Publication:
Health, Nutrition, and Population in Madagascar 2000-09

Loading...
Thumbnail Image
Files in English
English PDF (9.2 MB)
1,137 downloads
English Text (737.67 KB)
300 downloads
Published
2011-07-05
ISSN
Date
2012-03-19
2012-04-04
Editor(s)
Abstract
With an income per capita US$400 in 2008, Madagascar is one of the poorest countries in the world. Poverty is widespread but with significant urban-rural differences (52 percent versus 74 percent). Health, nutrition, and the fight against communicable diseases and HIV/AIDS are key goals of the country's poverty reduction strategy, the Madagascar Action Plan 2007-2012. The National Health Sector and Social Protection Development Plan 2007-2011 was developed to strengthen the health system and improve service delivery to reduce neonatal, child and maternal mortality, address malnutrition and control communicable illnesses. The health sector has benefited from increasing investment over the last years, and a number of studies and surveys have been carried out, providing a wealth of information that is yet to be analyzed in a complementary way. This Country Status Report (CSR) seeks to capitalize on all of the existing data in the health sector, compare Madagascar to countries of similar income levels and assess the results achieved by the health system. The CSR provides an analysis of the population's health and nutrition status by linking health outcomes, household/individual behaviors, community factors, government interventions, and service provision. Although Madagascar is performing beer than the SSA average of 645 per 100,000 live births, the maternal mortality rate has stagnated over the last decade and in 2008/09 was estimated at 498. Health care seeking behavior for preventive child health services at the health facility level is improving. Complete immunization coverage stands at 62 percent in 2008 (for children 12 to 23 months), but there are still large differences in coverage across regions, place of residence, and income groups.
Link to Data Set
Citation
Sharp, Maryanne; Kruse, Ioana. 2011. Health, Nutrition, and Population in Madagascar 2000-09. World Bank Working Paper ; No. 216. Africa Human Development Series. © World Bank. http://hdl.handle.net/10986/5957 License: CC BY 3.0 IGO.
Associated URLs
Associated content
Report Series
Report Series
Other publications in this report series
  • Publication
    Environmental Implications of a Central Bank Digital Currency (CBDC)
    (Washington, DC : World Bank, 2022-07) Lee, Soohyang; Park, Jinhee
    Two-thirds of central banks in the East Asia and Pacific (EAP) region have started researching or testing the implementation of a Central Bank Digital Currency (CBDC). At the same time, the region accounts for one-third of world CO2 emissions and is vulnerable to climate risks. As the Group of 7 (G7), European Central Bank (ECB), and Bank of England (BoE) have stated in their public statements, it is increasingly important to consider environmental impact when designing CBDC. However, only a few brief studies have been done on this subject, which will be crucial for the region. This Note explores the environmental implications of CBDC by comparing technical mechanisms and energy consumption within its distributed structure. It also illustrates differences in ecological footprint between CBDC and other payment methods (cryptocurrency, cash, and card networks). As the legitimacy of CBDC is backed by the trust of central banks, CBDC does not need to prove its legitimacy through its technological structure. Therefore, CBDC does not require the energy-intensive consensus or mining mechanisms used by a cryptocurrency, so its energy consumption is lower (comparable to that of a credit card system). CBDC can be designed to use various systems, such as Real Time Gross Settlement (RTGS), Distributed Ledger Technology (DLT), or a mixture of both. Careful deliberation to meet the objectives and implications will be important as CBDC can be a catalyst for financial innovation.
  • Publication
    Assessing Incentives to Increase Digital Payment Acceptance and Usage
    (World Bank, Washington, DC, 2022-01-18) Allen, Jeff; Carbo Valverde, Santiago; Chakravorti, Sujit; Rodriguez-Fernandez, Francisco; Pinar Ardic, Oya
    An important step to achieve greater financial inclusion is to increase the acceptance and usage of digital payments. Although consumer adoption of digital payments has improved dramatically globally, the acceptance and usage of digital payments for micro, small, and medium-sized retailers (MSMRs) remain challenging. Using random forest estimation, The authors identify 14 key predictors out of 190 variables with the largest predictive power for MSMR adoption and usage of digital payments. Using conditional inference trees, they study the importance of sequencing and interactions of various factors such as public policy initiatives, technological advancements, and private sector incentives. The authors find that in countries with low point of sale (POS) terminal adoption, killer applications such as mobile phone payment apps increase the likelihood of P2B digital transactions. They also find the likelihood of digital P2B payments at MSMRs increases when MSMRs pay their employees and suppliers digitally. The level of ownership of basic financial accounts by consumers and the size of the shadow economy are also important predictors of greater adoption and usage of digital payments. Using causal forest estimation, they find a positive and economically significant marginal effect for merchant and consumer fiscal incentives on POS terminal adoption on average. When countries implement financial inclusion initiatives, POS terminal adoption increases significantly and MSMRs’ share of person-to-business (P2B) digital payments also increases. Merchant and consumer fiscal incentives also increase MSMRs’ share of P2B electronic payments.
