Human Development Perspectives
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Investment Framework for Nutrition 2024
2024-09-23, Shekar, Meera, Shibata Okamura, Kyoko, Vilar-Compte, Mireya, Dell’Aira, Chiara, eds.
In 2017, the Investment Framework for Nutrition set the stage for transformative nutrition investments, culminating in strong donor and country commitments at the 2021 Tokyo Nutrition for Growth (N4G) Summit. Now—with only six years left until the Sustainable Development Goals (SDGs) end date of 2030—the world is facing polycrises, including food and nutrition insecurity; climate shocks; fiscal constraints; and rising rates of overweight, obesity, and noncommunicable diseases in low- and middle-income countries. Despite a 44 percent decline in child stunting between 1990 and 2022, global progress is insufficient, as increasing anemia rates among women of reproductive age as well as stagnating rates of child stunting, wasting, low birthweight, and rising obesity among children and adults persist. Nutrition is a marker of human capital, and both obesity and undernutrition are key contributors to the Human Capital Index. As we approach the 2025 Paris N4G, investing to address global nutrition challenges has become more critical than ever. Investment Framework for Nutrition 2024 broadens the focus of the 2017 Investment Framework for Nutrition to include low birthweight and obesity, and it adds policy considerations, operational guidance for country-level implementation, and gender and climate change perspectives. Financially, an additional $13 billion is needed annually to scale up a discrete set of evidence-based nutrition interventions to 90 percent coverage ($13 per pregnant woman and $17 per child under age five per annum), with the largest needs in South Asia (34 percent of total global needs) and Sub-Saharan Africa (26 percent of total needs). These investments need to be complemented with a strategically designed package of policies to influence consumer preferences by modifying the social and commercial determinants of health and dietary behaviors. The economic benefits of scaling up nutrition investments far outweigh the costs and offer substantial returns on investment. Innovative financing mechanisms—including responsible private sector engagement and climate funds, together with measures to enhance the efficiency of the existing financing—are vital to bridge the funding gap. A global effort is essential now to renew financial commitments, explore new funding avenues, and drive nutrition-positive investments—with the ultimate goal of enhancing health, human capital, economic growth, and sustainability.
Revisiting Targeting in Social Assistance: A New Look at Old Dilemmas
2022-03-31, Grosh, Margaret, Wai-Poi, Matthew, Tesliuc, Emil
Targeting is a commonly used, but much debated, policy within global social assistance practice. This book examines the well- known dilemmas in light of the growing body of experience, new implementation capacities, and the potential to bring new data and data science to bear. Chapter 1 presents a series of essays on the factors that shape choices around why or whether or how narrowly/broadly to target different parts of social assistance. Chapter 2 updates the global empirics around the outcomes and costs of focusing benefits on the poor or vulnerable. Chapter 3 illustrates the options and choices that must be made in moving from an abstract vision of focusing resources on the poor or vulnerable to more specific concepts and implementable definitions and procedures, and how the many choices should be informed by values, empirics and context. Chapter 4 provides a brief treatment of delivery systems and processes showing their importance to distributional outcomes and suggesting the many facets with room for improvement. Chapter 5 discusses the choice between targeting methods, how differences in purposes and contexts shape those. Chapter 6 summarizes and comprehensively updates the know-how with respect to the data and inference used by the different household-specific targeting methods. Chapter 7 contains a primer on measurement issues, going much deeper than usual and explaining how better measurement can lead to clearer understanding of targeting issues. Chapter 8 explores machine learning algorithms for household-specific mechanisms for eligibility determination.
