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  1. 1

    Challenges to MDG achievement in low income countries: lessons from Ghana and Honduras.

    Bussolo M; Medvedev D

    Washington, D.C., World Bank, Development Economics Prospects Group, 2007 Nov. 20 p. (Policy Research Working Paper No. 4383)

    This paper summarizes the policy lessons from applications of the Maquette for MDG Simulations (MAMS) model to two low income countries: Ghana and Honduras. Results show that costs of MDGs achievement could reach 10-13 percent of GDP by 2015, although, given the observed low productivity in the provision of social services, significant savings may be realized by improving efficiency. Sources of financing also matter: foreign aid inflows can reduce international competitiveness through real exchange appreciation, while domestic financing can crowd out the private sector and slow poverty reduction. Spending a large share of a fixed budget on growth-enhancing infrastructure may mean sacrificing some human development, even if higher growth is usually associated with lower costs of social services. The pursuit of MDGs increases demand for skills: while this encourages higher educational attainments, in the short term this could lead to increased income inequality and a lower poverty elasticity of growth. (author's)
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  2. 2
    Peer Reviewed

    Is trade liberalization of services the best strategy to achieve health-related Millennium Development Goals in Latin America? A call for caution.

    San Sebastian M; Hurtig AK; Rasanathan K

    Revista Panamericana de Salud Pública / Pan American Journal of Public Health. 2006 Nov; 20(5):341-346.

    In September 2000, at the United Nations (UN) Millennium Summit, 147 heads of state adopted the Millennium Declaration, with the aim of reflecting their commitment to global development and poverty alleviation. This commitment was summarized in 8 goals, 14 targets, and 48 measurable indicators, which together comprise the Millennium Development Goals (MDGs), to be attained by 2015. All of the MDGs contribute to public health, and three are directly health-related: MDGs 4 (reduce child mortality), 5 (improve maternal health), and 6 (combat HIV/AIDS, malaria, and other diseases). Progress towards these goals has proved difficult. In an attempt to identify practical steps to achieve the MDGs, the UN Development Programme initiated the UN Millennium Project in 2002. This three-year "independent" advisory effort established 13 task forces to identify strategies and means of implementation to achieve each MDG target, and each task force produced a detailed report. A Task Force on Trade was created for MDG 8 to develop a global partnership for development. The mandate of the Task Force on Trade was to explore how the global trading system could be improved to support developing countries, with special attention to the needs of the poorest nations. (excerpt)
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  3. 3

    HIV / AIDS and poverty reduction strategies. Policy note.

    Bjorkman H

    New York, New York, UNDP, 2002 Aug. 20 p. (Policy Note)

    UNDP Policy Notes are intended to inform and strengthen the delivery of policy and programme support to countries. This note provides policy guidance on the important challenge of integrating HIV/AIDS priorities into poverty reduction strategies, including Poverty Reduction Strategy Papers (PRSPs). Poverty reduction strategies are becoming the main development planning instrument in many countries, determining national priorities and domestic as well as external resource allocation. In the case of HIPC countries, poverty reduction strategies shape the speed of debt relief, and the allocation of debt relief savings. Integrating HIV/AIDS into poverty reduction strategies therefore helps to create the necessary policy and planning environment for a comprehensive, multi-sectoral and adequately funded response to the epidemic. The Policy Note provides a synthesis of cutting-edge thinking on the interface between poverty reduction strategies and efforts to reverse the spread of HIV/AIDS. It proposes nine policy areas that UNDP and its partners must focus on as a matter of priority. At the core of the Policy Note is a checklist with specific guidance on how to integrate HIV/AIDS into poverty reduction strategies, relevant for all countries regardless of their current HIV prevalence rates. The Note concludes by bringing the discussion to the global level. It recommends that UNDP--in the context of the Millennium Development Goals Campaign--step up its advocacy for placing HIV/AIDS at the centre of the international development agenda, capitalizing and building on its work at country level. (excerpt)
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  4. 4

    Debt, adjustment and the politics of effective response to HIV / AIDS in Africa.

    Cheru F

    In: Global health and governance. HIV / AIDS, edited by Nana K. Poku and Alan Whiteside. Basingstoke, England, Palgrave Macmillan, 2003 Dec. 109-122.

