The Politics of the Microfinance Crisis in Andhra Pradesh, India

The microfinance crisis in Andhra Pradesh incited controversy worldwide between those who supported and those who discredited the industry's ability to alleviate poverty. Many reporters defamed for-profit microfinance institutions (MFIs) as opportunists, and claimed that their fundamental deficiencies victimized the poor. This paper refutes this claim and suggests instead that the incompatibility of MFIs with the political system in Andhra Pradesh was the driving force behind the crash. A comparative analysis of the development of microfinance markets in Latin America, Andhra Pradesh, and Karnataka, and a study of the political actors involved in the industry reveal that the crisis was primarily precipitated by political rather than fundamentally economic factors

Aging is a Blessing, No Less than Youth Itself: A Debate at The World Bank

In March of 2023, The World Bank held an Oxford style debate on paradigms of aging. The event was held during the annual conference for Human Development at the Omni Shoreham Hotel in Washington, DC. Dr. Mukesh Chawla, Advisor for Health, Nutrition and Population at the World Bank Group and Coordinator of the Pandemic Emergency Financing Facility, conceived and chaired the debate. Below are written comments prepared by three of the debaters in favor of the resolution: This House Believes Aging is a Blessing, No Less Than Youth Itself, a variation from Henry Wadsworth Longfellow’s “Morituri Salutamas” poem. The “Wizeaykrs” team, consisted of Drs. Pooja Yerramilli, Ernest Gonzales, and George Alleyne, and argued aging is a blessing and framed each life stage as an opportunity for advancing a healthy and equitable society for individuals, families, communities, and society. The opposing team, the “Yonkers,” consisted of Drs. Michal Rutkowski, Adanna Chukwuma, and David Wilson, argued youth was far more of a blessing than later life. Each speaker had five (5) minutes, prior to questions and comments, and an audience vote. Although the vote was 50/50, the Yonkers were deemed winners, which was ascertained with a telephone app that measured the volume of cheers by the audience. Below, please find remarks written by the Wizeaykrs Team, as well as their biographies.The James Weldon Johnson Professorship at NYU and The Eisner Foundation supported this activity

Exploring Knowledge, Attitudes, and Practices Related to Breast and Cervical Cancers in Mongolia:A National Population-Based Survey

BACKGROUND. Mongolia bears the second-highest cancer burden in the world (5,214 disability-adjusted life years per 100,000 people, age standardized). To determine drivers of the growing burden of noncommunicable diseases, including breast and cervical cancers, a national knowledge, attitudes, and practices (KAP) survey was implemented in 2010. METHODS. This paper analyzed the results of the 2010 KAP survey, which sampled 3,450 households nationally. Reflecting Mongolian screening policies, women aged 30 and older were included in analyses of questions regarding breast and cervical cancer (n = 1,193). Univariate and multivariate odds ratios (MORs) were derived through logistic regression to determine associations between demographic covariables (residence, age, education, employment) and survey responses. RESULTS. This study found that 25.7% (95% confidence interval [CI]: 23.3–28.3) and 22.1% (95% CI: 19.8–24.5) of female participants aged 30 years or older self-rated their knowledge of breast and cervical cancers, respectively, as “none.” Employment and education were associated with greater awareness of both cancers and participation in screening examinations (p < .05). Clinical breast examinations were more common among rural than urban participants (MOR: 1.492; 95% CI: 1.125–1.979). Of all female participants, 17% (95% CI: 15.3–18.5) knew that cervical cancer is vaccine preventable. CONCLUSION. Our results suggest that cancer control in Mongolia should emphasize health education, particularly among lower-educated, rural, and unemployed women. The health infrastructure should be strengthened to reflect rural to urban migration. Finally, although there is awareness that early detection improves outcomes, a significant proportion of women do not engage in screening. These trends warrant further research on barriers and solutions. IMPLICATIONS FOR PRACTICE: The rising burden of breast and cervical cancers, particularly in low- and middle-income countries, necessitates the development of effective strategies for cancer control. This paper examines barriers to health service use in Mongolia, a country with a high cancer burden. The 2010 national knowledge, attitude and practices survey data indicate that cancer control efforts should focus on improving health education among lower-educated, rural, and unemployed populations, who display the least knowledge of breast and cervical cancers. Moreover, the findings support the need to emphasize individual risk for disease in cancer education and ensure that the health-care infrastructure reflects Mongolia’s urbanization

Exploring Knowledge, Attitudes, and Practices Related to Breast and Cervical Cancers in Mongolia: A National Population‐Based Survey

BACKGROUND. Mongolia bears the second-highest cancer burden in the world (5,214 disability-adjusted life years per 100,000 people, age standardized). To determine drivers of the growing burden of noncommunicable diseases, including breast and cervical cancers, a national knowledge, attitudes, and practices (KAP) survey was implemented in 2010. METHODS. This paper analyzed the results of the 2010 KAP survey, which sampled 3,450 households nationally. Reflecting Mongolian screening policies, women aged 30 and older were included in analyses of questions regarding breast and cervical cancer (n = 1,193). Univariate and multivariate odds ratios (MORs) were derived through logistic regression to determine associations between demographic covariables (residence, age, education, employment) and survey responses. RESULTS. This study found that 25.7% (95% confidence interval [CI]: 23.3–28.3) and 22.1% (95% CI: 19.8–24.5) of female participants aged 30 years or older self-rated their knowledge of breast and cervical cancers, respectively, as “none.” Employment and education were associated with greater awareness of both cancers and participation in screening examinations (p < .05). Clinical breast examinations were more common among rural than urban participants (MOR: 1.492; 95% CI: 1.125–1.979). Of all female participants, 17% (95% CI: 15.3–18.5) knew that cervical cancer is vaccine preventable. CONCLUSION. Our results suggest that cancer control in Mongolia should emphasize health education, particularly among lower-educated, rural, and unemployed women. The health infrastructure should be strengthened to reflect rural to urban migration. Finally, although there is awareness that early detection improves outcomes, a significant proportion of women do not engage in screening. These trends warrant further research on barriers and solutions. IMPLICATIONS FOR PRACTICE: The rising burden of breast and cervical cancers, particularly in low- and middle-income countries, necessitates the development of effective strategies for cancer control. This paper examines barriers to health service use in Mongolia, a country with a high cancer burden. The 2010 national knowledge, attitude and practices survey data indicate that cancer control efforts should focus on improving health education among lower-educated, rural, and unemployed populations, who display the least knowledge of breast and cervical cancers. Moreover, the findings support the need to emphasize individual risk for disease in cancer education and ensure that the health-care infrastructure reflects Mongolia’s urbanization

The feminization of medicine in Latin America: ‘More-the-merrier’ will not beget gender equity or strengthen health systems

This viewpoint addresses the lack of gender diversity in medical leadership in Latin America and the gap in evidence on gender dimensions of the health workforce. While Latin America has experienced a dramatic change in the gender demographic of the medical field, the health sector employment pipeline is rife with entrenched and systemic gender inequities that continue to perpetuate a devaluation of women; ultimately resulting in an under-representation of women in medical leadership. Using data available in the public domain, we describe and critique the trajectory of women in medicine and characterize the magnitude of gender inequity in health system leadership over time and across the region, drawing on historical data from Mexico as an illustrative case. We propose recommendations that stand to disrupt the status quo to more appropriately value women and their representation at the highest levels of decision making for health. We call for adequate measurement of equity in medical leadership as a matter of national, regional, and global priority and propose the establishment of a regional observatory to monitor and evaluate meaningful progress towards gender parity in the health sector as well as in medical leadership