Protecting All: Risk Sharing for a Diverse and Diversifying World of Work
2019-09-09, Packard, Truman, Gentilini, Ugo, Grosh, Margaret, O’Keefe, Philip, Palacios, Robert, Robalino, David, Santos, Indhira
This white paper focusses on the policy interventions made to help people manage risk, uncertainty and the losses from events whose impacts are channeled primarily through the labor market. The objectives of the white paper are: to scrutinize the relevance and effects of prevailing risk-sharing policies in low- and middle-income countries; take account of how global drivers of disruption shape and diversify how people work; in light of this diversity, propose alternative risk-sharing policies, or ways to augment and improve current policies to be more relevant and responsive to peoples’ needs; and map a reasonable transition path from the current to an alternative policy approach that substantially extends protection to a greater portion of working people and their families. This white paper is a contribution to the broader, global discussion of the changing nature of work and how policy can shape its implications for the wellbeing of people. We use the term risk-sharing policies broadly in reference to the set of institutions, regulations and interventions that societies put in place to help households manage shocks to their livelihoods. These policies include formal rules and structures that regulate market interactions (worker protections and other labor market institutions) that help people pool risks (social assistance and social insurance), to save and insure affordably and effectively (mandatory and incentivized individual savings and other financial instruments) and to recover from losses in the wake of livelihood shocks (“active” reemployment measures). Effective risk-sharing policies are foundational to building equity, resilience and opportunity, the strategic objectives of the World Bank’s Social Protection and Jobs Global Practice. Given failures of factor markets and the market for risk in particular the rationale for policy intervention to augment the options that people have to manage shocks to their livelihoods is well-understood and accepted. By helping to prevent vulnerable people from falling into poverty -and people in the poorest households from falling deeper into poverty- effective risk-sharing interventions dramatically reduce poverty. Households and communities with access to effective risk-sharing instruments can better maintain and continue to invest in these vital assets, first and foremost, their human capital, and in doing so can reduce the likelihood that poverty and vulnerability will be transmitted from one generation to the next. Risk-sharing policies foster enterprise and development by ensuring that people can take appropriate risks required to grasp opportunities and secure their stake in a growing economy.
Making Schools Work : New Evidence on Accountability Reforms
2011-02-24, Bruns, Barbara, Filmer, Deon, Patrinos, Harry Anthony
This volume is a systematic stock-taking of the evidence on school accountability reforms in developing countries. It provides a measured and insightful review and assessment of the results of a variety of approaches that developing countries are experimenting with in their quest for better schools. It is not the final word on the subject, but will hopefully contribute to better policy choices, grounded in the evidence currently available. This book is about the threats to education quality that cannot be explained by lack of resources. It focuses on publicly financed school systems and the phenomenon of service delivery failures: cases where programs and policies that increase the inputs to education fail to produce effective delivery of services where it counts-in schools and classrooms. It documents what authors know about the extent and costs of service delivery failures in public education in the developing world. And it further develops aspects of the conceptual model posited in the World development report 2004: that a root cause of low-quality and inequitable public services-not only in education-is the weak 'accountability' of providers to both their supervisors and their clients (World Bank 2003). The central focus of this book, however, is a new story. It is that developing countries are increasingly adopting innovative strategies to attack these issues.
Strategic Investment for Health System Resilience: A Three-Layer Framework
2024-08-26, Zhao, Feng, Kovacevic, Rialda, Bishai, David, Weintraub, Jeff, eds.
As efforts to build emergency-ready health systems intensify across the globe, Strategic Investment for Health System Resilience: A Three-Layer Framework provides a practical investment framework and a diverse set of country cases to inform decision-making and strategic resource allocations. The framework includes layer 1, risk reduction—promoting emergency-ready primary health care, public health, prevention, and community preparedness; layer 2, detection, containment, and mitigation capabilities; and layer 3, advanced case management and surge response. This three-layer framework prioritizes interventions that prevent a public health threat from developing in the first place (layer 1), limit its spread should one emerge (layer 2), and manage a widespread crisis that compromises a health system’s ability to deliver care sustainably (layer 3). All three layers play a role in achieving health system resilience, but not all of them have been leveraged equally in the past. Strategic Investment for Health System Resilience offers a glimpse of the relatively low cost of investments in improving the operation of the weakest parts of the three layers. Layer 1 functions are estimated to cost between US$2 per capita in low-income countries and US$4 per capita in lower-middle-income countries. The framework applies equally to short-term epidemics of communicable diseases and to slow-moving trends in noncommunicable diseases. The pace of the needed response to health threats can vary, but all require a system that is resilient across multiple layers of response. Although there is no universal blueprint for every setting, it behooves all countries to seize the moment and invest in the three layers in ways that fit their needs.
