This paper investigates the effects of intermittent screening and treatment of malaria on the health and education of school children in an area of low-to-moderate malaria transmission.
... See More + A cluster randomized trial was implemented with 5,233 children in 101 government primary schools on the south coast of Kenya in 2010-12. The intervention was delivered to children randomly selected from classes 1 and 5 who were followed up twice across 24 months. Once during each school term, public health workers used malaria rapid diagnostic tests to screen the children. Children who tested positive were treated with a six-dose regimen of artemether-lumefantrine. Given the nature of the intervention, the trial was not blinded. The primary outcomes were anemia and sustained attention and the secondary outcomes were malaria parasitaemia and educational achievement. The data were analyzed on an intention-to-treat basis. Anemia in this setting in Kenya, intermittent screening and treatment, as implemented in this study, is not effective in improving the health or education of school children. Possible reasons for the absence of an impact are the marked geographical heterogeneity in transmission, the rapid rate of reinfection following artemether-lumefantrine treatment, the variable reliability of malaria rapid diagnostic tests, and the relative contribution of malaria to the etiology of anemia in this setting.
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Policy Research Working Paper WPS6791 FEB 01, 2014
Halliday, Katherine E.; Okello, George; Turner, Elizabeth L.; Njagi, Kiambo; Mcharo, Carlos; Kengo, Juddy; Allen, Elizabeth; Dubeck, Margaret M.; Jukes, Matthew C.H.; Brooker, Simon J.
Following a decade-and-a-half stall, fertility in Rwanda dropped sharply between 2005 and 2010. Using a hierarchical age-period-cohort model, this paper finds that the drop in fertility is largely driven by cohort effects, with younger cohorts having substantially fewer children than older cohorts observed at the same age.
... See More + An Oaxaca-Blinder decomposition is applied on two successive rounds of the Demographic and Health Survey. The findings show that improved female education levels account for the largest part of the fertility decline, with improving household living standards and the progressive move toward non-agricultural employment being important secondary drivers. The drop in fertility has been particularly salient for the younger cohorts, for whom the fertility decline can be fully explained by changes in underlying determinants, most notably the large increase in educational attainment between 2005 and 2010.
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Policy Research Working Paper WPS6741 JAN 01, 2014
Transactional sex is believed to be an important risk-coping mechanism for women in Sub-Saharan Africa and a leading contributor to the HIV/AIDS epidemic.
... See More + This paper uses data from a panel of women in rural Tanzania whose primary occupation is agriculture. The analysis finds that following a negative shock (such as food insecurity), unmarried women are about three times more likely to have been paid for sex. Regardless of marital status, after a shock women have more unprotected sex and are 36 percent more likely to have a sexually transmitted infection. These empirical findings support the claims that transactional sex is not confined to commercial sex workers and that frequently experienced shocks, such as food insecurity, may lead women to engage in transactional sex as a risk-coping behavior.
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Policy Research Working Paper WPS6751 JAN 01, 2014
Drawing on three sources, a 2013 qualitative study in four districts of Punjab province; a targeted analysis of the baseline and end line surveys of the Family Advancement for Life and Health (FALAH 2007-2012) project; and the Pakistan Demographic Health Survey (PDHS) of 1990-1991 and of 2006-2007, this study explores Pakistani (especially Punjabi) couples' dynamics during their decision processes on fertility intentions and practices, along with community perceptions of male-focused interventions as well as men's suggestions for future intervention strategies.
... See More + It finds that men in Punjab seem now more concerned about their fertility intentions and practices due to the financial challenges of raising large families. This concern has not only increased spousal communication about family size and contraceptive use but has also encouraged Punjabi men to practice family planning. Most men now realize that either they or their wives should use family planning. It is the next step, however, of translating intention into practice, which is a challenge. Supply-side issues, including absence or paucity of family planning services as well as poor quality of services (including service providers' lack of capability to manage side effects) are the main factors hindering couples' adoption of family planning. Perceived or experienced side effects of contraceptive methods are other factors. Men's positive attitudes and their readiness to be involved in family planning programs suggest that the efforts of convincing men to use contraceptives have been effective and this it is now time for direct reproductive health interventions for men in Punjab. Yet heavy spending on media campaigns may not be as effective as interpersonal interventions. A focused effort to mobilize men through male-specific interventions is likely to increase the demand for contraceptives. These interventions have to be backed up by improved supply of contraceptives and availability of family planning services in accessible facilities.
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The Second Women's Health and Safe Motherhood Project for Philippines had an overall moderately satisfactory outcome, with the performances of the Bank and the borrower being deemed moderately satisfactory as well.
