Structural Adjustment, Industrialisation, and Export Promotion

The main objective of this paper was to explore if trade liberalisation has ushered in the large scale de-industrialisation that is feared by some to follow in its wake and whether it has been successful in enhancing export promotion. We relied on several different kinds of evidence to demonstrate that de-industrialisation has not coincided with the intensive structural adjustment period while export growth has. However, both industrialisation and export promotion in Pakistan have been below potential, below the mean for low income countries and have not even kept pace with progress in this regard in the low income country group. We were not able to establish, possibly due to the paucity of time-series observations, that either industry or exports generated positive externalities for or used resources more productively than the rest of the economy.

Structural Adjustment, Industrialisation, and Export Promotion

The main objective of this paper was to explore if trade liberalisation has ushered in the large scale de-industrialisation that is feared by some to follow in its wake and whether it has been successful in enhancing export promotion. We relied on several different kinds of evidence to demonstrate that de-industrialisation has not coincided with the intensive structural adjustment period while export growth has. However, both industrialisation and export promotion in Pakistan have been below potential, below the mean for low income countries and have not even kept pace with progress in this regard in the low income country group. We were not able to establish, possibly due to the paucity of time-series observations, that either industry or exports generated positive externalities for or used resources more productively than the rest of the economy

The Impact of the GOP's Wheat Pricing Policy on Flour Prices

The GOP attempts to influence flour prices by fixing its own wholesale price for wheat-the "release price"-at below market levels. We will try to determine who benefits from this intervention. In other words is the open-ended subsidy passed on to consumers, does it end up as excess profits for flour millers or is it dissipated in the pure economic waste of excessive investment in mills .. The analysis has implications for alternative subsidy options which will be considered. The paper is divided into three sections. We will begin with a brief institutional description which will set the framework for the following economic and statistical analysis

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Assessing poverty-deforestation links: Evidence from Swat, Pakistan

This paper contributes to the debate on the links between poverty and forestry degradation; the view that due to poverty and the meeting of subsistence needs the poor use natural resources more intensively and hence cause them to degrade. Using the case of the forest rich Swat district, Pakistan, the paper addresses the issue empirically, historically, and institutionally. We do not find empirical support for the "poverty-environment nexus", in that the poor and other income groups are equally resource dependent and also show that resource degradation is not associated with poverty. Our historical and institutional analyses provide alternative explanations for resource degradation. Selective and rotating ownership patterns, starting with the 17th century, provided limited incentive for resource conservation. It also created tension between de jure and de facto owners, that has persisted, and is one source of forest degradation. Ill-defined resource rights have also exacerbated the impacts of several other factors contributing to forest degradation which is compounded by poor management, corruption, and perverse incentives.Ecological degradation Deforestation Poverty Local institutions Resource management