Tackling the World's Fastest-Growing HIV Epidemic: More Efficient HIV Responses in Eastern Europe and Central Asia
2020-06-22, Benedikt, Clemens, Zhao, Feng, Wilson, David, Zhao, Feng, Benedikt, Clemens, Wilson, David
The Eastern Europe and Central Asia region has the world’s fastest growing HIV epidemic. Although still concentrated, the epidemic has diversified, affecting several key populations in many countries. This change has increased the number of people in need, the ways the epidemic can spread, and the complexity of formulating an effective strategy to combat it. At the same time, international funding is insufficient to cover the growing need, and domestic plans to cover the funding gaps, in many cases, fall short. In this environment, the need to use data to make the best possible decisions about using available funds is essential. Tackling the World’s Fastest-Growing HIV Epidemic tells the story of how, in 11 countries across Eastern Europe and Central Asia, small groups of decision-makers and experts came together to carry out innovative, groundbreaking analyses for each country. It details the steps these nations have taken to strengthen their HIV programs based on the findings while highlighting critical issues for the road ahead. In so doing, the book also shows the potential of what can be done with a mathematical model and how it can support real-life improvements in policy and more efficacious budget allocations. It is the record of a unique undertaking to improve public health investments that offers lessons for many communities.
Risking Your Health : Causes, Consequences, and Interventions to Prevent Risky Behaviors
2014, de Walque, Damien, de Walque, Damien
Behaviors that pose risks for an individual’s health and that also represent important threats for public health, such as drug use, smoking, alcohol, unhealthy eating causing obesity, and unsafe sex, are highly prevalent in low income countries, even though they are traditionally associated with richer countries. Individual choices are an important part of the risky behaviors. Risking Your Health: Causes, Consequences, and Interventions to Prevent Risky Behaviors explore how those choices are formed and what are their consequences. Why do people engage in risky behaviors? Many different explanations have been proposed by psychology, sociology, economics or public health. One trait common to all these behaviors is that there is a disconnect – a function of both delay and uncertainty - between the pleasure or satisfaction provided by them and their consequences. Another characteristic of risky behaviors is that they rarely occur in isolation. Peer-pressure, parental influences, networks and social norms often play an important role in initiating, continuing, or quitting those behaviors. Even if they might often be the first to suffer, the consequences of risky behaviors are also rarely limited to the individuals engaging in them. In certain cases, such as second-hand smoking or HIV transmission, the link is direct. In other cases, the link is less direct but not necessarily less real: the long term health consequences of many of these behaviors are costly to treat and could stretch households’ finances and worsen poverty. Finally, these risky behaviors have consequences for society as a whole since they often trigger a non-trivial amount of public health expenditures and lead to declines in aggregate productivity through premature death and morbidity. Changing behaviors is tricky -- public health interventions via legislation with strong enforcement mechanisms can be more effective than simple communication campaigns informing consumers about the risks associated with certain behaviors, since translating knowledge into concrete changes in behavior seems to be hard to achieve. Economic mechanisms such as taxes (especially on alcohol and tobacco products), subsidies (such as free condoms), and conditional/unconditional cash transfers are also used to reduce risky behaviors (for example in HIV prevention). Of great interest to policy makers, academics and practitioners, this book assesses the efficiency of those interventions designed to reduce the prevalence of behaviors that endanger health.
Quality Early Learning: Nurturing Children's Potential
2022-05-11, Bendini, Magdalena, Devercelli, Amanda E.