  • Publication
    The Behavioral Professional
    (Washington, DC : World Bank, 2022) Lourenço, Joana S.; Vakis, Renos; Zoratto, Laura
    Over the past decade, governments, multilateral organizations, and think tanks have been increasingly using behavioral science as an additional tool to understand and tackle complex policy challenges in several sectors. Yet despite this increase in the use of behavioral science for policy design, little attention has been given so far to those individuals responsible for designing and implementing public policies and programs: policy professionals. This note aims to achieve three objectives. first, it highlights recent examples building on work done by the eMBeD team and the World Bank at large on how behavioral bottlenecks can hinder key development goals, from ensuring inclusive and equitable education for all (SDG4) to ensuring good health and well-being (SDG3), among others. Second, the note presents a behavioral framework highlighting the individual, group and institutional contexts that affect policy professionals. Finally, it showcases the relevance of the behavioral approach to a broad range of areas - including public service design, corruption and accountability, service design, access and delivery, civil servants’ performance - by pinpointing common bottlenecks faced, and potential solutions to overcome them.
  • Publication
    Greening Digital in Korea
    (Washington, DC, 2022-02) World Bank
    Digital technologies are making a significant impact on societies, economies, and the physical world, presenting both opportunities and challenges for the green agenda. Applications of these technologies in sectors such as energy, urban, transport, and agriculture are creating new possibilities for climate change mitigation strategies. However, the rapid expansion of digital technologies increases energy usage too, and is therefore also increasing greenhouse gas (GHG) emissions. In seeking to address these challenges, the World Bank’s Digital Development Global Practice (DD) will publish a flagship report on Digital Development Opportunities for Climate Change, which will assess opportunities for greening with information communication technology (ICT), as well as opportunities for greening the ICT sector itself. To inspire and inform this flagship report, DD studied Korea’s experience in greening its ICT sector, with support from the Korean Green Growth Trust Fund. The Republic of Korea was selected for the case study due to its experience in both the digital and green sectors, and its status as a globally recognized ICT powerhouse. The country was also an early adopter of a green policy agenda, and is integrating DNA (data, network, and AI) into these policies. The government announced a national policy vision of “Low Carbon, Green Growth” in 2008 and has taken concrete steps to build a solid foundation for the green transition, through legislation, standardization, information-based instruments, economic instruments, research and development (R&D), and green procurement. More recently, the country has been aligning its green ICT strategy with the broader national GHG reduction target. Korea's experience can offer meaningful lessons to other countries looking to reduce the ICT sector’s climate impact. It shows that public policies have an important impact on the ICT market. The policy tools that can spur decarbonization of the ICT sector include green government procurement, information-based instruments, economic instruments, and provision of guidelines on green business practices. Keys to success in applying such tools include strong and early political commitment; long-term planning and comprehensive policies; prioritization; research and development (R&D) and investment; and a governance structure that allows a whole-of-government approach. Additionally, Korea’s experience shows that renewable energy will play an increasingly important role in reducing GHG emissions from the energy-intensive ICT industry. Korea’s experience also underscores the fact that more evidence and analysis are needed to measure and determine the effectiveness of policy and regulatory pathways for greening the ICT sector.
  • Publication
    Sustainable Cities Towards A Green, Resilient and Inclusive Recovery
    (Washington, DC, 2022-03) World Bank
    Cities are key to unlocking a climate-smart future for all, as they account for more than 50 percent of the global population, about 70 percent of global energy-related CO2 emissions and 80 percent of global GDP. Urban centers’ share of emissions is expected to grow as the urban population is projected to increase by 2.3 billion people by 20502. As the world recovers from the COVID-19 crisis, cities will present a huge opportunity to rebuild in a way that is climate friendly and meets some of the world’s ambitious climate targets. Cities are viewed as the source of and the solution to many of today's economic, social, and environmental challenges. This is not only because of the concentration of population and economic assets in urban areas, but also because local authorities perform key functions that impact the quality of life of their residents. From an urban management perspective, the leading resource and knowledge sharing platform is the GEF funded Global Platform for Sustainable Cities (GPSC), hosted by the World Bank. The GPSC states that achieving sustainability requires the balanced accomplishment of outcomes against four pillars, namely (1) robust economic growth, prosperity, and competitiveness across all parts of the city; (2) protection and conservation of ecosystems and natural resources into perpetuity; (3) mitigation of greenhouse gas (GHG) emissions while fostering overall city resilience; and (4) inclusiveness and livability, mainly through the reduction of city poverty levels and inequality. The Urban Sustainability Framework (USF), developed to outline the areas of work and support by the GPSC, offers a very useful representation of both outcomes as well as enabling actions and requirements (such as spatial data and good governance) cities could focus on.
