Search

You searched for: Content Type Working Paper Remove constraint Content Type: Working Paper Publishing Institution Center for Global Development Remove constraint Publishing Institution: Center for Global Development Topic Health Remove constraint Topic: Health
Number of results to display per page

Search Results

  • Author: Jeremy Shiffman, Stephanie Smith
  • Publication Date: 10-2007
  • Content Type: Working Paper
  • Institution: Center for Global Development
  • Abstract: Why do some global health initiatives receive priority from international and national political leaders while others receive minimal attention? We propose a framework for analyzing this question consisting of four categories of factors: the strength of the actors involved in the initiative, the power of the ideas they use to frame the issue, the nature of the political contexts in which they operate, and characteristics of the issue itself.
  • Topic: Health, International Cooperation, Politics
  • Author: Jeremy Shiffman
  • Publication Date: 05-2007
  • Content Type: Working Paper
  • Institution: Center for Global Development
  • Abstract: Why do some serious health issues—such as HIV/AIDS—get considerable attention and others—such as malaria and collapsing health systems—get very little? Why and under what conditions do political leaders consider an issue worthy of sustained attention, and back up that attention with money and other resources? In this CGD Brief, visiting fellow Jeremy Shiffman, an associate professor of public administration at the Maxwell School of Syracuse University, discusses nine factors that influenced the degree to which national leaders in five countries made one public health issue—maternal mortality—a political priority. Pregnancy-related complications are the leading cause of mortality globally among adult women of reproductive age, with more than half a million deaths annually. But in some countries maternal health has become a priority and maternal deaths have fallen, while in other countries this has not yet occurred. Drawing on his comparison of these countries, Shiffman offers recommendations for public health priority-setting in developing countries. His bottom line: attaining public health goals is as much a political as it is a medical or technical challenge; success requires not only appropriate technical interventions but also effective political strategies.
  • Topic: Globalization, Health, Political Economy, Third World
  • Publication Date: 05-2007
  • Content Type: Working Paper
  • Institution: Center for Global Development
  • Abstract: Today's global health programs will attain their objectives only if products appropriate to the health problems in low-and middle income countries are developed, manufactured and made available when and where they are needed. Achieving this requires mobilizing public and charitable money for more and better products to diagnose, prevent and treat HIV/AIDS, tuberculosis, malaria, reproductive health problems and childhood killers. But more money is only one part of the story. Weak links in the global health value chain—from research and development (R) through service delivery—are constraining on-the ground access to essential products. The consequences of those weak links are many: supply shortages, inefficient use of scarce funding, reluctance to invest in R for developing country needs and, most important, the loss of life among those who need essential products.
  • Topic: Globalization, Health, Political Economy, Poverty
  • Author: Michael Kremer, Alix Peterson Zwane
  • Publication Date: 04-2007
  • Content Type: Working Paper
  • Institution: Center for Global Development
  • Abstract: This paper critically reviews the existing research on the cost-effective prevention and treatment of diarrheal diseases, and identifies research priorities in this area aimed at finding ways to reduce the diarrheal disease burden. In contrast to the empirical knowledge base that exists for traditional child health programs to reduce diarrheal morbidity and mortality, evidence on the relative effectiveness and cost-effectiveness of various environmental health interventions is limited and subject to significant methodological concerns. There is a limited understanding of the determinants of long-term water and sanitation technology adoption and behavior change at the individual level. Even less is known about how collective action problems in water and sanitation infrastructure maintenance can be overcome. An agenda for future research includes evaluating alternative transmission interruption mechanisms, improving understanding of the determinants of individual-level technology adoption in the water and sanitation sector, and assessing the quality of infrastructure maintenance under different management schemes.
  • Topic: Health, Human Welfare, Humanitarian Aid, Poverty
  • Author: Ferdinando Regalía, Leslie Castro
  • Publication Date: 04-2007
  • Content Type: Working Paper
  • Institution: Center for Global Development
  • Abstract: Nicaragua's Red de Protección Social (RPS) is one of the first conditional cash transfer (CCT) programs implemented in a low-income country. Demand-side incentives, in the form of monetary transfers, are provided to poor households on condition that their children attend school and visit preventive health care providers. The design of the program is unique among CCT programs because these demand-side incentives are complemented by supply-side incentives aimed at improving the provision of health care. Health care providers are paid on the basis of their performance against predetermined targets. Both private and nonprofit health care providers contracted by the government extend the coverage of services to previously underserved areas.
  • Topic: Development, Health, Humanitarian Aid
  • Political Geography: Latin America
  • Author: Amanda Glassman, Jessica Todd, Marie Gaarder
  • Publication Date: 04-2007
  • Content Type: Working Paper
  • Institution: Center for Global Development
