Limits of the current implementation of incremental housing

2021 ◽  
pp. 1-10
Author(s):  
Goran Ivo Marinovic
Keyword(s):  
Middle Class ◽  
Housing Policy ◽  
Low Income ◽  
Bank Loans ◽  
Housing Project ◽  
Middle Income ◽  
Specific Location ◽  
Current Implementation ◽  
Incremental Housing

In the case of conventional public housing, urban planners and policymakers design the layout of a housing project in a specific location and then estimate how many households can afford a home. This housing policy has been pursued as a legitimate solution for housing low- and middle-income households where the houses are individually financed by bank loans or mortgages raised by the occupants. John Turner criticised conventional housing solutions by affirming that ‘developing governments take the perspective of the elite and act as if the process of low-income houses were the same as in high-income countries and the same as for the small upper-middle class of their own countries’. Bruce Ferguson and Jesus Navarrete extend this argument with their critique of distributing finished houses to low-income populations and then requiring long-term payments, which are harmful to the beneficiaries. They note that ‘governments think of housing as complete units built by developers that households must purchase with a long-term loan rather than as a progressive process’.

Disparate Entwicklung der Wohnungsmärkte fordert die Politik

2014 ◽  
Vol 63 (1) ◽  
Author(s):  
Oliver Arentz
Keyword(s):  
Housing Policy ◽  
Low Income ◽  
Conflicts Of Interest ◽  
Housing Allowance ◽  
Main Task ◽  
Trading System ◽  
The Public ◽  
Site Development ◽  
High Level

AbstractThe regional differences in the housing markets are enormous and will continue to exacerbate in the future. The main task for the housing policy is to take appropriate long term measures depending on the market structure. A central aspect of future housing policy is the site development. Potential conflicts of interest with other social objectives must be detected and resolved. Creating a trading system for development rights appears to be promising. In order to secure housing for low income households, the housing allowance (Wohngeld) must be promptly adjusted to the market conditions. The public housing sector should be seen as an instrument for the stabilization of neighborhoods. Appropriate market rents secure a housing supply at a high level.

scholarly journals Impact of Medical Debt on the Financial Welfare of Middle- and Low-Income Families across China

2020 ◽  
Vol 17 (12) ◽  
pp. 4597 ◽  
Author(s):  
Jiajing Li ◽  
Chen Jiao ◽  
Stephen Nicholas ◽  
Jian Wang ◽  
Gong Chen ◽  
...  
Keyword(s):  
Low Income ◽  
Concentration Index ◽  
Financial Burden ◽  
Medical Insurance ◽  
Tobit Regression ◽  
Middle Income ◽  
Medical Debt ◽  
Low Income Families ◽  
Low And Middle Income

Background: Medical debt is a persistent global issue and a crucial and effective indicator of long-term family medical financial burden. This paper fills a research gap on the incidence and causes of medical debt in Chinese low- and middle-income households. Method: Data were obtained from the 2015 China Household Finance Survey, with medical debt measured as borrowings from families, friends and third parties. Tobit regression models were used to analyze the data. The concentration index was employed to measure the extent of socioeconomic inequality in medical debt incidence. Results: We found that 2.42% of middle-income families had medical debt, averaging US$6278.25, or 0.56 times average household yearly income and 3.92% of low-income families had medical debts averaging US$5419.88, which was equivalent to 2.49 times average household yearly income. The concentration index for low and middle-income families’ medical debt was significantly pro-poor. Medical debt impoverished about 10% of all non-poverty households and pushed poverty households deeper into poverty. While catastrophic health expenditure (CHE) was the single most important factor in medical debt, age, education, and health status of householder, hospitalization and types of medical insurance were also significant factors determining medical debt. Conclusions: Using a narrow definition of medical debt, the incidence of medical debt in Chinese low- and middle-income households was relatively low. But, once medical debt happened, it imposed a long-term financial burden on medical indebted families, tipping many low and middle-income households into poverty and imposing on households several years of debt repayments. Further studies need to use broader definitions of medical debt to better assess the long-term financial impact of medical debt on Chinese families. Policy makers need to modify China’s basic medical insurance schemes to manage out-of-pocket, medical debt and CHE and to take account of pre-existing medical debt.

scholarly journals The paediatrician workforce and its role in addressing neonatal, child and adolescent healthcare in Kenya

2020 ◽  
Vol 105 (10) ◽  
pp. 927-931 ◽  
Author(s):  
Mike English ◽  
Brigid Strachan ◽  
Fabian Esamai ◽  
Thomas Ngwiri ◽  
Osman Warfa ◽  
...  
Keyword(s):  
Public Sector ◽  
Low Income ◽  
Tertiary Care ◽  
Leadership Role ◽  
Multiple Sources ◽  
Middle Income ◽  
The Public ◽  
Local Expert