    Today in much of Africa economic growth has slowed and living standards for the majority have suffered in the face of rising unemployment and mass poverty, resulting in incomes that are presently below the 1970 level. One problem that has been the focus of much attention and contention over the past 20 years is the huge foreign debt owed by African countries to bilateral donors and multilateral institutions. Debt servicing is consuming a disproportionate amount of scarce resources at the expense of the provision of basic services to the poor. In order to receive help in servicing their debts, countries must agree to implement structural economic reforms. This often entails drastic cuts in social expenditures, the privatisation of basic services, and the liberalisation of domestic trade consistent with WTO rules. These policy decisions have had a direct impact on the capacity of African countries to promote, fulfill and protect the right to health of their citizens. This is further compounded by ill-conceived privatisation of basic services such as water and health services, without any regard for the ability of the poor to access these essential services at a cost they can afford. Finally, adherence to WTO trade rules, which often comes as an extension of liberalisation policy, hampers the capacity of African governments to produce or purchase less expensive generic drugs for their citizen without fear of retaliation from the developed countries. (author's)
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  5. 5

    The challenge of Africa: ministers debate vicious cycle of poverty and conflict, new initiatives for development - UN Economic and Social Council.

    UN Chronicle. 1995 Dec; 32(4):[4] p..

    Faced with unrelenting impoverishment, marginalization and social strife engulfing Africa - home to the greatest proportion of least developed nations in the world - ministers from every region of the world convened during the 1995 session of the UN Economic and Social Council to tackle the complex range of interrelated issues and problems that have made the economic and social development of Africa a formidable challenge. "Today, this continent often baffles the world by continually giving the international community reasons for alternating between hope and discouragement", UN Secretary-General Boutros Boutros-Ghali said on 4 July in an address to the opening of the Council's three-day high-level segment, whose purpose is to set UN policy on major international matters. (excerpt)
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  6. 6

    Second LDC conference adopts new Action Programme in Paris - least developed countries.

    UN Chronicle. 1990 Dec; 27(4):[4] p..

    A new Programme of Action aimed at advancing the world's poorest countries offers a "menu approach" for donors to increase their official aid to the least developed countries (LDCs), stressing bilateral assistance in the form of grants or highly concessional loans and calling on donors to help reduce LDC debt. The Programme was adopted by consensus at the conclusion of the Second United Nations Conference on the LDCs (Paris, 3- 14 September). The UN recognizes more than 40 developing countries as "least developed". Although individual nation's indicators vary, in general LDCs have a per capita gross domestic product (GDP) of approximately $200 a year, a low life expectancy, literacy rates under 20 per cent and a low contribution of manufacturing industries to GDP. Reflecting the emergence during the 1980s of new priorities in development strategy, the Programme of Action for the LDCs for the 1990s differs from the Action Programme adopted at the first UN Conference on LDCs held in 1981 in Paris. The new Programme emphasizes respect for human rights, the need for democratization and privatization, the potential role of women in development and the new regard for population policy as a fundamental factor in promoting development. Greater recognition of the role of non-governmental organizations in LDC development is also emphasized. (excerpt)
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  7. 7

    UN proclaims 1996 as Poverty Eradication Year: progress on 'Agenda for Development.' - includes related article on outline of program for September 5-13, 1994 International Conference on Population.

    UN Chronicle. 1994 Mar; 31(1):[5] p..

    The year 1996 was proclaimed the Year for the Eradication of Poverty by the General Assembly on 21 December. That text was among 52 resolutions and 18 decisions adopted by the General Assembly on the recommendation of its Second Committee (Economic and Financial). Issues considered ranged from the environment to the international economy, from population and human settlements to international humanitarian assistance. The Assembly welcomed the intended completion of the Secretary-General's proposed Agenda for Development" this year. It also decided to convene in Japan in 1994 a World Conference on Natural Disaster Reduction. The concept of development had to be rethought, Nitin Desai, Under- Secretary-general for Policy Coordination and Sustainable Development, told the Second Committee on 8 October. The world today is not the same as 30 years ago, when the concept of development was originally framed, he said. The urge to rethink development had grown from the gap between promise and results, as well as from interdependence, the globalization of production, the impact of regional integration and the effects of global communication. A development policy had to give priority to health and education, as well as such areas as the protection of the environment. (excerpt)
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  8. 8

    Economic analysis of HIV / AIDS. Background paper.