Journal
Journal Volume
Journal Issue

Related items

Showing items related by metadata.

  • Publication
    Fertility Regulation Behaviors and Their Costs : Contraception and Unintended Pregnancies in Africa and Eastern Europe & Central Asia
    (World Bank, Washington, DC, 2007-12) Lule, Elizabeth; Singh, Susheela; Chowdhury, Sadia Afroze
    The report consists of three parts: global trends in fertility, contraceptive use and unintended pregnancies; studies of two regions (Africa and Eastern Europe/Central Asia) and two countries (Nigeria and Kazakhstan) on the costs of fertility regulation behaviors and provider attitudes towards contraceptive use. Fertility levels have declined steadily over the last three decades but the pace of decline varies among regions. Countries that have achieved a high level of contraceptive use have reached a lower fertility level. A gap continues to exist between actual and desired family size, resulting in unintended pregnancies. More than one-third of the pregnancies that occur are unintended and one in five pregnancies ends in induced abortion. Almost half of all induced abortions are unsafe, and the proportion of all abortions that are unsafe have increased during the last decade. Sixty-six percent of unintended pregnancies occur among women who are not using any method of contraception. Investing in quality family planning programs is a cost-effective way to address unmet need for contraception and reduce the risks of unsafe abortion, thereby improving maternal health. If contraception were provided to the 137 million women who lack access, maternal mortality will decline by 25-35 percent.
  • Publication
    Sparing Lives : Better Reproductive Health for Poor Women in South Asia, Summary for Policymakers
    (New Delhi: Macmillan India, Ltd., 2008) Chatterjee, Meera; Levine, Ruth; Murthy, Nirmala; Rao-Seshadri, Shreelata
    In this context, the overall purpose of this review is to bring attention to the opportunities that five countries in the region - Bangladesh, India, Nepal, Pakistan and Sri Lanka - have to strengthen and expand interventions to improve the reproductive health of poor women. The specific objectives are: i) to provide an accurate picture of the current status of women's reproductive health, describe the use of reproductive health services and barriers to use, and identify the improvements required to increase their effectiveness and improve health outcomes; ii) to elucidate individual and household characteristics that affect reproductive health status and use of services so that the most important of these can be used to identify women and households with the greatest need for care to achieve better health; iii) to describe a simple and effective approach - decentralized action planning - that can be used widely in all five countries to improve reproductive health service delivery and outcomes, and point to a body of best practices in reproductive health that provides models and lessons for improvements in South Asia; and iv) to strengthen the case for investing in poor women's reproductive health by demonstrating the links between poverty, inequality, reproductive health care and expenditure.
  • Publication
    The Potential for Integrating Community-Based Nutrition and Postpartum Family Planning : Review of Evidence and Experience in Low-Income Settings
    (World Bank, Washington, DC, 2013-11) Alvesson, Helle M.; Mulder-Sibanda, Menno
    The objective of this review was to study where community-based family planning and nutrition programs have been integrated, how this has been accomplished, and what the results have been. Although family planning is a nontraditional intervention in community-based nutrition programs, it can have profound effects on maternal and child health and nutrition. When family planning does not occur, short intervals between pregnancies deplete mothers' reserves of nutrients needed for pregnancy and later for breastfeeding. As a result, short birth intervals are associated with higher maternal and neonatal mortality and malnutrition rates of infants. Family planning, which promotes contraceptive use and the lactational amenorrhea method, can thus improve nutrition outcomes in both mothers and babies. The authors identified a few studies on integrated services in the published literature; thus the main part of the review is built on operational research studies and unpublished smaller scale intervention studies. However, the controlled studies that were identified indicate positive correlation between breastfeeding levels and increased contraception use. Additionally, although the design of the intervention studies did not make it possible to assess the degree to which integration had an impact, the studies did highlight factors that were key to a successful integration process. These are community engagement; multiple and frequent contact points between mothers, community volunteers, and health workers; involvement of husbands; moving implementation decisions closer to the users of the program; and assuring transparency, clarity, and simplicity in the transmission of development objectives to communities.
