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Author: Martin Eckhardt Publisher: Linköping University Electronic Press ISBN: 9176852709 Category : Languages : en Pages : 111
Book Description
Background: By the turn of the new millennium 84% of families in rural coastal Ecuador had difficulties to access health services. A health reform some years earlier to improve this situation had not been implemented. In 2001, the non-governmental organization (NGO) Foundation Human Nature together with a rural population established a primary health care center in North-Western Ecuador. A public private partnership with the Ministry of Public Health was formed. Services depended on out-ofpocket payments, restricting the poor’s access to care. In order to increase access to primary and emergency care, Foundation Human Nature planned to establish a community-based health insurance. In the meantime, a major health reform was initiated by a new government in 2008. It aimed at universal health coverage, providing qualitative services for all based on primary health care, while ensuring protection from financial hardship. The aims of this thesis were to appraise the feasibility of community- based health insurance in Ecuador; to study how rural stakeholders perceived the 2008 reform and its effects on rural health services; to explore the local population’s perception of the NGO in service delivery; and to measure the scope and describe the nature of perceived emergencies, the related health care seeking behavior and health expenditure. Methods: Quantitative and qualitative methods were applied to tackle the research objectives. Data collection for the health insurance study and the study of perceived emergencies was carried out through cross-sectional household surveys. For each of the studies 210 households were sampled with two-stage cluster sampling. Structured questionnaires were used with on the spot household interviews. Focus group discussions with local stakeholders were performed to explore their perceived effects of the 2008 health reform. The population’s perception of the NGO was also studied through focus group discussions, which were complemented by key-informant interviews with local stakeholders. Inductive qualitative content analysis, focusing on the manifest content was applied. Results: 69% of interviewees were willing to join the presented community- based health insurance scheme for 30 US$ per household and year. Attitudes towards the scheme were positive and 92% of interviewees stated they would increase their health service utilization with affiliation. The implementation of the 2008 health reform was perceived as topdown, lacking communication. However, the reform’s effects were mainly perceived as positive with free medical attendance and drugs. Increased service utilization was described as leading to a relative shortage of drugs and appointments. Access problems for remote dwellers were found, who were described of having to seek private care, also in emergencies. The NGO and its services were perceived positively by the population due to health care improvements in the region. The structure of the public private partnership was unclear, leading to dissatisfaction. Community participation was found to be rather weak. Perceived emergencies occurred to at least 90/1,000 inhabitants in the past year. Fever, traumatic injury and abdominal pain were the most frequent chief complaints. The first contacted providers in 57% of all cases were private for-profit providers, including traditional healers. Public health services treated one third of all cases. Health expenditure was found to be high and catastrophic health expenditure occurred in 24% of all cases. Conclusions: Prior to the 2008 reform community-based health insurance was found to be feasible in the study region. This financing instrument may have a role in the post-reform system, to cover services that the government does not yet sufficiently provide. The effects of the 2008 reform were mainly perceived positively, but an adjustment of the system is needed to improve the relative lack of drugs and appointments, especially for remote dwellers. Free health services may not be sufficient to reach universal health coverage for patients with perceived emergencies. Changes in public emergency departments and improved financial protection for emergency patients may improve the situation. The NGO’s role was perceived positively by the population. A lack of communication about the public private partnership and relatively weak community participation restricted the NGO’s full potential and should be improved.
Author: Martin Eckhardt Publisher: Linköping University Electronic Press ISBN: 9176852709 Category : Languages : en Pages : 111
Book Description
Background: By the turn of the new millennium 84% of families in rural coastal Ecuador had difficulties to access health services. A health reform some years earlier to improve this situation had not been implemented. In 2001, the non-governmental organization (NGO) Foundation Human Nature together with a rural population established a primary health care center in North-Western Ecuador. A public private partnership with the Ministry of Public Health was formed. Services depended on out-ofpocket payments, restricting the poor’s access to care. In order to increase access to primary and emergency care, Foundation Human Nature planned to establish a community-based health insurance. In the meantime, a major health reform was initiated by a new government in 2008. It aimed at universal health coverage, providing qualitative services for all based on primary health care, while ensuring protection from financial hardship. The aims of this thesis were to appraise the feasibility of community- based health insurance in Ecuador; to study how rural stakeholders perceived the 2008 reform and its effects on rural health services; to explore the local population’s perception of the NGO in service delivery; and to measure the scope and describe the nature of perceived emergencies, the related health care seeking behavior and health expenditure. Methods: Quantitative and qualitative methods were applied to tackle the research objectives. Data collection for the health insurance study and the study of perceived emergencies was carried out through cross-sectional household