    Bonnel R

    Washington, D.C., World Bank, AIDS Campaign Team for Africa, 2000 Sep. 16 p.

    HIV/AIDS is a major development crisis. Not since the Black Death devastated medieval Europe has humankind observed infectious disease deaths on such a scale. Life expectancies, which rose steadily before the onset of the HIV epidemic, are decreasing in nearly all the 25 countries where the adult prevalence rate exceeds 5 percent. In the countries most heavily affected by HIV/AIDS, life expectancy is projected to fall to about 30 years by 2010– a level not seen since the beginning of the 20th century. Various factors related to poverty, inequality, gender inequality, sexually transmitted infections, social norms, political and social changes, including labor migration, conflicts and ethnic factions have facilitated the rapid spread of HIV. But what has enabled HIV/AIDS to undermine economic and social development is its unprecedented erosion of some of the main determinants of economic growth such as social capital, domestic savings and human capital. For these reasons, the HIV epidemic has been transformed from a health issue into a much wider issue impairing economic and social development. Because it prevents an increasing share of the population from participating in economic growth, the HIV/AIDS epidemic increases poverty. The result is a vicious circle whereby HIV/AIDS reduces economic growth and increases poverty, which in turn accelerates the spread of HIV. Preventing further spread of HIV/AIDS, in addition to providing care and support programs to those both affected and infected by this epidemic, requires early intervention and the mobilization of external resources. The purpose of this paper is to discuss and quantify the economic rationale that underlies such an effort. (excerpt)
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  9. 9

    Senegal strives for millennium goals.

    Randle WJ

    Africa Recovery. 2004 Apr; 18(1):[9] p..

    On Senegal's tiny island of Gorée, residents are trying to make several of the objectives in the Millennium Development Goals (MDGs) a reality. A UN-led initiative adopted by the international community in 2000, the MDGs comprise eight specific development targets to be achieved globally by the year 2015, including halving the number of people living in poverty. Located about 20 minutes by boat off the coast of mainland Senegal, Gorée has a population of around 1,500. It was one of the busiest ports during the trans-Atlantic slave trade and is one of Senegal's main tourist attractions. Despite this distinction, Gorée is basically a poor island with few services. Two years ago community residents held a public discussion to develop their vision for the island. Among other things, they projected enrolling in pre-school all children between ages 3 and 5 by 2005 and ensuring that everyone working has "an authorized job," that is, steady employment. They have been making some progress. Thanks to increased parental involvement and some financial donations to help defray school fees, nearly all the island's 200 or so children in the age range are now enrolled. Efforts are under way to create new businesses and help existing ventures, such as restaurants and artistic services that cater to the tourist trade. (excerpt)
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  10. 10
    Peer Reviewed

    When do communities know best? UNICEF's search for relevant social indicators in Zimbabwe.

    Kararach G

    Development in Practice. 2004 Jun; 14(4):569-573.

    Monitoring and evaluation (M&E) are needed by all development interventions in order to document their output and outcomes. Once a set of goals has been established in response to a development ‘problem’, a corresponding set of indicators (i.e. variables or information) will also be identified in order to review progress towards those goals. In Africa, the so-called ‘expert’ evaluators—those who see M&E as their professional calling—have dominated the process of selecting social indicators. Unfortunately, this domination has given rise to sporadic and unreliable social data for M&E purposes facing every agency involved in development work in Africa. Zimbabwe is no exception. This Practical Note tells the story of UNICEF Zimbabwe’s search for relevant and reliable indicators based on solid data. The guiding philosophy in this effort is the belief that local communities themselves are among the many agencies involved in implementing development programmes—in the sense that they always seek ways of tackling whatever problems they face. These communities must therefore be active participants in the process of selecting indicators. The paper will first discuss the difficulty in establishing relevant data and indicators in the context of Zimbabwe, a task which is now an urgent priority given the dual problems of HIV/ AIDS and a declining economy. It is generally believed that these two problems have been responsible for the reversal of social gains made immediately after independence—hence the need to know exactly what is going on. The paper will then highlight recent attempts by UNICEF Zimbabwe—together with its partners—to establish good and reliable information sources so that not only can it monitor and evaluate the various impacts of its programmes but also the social environment of children. In part, the pressure for community-generated indicators has also been driven by the shift in UNICEF’s approach to its work—an approach underpinned by human rights principles. The final part of the paper discusses the challenges that UNICEF and its partners have faced and continue to struggle with. It draws some lessons learned and points to what more could be done to improve the qualities of social indicators. (excerpt)
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  11. 11

    The report of the Commission of Macroeconomics and Health: a summary critical appraisal.