In this volume, leading researchers and implementation experts from an array of disciplines provide evidence-based, cost-effective, and actionable strategies for delivering quality early childhood education (ECE) at scale in low- and middle-income countries (LMICS).Over the past decade, neuroscientists, developmental and cognitive psychologists, economists, and education researchers have amassed evidence to inform ECE program design. Yet much of this evidence has not been readily accessible to policymakers and practitioners, and potential synergies from cross-disciplinary considerations have not been realized.Quality Early Learning: Nurturing Children’s Potential synthesizes the evidence across disciplines and charts a forward course for quality ECE. The volume includes Overview, From Evidence to Effective Policies: How to Invest in Early Childhood Education to Nurture Children’s Potential, by Magdalena Bendini, Amanda E. Devercelli, Elaine Ding, Melissa Kelly, and Adelle Pushparatnam Chapter 1, Learning in the Early Years, by Elizabeth Spelke and Kristin Shutts Chapter 2, Pedagogy and Curricula Content: Building Foundational Skills and Knowledge, by David Whitebread and Yasmin Sitabkhan Chapter 3, Building an Effective Early Childhood Education Workforce, by Nirmala Rao, Emma Pearson, Benjamin Piper, and Carrie Lau Chapter 4, Creating Early Childhood Education Environments That Promote Early Learning, by Cynthia Adlerstein and Alejandra Cortázar Chapter 5, The Role of Management, Leadership, and Monitoring in Producing Quality Learning Outcomes in Early Childhood Education, by Iram Siraj, Violeta Arancibia, and Juan Barón Chapter 6, Toward Quality Early Learning: Systems for Success, by Sharon Lynn Kagan and Caitlin M. Dermody In the volume, the authors provide the latest evidence on how young children learn most effectively and how ECE programs can foster children’s natural ability and motivation to learn. It offers guidance for policy makers on policy design and implementation including what elements of ECE to prioritize in resource- and capacity-constrained settings in LMICs.
Obesity: Health and Economic Consequences of an Impending Global Challenge
2020, Shekar, Meera, Popkin, Barry, Shekar, Meera, Popkin, Barry, Dayton Eberwein, Julia, Dayton Eberwein, Julia, Oddo, Vanessa, Akuoku, Jonathan Kweku, Shibata Okamura, Kyoko, Schneider, Pia, Block, Charlotte, Provo, Anne Marie, Provo, Anne Marie
Obesity is a global ticking time-bomb with huge potential negative economic and health impacts, especially for the poor. As of 2016, an estimated 44 percent of adults (more than 2 billion) worldwide are overweight/obese, and over 70 percent of them live in low- or middle-income countries, dispelling the myth that obesity is a problem only in high-income countries. The global obesity epidemic presents a formidable challenge to human capital acquisition, national wealth accumulation, and the goals of ending extreme poverty and boosting shared prosperity. Given the renewed global focus on human capital, its links to the obesity epidemic, and the growing evidence base for double- and triple-duty actions, there is both an urgent need for action and a great opportunity for engagement that will require both a whole-of-government and a whole-of-development partner approach. Countries and global partners need to act urgently to address this ensuing epidemic with emphasis highlighting interventions that require corrective public action rather than one of individual responsibility.
The Right Skills for the Job? Rethinking Training Policies for Workers
2012, Behrman, Jere, Almeida, Rita, Robalino, David, Almeida, Rita, Behrman, Jere, Robalino, David
This book addresses the question of how to build and upgrade job relevant skills. Specifically, the authors focus on three types of training programs relevant for individuals who are leaving formal general schooling or are already in the labor market: pre-employment technical and vocational education and training (TVET); on-the-job training (OJT); and training-related active labor market programs (ALMPs). ALMPs are usually of shorter duration and target individuals who are seeking a second chance and who do not have access to TVET or OJT; these are often low-skilled unemployed or informal workers. Contrary to training-related ALMPs, pre-employment TVET is usually offered within the formal schooling track and tends to be administered by the ministries of education. The book discusses the main justifications for these programs and how they relate to market failures that can lead to underinvestment in training and misalignment between supply and demand for skills. Unfortunately, governments are also prone to failure and many of the programs that countries have adopted today are part of the problem and not the solution. This book proposes options to improve the design and implementation of current skills development systems. Clearly, the authors cannot cover all issues in detail. Training methods among TVET, OJT, and ALMP programs are quite different, ranging from classroom instruction, laboratory research, TVET workshops, and apprenticeship arrangements and internships in firms. All have different challenges and specificities. The report highlights the most important design features of the different programs and points to the main knowledge gaps and areas for future research and analysis. The book is organized into five chapters. Following this overview, chapter two introduces the policy framework that guides the analysis in the book. This framework describes the main market and government failures that require attention and identifies potential interventions to address them. Chapter's three to five then discuss the main challenges facing, respectively, TVET, OJT, and training-related ALMP programs and outlines recommendations to address them. The rest of this overview summarizes the main messages from each of the chapters and in the last section outlines the main knowledge gaps and proposes an agenda for future research and policy analysis.