School food, politics and child health

AbstractObjectiveAn analysis undertaken jointly in 2009 by the UN World Food Programme, The Partnership for Child Development and the World Bank was published as Rethinking School Feeding to provide guidance on how to develop and implement effective school feeding programmes as a productive safety net and as part of the efforts to achieve Education for All. The present paper reflects on how understanding of school feeding has changed since that analysis.DesignData on school feeding programme outcomes were collected through a literature review. Regression models were used to analyse relationships between school feeding costs (from data that were collected), the per capita costs of primary education and Gross Domestic Product per capita. Data on the transition to national ownership, supply chains and country examples were collected through country case studies.ResultsSchool feeding programmes increase school attendance, cognition and educational achievement, as well as provide a transfer of resources to households with possible benefits to local agricultural production and local market development. Low-income countries exhibit large variations in school feeding costs, with concomitant opportunities for cost containment. Countries are increasingly looking to transition from externally supported projects to national programmes.ConclusionsSchool feeding is now clearly evident as a major social programme in most countries with a global turnover in excess of $US 100 billion. This argues for a continuing focus on the evidence base with a view to helping countries ensure that their programmes are as cost-effective as possible. Clear policy advice has never been more important.

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Establishing Global School Feeding Program Targets: How Many Poor Children Globally Should Be Prioritized, and What Would Be the Cost of Implementation?

Frontiers in Public Health ◽

10.3389/fpubh.2020.530176 ◽

2020 ◽

Vol 8 ◽

Author(s):

Lesley J. Drake ◽

Nail Lazrak ◽

Meena Fernandes ◽

Kim Chu ◽

Samrat Singh ◽

...

Keyword(s):

Low Income ◽

School Health ◽

Scale Up ◽

Good Health ◽

Global Strategy ◽

Low Income Countries ◽

School Age Children ◽

Middle Income ◽

Middle Income Countries ◽

School Feeding

The creation of Human Capital is dependent upon good health and education throughout the first 8,000 days of life, but there is currently under-investment in health and nutrition after the first 1,000 days. Working with governments and partners, the UN World Food Program is leading a global scale up of investment in school health, and has undertaken a strategic analysis to explore the scale and cost of meeting the needs of the most disadvantaged school age children and adolescents in low and middle-income countries globally. Of the 663 million school children enrolled in school, 328 million live where the current coverage of school meals is inadequate (<80%), of these, 251 million live in countries where there are significant nutrition deficits (>20% anemia and stunting), and of these an estimated 73 million children in 60 countries are also living in extreme poverty (<USD 1.97 per day). 62.7 million of these children are in Africa, and more than 66% live in low income countries, with a substantial minority in pockets of poverty in middle-income countries. The estimated overall financial requirement for school feeding is USD 4.7 billion, increasing to USD 5.8 billion annually if other essential school health interventions are included in the package. The DCP3 (Vol 8) school feeding edition and the global coverage numbers were launched in Tunis, 2018 by the WFP Executive Director, David Beasley. These estimates continue to inform the development of WFP's global strategy for school feeding.

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Estimated number of ophthalmologists worldwide (International Council of Ophthalmology update): will we meet the needs?

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2019-314336 ◽

2019 ◽

Vol 104 (4) ◽

pp. 588-592 ◽

Cited By ~ 18

Author(s):

Serge Resnikoff ◽

Van Charles Lansingh ◽

Lindsey Washburn ◽

William Felch ◽

Tina-Marie Gauthier ◽

...

