (5.6 percent) are overweight (too heavy for their height). Children living in lower-middle income countries (LMIC) are particularly affected. At these rates, the world is off course to reach the World Health Assembly targets for 2025 and the Sustainable Development Goals for 2030.
The Drive toward Universal Health Coverage

(World Bank, Washington, DC, 2018-09) Kim, Young Eun ; Loayza, Norman V.

Universal health coverage is a social goal that enables everyone to receive the quality health care they need, irrespective of ability to pay, without suffering financial hardship in the process. To move toward that goal, policy makers should address three main considerations: the population to be covered, the health services to be provided, and the financing mechanism to be used. Successful cases show that to achieve universal health coverage, a change of perspective is essential, from seeing health care benefits as a contingent good to considering them as an essential public service. While expanding the demand for health care is necessary, improving the quantity and quality of the supply of health services is essential. Getting diverse stakeholders to cooperate, making cost-efficient and people-centered choices, and ensuring fiscal sustainability are needed to expand health coverage for everyone who needs it.
Food Security and Nutrition

(World Bank, Washington, DC, 2018-03) UNCTAD ; World Bank

This note provides guidance on how to ensure tan agricultural investment makes a positive contribution to local and national food security and nutrition. Investments can play a critical role by introducing technologies to increase productivity, by providing demonstration effects, by creating quality jobs, by catalyzing modernization of the sector, and by linking small-scale producers with global markets—all of which, in the right circumstances, contribute to food securityand nutrition. Yet, investments can have a negative impact and be detrimental to food security and nutrition, especially where investments reduce local access to land and water. The challenge for policymakers and investors is how to design policy and business models that maximize the positive benefits to food security and nutrition but minimize the associated risks.
Using Technology in Fragile, Conflict, and Violence Situations: Five Key Questions to be Answered

(World Bank, Washington, DC, 2018-01) Garber, Kent ; Carrette, Sheila

Many technologies are now widely used by humanitarian and development partners to collect data, improve planning and project implementation, and strengthen monitoring and evaluation in fragile and conflict-affected contexts and many other technologies are in the pipeline. Within the World Bank, there is growing interest to incorporate technology more strongly into FCV projects; at the same time, there is also a recognition that technology is not a “one size fits all” solution, and some technologies may be more appropriate for certain contexts than others. This note offers some basic guidance to Task Team Leaders (TTLs) on how to approach this “new frontier” when considering the use of technology in FCV health projects. Five key questions to be answered: i) What challenges can technology help address in FCV settings?; ii) What basic enabling factors should be assessed for technologies in FCV settings?; iii) What risks and limitations should be considered with these technologies?; iv) How have technologies been used in World Bank FCV health projects? and v) What disruptive technologies are on the horizon?
WASH for Human Development: Can Scaling Up Water Supply, Sanitation, and Hygiene Interventions Help Children Grow in Tanzania?

(World Bank, Washington, DC, 2017-09) World Bank Group

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.
Health Impact and Effectiveness of Distribution Models for Plastic Latrine Slabs in Kenya

(World Bank, Washington, DC, 2017-03) World Bank Group

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.
Providing Sustainable Sanitation Services for All in WASH Interventions through a Menstrual Hygiene Management Approach

(Washington, DC: World Bank, 2017-03) World Bank

A gender-inclusive approach to sanitation through Menstrual Hygiene Management (MHM) is needed to ensure that the benefits of sanitation and hygiene are truly universal. The key takeaways from this brief are: (1) the need to do contextual research before proposing an intervention, ideally by working with a gender specialist; and (2) the value of working through Water, Sanitation, and Hygiene (WASH) interventions to integrate the key pillars of MHM. This note presents some of the knowledge gained through this event and some recent research findings on the topic. As MHM cuts across many development sectors, it aims to be relevant to development practitioners looking for practical resources to integrate this approach into interventions in the water sector, but also in health, education, social protection, community development, and other related development programs.In recent years, issues deriving from the lack of adequate MHM have been coming to the fore in the WASH sector, particularly in relation to girls reportedly missing school because of poor MHM.The extent to which women and girls’ activities are affected by menstruation varies, depending on the context, but remains significant throughout their life, particularly in low-income countries.
Tunisia: Strengthening Early Childhood Development

(World Bank, Washington, DC, 2017-01) World Bank

As Tunisia emerges from the Arab Spring, its new constitution explicitly recognizes the rights of the child and the responsibility of both the State and parents to act in the child’s best interest to guarantee dignity, healthcare, protection, and education. In accordance with these guarantees, the Tunisian Ministry of Women, Family, and Childhood (MFFE) has utilized the Systems Approach for Better Education Results (SABER) diagnostic tools to analyze policies and programs that affect young children in Tunisia. Through this SABER-ECD collaboration with UNICEF and the World Bank, MFFE has used policy recommendations to develop its own multisectoral strategy to improve early childhood development (ECD) for Tunisia’s children.
Ending AIDS in Johannesburg: An Analysis of the Status and Scale-Up Towards HIV Treatment and Prevention Targets

(World Bank, Washington, DC, 2016-10) World Bank Group

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).