  • Publication
    Fertility Decline in Botswana 1980-2006
    (World Bank, Washington, DC, 2010-05) World Bank
    Botswana has had a stable democratic government and good governance since independence in 1966. With a sustained high average economic growth (about 9 percent) fueled by the diamond mining industry, it is the only country in Africa listed among the 13 'economic miracles' of the world for 1960-2005. The total fertility rate remains high in Sub-Saharan Africa, with 25 countries showing a rate greater than 5.0. In contrast, Botswana experienced the greatest fertility decline in the region during 1980-2006, with the total fertility rate decreasing from 7.1 in 1981 to 3.2 in 2006. The Botswana national family planning program, judged the strongest in Africa, contributed to this decline. The government strongly committed to meeting family planning needs, integrated maternal and child health/family planning (MCH/FP) and sexually transmitted infection (STI) services in 1973. The government spends about 18 percent of its total budget on health, a higher proportion than the Abuja declaration's target of 15 percent.
  • Publication
    Universal Maternal Health Coverage? Assessing the Readiness of Public Health Facilities to Provide Maternal Health Care in Indonesia
    (World Bank, Jakarta, 2014-07) World Bank; Indonesia National Institute of Research and Development
    Over the period 2011-2013, Indonesia had universal maternal health coverage for its population. Facility-based deliveries, however, remain relatively low: only about 63 percent of all deliveries occurred at a health facility in Indonesia. Recent progress notwithstanding, and despite the relatively high utilization rates for most key maternal health services, the level of maternal mortality remains high in Indonesia, especially in provinces such as West Papua, North Maluku, Papua, Gorontalo, West Sulawesi, Maluku, and South Kalimantan. This policy paper assesses the supply-side readiness of Indonesia s public health facilities in providing key maternal health services such as antenatal care (ANC) as well as basic and comprehensive emergency obstetric care. The focus in the paper is on assessing to what extent Indonesia's universal maternal health coverage is real. Ensuring the supply-side readiness of Indonesia's health system, incorporating lessons from the past experiences of implementing universal maternal health coverage under the different social health insurance programs, will be one key factor in ensuring that implementation of universal health coverage (UHC) results in improvements in health outcomes, including for maternal health. The policy paper is structured as follows: the section maternal health in Indonesia provides background on maternal health in Indonesia and on intended reforms to attain UHC by 2019. Assessing universal maternal health coverage in Indonesia provides information on maternal health benefits under existing social health insurance programs. Public facility supply-side service readiness for maternal health outlines the supply-side implications of maternal health coverage using national guidelines as well as the World Health Organization's (WHO's) service availability and readiness assessment (SARA) framework, focusing specifically on ANC as well as basic and emergency obstetric care services and presents an assessment of service readiness using facility-level data. The report concludes with policy implications in the final section, policy implications and conclusions.

Users also downloaded

Showing related downloaded files

  • Publication
    Classroom Assessment to Support Foundational Literacy
    (Washington, DC: World Bank, 2025-03-21) Luna-Bazaldua, Diego; Levin, Victoria; Liberman, Julia; Gala, Priyal Mukesh
    This document focuses primarily on how classroom assessment activities can measure students’ literacy skills as they progress along a learning trajectory towards reading fluently and with comprehension by the end of primary school grades. The document addresses considerations regarding the design and implementation of early grade reading classroom assessment, provides examples of assessment activities from a variety of countries and contexts, and discusses the importance of incorporating classroom assessment practices into teacher training and professional development opportunities for teachers. The structure of the document is as follows. The first section presents definitions and addresses basic questions on classroom assessment. Section 2 covers the intersection between assessment and early grade reading by discussing how learning assessment can measure early grade reading skills following the reading learning trajectory. Section 3 compares some of the most common early grade literacy assessment tools with respect to the early grade reading skills and developmental phases. Section 4 of the document addresses teacher training considerations in developing, scoring, and using early grade reading assessment. Additional issues in assessing reading skills in the classroom and using assessment results to improve teaching and learning are reviewed in section 5. Throughout the document, country cases are presented to demonstrate how assessment activities can be implemented in the classroom in different contexts.
