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Assessing Fiscal Space for Health in Nepal
No full textNepal has seen impressive improvements in health outcomes and has done well both in its rate of progress and relative to its income level. Infant mortality has been declining over the past five decades to 38.6 per 1,000 live births in 2009. Similarly, maternal mortality has decreased to 380 per 100,000 live births in 2008. Life expectancy has been steadily increasing to 67 years in 2009. The rate of progress is better than those witnessed by neighboring countries. But challenges remain in addressing inequality, high and increasing out of pocket payments. Geographic and income-related inequalities in population health outcomes remain large and are increasing. For example, not only is the decline in infant mortality not uniform, some regions have seen an increase. The policy response to these challenges has been to expand free care services and pilot protection mechanism against the financial risk of ill health. There is growing demand to expand the package as well as the coverage of existing free essential health care to all Nepalese; to introduce new programs such as health insurance, and other similar initiatives This note identifies efficiency gains as the main potential source of additional fiscal space. The analysis presented herein indicates that improvement in health system efficiency i.e., getting more value for money is by far the most plausible option for realizing additional fiscal space for health in Nepal. As the note demonstrates, the prospects for additional resources for health from all other possible sources from conducive macroeconomic conditions, re-prioritization of health, external resources, and other health-sector specific sources is limited in Nepal. On the other hand, there are many indications of systemic inefficiencies in the health system of the country and the challenge would be to focus on identifying and implementing appropriate interventions to improve the situation and reduce waste. The note highlights some specific areas, such as those related to provider payments, drug procurement mechanisms, and hospital and district grant allocations whereby significant improvements in obtaining better value for money can be realized
What Explains the Stagnation of Female Labor Force Participation in Urban India?
No full textFemale labor force participation rates in urban India between 1987 and 2011 are surprisingly low and have stagnated since the late 1980s. Despite rising growth, fertility decline, and rising wages and education levels, married women's labor force participation hovered around 18 percent. Analysis of five large cross-sectional micro surveys shows that a combination of supply and demand effects have contributed to this stagnation. The main supply side factors are rising household incomes and husband's education as well as the falling selectivity of highly educated women. On the demand side, the sectors that draw in female workers have expanded least, so that changes in the sectoral structure of employment alone would have actually led to declining participation rates
Sustainable agriculture in China: Land policies, food and farming issues
No full textDespite overproduction, the industrial model of globalized agriculture does not provide sufficient and nutritious food for the world’s population. According to Food and Agriculture Organisation (FAO) estimates, approximately 805 million people worldwide are currently affected by hunger. The IAASTD study, commissioned by the World Bank, clearly debunks the myth that industrial agriculture is superior to small-scale farming in economic, social, and ecological terms. The report argues for a new agriculture paradigm in the 21st century, recognizing the pivotal role that small-scale farmers play in feeding a growing world population in a sustainable way – particularly in Asia, Africa and Latin America. In January 2015, Chinese dairy farmers had to pour away 600 kilograms of milk per day, as a global glut of milk drove prices to six-year lows. This occurred although Chinese imports of milk and milk products (especially milk power) from Germany had doubled the previous year. Additionally, media reported on gigantic new Chinese dairy farm investments in Russia, with Russian farmers protesting against Chinese land-grabbing in their country. In June 2015, the Chinese enterprise Huae Sinban leased 115,000 hectare of land in the Baikal region, another 100,000 hectare were rented for feeding 100,000 milk cows. Why did Chinese farmers have to pour away their milk while gigantic new dairy farms were built
Oral Democracy and Women’s Oratory Competency in Indian Village Assemblies: A Qualitative Analysis
No full textIn democracies, innovative political institutions have opened up scope for direct public participation often in the form of talk: citizens talking to the state and mutual talk among citizens on matters concerning community development. A prominent example is the Indian gram sabha, or village assembly, which occurs in a highly stratified context. This paper undertakes a talk-centered analysis of the gram sabha with a focus on examining the oral participation of women in general and women affiliated with microcredit self-help groups who have access to an associational life. The qualitative analysis of 255 gram sabha transcripts from four South Indian states finds that women associated with microcredit self-help groups employ a wider variety of narrative styles and utilize a more multilayered structure to convey their messages compared with all women taken together. Thus, the difference is not so much in the numerical instances of talking or in the types of issues raised, but rather in the quality of participation. The paper makes an important theoretical contribution by proposing the concept of oral democracy as an alternative to deliberative democracy, and urges an analytical focus on the oral or oratory competency of subordinated groups as they participate in these important institutions
Maldives: Identifying Opportunities and Constraints to Ending Poverty and Promoting Shared Prosperity
No full textMaldives is an island nation scattered in the Indian Ocean comprising 1,190 small coral islands of which 190 are inhabited by a local population of 341,000. Maldives’ unique archipelagic coral island provides the country with an extremely rich and diverse marine ecological system. With more territorial sea than land, marine resources have played a vital role shaping the contours of economic development, with nature-based tourism being the key driver of economic growth and fisheries an important sector of employment for the local population. Maldives developed a successful high-end tourism sector, whose sizeable rents have been redistributed to the population to address its development challenges. This systematic country diagnostic for Maldives aims at identifying the most critical constraints and opportunities facing the country as it works towards promoting sustainable growth, reducing poverty and boosting shared prosperity. In addition to serving as a public good for the government, civil society, research and academic community, and local and international development partners, the findings of the SCD will be used as key inputs in the preparation of the WBG strategy, the Country Partnership Framework, which will outline how the Bank Group’s engagement in Maldives can best contribute towards achieving the twin goals
Human Rights in Balochistan: A role for the European Union?