    Sanders D

    SCN News. 2002 Dec; (25):61-63.

    The Report of the CMH (Commission on Macroeconomics and Health) is likely to be influential given the high profile of the Commissioners, the weighty composition of its Working Groups and its endorsement by WHO. Its description of the global health situation and of health systems in poor countries, as well as its key recommendations are strongly reminiscent of the central thrust of the World Bank's influential 1993 Report, "Investing in Health", which also emphasized the point that health is a major input to economic growth, but also studiously avoided any critical engagement with the global macroeconomic architecture that continues to generate economic growth accompanied by deepening inequalities. A decade has elapsed since that influential global health policy document was published and promoted. Yet in poor countries, particularly Africa, poverty has deepened and the health situation has further deteriorated, and health systems and their capacity have declined. It is difficult to avoid asking the question: "Why should things be different this time?" (excerpt)
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  12. 12

    U.N. will back entrepreneurs in bid to lift poor nations.

    Barringer F

    New York Times. 2003 Jul 27; [2] p..

    Nearly a decade after microfinancing took hold as a method of stimulating the growth of grass-roots private sectors in developing countries, the United Nations is beginning a new effort to support entrepreneurial efforts that could help lift countries out of poverty. Secretary General Kofi Annan said today that a new commission would work to eliminate the institutional, legal and cultural roadblocks that could inhibit the development of small and medium-size businesses in poor countries. (excerpt)
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  13. 13

    Population and development linkages: new research priorities after the Cairo and Beijing conferences.

    Sadik N; Bukman P

    The Hague, Netherlands, Netherlands Interdisciplinary Demographic Institute [NIDI], 1996. 23 p. (NIDI Hofstee Lecture Series 13)

    This document contains the text of the 1996 Hofstee Lecture organized by the Netherlands Interdisciplinary Demographic Institute. The 1996 lecture, entitled "Population and Development Linkages: New Research Priorities after the Cairo and Beijing Conferences," was delivered by Nafis Sadik, Executive Director of the UN Population Fund. Dr. Sadik suggested that research is needed to explore 1) the interrelations between population, sustainable development, and the environment and 2) to improve design and implementation of more effective reproductive health programs and solve methodological problems. After sketching the linkages between population and development, her lecture analyzed research needs to clarify the population/development relationship in terms of macroeconomic linkages, population/environment linkages (for rural and for urban environments), microeconomic linkages (such as education, poverty, and unintended poverty), and macro-microeconomic linkages. The next part of her lecture presented sociocultural research and operations research proposals to identify the constraints on full access to reproductive health services and to improve quality of care. Dr. Sadik concluded that results of investigations in the areas of methodological development; conceptual clarification; and substantive, theoretical, and applied research should be consolidated into databases to enhance policy development and measurement of progress in meeting the goals of the world population conferences. In response to this lecture, Dr. Piet Bukman of the Netherlands discussed the problem of achieving food security and the urgent need for an effective population policy that will adopt short-term as well as longterm measures to limit global population growth.
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  14. 14

    Macroeconomic adjustment, food availability and nutrition status in Nigeria. A look at the 1990s.

    Igbedioh SO

    FOOD POLICY. 1990 Dec; 15(6):518-24.

    Faced with balance of payment problems, declining commodity prices, and a corresponding reduction in foreign exchange earnings, Nigeria implemented a structural adjustment program in 1986. This step was taken in response to encouragement from the International Monetary Fund and the World Bank, and was aimed to accomplish the following: find the true value of the official currency; overcome public sector inefficiency through improved public expenditure and parastatal rationalization; reschedule medium- and long-term debt to relieve debt burden; and encourage net foreign capital inflow while limiting foreign loans. Implementing and adhering to these macroeconomic adjustment policies has brought unprecedented inflation, lower real earnings, and increased malnutrition among lower income sectors of the population. The poor have suffered diminishing access to nutritious foods. Conscribed access to food and compromised nutritional status will most likely persist into the 1990s unless corrective policies are adopted. Appropriate policy would aim to increase the poor's access to food and limit population growth.
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  15. 15

    Interview: Mr. George Walmsley: UNFPA Country Director for the Philippines.

