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Transforming Kenya’s healthcare system: a PPP success story

Monish Patolawala's picture


Photo: Direct Relief, Flicker Creative Commons

The Kenyan government launched its national long-term development plan, Vision 2030, in 2008 with the aim of transforming Kenya into a newly-industrialised, middle-income country providing a high quality of life to all citizens by 2030, in a clean and secure environment.

Constructed around three key pillars – economic, social and political – the blueprint has been designed to address all aspects of the country’s infrastructure and economy, with a key component of the social pillar consisting of ambitious healthcare reforms. Ultimately, the government’s goal is to ensure continuous improvement of health systems and to expand access to quality and affordable healthcare to tackle the high incidence of non-communicable diseases that affect the region.

The future of business matchmaking

Aman Baboolal's picture

How a new green business facility in South Africa is connecting local companies to the global green economy

Traditional trade mission functions are becoming obsolete. Over hors d'oeuvres, business cards are exchanged, elevator pitches are delivered but, in most cases, entrepreneurs leave with empty promises to stay in touch and no useful contacts. This may sound a little cynical but the reality is that in an age of business models “ripe for disruption,” the ways to create viable business partnerships across borders have not changed for decades.
 

Campaign Art: #GirlsCount

Darejani Markozashvili's picture

People, Spaces, Deliberation bloggers present exceptional campaign art from all over the world. These examples are meant to inspire.

Getting access to quality education is one of the most pressing challenges. Around 61 million primary school-age children remained out of school in 2014, even though globally the enrollment in primary education in developing countries reached 91 percent.
 


Source: United Nations Educational, Scientific and Cultural Organization Institute for Statistics; WDI (SE.PRE.ENRRSE.PRM.ENRRSE.SEC.ENRRSE.TER.ENRR).

Although a global issue, it affects some groups more disproportionally than others. In many countries around the world girls are more likely to be denied education than boys. In order to raise awareness about the gender inequality and to urge global leaders to prioritize girls’ education, The One Campaign has launched a digital campaign #GirlsCount.

Should a country limit unskilled immigrant workers to safeguard national productivity growth?

Sharmila Devadas's picture

There are about 245 million migrants worldwide – around 3% of the world population. Roughly one-fifth are tertiary educated. Middle-income countries have a smaller proportion of immigrants than high-income countries (about 1% versus 12%). But for a number of middle-income countries with more immigrants than others, there is uneasiness about relying on unskilled foreigners as they strive to leap from low-wage labor and imitation to high-skilled labor and innovation. There are palpable concerns in Malaysia, for example, with some 2.1 million registered immigrants – about 7% of its population - and likely over 1 million undocumented immigrants. Things reached a crescendo early last year when all new hiring of unskilled foreign workers was suspended as the Malaysian government re-evaluated the management and need for foreign workers. The freeze was subsequently lifted for select sectors amid complaints of labor shortages.

A Framework for Taking Evidence from One Location to Another

David Evans's picture

“Just because it worked in Brazil doesn’t mean it will work in Burundi.” That’s true. And hopefully obvious. But some version of this critique continues to be leveled at researchers who carry out impact evaluations around the world. Institutions vary. Levels of education vary. Cultures vary. So no, an effective program to empower girls in Uganda might not be effective in Tanzania.

Of course, policymakers get this. As Markus Goldstein put it, “Policy makers are generally not morons.   They are acutely aware of the contexts in which they operate and they generally don’t copy a program verbatim. Instead, they usually take lessons about what worked and how it worked and adapt them to their situation.”

In the latest Stanford Social Innovation Review, Mary Ann Bates and Rachel Glennerster from J-PAL propose a four-step strategy to help policy makers through that process of appropriate adaptation of results from one context to another.

To build resilient cities, we must treat substandard housing as a life-or-death emergency

Luis Triveno's picture

Also available in: Español

Damaged houses in Long Island, New York after Hurricane Sandy. Photo by UNISDR.

The scene is as familiar as it is tragic: A devastating hurricane or earthquake strikes a populated area in a poor country, inflicting a high number of casualties, overwhelming the resources and capacity of rescue teams and hospital emergency rooms. First responders must resort to “triage” – the medical strategy of maximizing the efficient use of existing resources to save lives, while minimizing the number of deaths. 

But if governments could apply triage to substandard housing, medical triage would be a much less frequent occurrence – because in the developing world, it is mainly housing that kills people, not disasters.
 
Worldwide, most injuries and deaths from natural disasters are a result of substandard housing. In Latin America and the Caribbean, for example, one-third of the population – 200 million people – lives in informal settlements, which are densely packed with deadly housing units. In 2010, when the 7.0-magnitude Haiti earthquake killed 260,000 people, 70% of damages were related to housing. Similarly, it’s estimated that if an 8.0-magnitude earthquake hit Peru, 80% of the economic losses would be to housing.
 