  • Abstract: In order to support poor families in the developing world to seek and use health care, a multi-pronged strategy is needed on both the supply and the demand side of health care. A demand-side program called Conditional Cash Transfers (CCTs) strives to reduce poverty and also increase food consumption, school attendance, and use of preventive health care. Since 1997, seven countries in Latin America have implemented and evaluated CCT programs with health and nutrition components. The core of the program is based on encouraging poor mothers to seek preventive health services and attend health education talks by providing a cash incentive for their healthy behavior (with healthy behavior representing performance). Evaluations of these programs measured outputs in the utilization of services; health knowledge, attitudes, and practice; food consumption; the supply and quality of services; as well as outcomes in vaccination rates; nutritional status; morbidity; mortality; and fertility.
  • Topic: Development, Health, Humanitarian Aid
  • Political Geography: Latin America
  • Author: Amanda Glassman, Jessica Todd, Marie Gaarder
  • Publication Date: 04-2007
  • Content Type: Working Paper
  • Institution: Center for Global Development
  • Abstract: USAID launched a project in 1995 to deliver basic health services in Haiti. The project began by reimbursing contracted NGOs for documented expenditures or inputs. In 1999, payment was changed to being based partly on attaining performance targets or outputs. The project also provided technical assistance to the NGOs, along with opportunities to participate in an NGO network and other cross-fertilization activities. Remarkable improvements in key health indicators have been achieved in the six years since payment for performance was phased in. Although it is difficult to isolate the effects of performance-based payment on these improved indicators from the efforts aimed at strengthening NGOs and other factors, panel regression results suggest that the new payment incentives were responsible for considerable improvements in both immunization coverage and attended deliveries. Results for prenatal and postnatal care were less significant, perhaps suggesting a strong patient behavioral element that is not under the influence of provider actions.
  • Topic: Development, Health, Humanitarian Aid
  • Political Geography: Caribbean, Haiti
  • Author: Rena Eichler, Diana Weil, Alexandra Beith
  • Publication Date: 04-2007
  • Content Type: Working Paper
  • Institution: Center for Global Development
  • Abstract: Tuberculosis is a public health emergency in Africa, Eastern Europe, and Central Asia. Of the estimated 1.7 million deaths from TB, 98 percent are in the developing world, the majority being among the poor. In order to reach the MDG and the Stop TB partnership targets for 2015, TB detection rates need to double, treatment success rates must increase to more than 7075 percent, and strategies to address HIV-associated TB and multi-drug resistant TB must be aggressively expanded. DOTS, the internationally-recommended TB control strategy is the foundation of TB control efforts worldwide. A standard recording and monitoring system built on routine service-based data allows nearly all countries in the world to track progress in case detection and treatment completion through routine monitoring. This provides a good base for measuring the impact of different strategies for improving TB control outcomes.
  • Topic: Development, Health, Human Welfare, Humanitarian Aid
  • Political Geography: Africa, Central Asia, Eastern Europe
  • Author: Michael Clemens
  • Publication Date: 03-2007
  • Content Type: Working Paper
  • Institution: Center for Global Development
  • Abstract: The emigration of highly skilled workers can in theory lower social welfare in the migrant-sending country. If such workers produce a good whose consumption conveys a positive externality—such as nurses and doctors in a very poor country—the loss can be greater, and welfare can even decline globally. Policies to impede emigration thus have the potential to raise sending-country and global welfare. This study uses a new database of health worker emigration from Africa to test whether exogenous decreases in emigration raise the number of domestic health professionals, increase the mass availability of basic primary care, or improve a range of public health outcomes. It identifies the effect through two separate natural quasi-experiments arising from the colonial division of the African continent. These produce exogenous changes in emigration comparable to those that would result from different immigration policies in principal receiving countries. The results suggest that Africa's generally low staffing levels and poor public health conditions are the result of factors entirely unrelated to international movements of health professionals. A simple model proposes that such results would be explained by segmentation of health workforce labor markets in the sending countries. The results further suggest that emigration has caused a greater production of health workers in Africa.
  • Topic: International Relations, Health, Migration
  • Political Geography: Africa
  • Author: Markus Goldstein, Joshua Graff Zivin, Harsha Thirumurthy
  • Publication Date: 01-2007
  • Content Type: Working Paper
  • Institution: Center for Global Development
  • Abstract: The provision of life-saving antiretroviral (ARV) treatment has emerged as a key component of the global response to HIV/AIDS, but very little is known about the impact of this intervention on the welfare of children in the households of treated persons. We estimate the impact of ARV treatment on children's schooling and nutrition outcomes using longitudinal household survey data collected in collaboration with a treatment program in western Kenya. We find that children's weekly hours of school attendance increase by over 20 percent within six months after treatment is initiated for the adult household member. For boys in treatment households, these increases closely follow their reduced market labor supply. Similarly, young children's short-term nutritional status—as measured by their weight-for-height Z-score—also improves dramatically. We also present evidence that the impact of treatment is considerably larger when compared to the counterfactual scenario of no ARV treatment. The results illustrate how intrahousehold allocations of time and resources are altered in response to significant health improvements. Since the improvements in children's schooling and nutrition at these critical early ages will affect their socio-economic outcomes and wellbeing in adulthood, the widespread provision of ARV treatment is likely to generate significant long-run welfare benefits.
  • Topic: Health, Human Welfare
  • Political Geography: Kenya, Africa