... See More + Of the thirteen project development objective indicators, seven were achieved while six were partially achieved. Of the fourteen intermediate outcome indicators, seven were achieved while the remaining indicators were partially achieved. Significant lessons learned during the project implementation include: 1) ownership of a project by the government and the implementation teams across all levels of regional and sub-regional government is crucial to the success of a project; 2) the most common reasons for project implementation delays were the procurement system and financial management reporting processes; 3) the experience from using performance based grants had both positive and negative effects; and 4) as the Philippines has a highly decentralized health system, implementing a project with one lead agency was not easy as the authority and reporting back mechanisms for the project were different from the usual practice of working.
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Implementation Completion and Results Report ICR2876 DEC 20, 2013
This report contributes to the design and implementation of policies that promote healthy living in Latin America and the Caribbean (LAC), thus effectively preventing premature mortality from non-communicable diseases (NCDs) in the region.
... See More + It examines the health and economic impact of NCDs in the region and the governance challenges in the design and implementation of multisectoral policies to prevent these conditions, including polices to improve diet, increase physical activity, and reduce tobacco use and alcohol abuse. The study focuses on how policy decisions involving multisectoral interventions to prevent health risk factors are taken, which stakeholders directly or indirectly participate in those decisions, which incentives they experience, and what strategies they use in these processes. This document is divided into six chapters: 1) non-communicable diseases in Latin America and the Caribbean, 2) risk factors for NCDs in Latin America and the Caribbean, 3) economic impact of NCDs in Latin America and the Caribbean, 4) governance of multisectoral interventions to promote healthy living: international examples, 5) multisectoral interventions to promote healthy living in Latin America and the Caribbean, and 6) lessons learned and agenda for the future. See Less -
Despite advances in gender equality, women and girls still face disadvantages and limits on their agency. Men and boys can be key stakeholders and allies to increase women's agency.
... See More + This paper focuses on examining men's attitudes and behaviors related to gender equality and violence perpetration to better understand how to engage men and boys as. It uses data collected from men and women from eight countries (Bosnia, Brazil, Chile, Croatia, Democratic Republic of Congo, India, Mexico, and Rwanda) as part of the International Men and Gender Equality Survey (IMAGES). There is wide variation across countries in men's support for gender equality, equal roles for men and women, and acceptability of violence against women. Key findings of this investigation include: 1) that in most countries male perpetrators of violence are more likely to be depressed or engage in binge drinking than non-perpetrators; 2) that witnessing one's mother being abused by a partner is one of the strongest predictors of ever perpetrating violence, suggesting that efforts should focus on breaking the intergenerational transmission of norms and violence; 3) that being involved with violent fights generally is a significant predictor of ever perpetrating violence, suggesting that programs and policies reducing violence generally may also have an effect on violence specifically against women; and 4) that a majority of men is willing to intervene upon witnessing violence against a woman, and men who do not support violence against women, are not violent generally, and who are aware of laws prohibiting violence against women are more likely to intervene.
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Working Paper (Numbered Series) 82534 NOV 01, 2013
Fleming, Paul J.; Barker, Gary; McCleary-Sills, Jennifer; Morton, Matthew
The aim of this study is to explore the relationship between women's labor market outcomes and partner violence among Tanzanian women, and to estimate the difference in women's weekly earnings between women who have been abused and women who have not.
... See More + In addition, this study estimates the lost earnings to women because of partner violence as a share of Tanzania's gross domestic product. Partner violence is the most common form of violence against women and the adverse consequences for womens health have been well documented. Few studies have estimated the economic costs of partner violence in low- and middle-income countries and current evidence suggests that the cost is large. Using data from the nationally representative 2008-2009 Tanzania National Panel Survey, the study uses propensity score matching methods to estimate the difference in women's earnings from formal waged work and non-agricultural self-employment. Data on women's earnings from agricultural self-employment, the largest employment sector for women in Tanzania, were not collected in the survey. Findings from this study reveal that partner violence is pervasive in Tanzania and that abused women earn less than women who have never been abused, with the greatest loss of earnings experienced by women in formal waged work (compared to women in non-agricultural self-employment) and by women in urban areas (compared to women in rural areas).
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Working Paper (Numbered Series) 82535 NOV 01, 2013
Violence against women, recognized globally as a fundamental human rights violation, is widely prevalent across high-, middle-, and low-income countries.