But the story in rich countries is different. In the past 10 years, high-income countries experienced 47% of disasters worldwide, but accounted for only 7% of fatalities.

Cows and Television: Rolling out a New System for Financial Management Information in Cambodia

Saroeun Bou's picture



On a recent visit to provincial treasury offices to learn about the Financial Management Information Systems, or FMIS, that our Governance teams helped introduce, the conversation became about cows.

The learning curve for an institution accustomed to managing public finances the manual way – that is, with papers and pens – to switch to an automated state-of-the-art system was, some treasury staff said, comparable to bringing a cow to watch television. Cows, they explained, are as unfamiliar with television as some treasury staff are with computers, the internet, and FMIS.

Fortunately, the relevance of the analogy was short-lived. It was soon clear that treasury staff can overcome the learning curve and that the new system has been helpful. I consistently heard praise about the system’s usefulness, because it provides useful financial information, reduces the amount of repetitive work, and generates timely reports. That is a big change.

Who shares in the European sharing economy?

Hernan Winkler's picture
Data on the sharing economy (Uber, Airbnb and so on) are scarce, but a recent study estimates that the revenue growth of these platforms has been dramatic. In the European Union (EU), the total revenue from the shared economy increased from around 1 billion euros in 2013 to 3.6 billion euros in 2015. While this estimate may equal just 0.2% of EU GDP, recent trends indicate a continued, rapid expansion.

This is important, as the sharing economy has the potential to bring efficiency gains and improve the welfare of many individuals in the region.

This can also generate important disruptions.

While online platforms represent a small fraction of overall incomes, the share of individuals participating in these platforms is large in many European countries. For example, roughly 1 in 3 people in France and Ireland have used a sharing economy platform, while at least 1 in 10 have in Central and Northern Europe (see figure below).

At the same time, the share of the population that has used these platforms to offer services and earn an income is also significant, reaching 10% or more in France, Latvia, and Croatia. This means that at least one out of every ten adults in these countries worked as a driver for a ride-sharing platform such as Uber, rented out a room of his or her house using a peer-to-peer rental platform such as Airbnb, or provided ICT services through an online freelancing platform such as Upwork, to name a few examples.

Why rethinking how we work on market systems and the private sector is really hard

Duncan Green's picture

Whatever your ideological biases about ‘the private sector’ (often weirdly conflated with transnational corporations in NGO-land), markets really matter to poor people (feeding families, earning a living, that kind of thing).  But ‘making markets work for the poor’ turns out to be really difficult and, just as with attempts to tackle corruption or improve institutions, there is a rethink going on in the aid business. Critics of conventional approaches (of which I am one) argue that systems thinking and complexity both explain why a lot of previous approaches haven’t worked that well, and suggest some new ways to tackle the problem.

To catch up on some new research on all this, I spent a fascinating afternoon at DFID last week. The ‘knowledge hub’ BEAM Exchange (they don’t like to be called a thinktank) presented a discussion paper and technical paper on ‘rethinking systemic change’, along with a warts-and-all case study from Palladium on the difficulty of trying to put this into practice in a large market development programme in Uganda. Some highlights.

The discussion and technical papers reviewed the lessons from the 3 elements of New Economic Thinking: evolutionary economics, new institutional economics and complex adaptive systems. Eric Beinhocker’s influence much in evidence. The papers draw some useful and pretty challenging conclusions:

‘The aim of development must be to enhance the evolutionary process in an economy and create access to this process for all levels of the society, both politically and economically.’

Can you make a #Loop4Dev? Join our cities boomerang challenge!

Mario Trubiano's picture

Ever notice how cities can really encapsulate many of the things that make life enjoyable? Green spaces to enjoy the outdoors, access to jobs, affordable housing for all, a well-connected public transportation system, access to healthy food, schools for all children, and so on. Some cities achieve this better than others, but creating a city that works for all of its citizens can be a challenge for governments and communities alike.

Why? Let’s look at some numbers: Up to 1 billion people living in slums in the cities of the world are in need of better services; Cities consume 2/3 of the world’s energy and account for 70% of greenhouse gas emissions; 66 out of 100 people will live in cities by 2050, which tells us the global population is becoming increasingly urban.

Every city is a work in progress in this sense and for organizations like the World Bank, cities offer opportunities to help people raise themselves out of poverty. With so many people concentrated geographically, it’s possible to make improvements that benefit many, and with investments across multiple sectors in cities , governments can really make an impact on the lives of their citizens.


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