ObjectiveTo examine the availability of paediatricians in Kenya and plans for their development.DesignReview of policies and data from multiple sources combined with local expert insight.SettingKenya with a focus on the public, non-tertiary care sector as an example of a low-income and middle-income country aiming to improve the survival and long-term health of newborns, children and adolescents.ResultsThere are 305 practising paediatricians, 1.33 per 100 000 individuals of the population aged <19 years which in total numbers approximately 25 million. Only 94 are in public sector, non-tertiary county hospitals. There is either no paediatrician at all or only one paediatrician in 21/47 Kenyan counties that are home to over a quarter of a million under 19 years of age. Government policy is to achieve employment of 1416 paediatricians in the public sector by 2030, however this remains aspirational as there is no comprehensive training or financing plan to reach this target and health workforce recruitment, financing and management is now devolved to 47 counties. The vast majority of paediatric care is therefore provided by non-specialist healthcare workers.DiscussionThe scale of the paediatric workforce challenge seriously undermines the ability of the Kenyan health system to deliver on the emerging survive, thrive and transform agenda that encompasses more complex health needs. Addressing this challenge may require innovative workforce solutions such as task-sharing, these may in turn require the role of paediatricians to be redefined. Professional paediatric communities in countries like Kenya could play a leadership role in developing such solutions.

scholarly journals Long COVID, A Comprehensive Systematic Scoping Review

2021 ◽  
Author(s):  
Hossein Akbarialiabad ◽  
Mohammad Hossein Taghrir ◽  
Ashkan Abdollahi ◽  
Nasrollah Ghahramani ◽  
Manasi Kumar ◽  
...  
Keyword(s):  
Acute Phase ◽  
Scoping Review ◽  
Low Income ◽  
Search Strategy ◽  
Renal Involvement ◽  
Signs And Symptoms ◽  
Cochrane Library ◽  
Cross Sectional ◽  
Middle Income

Introduction: Despite more than one year passed since the first cases of SARS-CoV-2 were reported, there is still no consensus on the definition and clinical management of post-acute-COVID-19. The condition has heterogeneously been named as Chronic COVID syndrome, Post COVID-19 Syndrome, post-acute sequela of SARS-CoV-2 (PASC), and the more familiar long COVID. Method: In order to capture all relevant published studies, we undertook a multi-step search with no language restriction. The following four-step search strategy was utilized: First, a preliminary (limited) search was conducted on January 20, 2021, in Google Scholar and PubMed to identify the appropriate keywords. Then, on January 30, 2021, we adopted a search strategy of electronic databases from Cochrane Library, PsycINFO, PubMed, Embase, Scopus, and Web of sciences, using those keywords. Then, after duplicate removal, we screened all titles, abstracts, and full texts. This resulted in 66 eligible studies. Subsequently, after a forward and backward search of their references and citations an additional 54 publications were found, resulting in a total of 120 publications that formed the basis of the present analysis. The titles, abstracts, and full-texts of non-English articles were translated using Google Translate for further evaluation. We conducted our scoping review based on the PRISMA-ScR Checklist.Results: We found only one randomized clinical trial in our search. Of the 67 original studies, 22 were cohort and 28 were cross-sectional studies totaling 74.6% of the original studies. Of the total of 120 publications, 59 (49.1%) focused on signs and symptoms, 28 (23.3%) were focused on management, and 13 (10.8%) focused on pathophysiology. Ten (9%) publications focused on imaging studies. Ninety-one percent of the original investigations came from high and upper-middle-income countries, highlighting the scarcity of reports originating from low-income and lower-middle-income countries.Conclusion: The predominant symptoms among those with the so-called &ldquo;Long COVID&rdquo; were: fatigue, breathlessness, arthralgia, sleep difficulties, and chest pain. Recent reports also point to the risk of long-term sequela with cutaneous, respiratory, cardiovascular, musculoskeletal, mental health, neurologic, and renal involvement in those who survive the acute phase of the illness. The ambiguity and controversies in its definition have impaired proper recognition and management of those requiring additional support following the resolution of the acute phase of this infection. This has resulted in long-standing distress for the patients and their families. Our findings highlight the need for a multidisciplinary approach, support, and rehabilitation for these patients in terms of long-term mental and physical health.

scholarly journals Coping with healthcare costs for chronic illness in low-income and middle-income countries: a systematic literature review