Keyword(s):

Cataract Surgery ◽

Visual Impairment ◽

Low Income ◽

Care Delivery ◽

Low Income Countries ◽

Gdp Per Capita ◽

Prevalence Rates ◽

Eye Care ◽

Care Needs ◽

Per Capita

Background/aimsTo estimate 2015 global ophthalmologist data and analyse their relationship to income groups, prevalence rates of blindness and visual impairment and gross domestic product (GDP) per capita.MethodsOnline surveys were emailed to presidents/chairpersons of national societies of ophthalmology and Ministry of Health representatives from all 194 countries to capture the number and density (per million population) of ophthalmologists, the number/density performing cataract surgery and refraction, and annual ophthalmologist population growth trends. Correlations between these data and income group, GDP per capita and prevalence rates of blindness and visual impairment were analysed.ResultsIn 2015, there were an estimated 232 866 ophthalmologists in 194 countries. Income was positively associated with ophthalmologist density (a mean 3.7 per million population in low-income countries vs a mean 76.2 in high-income countries). Most countries reported positive growth (94/156; 60.3%). There was a weak, inverse correlation between the prevalence of blindness and the ophthalmologist density. There were weak, positive correlations between the density of ophthalmologists performing cataract surgery and GDP per capita and the prevalence of blindness, as well as between GDP per capita and the density of ophthalmologists doing refractions.ConclusionsAlthough the estimated global ophthalmologist workforce appears to be growing, the appropriate distribution of the eye care workforce and the development of comprehensive eye care delivery systems are needed to ensure that eye care needs are universally met.

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Lowering Transport Costs and Prices by Competition: Regulatory and Institutional Reforms in Low Income Countries

Sustainability ◽

10.3390/su11215940 ◽

2019 ◽

Vol 11 (21) ◽

pp. 5940 ◽

Cited By ~ 1

Author(s):

Phill Wheat ◽

Alexander D. Stead ◽

Yue Huang ◽

Andrew Smith

Keyword(s):

Low Income ◽

Evidence Base ◽

Freight Transport ◽

Sub Saharan Africa ◽

Low Income Countries ◽

Quality Improvements ◽

Transport Costs ◽

Institutional Reforms ◽

The Road ◽

Sub Saharan

High passenger and freight transport costs are a barrier to economic growth and social mobility, particularly in Low Income Countries (LICs). This paper considers the current state of knowledge regarding the barriers to achieving lower generalised transport costs. It considers both the road and railway modes across passenger and freight transport. These issues include a reform on the regulations for driver hours (preventing the road infrastructure from overloading), structuring rail concessions, increasing competition, and tackling corruption. Such reforms aim to deliver efficiency gains and service quality improvements at lower costs for users. This paper identifies the knowledge gap in previous research and concludes by setting out a research agenda that builds the evidence base for how the best practices from around the world can best be applied to the specific circumstances in Low Income Countries, with a particular focus on Sub-Saharan Africa and South Asia.

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Out-of-Pocket Expenditures on Health: A Global Stocktake

The World Bank Research Observer ◽

10.1093/wbro/lkz009 ◽

2020 ◽

Vol 35 (2) ◽

pp. 123-157 ◽

Cited By ~ 2

Author(s):

Adam Wagstaff ◽

Patrick Eozenou ◽

Marc Smitz

Keyword(s):

Health System ◽

Low Income ◽

Poverty Line ◽

Low Income Countries ◽

Two Measures ◽

Per Capita ◽

Summary Measures ◽

The Rich ◽

Catastrophic Expenditures ◽

Highly Correlated

Abstract This paper provides an overview of research on out-of-pocket health expenditures by reviewing the various summary measures and the results of multi-country studies using these measures. The paper presents estimates for 146 countries from all World Bank income groups for all summary measures, along with correlations between the summary measures and macroeconomic and health system indicators. Large differences emerge across countries in per capita out-of-pocket expenditures in 2011 international dollars, driven in large part by differences in per capita income and the share of GDP spent on health. The two measures of dispersion or risk—the coefficient of variation and Q90/Q50—are only weakly correlated across countries and not explained by our macroeconomic and health system indicators. Considerable variation emerges in the out-of-pocket health expenditure budget share, which is highly correlated with the incidence of “catastrophic expenditures”. Out-of-pocket expenditures tend to be regressive and catastrophic expenditures tend to be concentrated among the poor when expenditures are assessed relative to income, while expenditures tend to be progressive and catastrophic expenditures tend to be concentrated among the rich when expenditures are assessed relative to consumption. At the extreme poverty line of $1.90-a-day, most impoverishment due to out-of-pocket expenditures occurs among low-income countries.