    ASIA-PACIFIC POPIN BULLETIN. 1991 Jun; 3(2):7-11.

    George Walmsley, UNFPA country director for the Philippines, discusses demographic and economic conditions in the Philippines, and present plans to revitalize the national population program after 20 years of only modest achievements. The Philippines is a rapidly growing country with much poverty, unemployment and underemployment, uneven population distribution, and a large, highly dependent segment of children and youths under age 15. Initial thrusts of the population program were in favor of fertility reduction, ultimately changing to adopt a perspective more attuned to promoting overall family welfare. Concurrent with this change also came a shift from a clinic-based to community-based approach. Fertility declines have nonetheless grown weaker over the past 8-10 years. A large gap exists between family planning knowledge and practice, with contraceptive prevalence rates declining from 45% in 1986 to 36% in 1988. Behind this lackluster performance are a lack of consistent political support, discontinuities in program implementation, a lack of coordination among participating agencies, and obstacles to program implementation at the field level. The present government considers the revitalization of this program a priority concern. Mr. Walmsley discusses UNFPA's definition of a priority country, and what that means for the Philippines in terms of resources nd future activities. He further responds to questions about the expected effect of the Catholic church upon program implementation and success, non-governmental organization involvement, the role of information and information systems in the program, the relationship between population, environment and sustainable development, and the status of women and its effect on population.
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  16. 16
    Peer Reviewed

    Debt crisis, health and health services in Africa.

    Alubo SO

    Social Science and Medicine. 1990; 31(6):639-48.

    Sub-Sahara Africa (SSA) has gone from "classical colonialism to neocolonial debt bondage." this article traces SSA's deterioration from a master-servant relationship during colonialism to the present-day "hybrid of decay and anarchy" from which people's health status and health services in the region are being asphyxiated by the debt crisis. The tragedy facing the continent is a carryover from colonialism SSA remains dependent on outside multinational forces that continue to determine her policies, extract her natural wealth, and minimally invest in the SSA region. This continued "cola-colonization" or external control of SSA has resulted in the "catastrophic" decline of most of SSA's social and economic institutions reflecting the collapse in the economies of the West. By the end of 1986, SSA owed US $200 billion or 45% of its GDP--growing to over US$600 million by the year 2000. By 1990 all SSA countries had to accept structural adjustment policies (SAP's) imposed by the International Monetary Fund and the World Bank to monitor cuts in Government public spending, remove subsidies, trade liberalization and currency devaluation all leading to "tragic declines" in the standard of living. Health services in SSA also originated from colonialism and today remains dependent on the home government's. One of the major carry-over's is the urban/rural disparity; 70% of SSA's population is rural yet most health services and providers are in the urban areas contributing to higher infant mortality rates (2-5 times) in the rural areas. The debt crisis has compounded the magnitude of the lack of health services for the majority of people. Shortages exist for all essential drugs and equipment while social services and institutions have deteriorated, aggravating the already low health status in the region. SAP's have increased starvation, epidemics and the brain drain. Perhaps there is a need for a "Marshall Plan" to help SSA out of its underdevelopment.
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  17. 17
    Peer Reviewed

    Structural adjustment and health in Africa.

    Ekwempu CC; Maine D; Olorukoba MB; Essien ES; Kisseka MN

    Lancet. 1990 Jul 7; 336(8703):56-7.