  • Publication
    World Development Report 2006
    (Washington, DC, 2005) World Bank
    This year’s Word Development Report (WDR), the twenty-eighth, looks at the role of equity in the development process. It defines equity in terms of two basic principles. The first is equal opportunities: that a person’s chances in life should be determined by his or her talents and efforts, rather than by pre-determined circumstances such as race, gender, social or family background. The second principle is the avoidance of extreme deprivation in outcomes, particularly in health, education and consumption levels. This principle thus includes the objective of poverty reduction. The report’s main message is that, in the long run, the pursuit of equity and the pursuit of economic prosperity are complementary. In addition to detailed chapters exploring these and related issues, the Report contains selected data from the World Development Indicators 2005‹an appendix of economic and social data for over 200 countries. This Report offers practical insights for policymakers, executives, scholars, and all those with an interest in economic development.
  • Publication
    Argentina Country Climate and Development Report
    (World Bank, Washington, DC, 2022-11) World Bank Group
    The Argentina Country Climate and Development Report (CCDR) explores opportunities and identifies trade-offs for aligning Argentina’s growth and poverty reduction policies with its commitments on, and its ability to withstand, climate change. It assesses how the country can: reduce its vulnerability to climate shocks through targeted public and private investments and adequation of social protection. The report also shows how Argentina can seize the benefits of a global decarbonization path to sustain a more robust economic growth through further development of Argentina’s potential for renewable energy, energy efficiency actions, the lithium value chain, as well as climate-smart agriculture (and land use) options. Given Argentina’s context, this CCDR focuses on win-win policies and investments, which have large co-benefits or can contribute to raising the country’s growth while helping to adapt the economy, also considering how human capital actions can accompany a just transition.
  • Publication
    Digital Africa
    (Washington, DC: World Bank, 2023-03-13) Begazo, Tania; Dutz, Mark Andrew; Blimpo, Moussa
    All African countries need better and more jobs for their growing populations. "Digital Africa: Technological Transformation for Jobs" shows that broader use of productivity-enhancing, digital technologies by enterprises and households is imperative to generate such jobs, including for lower-skilled people. At the same time, it can support not only countries’ short-term objective of postpandemic economic recovery but also their vision of economic transformation with more inclusive growth. These outcomes are not automatic, however. Mobile internet availability has increased throughout the continent in recent years, but Africa’s uptake gap is the highest in the world. Areas with at least 3G mobile internet service now cover 84 percent of Africa’s population, but only 22 percent uses such services. And the average African business lags in the use of smartphones and computers as well as more sophisticated digital technologies that catalyze further productivity gains. Two issues explain the usage gap: affordability of these new technologies and willingness to use them. For the 40 percent of Africans below the extreme poverty line, mobile data plans alone would cost one-third of their incomes—in addition to the price of access devices, apps, and electricity. Data plans for small- and medium-size businesses are also more expensive than in other regions. Moreover, shortcomings in the quality of internet services—and in the supply of attractive, skills-appropriate apps that promote entrepreneurship and raise earnings—dampen people’s willingness to use them. For those countries already using these technologies, the development payoffs are significant. New empirical studies for this report add to the rapidly growing evidence that mobile internet availability directly raises enterprise productivity, increases jobs, and reduces poverty throughout Africa. To realize these and other benefits more widely, Africa’s countries must implement complementary and mutually reinforcing policies to strengthen both consumers’ ability to pay and willingness to use digital technologies. These interventions must prioritize productive use to generate large numbers of inclusive jobs in a region poised to benefit from a massive, youthful workforce—one projected to become the world’s largest by the end of this century.
  • Publication
    Lebanon Economic Monitor, Fall 2022
    (Washington, DC, 2022-11) World Bank
    The economy continues to contract, albeit at a somewhat slower pace. Public finances improved in 2021, but only because spending collapsed faster than revenue generation. Testament to the continued atrophy of Lebanon’s economy, the Lebanese Pound continues to depreciate sharply. The sharp deterioration in the currency continues to drive surging inflation, in triple digits since July 2020, impacting the poor and vulnerable the most. An unprecedented institutional vacuum will likely further delay any agreement on crisis resolution and much needed reforms; this includes prior actions as part of the April 2022 International Monetary Fund (IMF) staff-level agreement (SLA). Divergent views among key stakeholders on how to distribute the financial losses remains the main bottleneck for reaching an agreement on a comprehensive reform agenda. Lebanon needs to urgently adopt a domestic, equitable, and comprehensive solution that is predicated on: (i) addressing upfront the balance sheet impairments, (ii) restoring liquidity, and (iii) adhering to sound global practices of bail-in solutions based on a hierarchy of creditors (starting with banks’ shareholders) that protects small depositors.