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Update on the Financing of the Fund’s Concessional Assistance and Debt Relief to Low-Income Countries

Policy Papers ◽

10.5089/9781498346986.007 ◽

2017 ◽

Vol 17 (15) ◽

Author(s):

Keyword(s):

Natural Disasters ◽

Financial Market ◽

Low Income ◽

Commodity Prices ◽

Safety Net ◽

Debt Relief ◽

Balance Of Payments ◽

Low Income Countries ◽

Market Conditions ◽

Financial Safety Net

PRGT-related policies following the 2015 enhancement of the financial safety net for LICs, while options to better assist countries confronting sudden balance of payments needs due to large natural disasters are under consideration. Demand for PRGT resources has increased. Demand for concessional resources has exceeded historical averages in recent years, mainly in response to sustained low commodity prices and deteriorated global financial market conditions. Demand is expected to reach new highs in 2017 and longer-term estimates have been raised somewhat.

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2017 Handbook of IMF Facilities for Low-Income Countries

Policy Papers ◽

10.5089/9781498346238.007 ◽

2017 ◽

Vol 2017 (2) ◽

Author(s):

Keyword(s):

Developing Countries ◽

Low Income ◽

Poverty Reduction ◽

Safety Net ◽

Policy Coordination ◽

Low Income Countries ◽

Executive Board ◽

Reference Tool ◽

Financial Safety Net ◽

Comprehensive Reference

This Handbook provides guidance to staff on the financial facilities and non-financial instruments for low-income countries (LICs), defined here as all countries eligible to obtain concessional financing from the Fund. It updates the previous version of the Handbook that was published in February 2016 (IMF, 2016d) by incorporating modifications resulting from Board papers and related decisions since that time, including Financing for Development—Enhancing the Financial Safety Net for Developing Countries—Further Considerations (IMF, 2016c), Review of Poverty Reduction and Growth Trust – Review of Interest Rate Structure (IMF, 2016b), Eligibility to Use the Fund’s Facilities for Concessional Financing (IMF, 2017a), Large Natural Disasters—Enhancing the Financial Safety Net for Developing Countries (IMF, 2017b) and Adequacy of the Global Financial Safety Net – Proposal for a New Policy Coordination Instrument (IMF, 2017c). Designed as a comprehensive reference tool for program work on LICs, the Handbook also refers, in summary form, to a range of relevant policies that apply more generally to IMF members. As with all guidance notes, the relevant IMF Executive Board decisions, including the terms of the various LIC Trust Instruments that have been adopted by the Board, remain the sole legal authority on the matters covered in the Handbook

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Sustaining Long-Run Growth and Macroeconomic Stability in Low-Income Countries—The Role of Structural Transformation and Diversification

Policy Papers ◽

10.5089/9781498343688.007 ◽

2014 ◽

Vol 2014 (38) ◽

Cited By ~ 5

Author(s):

Keyword(s):

Structural Transformation ◽

Low Income ◽

Low Income Countries ◽

Macroeconomic Performance ◽

Export Structure ◽

Long Run ◽

Trading Partners ◽

Per Capita

Diversification and structural transformation play important roles in influencing the macroeconomic performance of low-income countries (LICs). Increases in income per capita at early stages of development are typically accompanied by a transformation in a country’s production and export structure. This can include diversification into new products and trading partners as well as increases in the quality of existing products.

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Are Low Income Countries Catching up or Falling Further Behind? Evidence from Income and Demographic Indicators

The Economic and Labour Relations Review ◽

10.1177/103530469300400106 ◽

1993 ◽

Vol 4 (1) ◽

pp. 98-119

Author(s):

N. Kakwani ◽

K. Subbarao

Keyword(s):

Low Income ◽

Living Standards ◽

Infant Mortality Rate ◽

Standard Of Living ◽

Low Income Countries ◽

Demographic Indicators ◽

Life Expectancy At Birth ◽

Catching Up ◽

The World ◽

Per Capita

The main objective of this paper is to measure changes in living conditions in one hundred and ten countries of the World during the period 1961 to 1990. Our concern is whether the economic and social gap is narrowing or widening. We also examine in which countries has there been a consistent improvement in average living standards. The standard of living is measured in terms of (a) per capita income, (b) life expectancy at birth and (c) infant mortality rate. The justification of these indicators is provided in terms of functionings and capabilities.

