WEIGHTING DIMENSIONS OF POVERTY BASED ON PEOPLES PRIORITIES: Constructing a Composite Poverty Index for the Maldives

We work with a panel of bilateral trade flows from 1988 to 2002, exploring the influence of infrastructure, institutional quality, colonial and geographic context, and trade preferences on the pattern of bilateral trade. We are interested in threshold effects, and so emphasize those cases where bilateral country pairs do not actually trade. We depart from the institutions and infrastructure literature in this respect, using Heckman selection model-based gravity estimators of trade flows. We also depart from this literature by mixing principal components (to condense our institutional and infrastructure measures) with a focus on deviations from expected values for given income cohorts to control for multicollinearity. Infrastructure, and institutional quality, are significant determinants not only of export levels, but also of the likelihood exports will take place at all. Our results support the notion that export performance, and the propensity to take part in the trading system at all, depends on institutional quality and access to well developed transport and communications infrastructure. Indeed, this dependence is far more important, empirically, than variations in tariffs in explaining sample variations in North-South trade. This implies that policy emphasis on developing country market access, instead of support for trade facilitation, may be misplaced.poverty measures, living standard dimensions, aggregation, composite index, Maldives

VULNERABILITY AND POVERTY DYNAMICS IN THE MALDIVES

Despite rapid economic and social development of the Maldives, the vulnerability of the island population in terms of poverty remains high. Using household panel data for the period 1997/98 Ð 2004 we show that, although the majority of the poor manages to escape from poverty, a substantial part of the non-poor falls back into poverty at the same time. Using Logit regression analysis, the most influential determinants of escaping household poverty are shown to be: the level of education, participation in community activities, and the proportion of adults employed. Factors that have the largest impact on impeding a poverty escape are: the proportion of household members not working due to bad health, living in the North, and the proportion of female household members. The former two factors, in addition to household size, are also most influential on the odds of falling into poverty. Working in tourism, or the public sector, and taking out a loan to invest are important factors that prevent households from falling into poverty. Policy implications of these results are not only relevant at government level but also at household level. The government may consider paying more attention to the development of the two Northern regions, improve access to good quality education and health care, and further develop (private sector) tourism across the country. Household coping strategies involve investing in education, entering the labour market (especially in tourism and the public sector) and family planning.vulnerability, income poverty dynamics, Maldives, Logit regression, probability of escaping from or falling into poverty

Changes in Poverty and Income Inequality in Pakistan during the 1970s

According to Paul Streeten [101, the relationship between poverty eradication and reducing income inequalities is still an unsettled question. He mentions empirical studies of eleven countries. In ten of these countries, poverty and inequality move in the same direction, both increasing (Brazil, Mexico, Indonesia) or both declining (Korea, Taiwan, Sri Lanka, Costa Rica, Yugoslavia, China and Israel). The only exception is perhaps Kuwait, where poverty (of Kuwaiti citizens, but not of the large group of immigrant workers) has been reduced, while inequality has increased (explanation: oil wealth)

Consumption and Trade of Wheat and Flour in Pakistan - The Role of Public and Private Sectors

This article, the second of two articles In this Review on the operation of the wheat market in Pakistan,- describes the various sources from which consumers in the Punjab, Sind and the NWFP obtain wheat and flour. There appear to be considerable differences in the patterns of wheat provisioning, if consumers are distinguished by province, rural and urban areas and household income. Further, an evaluation is made of the performance of private traders in wheat- and flour-markets. These findings are then used to examine whether the position of self-sufficiency in wheat, which the country has recently achieved, provides arguments for revising the wheat-market policies adopted during a period when the situation was much less favourable

Growth, Employment and Education: An Application of Multicriteria Analysis to Pakistan

Development planning is a multicriteria problem. Apart from economic goals (like economic growth, income distribution, employment, price stability, balance of payments, etc.) a set of basic human needs (like food, health , housing, clothing, education, etc.) has to be fulfilled within a limited time horizon. Of course, not all targets of economic policy can reach desirable levels within a plan period given scarce resources and trade-offs between goals and basic needs. Priorities have to be formulated and goals and needs have to be weighted against another. Multicriteria analysis can contribute to this weighing process by circumscribing feasible areas and by quantifying above mentioned trade-offs. The purpose of this paper is to present an illustration of multicriteria analysis in which at least two goals of economic policy (growth and employment) and one basic human need (education) are incorporated. The model is applied to Pakistan due to data access

Poverty Dynamics: the case of the Maldives

Poverty dynamics research leads to a better understanding of poverty than point-in-time studies. We have executed a comprehensive longitudinal poverty study based on 3 large-scale household surveys carried out on all 200 inhabited islands in the Maldives. The first wave was conducted in 1997 with follow-ups in 2004 and 2005. We have followed more than 1,000 of the same households over time to get insight in poverty dynamics and in the characteristics of households that managed to escape from poverty and of households that fell back to poverty. This thesis presents the results and introduces some conceptual and methodological innovations, such as a new poverty indicator, the Multidimensional Poverty Index with 12 dimensions: income, health, education, employment, housing, transport, electricity, communication, food security, environmental security, drinking water, and consumer goods. Policy implications of our results are not only relevant at government level but also at household level. Poverty reduction strategies of the government should be designed not just to lift the poor out of poverty, but also to prevent the non-poor from falling into poverty. In the Maldives case, the government may consider paying more attention to the North, further stimulating access to good quality education and health care, and further stimulating the development of (private sector) tourism across the country. As for poverty reduction strategies of the households themselves, our results point to more education, remittances, taking a loan to invest, and increasing the household labour force participation rate, especially in the public sector and in the tourism sector