surveys. For each of the studies 210 households were sampled with two-stage cluster sampling. Structured questionnaires were used with on the spot household interviews. Focus group discussions with local stakeholders were performed to explore their perceived effects of the 2008 health reform. The population’s perception of the NGO was also studied through focus group discussions, which were complemented by key-informant interviews with local stakeholders. Inductive qualitative content analysis, focusing on the manifest content was applied. Results: 69% of interviewees were willing to join the presented community- based health insurance scheme for 30 US$ per household and year. Attitudes towards the scheme were positive and 92% of interviewees stated they would increase their health service utilization with affiliation. The implementation of the 2008 health reform was perceived as topdown, lacking communication. However, the reform’s effects were mainly perceived as positive with free medical attendance and drugs. Increased service utilization was described as leading to a relative shortage of drugs and appointments. Access problems for remote dwellers were found, who were described of having to seek private care, also in emergencies. The NGO and its services were perceived positively by the population due to health care improvements in the region. The structure of the public private partnership was unclear, leading to dissatisfaction. Community participation was found to be rather weak. Perceived emergencies occurred to at least 90/1,000 inhabitants in the past year. Fever, traumatic injury and abdominal pain were the most frequent chief complaints. The first contacted providers in 57% of all cases were private for-profit providers, including traditional healers. Public health services treated one third of all cases. Health expenditure was found to be high and catastrophic health expenditure occurred in 24% of all cases. Conclusions: Prior to the 2008 reform community-based health insurance was found to be feasible in the study region. This financing instrument may have a role in the post-reform system, to cover services that the government does not yet sufficiently provide. The effects of the 2008 reform were mainly perceived positively, but an adjustment of the system is needed to improve the relative lack of drugs and appointments, especially for remote dwellers. Free health services may not be sufficient to reach universal health coverage for patients with perceived emergencies. Changes in public emergency departments and improved financial protection for emergency patients may improve the situation. The NGO’s role was perceived positively by the population. A lack of communication about the public private partnership and relatively weak community participation restricted the NGO’s full potential and should be improved.
Author: Christopher B. Barrett Publisher: University of Chicago Press ISBN: 022657430X Category : Business & Economics Languages : en Pages : 425
Book Description
What circumstances or behaviors turn poverty into a cycle that perpetuates across generations? The answer to this question carries especially important implications for the design and evaluation of policies and projects intended to reduce poverty. Yet a major challenge analysts and policymakers face in understanding poverty traps is the sheer number of mechanisms—not just financial, but also environmental, physical, and psychological—that may contribute to the persistence of poverty all over the world. The research in this volume explores the hypothesis that poverty is self-reinforcing because the equilibrium behaviors of the poor perpetuate low standards of living. Contributions explore the dynamic, complex processes by which households accumulate assets and increase their productivity and earnings potential, as well as the conditions under which some individuals, groups, and economies struggle to escape poverty. Investigating the full range of phenomena that combine to generate poverty traps—gleaned from behavioral, health, and resource economics as well as the sociology, psychology, and environmental literatures—chapters in this volume also present new evidence that highlights both the insights and the limits of a poverty trap lens. The framework introduced in this volume provides a robust platform for studying well-being dynamics in developing economies.
Author: Stephane Hallegatte Publisher: World Bank Publications ISBN: 1464806748 Category : Business & Economics Languages : en Pages : 227
Book Description
Ending poverty and stabilizing climate change will be two unprecedented global achievements and two major steps toward sustainable development. But the two objectives cannot be considered in isolation: they need to be jointly tackled through an integrated strategy. This report brings together those two objectives and explores how they can more easily be achieved if considered together. It examines the potential impact of climate change and climate policies on poverty reduction. It also provides guidance on how to create a “win-win†? situation so that climate change policies contribute to poverty reduction and poverty-reduction policies contribute to climate change mitigation and resilience building. The key finding of the report is that climate change represents a significant obstacle to the sustained eradication of poverty, but future impacts on poverty are determined by policy choices: rapid, inclusive, and climate-informed development can prevent most short-term impacts whereas immediate pro-poor, emissions-reduction policies can drastically limit long-term ones.
Author: Rafael Di Tella Publisher: University of Chicago Press ISBN: 0226791858 Category : Business & Economics Languages : en Pages : 486
Book Description
This title presents a survey of the crime problem in Latin America, which takes a very broad and appropriately reductionist approach to analyse the determinants of the high crime levels, focusing on the negative social conditions in the region, including inequality and poverty, and poor policy design, such as relatively low police presence. The chapters illustrate three channels through which crime might generate poverty, that is, by reducing investment, by introducing assets losses, and by reducing the value of assets remaining in the control of households.