No full textOn the 14th of December 2015, according to a Balochwarna News report from the 17th, Pakistani security forces raided and carried out a house-to-house search operation in New Kahan (Quetta, Balochistan) after the burial of Surriya Begum, the wife of a prominent Baloch tribal leader. The security forces not only intimidated and harassed the local population, it also arrested several individuals. Furthermore, this was not an isolated incident, since operations were being reported in several parts of Balochistan; in the following days two people were allegedly killed and a dozen where abducted. These kinds of operations are not a novel phenomenon. On the 16th of December, Pakistani news and media outlets such as “The Nation”, reported that security forces had killed at least 204 people and detained 8326 during 1863 operations carried out under the “National Action Plan”, which started on the 16th of December 2014. . Given the context of the aftermath of the attack on the Peshawar School massacre, some might argue that these kinds of actions are part of a new policy; but the Pakistani military forces have a long history of comparable incidents
Sectarianism in Pakistan: less visible, yet pretty evident
No full textAre we Muslims and equal citizens of Pakistan? That is what Pakistani Shia identity has come down to. This question of their faith (or nonfaith) has led to a number of sectarian attacks on Shia mosques or busses loaded with pilgrims, with the state taking little or no notice of it. Adding to that, Pakistan’s current religio-political landscape is rife with intolerance aimed at increasing power at the cost of minority persecution. Things weren’t that bad at the time of inception of Pakistan. Jinnah, Pakistan’s founder, was an Ismailia Shia himself, whereas one of his cabinet ministers belonged to the Ahmadi faith - another at-risk minority community targeted by the militant organizations. Jinnah once tipped Pakistan to be a “laboratory of Islam”. This prophecy was taken quite literally by the militant outfits, whose experiments have precipitated a Sunni-dominated narrative in the country. Pakistan is in the midst of coming out of a deadly 13 year terror streak, with a successful operation against the militant factions in the FATA region. Yet, many Pakistani security experts underrate the importance or significance of countering the sectarian violence in the country that has haunted Pakistan for many decades now
Hurting the Host: The Rationale of the Afghan Exodus
No full text"Afghanistan has experienced close to four decades of perpetual violence wars, political upheavals, and religious and ethnic clashes, resulting in millions of Afghans fleeing to neighbouring countries for protection. Facing the Soviet invasion after the Saur revolution and the ensuing civil conflict, between 1979 and the early 1990s approximately six million escaped to Pakistan and Iran, marking the first exodus of Afghan refugees. After Soviet forces withdrew from Afghanistan, around two million refugees decided to return to their country. However, beginning in the mid-1990s, factional clashes led to an outbreak of civil war and the rise of the Taliban, who were able to gain control of major areas and ensued by the establishment of an extraordinary cruel autocratic terror regime. (...).
Scaling the Heights : Social Inclusion and Sustainable Development in Himachal Pradesh
No full textHimachal Pradesh has the reputation of being stable, inclusive, cohesive and well-governed and it stands apart in many respects from its neighbors in northern India. It has additionally, achieved remarkable growth, especially in the last two decades, which has been accompanied by very good human development outcomes. Despite being a predominantly rural society, educational attainment in Himachal Pradesh for instance, is among the best in the country; poverty headcount is nearly one-third of the national average; life expectancy is 3.4 years longer than the number of years an average Indian expects to live; and, per capita income is the second highest in India. Underlying its strong economic and social development outcomes is Himachal Pradesh s commitment to expand access to public services to the remotest areas, across tough, hilly terrain and its strong institutional foundations. Inter-group disparities are low in a state where traditionally disadvantaged groups such as the Scheduled Castes (SCs) and Scheduled Tribes (STs) make up a solid 30 percent of the population
Innere Aufbruchstimmung und außenpolitische Neujustierung: Hintergründe und Perspektiven zur neuen indischen Regierung
No full textDer Beitrag der beiden Autoren liefert eine erste Analyse der indischen Parlamentswahl von 2014. Außerdem werden mögliche inhaltliche Schwerpunkte der neuen Regierung skizziert