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Health spending and vaccination coverage in low-income countries

10.1101/2020.11.10.20229245 ◽

2020 ◽

Author(s):

Francisco Castillo-Zunino ◽

Pinar Keskinocak ◽

Dima Nazzal ◽

Matthew C Freeman

Keyword(s):

Vaccination Coverage ◽

Low Income ◽

National Income ◽

Health Spending ◽

Gross National Income ◽

Low Income Countries ◽

Childhood Immunization ◽

Government Health ◽

Per Capita ◽

The Impact

SummaryBackgroundRoutine childhood immunization is a cost-effective way to save lives and protect people from disease. Some low-income countries (LIC) have achieved remarkable success in childhood immunization, despite lower levels of gross national income or health spending compared to other countries. We investigated the impact of financing and health spending on vaccination coverage across LIC and lower-middle income countries (LMIC).MethodsAmong LIC, we identified countries with high-performing vaccination coverage (LIC+) and compared their economic and health spending trends with other LIC (LIC-) and LMIC. We used cross-country multi-year linear regressions with mixed-effects to test financial indicators over time. We conducted three different statistical tests to verify if financial trends of LIC+ were significantly different from LIC- and LMIC; p-values were calculated with an asymptotic χ2 test, a Kenward-Roger approximation for F tests, and a parametric bootstrap method.FindingsDuring 2014–18, LIC+ had a mean vaccination coverage between 91–96% in routine vaccines, outperforming LIC- (67–80%) and LMIC (83–89%). During 2000–18, gross national income and development assistance for health (DAH) per capita were not significantly different between LIC+ and LIC- (p > 0·13, p > 0·65) while LIC+ had a significant lower total health spending per capita than LIC- (p < 0·0001). Government health spending per capita per year increased by US$0·42 for LIC+ and decreased by US$0·24 for LIC- (p < 0·0001). LIC+ had a significantly lower private health spending per capita than LIC- (p < 0·012).InterpretationLIC+ had a difference in vaccination coverage compared to LIC- and LMIC that could not be explained by economic development, total health spending, nor aggregated DAH. The vaccination coverage success of LIC+ was associated with higher government health spending and lower private health spending, with the support of DAH on vaccines.

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Nanomedicine for the poor: a lost cause or an idea whose time has yet to come?

Nanomedicine ◽

10.2217/nnm-2021-0024 ◽

2021 ◽

Author(s):

Vuk Uskoković

Keyword(s):

Low Income ◽

Low Income Countries ◽

Gdp Per Capita ◽

Lost Cause ◽

Middle Income ◽

Middle Income Countries ◽

The Poor ◽

Scientific Innovation ◽

Per Capita ◽

To Come

The most effective COVID-19 vaccines, to date, utilize nanotechnology to deliver immunostimulatory mRNA. However, their high cost equates to low affordability. Total nano-vaccine purchases per capita and their proportion within the total vaccine lots have increased directly with the GDP per capita of countries. While three out of four COVID-19 vaccines procured by wealthy countries by the end of 2020 were nano-vaccines, this amounted to only one in ten for middle-income countries and nil for the low-income countries. Meanwhile, economic gains of saving lives with nano-vaccines in USA translate to large costs in middle-/low-income countries. It is discussed how nanomedicine can contribute to shrinking this gap between rich and poor instead of becoming an exquisite technology for the privileged. Two basic routes are outlined: (1) the use of qualitative contextual analyses to endorse R&D that positively affects the sociocultural climate; (2) challenging the commercial, competitive realities wherein scientific innovation of the day operates.

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