    In response to The Lancet's April 14 editorial on structural adjustment and health in Africa, it is surprising that the World Bank report did not include maternal mortality as a yardstick for monitoring health standards in Africa: maternal mortality seems to be a better index of social and economic development than perinatal or infant mortality. Obstetric performance was reviewed in parts of Nigeria after the introduction of the structural adjustment program (SAP). In the 1970's and early 1980's the Nigerian economy was buoyant, thanks to petroleum exports, but when oil prices slumped the government was forced to introduce SAP. As a result most of the costs that had been borne by the government were gradually passed on to individuals, of all the sectors affected health seems to have been the hardest hit. Looking at factors that might have been responsible for the rising maternal mortality rate in the Zaria area of Northern Nigeria, it was found that between 1983 and 1988 there had been no significant change in the numbers of obstetricians and obstetric residents at the Ahmadu Bello Teaching Hospital; there was a slight rise in the number of midwives. However, the number of deliveries in 1988 was only 46% of the figure for 1983, and the proportion of obstetric admissions that were complicated more than tripled. Maternal deaths at the hospital numbered 48 per year in 1983-85 and 75 in 1988, an increase of 56%. These changes in obstetric indices may not be unrelated to financial policies in hospital care. In 1983 all aspects of maternity care at the hospital were free. In 1985, following the reduction in government subsidy, fees were introduced for some services, leading to a fall in the number of pregnant women attending the hospital. By 1988 patients were asked to pay for their treatment; with the mean interval between admission and surgery increasing significantly and contributing to the high maternal morbidity and mortality rates in Zaria. (Full text modified)
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  18. 18

    Economic adjustment and development in Peru: towards an alternative policy.

    Figueroa L

    In: Adjustment with a human face, Vol. II: country case studies, edited by Giovanni Andrea Cornia, Richard Jolly, and Frances Stewart. Oxford, England, Clarendon Press, 1988. 156-83.

    Peru implemented a series of orthodox economic structural adjustment policies (SAP's) in 1985 to promote economic stability. The SAP's have aimed to target and protect the growth and redistribution of income to the most vulnerable groups in the population. This chapter analyzes the period between 1977-85 characterized by decline in the gross domestic product, increases in underemployment and unemployment, inflation and a total deterioration in the living conditions for the majority of Peruvians. The chapter's profile on Peru is divided into 4 sections: 1) introduction; 2) structural problems and economic development, 1977- 1985; 3) adjustment policies, 1977-1985 and 4) the new economic policy. Orthodox economic adjustment policies are measures introduced by the International Monetary Fund and The World Bank "to reduce aggregate demand and promote international competitiveness." Peru's SAP's led to a worsening of the country's social conditions that included government's policies on employment, income, health and education. The effects of SAP's on each of these sectors are described in detail. However, since 1985 new economic and development policies were introduced which included policies on: 1) wages and prices; 2) employment; 3) fiscal policy; 4) monetary and credit policy; and 5) external sector policies. The basis of this new policy is the redistribution of income to benefit those marginal populations in the country, the introduction of social policies that are interconnected with the economic policies, and policies which have "autonomous" linkages with the world economy. Unfortunately Peru has faced international and domestic obstacles with these new policies; "effective reorientation of the adjustment process will depend on the continued restoration of order and confidence in government to move forward with the alternative policies that have been undertaken."
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  19. 19

    Adjustment with a human face, Vol. II: country case studies.

    Cornia GA; Jolly R; Stewart F

    Oxford, England, Clarendon Press, 1988.

    This is UNICEF's 2nd volume on its analysis of how economic conditions of most developing countries worsened during the 1980's, forcing the World Bank and the International Monetary Fund to introduce strict structural adjustment policies (SAP's). These SAP's accelerated the deterioration of the most vulnerable groups, including children, through neglect of social welfare interventions, health and nutrition. In light of the widespread poverty, UNICEF's alternative policies, "Adjustment with a human face" are "designed to protect the conditions of the vulnerable during periods of economic decline and adjustment as well as accelerating economic growth over the medium and long term." This volume provides country studies to help the reader understand, in-depth, the effects of the economic recession on each country and those of the SAP's. The countries are Botswana, Ghana, Zimbabwe, the Philippines, South Korea, Sri Lanka, Brazil, Chile, Peru and Jamaica. The basic format used for each study is a description of the initial conditions, the effects of the economic deterioration and macroeconomic responses, analysis of development policies and the country's compensatory programs in response to its socioeconomic problems and the conclusion. Each country chapter also includes a series of tables giving such data as economic indicators, budget deficits, wage increases, income distribution and nutritional status of children.
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  20. 20

    Summary and conclusions.

    Cornia GA; Jolly R; Stewart F

    In: Adjustment with a human face, Vol. I: protecting the vulnerable and promoting growth, edited by Giovanni Andrea Cornia, Richard Jolly, and Frances Stewart. Oxford, England, Clarendon Press, 1987. 287-97.