2019 ◽  
Vol 4 (4) ◽  
pp. e001475 ◽  
Author(s):  
Adrianna Murphy ◽  
Catherine McGowan ◽  
Martin McKee ◽  
Marc Suhrcke ◽  
Kara Hanson
Keyword(s):  
Chronic Illness ◽  
Coping Strategies ◽  
Low Income ◽  
Financial Risk ◽  
Long Term Effects ◽  
Financial Risk Protection ◽  
Middle Income ◽  
Middle Income Countries ◽  
Risk Protection

BackgroundExperiencing illness in low-income and middle-income countries (LMICs) can incur very high out-of-pocket (OOP) payments for healthcare and, while the existing literature typically focuses on levels of expenditure, it rarely examines what happens when households do not have the necessary money. Some will adopt one or more ‘coping strategies’, such as borrowing money, perhaps at exorbitant interest rates, or selling assets, some necessary for their future income, with detrimental long-term effects. This is particularly relevant for chronic illnesses that require consistent, long-term OOP payments. We systematically review the literature on strategies for financing OOP costs of chronic illnesses in LMICs, their correlates and their impacts on households.MethodsWe searched MEDLINE, EconLit, EMBASE, Global Health and Scopus on 22 October 2018 for literature published on or after 1 January 2000. We included qualitative or quantitative studies describing at least one coping strategy for chronic illness OOP payments in a LMIC context. Our narrative review follows Preferred Reporting Items for Systematic Reviews and Meta-Analyses reporting guidelines.ResultsForty-seven papers were included. Studies identified coping strategies for chronic illness costs that are not traditionally addressed in financial risk protection research (eg, taking children out of school, sending them to work, reducing expenditure on food or education, quitting work to give care). Twenty studies reported socioeconomic or other correlates of coping strategies, with poorer households and those with more advanced disease more vulnerable to detrimental strategies. Only six studies (three cross-sectional and three qualitative) included evidence of impacts of coping strategies on households, including increased labour to repay debts and discontinuing treatment.ConclusionsMonitoring of financial risk protection provides an incomplete picture if it fails to capture the effect of coping strategies. This will require qualitative and longitudinal research to understand the long-term effects, especially those associated with chronic illness in LMICs.

scholarly journals Through the pyramid: implications of interconnectedness in Africa

2019 ◽  
Vol 31 (3) ◽  
pp. 289-303 ◽  
Author(s):  
Kerry Chipp ◽  
Marcus Carter ◽  
Manoj Chiba
Keyword(s):  
Middle Class ◽  
Low Income ◽  
Middle Income ◽  
Content Type ◽  
The Poor ◽  
Insurance Cover ◽  
Value Propositions ◽  
Vicarious Consumption ◽  
Economic Ties ◽  
Low And Middle Income

Purpose Many markets are conceptualized as a stratified low- and middle-income “pyramid” of consumers. Emerging markets are sites of rapid consumer mobility, and thus the middle class there is connected to, and often supports, low-income relatives and employees. Therefore, this paper aims to establish that African income groups are not insular, but rather interrelated and have strong social ties reinforced with longstanding communal values, such as ubuntu. Design/methodology/approach Using a between-subjects experimental vignette design, the propensity of the middle class to cover low-income individuals on an insurance product was assessed. Findings Income strata are interrelated and can inform value propositions, which is demonstrated in this paper with insurance, where the middle class are willing to include others, depending on their social proximity, on their insurance cover. Research limitations/implications The context for this study was personal home insurance; hence, the generalisability of the results is circumscribed. Other more tangible forms of cover, such as medical, funeral or educational insurance, may engender far stronger effects. Practical implications Marketers tend to view low- and middle-income consumers as independent. A view of their interrelation will change the design of many products and services, such as a service catered to the poor but targeted at their support networks. An example of such a service is insurance, which is traditionally hard to sell to the poor. A less atomistic approach to income strata could have implications for vicarious consumption, as well as a reconsideration of the disposable income of both groups. Originality/value The pyramid is an interconnected network of social and economic ties.

scholarly journals 40 years after Alma-Ata, is building new hospitals in low-income and lower-middle-income countries beneficial?

2019 ◽  
Vol 3 (Suppl 3) ◽  
pp. e001293 ◽  
Author(s):  
Fanny Chabrol ◽  
Lucien Albert ◽  
Valéry Ridde
Keyword(s):  
Low Income ◽  
Environmental Sustainability ◽  
Public Hospitals ◽  
Decision Makers ◽  
Middle Income ◽  
Middle Income Countries ◽  
Geographical Inequalities ◽  
Urban Rural ◽  
Hospital Construction

Public hospitals in low-income and lower-middle-income countries face acute material and financial constraints, and there is a trend towards building new hospitals to contend with growing population health needs. Three cases of new hospital construction are used to explore issues in relation to their funding, maintenance and sustainability. While hospitals are recognised as a key component of healthcare systems, their role, organisation, funding and other aspects have been largely neglected in health policies and debates since the Alma Ata Declaration. Building new hospitals is politically more attractive for both national decision-makers and donors because they symbolise progress, better services and nation-building. To avoid the ‘white elephant’ syndrome, the deepening of within-country socioeconomic and geographical inequalities (especially urban–rural), and the exacerbation of hospital-centrism, there is an urgent need to investigate in greater depth how these hospitals are integrated into health systems and to discuss their long-term economic, social and environmental sustainability.

