Urbanisation, Sustainable Growth and Poverty Reduction in Asia

Almost 3 billion people live in urban areas across the world – equivalent to 48 per cent of the world’s total population. Asia accounts for almost half of these, with an urban population of between 1.3 and 1.5 billion people, accounting for approximately 37 per cent of Asia’s total population (UN-Habitat 2003a; ACHR 2005). These statistics for Asia are perhaps conservative, as different countries define ‘urban centres ’ differently, based upon both population size and other criteria. If either India or China were to redefine their criteria to include some smaller settlements as ‘urban’, then an even greater proportion of Asia’s population would be considered ‘urban’ (Satterthwaite 2005). Asia has a fast growing urban population. The urban population in the region as a whole is projected to grow to 1.8 billion by 2010 (see Figure 1), and as a result Asia is expected to account for a growing proportion of the world’s urban population – just over 50 per cent by 2010 (see Figures 2 and 3). The UN expects this number to increase to between 53 per cent and 55 per cent of the world’s urban population by 2030 (UN-Habitat 2004). In addition to a growing urban population, Asia is also urbanising – that is a growing proportion of its total population live in urban areas (see Figure 4). There are three potential factors contributin

Maternity waiting homes in Southern Lao PDR : the unique \u27silk home\u27

The concept of maternity waiting homes (MWH) has a long history spanning over 100 years. The research reported here was conducted in the Thateng District of Sekong Province in southern Lao People&rsquo;s Democratic Republic (PDR) to establish whether the MWH concept would be affordable, accessible, and most importantly acceptable, as a strategy to improve maternal outcomes in the remote communities of Thateng with a high proportion of the population from ethnic minority groups. The research suggested that there were major barriers to minority ethnic groups using existing maternal health services (reflected in very low usage of trained birth attendants and hospitals and clinics) in Thateng. Unless MWH are adapted to overcome these potential barriers, such initiatives will suffer the same fate as existing maternal facilities. Consequently, the Lao iteration of the concept, as operationalized in the Silk Homes project in southern Lao PDR is unique in combining maternal and infant health services with opportunities for micro credit and income generating activities and allowing non-harmful traditional practices to co-exist alongside modern medical protocols. These innovative approaches to the MWH concept address the major economic, social and cultural barriers to usage of safe birthing options in remote communities of southern Lao PDR.<br /

Reducing Inequality – The Missing MDG: A Content Review of PRSPs and Bilateral Donor Policy Statements

Although important gains have been made in reducing global poverty, the pace of progress across the world is not on track to achieve the 2015 MDG targets. Is this due to lack of ownership on the part of national governments and the international community? This article examines whether the Poverty Reduction Strategy Papers (PRSPs) and donor policy statements are aligned with MDG priorities and targets. The analysis found a high degree of commitment to MDGs as a whole but both PRSPs and donor statements are selective, consistently emphasising income poverty and social investments for education, health and water but not other targets concerned with empowerment and inclusion of the most vulnerable such as gender violence or women's political representation. The article concludes that a new, ninth Goal needs to be added – to reduce inequality – to make the MDGs aligned to the original purpose of the Millennium Declaration

Algorithms for converting estimates of child malnutrition based on the NCHS reference into estimates based on the WHO Child Growth Standards

<p>Abstract</p> <p>Background</p> <p>The child growth standards released by the World Health Organization (WHO) in 2006 have several technical advantages over the previous 1977 National Center for Health Statistics (NCHS)/WHO reference and are recommended for international comparisons and secular trend analysis of child malnutrition. To obtain comparable data over time, earlier surveys should be reanalyzed using the WHO standards; however, reanalysis is impossible for older surveys since the raw data are not available. This paper provides algorithms for converting estimates of child malnutrition based on the NCHS reference into estimates based on the WHO standards.</p> <p>Methods</p> <p>Sixty-eight surveys from the WHO Global Database on Child Growth and Malnutrition were analyzed using the WHO standards to derive estimates of underweight, stunting, wasting and overweight. The prevalences based on the NCHS reference were taken directly from the database. National/regional estimates with a minimum sample size of 400 children were used to develop the algorithms. For each indicator, a simple linear regression model was fitted, using the logit of WHO and NCHS estimates as, respectively, dependent and independent variables. The resulting algorithms were validated using a different set of surveys, on the basis of which the point estimate and 95% confidence interval (CI) of the predicted WHO prevalence were compared to the observed prevalence.</p> <p>Results</p> <p>In total, 271 data points were used to develop the algorithms. The correlation coefficients (R²) were all greater than 0.90, indicating that most of the variability of the dependent variable is explained by the fitted model. The average difference between the predicted WHO estimate and the observed value was <0.5% for stunting, wasting and overweight. For underweight, the mean difference was 0.8%. The proportion of the 95% CI of the predicted estimate containing the observed prevalence was above 90% for all four indicators. The algorithms performed equally well for surveys without the entire age coverage 0 to 60 months.</p> <p>Conclusion</p> <p>To obtain comparable data concerning child malnutrition, individual survey data should be analyzed using the WHO standards. When the raw data are not available, the algorithms presented here provide a highly accurate tool for converting existing NCHS estimates into WHO estimates.</p