    Between 1980-85 each year there were about 47 countries with structural adjustment policies (SAP's) introduced by the International Monetary Fund. These SAP's contributed to the rapid deterioration of the human condition because most of the programs depended on depressed employment and real income and the macroeconomic policies effected the welfare of the most deprived groups (rising food prices, cuts in food subsides and cuts in social expenditures). The chapter concludes with outcomes from the 10 studies that alternative adjustment policies at both the macro and micro levels are necessary and children do not have to suffer during the process of adjustment. There is a need for a broader definition of SAP which is "adjustment with a human face" which includes 6 policy components: 1) more expansionary macroeconomic policies; 2) the use of meso policies; 3) sectoral policies aiming at restructuring the productive sector; 4) improving the equity and efficiency of the social sector; 5) contemporary programs; and 6) monitoring of the human condition. Examples from South Korea, Brazil and Zimbabwe demonstrate that with implementation of expansionary macro policies, expanded economic growth is experienced. Governments can improve their social services even during periods of economic hardship by introducing low- cost interventions such as primary health care, basic education, and self-help housing by implementing targeting and effective management systems. Adjustment with a human face "involves restructuring the economy so that major imbalances are eliminated and investment in human capabilities are is a precondition for long-term growth." However, in order to achieve such structural changes there must be community participation within countries; governments need good leadership and political commitment to change and donors need to offer increased and long-term financial aid and changes in the world economic environment.
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  21. 21


    Lamrani K

    In: Population perspectives. Statements by world leaders. Second edition, [compiled by] United Nations Fund for Population Activities [UNFPA]. New York, New York, UNFPA, 1985. 111-2.

    The 1974 World Population Conference called for the establishment of a world economic order based on equality and respect for the independence and sovereignty of every nation. This aspiration has been thwarted by the deadlock in the North-South dialogue, aggravation of the Third World debt, alarming increases in arms expenditures, and the continuous decrease in aid allocated to development in the Third World. The unequal relations between developed and developing countries continue to foster a lack of balance between population density and the concentration of wealth. There is thus a need to renew commitment to a new international order. In this spirit, it will be possible to reduce tension among blocs and to enable the international community to establish economic relations based on principles of justice and mutual interest, especially in terms of prices of industrial goods and raw materials. Until there is a more equitable distribution of wealth in the world, the welfare of the entire human race will be jeopardized. Thus, Morocco reaffirms the necessity of forming a comprehensive, effective policy to fight poverty and improve the standard of living of the world's peoples. Morocco believes that successful population policies will have to be humane, balanced, and integrated in the framework of a comprehensive world plan of action that respects national sovereignty and human rights.
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  22. 22

    Barber Conable on the World Bank's view on poverty and population.

    Conable B


    A primary goal of the World Bank is to attack and to overcome poverty. Determined and sustained action is called for on 5 fronts: securing economic growth; combatting hunger; curbing excessive population growth; investing in education; and protecting the interests of the poor during the process of economic adjustment. Growth is essential. It provides the poor with access to better markets and opportunities. Further, it provides the resources for public and private programs which are vital to the poor. Sensible macroeconomic policies are critical for growth and for a successful attack on poverty. The World Bank supports such policies through lending for adjustment, which now accounts for 1/4 of the Bank's new commitments. Second, the impact of economic growth must be strengthened by direct action to combat hunger. The World Bank will continue to support national programs which bring the needed technology and services to small farmers. Soon such programs will be under way with Bank support in 31 African countries. The Bank will work persistently with African governments, official and nongovernmental donors, and other international institutions to make food security a reality. An essential part of the Bank's effort involves development activities that have a strong impact on population. Many projects improve economic opportunity and education for poor people, particularly women and girls. The Bank is financing health and safe motherhood programs and will expand its direct support for family-related activities. Population issues will be prominent in any dialogue with governments. The Bank and its members cannot ignore the fact that investment in education has declined as the need for it has increased. Countries which work to reform and upgrade their education systems will find the Bank a supportive partner. Finally, governments and donors need to do more to protect the poor during the adjustment process. Deliberate measures must be taken to deal with the social consequences of adjustment. A Bank-managed multi-agency effort, the Social Dimensions of Adjustment Program, now is underway in a score of African nations. Effective implementation of these 5 priority areas is the crucial test and demands that poverty measures focus directly on those in need and that available resources be used more efficiently. Bank lending in the social sectors will support better design, targeting, and delivery of services for the poor.
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  23. 23

    Towards a strategy for linking women, population growth, poverty alleviation and sustainable development.