... See More + Violence against women has significant economic costs in terms of expenditures on service provision, lost income for women and their families, decreased productivity, and negative impacts on future human capital formation. The paper makes a major contribution to the discussion of economic implications of intimate partner violence (IPV) through its conceptual mapping of the links between IPV and economic growth based on a review of literature on their complex dynamics based on data from Vietnam. It reviews costing methodologies and identifies types of costs that potentially can be estimated given different degrees of data availability. The paper argues strongly for a focus on estimating impacts on productivity, which is a key driver of economic growth. It also calls for committed action by both national governments and The World Bank Group in terms of integrating IPV and violence against women and girls (VAWG) into national and sectoral development plans and Bank funding streams; strengthening national statistics offices to collect, manage, and analyze data on violence systematically and regularly basis; prioritizing multi-sectoral and inter-ministerial responses; and most importantly establishing a dedicated budget or funding stream for IPV and VAWG policies, programs, and interventions.
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Working Paper (Numbered Series) 82532 NOV 01, 2013
Sexual and gender-based violence (SGBV) is the most prevalent form of gender inequality. More than one third of the women in the world have experienced some form of gender based violence.
... See More + The impacts of such violence extend far beyond the individual survivors, affecting households and communities, and spanning across generations. SGBV is widely recognized as a development constraint that falls within the World Bank's mandate. This report is an effort to take stock of the experience of the World Bank in addressing SGBV, from 2008 to 2013, in order to capture lessons for engaging more strategically on this issue across the Bank portfolio. The report elaborates on the prevalence of SGBV, the methodology adopted for the purpose of this review, an overview of World Bank activities for SGBV, lessons learned, addressing SGBV in design and implementation, cross-cutting and operational lessons, conclusions and recommendations.
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Ms. Geeta Rao Gupta, Deputy Executive Director of UNICEF starts describing briefly about as the development committee meets, global economic prospects remain subdued.
... See More + Inequalities continue to affect all dimensions of human life, while fragility and conflict still undermine the well-being of too many. Children everywhere remain among the most vulnerable. At the same time, we know that healthy and prosperous economies start with healthy children born to healthy women. The aim of eradicating extreme poverty by 2030 is important for children as they bear a disproportionate risk of being extremely poor. Children are also over-represented in the bottom 40 per cent of the population in the majority of developing countries. Improving the well-being of children today leads to more prosperous generations in the future. A growing body of evidence shows that a substantial degree of poverty persists across generations. Fragile and conflict-affected states have the longest and hardest way to go in achieving development goals. It is estimated that by 2025 five-sixths of the world's poor will live in Africa, a continent suffering from some of the most intractable conflicts. UNICEF welcomes the World Bank Group strategy's emphasis on partnering with the United Nations in fragile and conflict-affected states. As fragilities arise and global economic indicators fluctuate, our collective commitment to child rights and well-being should not waver.
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Younger adults make up a disproportionately large share of unbanked adults worldwide. Data from the Global Financial Inclusion (Global Findex) database show that 44 percent of youth (ages 18-25) have an account at a formal financial institution, compared with 55 percent of older adults (ages 26-64).
... See More + Just 18 percent of youth report having saved formally in the past year, and 6 percent having borrowed formally. The age gap in account penetration persists across regions and across income, gender, and education groups within economies. The Global Findex database can be used to track the effects of youth-specific financial inclusion policies worldwide and develop a deeper and more nuanced understanding of how younger adults save, borrow, make payments, and manage risk.
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Brief 82398 OCT 01, 2013
Demirguc-Kunt, Asli; Klapper, Leora; Kumar, Atisha; Randall, Douglas
Ratings for the Multi-Sector Demographic Project for Niger were as follows: outcomes were moderately satisfactory, risk to development outcome was substantial, Bank performance was moderately satisfactory, and Borrower performance was moderately unsatisfactory.
... See More + Some lessons learned included: as one of Niger's top development objectives and given its multi-sectoral nature, the population agenda should fall under the mandate of the Prime Minister who is responsible for managing all ministries ensuring full exploitation of comparative advantages to contribute to the country's overall development. Technical assistance to address the population challenge should be clearly devised at all levels of society for increased country ownership. Ownership of design by the government is a key for successful implementation and impact on the ground. The information, education, and, communication (IEC) and behavior change communication (BCC) campaigns should be linked to the support for women empowerment in order to impact on women's economic conditions which can reinforce the awareness messages and activities in the general population. There is a need for specialized IEC and BCC expertise and for the design and implementation of interventions to be cognizant of local culture, needs, and issues; it points to a need for joint design; local delivery with expert oversight, supervision, follow-up, and monitoring and evaluation (M and E).
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Implementation Completion and Results Report ICR1949 SEP 30, 2013