Cambodia will see development challenges in 2016

2016 ◽  
Keyword(s):  
Low Income ◽  
Political Institutions ◽  
Value Chain ◽  
Economic Value ◽  
Middle Income ◽  
Content Type ◽  
Industrial Base ◽  
Income Status ◽  
Social Tensions

Subject Cambodia economic challenges and reform outlook. Significance Cambodia will graduate to lower-middle- from low-income status in 2016. However, the country faces challenges moving further up the economic value chain, including social tensions, corruption and weak political institutions. Funding needed to remove industry bottlenecks and create a more diversified manufacturing base is being diverted into populist programmes. Impacts Cambodia will struggle in the long term to avoid the 'middle-income' trap unless it broadens its industrial base. Proposed investment reforms appear promising, but need better enforcement measures. The garment sector faces further strikes, potentially hitting competitiveness.

Pandemic deepens long-term risks to US women workers

2020 ◽  
Keyword(s):  
Women Workers ◽  
Low Income ◽  
Labour Force ◽  
The United States ◽  
Middle Income ◽  
Content Type ◽  
Flexible Working ◽  
Part Time ◽  
Service Jobs

Significance Women, especially those from minorities, are more likely to have dropped out of the labour force or moved to part-time or precarious employment. Jobs recovery has also been slower than for men. Women bearing the brunt of the COVID-19 pandemic in the United States likely cost President Donald Trump critical votes in yesterday’s election. Impacts Flexible working arrangements will benefit higher-income mothers most, as many low-income service jobs will be unsuited to teleworking. Automation of middle-income administrative and support jobs threatens future structural job losses for women. The magnitude of the switch to home working induced by the crisis may shift social norms around childcare, but slowly.

scholarly journals Feasibility of telephone-administered interviews to evaluate long-term outcomes of trauma patients in urban Ethiopia

2018 ◽  
Vol 3 (1) ◽  
pp. e000256 ◽  
Author(s):  
Adam D Laytin ◽  
Nebyou Seyoum ◽  
Aklilu Azazh ◽  
Ayalew Zewdie ◽  
Catherine J Juillard ◽  
...  
Keyword(s):  
Low Income ◽  
Functional Outcomes ◽  
Functional Disability ◽  
Mobile Telephone ◽  
Sub Saharan Africa ◽  
Financial Impact ◽  
Trauma Patients ◽  
Level Of Evidence ◽  
Middle Income

BackgroundLittle is known about long-term functional outcomes of trauma patients in low-income and middle-income countries. In sub-Saharan Africa most studies of injury only collect data through emergency department disposition or hospital discharge, and methods of collecting long-term data are subject to significant bias. With the recent increase in access to mobile telephone technology, we hypothesized that structured, telephone-administered interviews now offer a feasible means to collect data about the long-term functional outcomes of trauma patients in urban Ethiopia.MethodsWe piloted a telephone-administered interview tool based on the Glasgow Outcome Scale-Extended. Using departmental logbooks, 400 consecutive patients presenting to two public referral hospitals were identified retrospectively. Demographics, injury data, and telephone numbers were collected from medical records. When a telephone number was available, patients or their surrogates were contacted and interviewed 6 months after their injuries.ResultsWe were able to contact 47% of subjects or their surrogates, and 97% of those contacted were able and willing to complete an interview. At 6-month follow-up, 22% of subjects had significant persistent functional disability. Many injuries had an ongoing financial impact, with 17% of subjects losing or changing jobs, 18% earning less than they had before their injuries, and 16% requiring ongoing injury-related medical care. Lack of documented telephone numbers and difficulty contacting subjects at recorded telephone numbers were the major obstacles to data collection. Language barriers and respondents’ refusal to participate in the study were not significant limitations.DiscussionIn urban Ethiopia, many trauma patients have persistent disability 6 months after their injuries. Telephone-administered interviews offer a promising method of collecting data about the long-term trauma outcomes, including functional status and the financial impact of injury. These data are invaluable for capacity building, quality improvement efforts, and advocacy for injury prevention and trauma care.Level of evidenceIII, retrospective cohort study.

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