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Publication(Washington, DC: World Bank, 2006) Gragnolati, Michele ; Bredenkamp, Caryn ; Shekar, Meera ; Das Gupta, Monica ; Lee, Yi-KyoungThe prevalence of child undernutrition in India is among the highest in the world; nearly double that of Sub-Saharan Africa, with dire consequences for morbidity, mortality, productivity and economic growth. Drawing on qualitative studies and quantitative evidence from large household surveys, this book explores the dimensions of child undernutrition in India and examines the effectiveness of the Integrated Child Development Services (ICDS) program, India's main early child development intervention, in addressing it. Although levels of undernutrition in India declined modestly during the 1990s, the reductions lagged behind those achieved by other countries with similar economic growth. Nutritional inequalities across different states and socioeconomic and demographic groups remain large. Although the ICDS program appears to be well-designed and well-placed to address the multi-dimensional causes of malnutrition in India, several problems exist that prevent it from reaching its potential. The book concludes with a discussion of a number of concrete actions that can be taken to bridge the gap between the policy intentions of ICDS and its actual implementation.
Reducing Maternal Mortality : Learning from Bolivia, China, Egypt, Honduras, Indonesia, Jamaica, and Zimbabwe(Washington, DC: World Bank, 2003-04) Koblinsky, Marjorie A. ; Koblinsky, Marjorie A.Of the 515,000 maternal deaths that occur every year worldwide, 99 percent take place in developing countries. Women In the developing world have a 1 in 48 chance of dying from pregnancy-related causes; the ratio in industrial countries is 1 in 1,800. Of all the human development indicators, the greatest discrepancy between industrial, and developing countries is in maternal health. The stimulus for this study was the question - Can current program strategies reduce maternal mortality faster that the decades required in the historically successful countries of Malaysia, and Sri Lanka? The answer was no. Based on case studies in seven selected countries, the study stipulates the factor common to all reviewed programs, is the high availability of a provider who is, either a skilled birth attendant, or closely connected with a capable referral system. A second common factor is the high availability of facilities that can provide basic, and essential obstetric care. But, unlike historic successes however, strong government policy now focuses explicitly on safe motherhood, and sets the tone for programs in most of the selected countries. Another difference between the case studies selected, and that in historically successful countries, is the financing of services: while service were free to families in Malaysia and Sri Lanka, costs of safe motherhood services are now substantial, and a major deterrent to use.
Publication(Washington, DC: World Bank, 2001-06) Aoyama, AoyamaThis reproductive health review of the Middle East and North Africa (MENA) region provides an overview of the issues and establishes a base of knowledge upon which a strategy could be constructed. Despite achievements in the population and health sectors during the last decades, several reproductive health issues remain, while new challenges have emerged. Major reproductive health issues in the region include high maternal mortality, particularly in Yemen, Morocco, Egypt, and Iraq; high fertility and slowing fertility decline; early marriage and high teenage fertility; the increasing prevalence of sexually transmitted infections and HIV/AIDS; and female genital cutting in Egypt and Yemen. There is a correlation between reproductive health issues, a country's level of social development, and the size of gaps within a country; between men and women, urban and rural, rich and poor. Therefore, it is necessary to plan and implement programs targeted to specific issues and underprivileged groups; develop effective and sustainable health systems with high-quality services; raise awareness and change behaviors of both the public and policymakers; and empower women. Strong political commitment is essential to overcoming social and cultural constraints. Possible intervention components and possible roles of the World Bank are suggested.