Risk factors for childhood malnutrition in Roma settlements in Serbia

<p>Abstract</p> <p>Background</p> <p>Children living in Roma settlements in Central and Eastern Europe face extreme levels of social exclusion and poverty, but their health status has not been well studied. The objective of this study was to elucidate risk factors for malnutrition in children in Roma settlements in Serbia.</p> <p>Methods</p> <p>Anthropometric and sociodemographic measures were obtained for 1192 Roma children under five living in Roma settlements from the 2005 Serbia Multiple Indicator Cluster Survey. Multiple logistic regression was used to relate family and child characteristics to the odds of stunting, wasting, and underweight.</p> <p>Results</p> <p>The prevalence of stunting, wasting, and underweight was 20.1%, 4.3%, and 8.0%, respectively. Nearly all of the children studied fell into the lowest quintile of wealth for the overall population of Serbia. Children in the lowest quintile of wealth were four times more likely to be stunted compared to those in the highest quintile, followed by those in the second lowest quintile (AOR = 2.1) and lastly by those in the middle quintile (AOR = 1.6). Children who were ever left in the care of an older child were almost twice as likely to stunted as those were not. Children living in urban settlements showed a clear disadvantage with close to three times the likelihood of being wasted compared to those living in rural areas. There was a suggestion that maternal, but not paternal, education was associated with stunting, and maternal literacy was significantly associated with wasting. Whether children were ever breastfed, immunized or had diarrhoeal episodes in the past two weeks did not show strong correlations to children malnutrition status in this Roma population.</p> <p>Conclusions</p> <p>There exists a gradient relationship between household wealth and stunting even within impoverished settlements, indicating that among poor and marginalized populations socioeconomic inequities in child health should be addressed. Other areas on which to focus future research and public health intervention include maternal literacy, child endangerment practices, and urban settlements.</p

Lessons from the Making of the MDGs: Human Development Meets Results?based Management in an Unfair World

This article argues that two ideas – human development and results?based management – were particularly significant in shaping the MDGs. These are unlikely intellectual bedfellows, but by charting the evolution of the MDGs, their many influences are demonstrated. The conclusion identifies three main lessons. First, it argues that the MDGs have had only limited impact on policies and actions because the idea behind them, human development, was never fully institutionalised. Second, the article points out the disjuncture that occurred with global goals, the MDGs being operationalised by country level Poverty Reduction Strategies (PRSs) overseen by the International Monetary Fund (IMF) and the World Bank. PRSs need to be genuinely owned by countries, and the IMF and World Bank need to introduce internal ‘Arrogance Reduction Strategies’ to transform their control?oriented cultures. Finally, the conclusion questions whether the idea of human development is past its ‘sell?by’ date – do we need a new idea to mobilise and guide post?2015 pro?poor policy

How states exerted power to create the Millennium Development Goals and how this shaped the global health agenda: Lessons for the sustainable development goals and the future of global health.

Since 2000, the eight Millennium Development Goals (MDGs) provided the framework for global development efforts transforming the field now known as global health. The MDGs both reflected and contributed to shaping a normative global health agenda. In the field of global health, the role of the state is largely considered to have diminished; however, this paper reasserts states as actors in the conceptualisation and institutionalisation of the MDGs, and illustrates how states exerted power and engaged in the MDG process. States not only sanctioned the MDGs through their heads of states endorsing the Millennium Declaration, but also acted more subtly behind the scenes supporting, enabling, and/or leveraging other actors, institutions and processes to conceptualise and legitimize the MDGs. Appreciating the MDGs' role in the conceptualisation of global health is particularly relevant as the world transitions to the MDGs' successor, the Sustainable Development Goals (SDGs). The SDGs' influence, impact and importance remains to be seen; however, to understand the future of global health and how actors, particularly states, can engage to shape the field, a deeper sense of the MDGs' legacy and how actors engaged in the past is helpful

Poverty reduction during 1990-2013: did millennium development goals adoption and state capacity matter?

While poverty reduction remains central in the Post-2015 Agenda, its determinants remain debated in the literature, especially the role of structural conditions related to governance. This paper provides an assessment of two key dimensions: the global adoption of MDGs and state capacity. We do so by studying whether they facilitated convergence in income poverty measures, using cross-section and panel methods, with data on 89 developing economies for the period 1990–2013. We find that poverty headcount and gap measures tended to decrease faster in countries with initially higher income poverty. Such convergence accelerated after 2000, suggesting that MDGs adoption was instrumental to poverty reduction. However, this still leaves unexplained substantial variation in poverty reduction performance across countries. Such variation is explained by state capacity: countries with greater ability to administer their territories in 1990 experienced faster income poverty reduction and were more likely to have achieved the MDG target. This result is insensitive to robust regression methods and to a large set of controls (initial level of income, dependence on natural resources, education and health inputs, dependence on foreign aid, ethnic fractionalization, regional effects and a set of governance variables). As good governance and effective institutions are included in the Sustainable Development Goals, this result provides empirical justification for this move, suggesting that more effective states could be crucial to sustain the development progress achieved so far