Drug adherence and multidisciplinary care in patients with multiple sclerosis: Protocol of a prospective, web-based, patient-centred, nation-wide, Dutch cohort study in glatiramer acetate treated patients (CAIR study)

Background: Multiple sclerosis (MS) is a chronic inflammatory demyelinating disease of the central nervous system, for which no definitive treatment is available. Most patients start with a relapsing-remitting course (RRMS). Disease-modifying drugs (DMDs) reduce relapses and disability progression. First line DMDs include glatiramer acetate (GA), interferon-beta (INFb)-1a and INFb-1b, which are all administered via injections. Effectiveness of DMD treatment depends on adequate adherence, meaning year-long continuation of injections with a minimum of missed doses. In real-life practice DMD-treated patients miss 30% of doses. The 6-month discontinuation rate is up to 27% and most patients who discontinue do so in the first 12 months.Treatment adherence is influenced by the socio-economic situation, health care and caregivers, disease, treatment and patient characteristics. Only a few studies have dealt with adherence-related factors in DMD-treated patients. Self-efficacy expectations were found to be related to GA adherence. Patient education and optimal support improve adherence in general. Knowledge of the aspects of care that significantly relate to adherence could lead to adherence-improving measures. Moreover, identification of patients at risk of inadequate adherence could lead to more efficient care.In the near future new drugs will become available for RRMS. Detailed knowledge on factors prognostic of adherence and on care aspects that are associated with adequate adherence will improve the chances of these drugs becoming effective treatments. We investigate in RRMS patients the relationship between drug adherence and multidisciplinary care, as well as factors associated with adherence. Given the differences in the frequency of administration and in the side effects between the DMDs we decided to study patients treated with the same DMD, GA.Methods/design: The Correlative analyses of Adherence In Relapsing remitting MS (CAIR) study is an investigator-initiated, prospective, web-based, patient-centred, nation-wide cohort study in the Netherlands.The primary objective is to investigate whether GA adherence is associated with specific disciplines of care or quantities of specific care. The secondary objective is to investigate whether GA adherence is associated with specific aspects of the socio-economic situation, health care and caregivers, disease, treatment or patient characteristics.All data are acquired on-line via a study website. All RRMS patients in the Netherlands starting GA treatment are eligible. Patients are informed by neurologists, nurses, and websites from national MS patient organisations. All data, except on disability, are obtained by patient self-reports on pre-defined and random time points. The number of missed doses and the number of patients having discontinued GA treatment at 6 and 12 months are measures of adherence. Per care discipline the number of sessions and the total duration of care are measures of received care. The full spectrum of non-experimental care that is available in the Netherlands is assessed. Care includes 'physical' contacts, contacts by telephone or internet, health-promoting activities and community care activities. Care received over the preceding 14 days is assessed by patients at baseline and every other week thereafter up to month 12. Every 3 months neurologists and nurses record care disciplines to which patients have been referred.The Dutch Adherence Questionnaire-90 (DAQ-90) is a 90-item questionnaire based on the World Health Organisation (WHO) 2003 report on adherence and comprehensively assesses five domains of evidence-based determinants of adherence: socio-economic, health care and caregivers, disease, treatment, and patient-related factors. In addition, self-efficacy is assessed by the MS Self-Efficacy Scale (MSSES), and mood and health-related quality of life (HRQoL) by the Multiple Sclerosis Quality of Life-54 questionnaire (MSQoL-54). Relapses and adverse events probably or definitively related to GA are also reported.Discussion: In this study data is mainly acquired by patients' self-reporting via the internet. On-line data acquisition by patients does not require study visits to the hospital and can easily be integrated into daily life. The web-based nature of the study is believed to prevent missing data and study drop-outs. Moreover, the automated process of filling in questionnaires ensures completeness and consistency, thus improving data quality. The combination of patient-reported outcomes, fully web-based data capture and nation-wide information to all eligible patients are distinguishing features of the study and contribute to its scientific potential.Trial registration: Netherlands Trial Register (NTR): NTR2432

Sources of Income Inequality in Pakistan

In a paper presented at the 1985 Conference of this Society [Kruijk and Leeuwen (1985)] we described some structural changes in poverty and income inequality in Pakistan during the 1970s. All inequality measures and poverty indicators pointed to the conclusion that poverty has declined while at the same time inequality has increased. However, the paper did not go deep enough into the reasons why inequality has increased. It did appear that neither the urban/rural distinction nor interprovincial income differences are important determinants of overall income inequality in Pakistan 1 so that these elements cannot contribute much to explaining changes in inequality. In his comments, Kernal, (1986) suggests to extend the applied decomposition technique by decomposing income also into its sources. This is precisely the purpose of the present paper. In fact, total income of a household (or any other unit) is the sum of income derived from various sources like labour, property, remittances, etc. Accordingly, income inequality is the aggregate of inequalities of these sources and changes in overall inequality are made up of changes in its components. Decomposition analysis is a clear and consistent framework to investigate these issues. It provides a sense of proportion and avoids to suggest - as some authors do - that overall inequality may have decreased because inequality of one single component has decreased. This kind of speculation is not possible within a decomposition framework because the relative importance of that particular component is taken into account and related to the importance of other components together with their development over time

The Distribution of Purchasing Power in Pakistan, 1985-86

Suppose that you and I earn the average income of Pakistan and that we are looking at a parade in which the whole population of Pakistan takes part. It is a spectacular parade because the size of all marchers is proportionate to their income. We have the average height. Anyone who earns more than the average is taller than we are; anyone who earns less than the average is smaller. The procession is organized in such a way that the smallest walks in front and the tallest in the rear. The parade moves at uniform speed and its dUration is one hour exactly. What do we see? What is the size of the marchers in front and in the rear? Who passes by during the first ten minutes, the second ten minutes, etc.? Where do they live, in which p