Author: World Bank Publisher: World Bank Publications ISBN: 0821372246 Category : Science Languages : en Pages : 92
Book Description
Drawing upon recent analytical work prepared inside and outside the World Bank, this report identifies key lessons concerning the linkages between poverty and the environment. With a focus on the contribution of environmental resources to household welfare, the analysis increases our understanding of how specific reforms and interventions can have an impact on the health and livelihoods of poor people. 'Scholars and development practitioners increasingly recognize that in low-income countries there are inextricable links between poverty reduction and natural resources management. Demand has grown immensely for not only more, but better empirical evidence on those links. This volume offers a careful synthesis of key findings from growing literature on the environmental determinants of household welfare, as reflected by indicators of consumption, health, and income. The primary contribution of this study is that is has drawn out vital policy conclusions that will be of value to organizations and governments concerned about poverty and the environment in the developing world.' --Professor Christopher B. Barrett, Cornell University
Author: World Bank Publisher: World Bank Publications ISBN: 1464809623 Category : Business & Economics Languages : en Pages : 176
Book Description
In 2013, the World Bank Group announced two goals that would guide its operations worldwide. First is the eradication of chronic extreme poverty bringing the number of extremely poor people, defined as those living on less than 1.25 purchasing power parity (PPP)†“adjusted dollars a day, to less than 3 percent of the world’s population by 2030.The second is the boosting of shared prosperity, defined as promoting the growth of per capita real income of the poorest 40 percent of the population in each country. In 2015, United Nations member nations agreed in New York to a set of post-2015 Sustainable Development Goals (SDGs), the first and foremost of which is the eradication of extreme poverty everywhere, in all its forms. Both the language and the spirit of the SDG objective reflect the growing acceptance of the idea that poverty is a multidimensional concept that reflects multiple deprivations in various aspects of well-being. That said, there is much less agreement on the best ways in which those deprivations should be measured, and on whether or how information on them should be aggregated. Monitoring Global Poverty: Report of the Commission on Global Poverty advises the World Bank on the measurement and monitoring of global poverty in two areas: What should be the interpretation of the definition of extreme poverty, set in 2015 in PPP-adjusted dollars a day per person? What choices should the Bank make regarding complementary monetary and nonmonetary poverty measures to be tracked and made available to policy makers? The World Bank plays an important role in shaping the global debate on combating poverty, and the indicators and data that the Bank collates and makes available shape opinion and actual policies in client countries, and, to a certain extent, in all countries. How we answer the above questions can therefore have a major influence on the global economy.
Author: World Bank;International Monetary Fund Publisher: World Bank Publications ISBN: 9781464803369 Category : Business & Economics Languages : en Pages : 0
Book Description
The Global Monitoring Report 2014/2015: Ending Poverty and Sharing Prosperity was written jointly by the World Bank Group (WBG) and the International Monetary Fund, with substantive inputs from the Organisation for Economic Co-operation and Development. This year's report details, for the first time, progress toward the WBG's twin goals of ending extreme poverty by 2030 and promoting shared prosperity and assesses the state of policies and institutions that are important for achieving them. The report continues to monitor progress on the Millennium Development Goals (MDGs). Also for the first time, the report includes information about high-income countries. It finds that while gaps in living standards have been closing in many countries, the well-being of households in the bottom 40 percent, as measured by the non-income MDGs such as access to education and health services, remains below that of households in the top 60 percent. The focus of this year's report is on three elements needed to make growth more inclusive and sustainable: investment in human capital that favors the poor, the best use of safety nets, and steps to ensure the environmental sustainability of economic growth. These three elements are imperative to all countries' development strategies, and are also fundamental to global efforts to achieve the twin goals, the MDGs, and the Sustainable Development Goals that will succeed the MDGs. Global Monitoring Report 2014/2015 was prepared in collaboration with regional development banks and other multilateral partners.
Author: Stéphane Hallegatte Publisher: Springer ISBN: 3319089331 Category : Business & Economics Languages : en Pages : 214
Book Description
This book explores economic concepts related to disaster losses, describes mechanisms that determine the economic consequences of a disaster, and reviews methodologies for making decisions regarding risk management and adaptation. The author addresses the need for better understanding of the consequences of disasters and reviews and analyzes three scientific debates on linkage between disaster risk management and adaptation to climate change. The first involves the existence and magnitude of long-term economic impact of natural disasters on development. The second is the disagreement over whether any development is the proper solution to high vulnerability to disaster risk. The third debate involves the difficulty of drawing connections between natural disasters and climate change and the challenge in managing them through an integrated strategy. The introduction describes economic views of disaster, including direct and indirect costs, output and welfare losses, and use of econometric tools to measure losses. The next section defines disaster risk, delineates between “good” and “bad” risk-taking, and discusses a pathway to balanced growth. A section entitled “Trends in Hazards and the Role of Climate Change” sets scenarios for climate change analysis, discusses statistical and physical models for downscaling global climate scenarios to extreme event scenarios, and considers how to consider extremes of hot and cold, storms, wind, drought and flood. Another section analyzes case studies on hurricanes and the US coastline; sea-level rises and storm surge in Copenhagen; and heavy precipitation in Mumbai. A section on Methodologies for disaster risk management includes a study on cost-benefit analysis of coastal protections in New Orleans, and one on early-warning systems in developing countries. The next section outlines decision-making in disaster risk management, including robust decision-making, No-regret and No-risk strategies; and strategies that reduce time horizons for decision-making. Among the conclusions is the assertion that risk management policies must recognize the benefits of risk-taking and avoid suppressing it entirely. The main message is that a combination of disaster-risk-reduction, resilience-building and adaptation policies can yield large potential gains and synergies.
Author: Martin Eckhardt
Author: Martin Eckhardt
Author: Christopher B. Barrett
Author: Stephane Hallegatte
Author: Rafael Di Tella
Author: World Bank
Author: 
Author: 
Author: World Bank
Author: World Bank;International Monetary Fund
Author: Stéphane Hallegatte