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

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

"Financial Disturbances and Depressions: The View from Economic History"

Events of the past quarter century have renewed the interest of economic historians in major financial disturbances. The study of financial crises was common before World War II, but for the next quarter century little fresh work was done in the area. The chief exception was J. K. Galbraith's The Great Crash. 1929 (1954). Then came M. Friedman and A. J. Schwartz's Monetarv History of the United States. 1867-1960 (1963) with its bold analysis of the great contraction of 1929-1933. Just as that analysis was gaining the attention of economic historians, the United States began to experience credit crunches, steeply rising interest rates, bank failures, debt crises, and a host of other financial disturbances the likes of which had not been seen for a good long time. Soon C. P. Kindleberger's widely read book, Manias. Panics. and Crashes--A Historv of Financial Crises (1978) reminded economic historians and others of the long history of such disturbances. My assignment here, from H. Minsky, is to review what economic historians, especially in recent years, have had to say about financial disturbances and depressions. I inferred from discussions with Prof. Minsky and from some familiarity with his own work that he very much wanted to tie together the two concepts, financial disturbance and depression. The "It" in his book, Can "It Can Happen Again" (1982) is, it will be recalled, a Great Depression. In Minsky's work, a Great Depression results from a debt deflation or, in other words, from an extreme form of t he financial instability that he and others regard as inherent in a capitalist economic system.

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

human development, water, sanitation

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

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