    Thahane TT

    [Unpublished] 1989. Presented at the Regional Conference of African Women Leaders, Nairobi, Kenya, February 8-10, 1989. 24 p.

    There is a pressing need in Africa to achieve a sustainable balance between population, the environment, and a decent standard of living for all the people. If African women are to play a leadership role in this campaign, clear policies must be instituted to improve their access to education, higher earnings, credit, and health and family planning services. Investing to improve opportunities for women can bring the following benefits: since women produce more than half of Africa's food, effective extension programs can make development programs more productive; such an approach will make development programs more responsive to the poor in that most of the poor in Africa are women and their children; investments in female education in particular can improve family well-being; involving women in natural resource management programs can promote more sustainable use of wood, water, and other resources; and access to family planning services can slow population growth. Better life options for young women would also serve to reduce high rates of teen pregnancy. The World Bank has operationalized this awareness into a program aimed at showing what can be achieved by bringing women into the mainstream of social and economic development in Africa. Initially, the Bank is focusing on a few countries in every region of Africa. The World Bank's program includes: 1) country action plans to develop ways to improve Bank lending in several sectors by more effectively including women; 2) preparation of guidelines and identification of project approaches that address women more effectively in macroeconomic and sectoral analyses; 3) program expansions in agricultural extension services and credit for women; 4) program initiatives to improve the productivity of women entrepreneurs in the informal manufacturing, trade, and services sectors; 5) program expansion in primary, secondary, and technical education for girls and adult women; and 6) the Safe Motherhood Initiative aimed at reducing maternal mortality and morbidity.
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  24. 24

    The Oslo Declaration. Joint summary of the Oslo Conference on Sustainable Development.

    Brundtland GH; Perez de Cuellar J

    POPULI. 1988; 15(4):50-2.

    Participants in the 1988 Oslo Conference on Sustainable Development explored ways the United Nations system can promote sustainable development by enhancing global economic growth and social development. The deterioration of the environment, and the attendant problems of poverty and resource depletion, demand international cooperation and a new ethic based on equity, human solidarity, and accountability. Priority issues identified by conference participants included the following: developing human resources and fully integrated population policies; protecting the atmosphere and the global climate, ocean, and water resources; halting desertification and countering deforestation; controlling dissemination of dangerous wastes and aiming at the elimination of such toxins; increasing technology cooperation; controlling soil erosion and the loss of species; and securing economic growth, social justice, and a more equitable distribution of income and resources within and among countries as means for alleviating poverty. It was emphasized that poverty alleviation and environmental preservation can be made cost-effective components of development plans and programs and should not be considered as barriers to economic growth.
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  25. 25

    Burundi: country profile.

    Hilsum L

    NEW INTERNATIONALIST. 1988 Oct; (188):32.

    One of Africa's most rural and densely populated countries, Burundi is a landlocked nation in Central Africa. The 4.9 million people are 85% Hutus, agricultural people of Bantu origin. However, the Hutus are excluded from power by the minority Tutsis, and the 2 groups have engaged in violent conflict. After a military coup in 1987, a new president, Major Pierre Buyoya, was installed, but restrictions on the Hutus continue. The major difference in Burundi has been a relaxation of restrictions on the Catholic church, which were severe under the former President Bagaza. Most Hutus are Catholic, with a minority of Muslims. For the peasant farmer, faced with diminishing arable land and reliance on 1 export crop (coffee), life is becoming more difficult. An expansion of sugar production was planned to reduce reliance on coffee, although the government has a rather ambivalent approach to development. While promoting private sector development with the help of the World Bank and the U.S. government, the Burundi government maintains a rigid 1-party system with strict control over the lives of the people. Infant mortality stands at 196/1,000 live births and life expectancy is low--43 years for women and 40 years for men. The literacy rate is low (39% for men, 15% for women), and the GNP per capita is low ($230). Most land is used for subsistence crops such as cassava, bananas, sweet potatoes, maize, pulses, and sorghum.
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