Why are IPTp Coverage Targets so Elusive in Sub-Saharan Africa? A Systematic Review of Health System Barriers.

Use of intermittent preventive treatment (IPTp) is a proven cost-effective intervention for preventing malaria in pregnancy. However, despite the roll-out of IPTp policies across Africa more than ten years ago, utilization levels remain low. This review sought to consolidate scattered evidence as to the health system barriers for IPTp coverage in the continent.Methods and findings: Relevant literature from Africa was systematically searched, reviewed and synthesized. Only studies containing primary data were considered. Studies reveal that: (i) poor leadership and governance contribute to slow decentralization of programme management, lack of harmonized guidelines, poor accountability mechanisms, such as robust monitoring and evaluation systems; (ii) low budgetary allocation towards policy implementation slows scale-up, while out-of-pocket expenditure deters women from seeking antenatal services that include IPTp; (iii) there are rampant human resource challenges including low staff motivation levels attributed to such factors as incorrect knowledge of IPTp recommendations and inadequate staffing; (iv) implementation of IPTp policies is hampered by prevailing service delivery barriers, such as long waiting time, long distances to health facilities and poor service provider/client relations; and (v) drug stock-outs and poor management of information and supply chains impair sustained availability of drugs for IPTp. For successful IPTp policy implementation, it is imperative that malaria control programmes target health system barriers that result in low coverage and hence programme ineffectiveness

Decentralized Managment of Irrigation Areas in the Sahel : Water User Associations in the Senegal River Valley

human development, water, sanitation

The rise of securities markets : what can government do?

Using U.S. securities markets as a case history, the author explores the role securities markets play in economic development, how they emerge, and how regulation can make them more effective. Why the United States? Two centuries ago, it was a small undeveloped country with serious financial problems. It confronted those problems and, guided by Alexander Hamilton, creatively reformed its financial system, which then became a foundation of the U.S. economic infrastructure and a bulwark for long-term growth. When Hamilton's program established public credit and securitiesmarkets in the 1790s, U.S. citizens were immediately able to borrow from older, richer countries. U.S. wealth then increased until, by the end of the nineteenth century, U.S. residents began to lend and invest more abroad than they borrowed. During the 1820s and 1830s, the United States (usually state governments) borrowed large sums from foreign investors to build roads, canals, and early railroads, to make other transportation improvements, and to capitalize state banks. From the 1830s to the end of the century, still larger sums from overseas went into private U.S. railway companies that provided cheap transcontinental transportation. Most of this borrowing took the form of state and corporate bond sales to overseas investors. The pristine U.S. government credit established by Hamilton thus rubbed off on U.S. state and corporate debt. The British stock market did better than the U.S. market until the United States adopted security-market regulation (including disclosuire rules) under the SEC. Then the U.S. market became a world leader. The U.S. stock market developed more slowly than the bond market, but it both aided and benefited from foreign investment in U.S. bonds. Foreign investors preferred debt securities to equities, yet equities create a safety margin for bondholders who, because of this margin, are more willing to purchase and hold bonds. Foreign investors preferred bonds; U.S. investors, after exporting bonds, held more stocks than bonds at home. Why? Because good stock markets permit the conversion of equity securities into cash.Environmental Economics&Policies,Payment Systems&Infrastructure,Financial Intermediation,International Terrorism&Counterterrorism,Economic Theory&Research,Housing Finance,Insurance&Risk Mitigation,Financial Intermediation,Environmental Economics&Policies,Economic Theory&Research

U.S. securities markets and the banking system, 1790-1840

Banks and banking - History ; Stock market ; Securities ; Bank stocks

A chance to seize by women in francophone Africa

A rather disillusioned observation was recently made during a pan-Africa conference: Africa women consider new information and communication technologies as "futuristic" rather than a tool for development to be used today. If initiatives are not taken now to thwart this attitude, activities by women in Africa to promote sustainable development that also benefit them will take event longer. This will be especially true in regions on the continent where English is not the common language

Emerging Financial Markets and Early U.S. Growth

Studies of early U.S. growth traditionally have emphasized real-sector explanations for an acceleration that by many accounts became detectable between 1815 and 1840. Interestingly, the establishment of the nation's basic financial structure predated by three decades the canals, railroads, and widespread use of water and steam-powered machinery that are thought to have triggered modernization. We argue that this innovative and expanding financial system, by providing debt and equity financing to businesses and governments as new technologies emerged, was central to the nation's early growth and modernization. The analysis includes a set of multivariate time series models that relate measures of banking and equity market activity to measures of investment, imports and business incorporations from 1790 to 1850. The findings offer support for our hypothesis of finance-led' growth in the U.S. case. By implication, the interest today in improving financial systems as a means of fostering sustainable growth is not misplaced.