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In the aftermath of the invasion of Afghanistan, the U.S. Agency for International Development supported the Afghan Ministry of Public Health to deliver basic healthcare to 90 percent of the population, at a cost of $4.50 a head. The program played a vital role in improving the country's health; the number of children dying before the age of five dropped by 100,000 a year. But accounting standards at the Ministry of Public Health concerned the United States Special Investigator General for Afghanistan. There was no evidence of malfeasance, nor argument about the success of the program. For all that the results were fantastic, receipts were not in order. The investigator called for the health program to be suspended because of "e;financial management deficiencies"e; at the ministry.This case illustrates a growing problem: an important and justified focus on corruption as a barrier to development has led to policy change in aid agencies that is damaging the potential for aid to deliver results. Donors have treated corruption as an issue they can measure and improve, and from which they can insulate their projects at acceptable costs by controlling processes and monitoring receipts. Results Not Receipts highlights the weak link between donors preferred measures of corruption and development outcomes related to our limited ability to measure the problem. It discusses the costs of the standard anti-corruption tools of fiduciary controls and centralized delivery, and it suggests a different approach to tackling the problem of corruption in development: focus on outcomes.
The United States is one of the world's largest producers and exporters of a range of agricultural commodities, so U.S. policies have big effects on global food security and other global public goods linked to agriculture. On the positive side of the ledger, President Obama created the Feed the Future aid initiative to promote agricultural development in poorer countries as a tool to achieve the global goals of ending hunger and extreme poverty, which are mostly rural. But that generosity is undercut by U.S. support for farmers and livestock producers that suppresses global prices for developing country producers, increases food market volatility, increases greenhouse gas emissions, and contributes to the spread of antibiotic-resistant bacteria.In this book, Elliott focuses on three policy areas that are particularly damaging for developing countries: traditional agricultural subsidy and trade policies that support the incomes of American farmers at the expense of farmers elsewhere; the biofuels mandate, which in its current form increases market volatility while doing little if anything to mitigate climate change; and weak regulation of antibiotic use in livestock. While noting that broad reforms are needed to fix these problems, Elliott also identifies practical steps that U.S. policymakers could take in the relatively short run to improve farm policies for American taxpayers and consumers as well as for the poor and vulnerable in developing countries.
Some 600 million children worldwide do not legally exist. Without verifiable identification, they—and unregistered adults—could face serious difficulties in proving their identity, whether to open a bank account, purchase a SIM card, or cast a vote. Lack of identification is a barrier to full economic and social inclusion.Recent advances in the reach and technological sophistication of identification systems have been nothing less than revolutionary. Since 2000, over 60 developing countries have established national ID programs. Digital technology, particularly biometrics such as fingerprints and iris scans, has dramatically expanded the capabilities of these programs. Individuals can now be uniquely identified and reliably authenticated against their claimed identities. By enabling governments to work more effectively and transparently, identification is becoming a tool for accelerating development progress. Not only is provision of legal identity for all a target under the Sustainable Development Goals, but this book shows how it is also central to achieving numerous other SDG targets.Yet, challenges remain. Identification systems can fail to include the poor, leaving them still unable to exercise their rights, access essential services, or fully participate in political and economic life. The possible erosion of privacy and the misuse of personal data, especially in countries that lack data privacy laws or the capacity to enforce them, is another challenge. Yet another is ensuring that investments in identification systems deliver a development payoff. There are all too many examples where large expenditures—sometimes supported by donor governments or agencies—appear to have had little impact.Identification Revolution: Achieving Sustainable Development in the Digital Age offers a balanced perspective on this new area, covering both the benefits and the risks of the identification revolution, as well as pinpointing opportunities to mitigate those risks.
Vaccinate children against deadly pneumococcal disease, or pay for cardiac patients to undergo lifesaving surgery? Cover the costs of dialysis for kidney patients, or channel the money toward preventing the conditions that lead to renal failure in the first place? Policymakers dealing with the realities of limited health care budgets face tough decisions like these regularly. And for many individuals, their personal health care choices are equally stark: paying for medical treatment could push them into poverty.Many low- and middle-income countries now aspire to universal health coverage, where governments ensure that all people have access to the quality health services they need without risk of impoverishment. But for universal health coverage to become reality, the health services offered must be consistent with the funds availableand this implies tough everyday choices for policymakers that could be the difference between life and death for those affected by any given condition or disease. The situation is particularly acute in low- and middle income countries where public spending on health is on the rise but still extremely low, and where demand for expanded services is growing rapidly.What's In, What's Out: Designing Benefits for Universal Health Coverage argues that the creation of an explicit health benefits plana defined list of services that are and are not availableis an essential element in creating a sustainable system of universal health coverage. With contributions from leading health economists and policy experts, the book considers the many dimensions of governance, institutions, methods, political economy, and ethics that are needed to decide what's in and what's out in a way that is fair, evidence-based, and sustainable over time.
Cash on Delivery (COD) Aid proposes a new approach to foreign assistance -one that links aid payments more directly to desired outcomes to promote accountability, responsibility, learning, and strengthening of local institutions.
This volume demonstrates how incentives can improve the delivery and use of health services in low- and middle-income countries. The authors describe the rationale for introducing incentives tied to achievement of specific health-related targets, and they provide clear guidance about designing, implementing, and evaluating programs that provide incentives to health care providers and patients.
Failed states are at greatest risk for collapse and pose an urgent threat to international security. Yet, ironically, new U.S. foreign assistance programs such as the Millennium Challenge Account (MCA) routinely bypass these poorly performing countries, while providing increased aid to so-called good performers.
Over the past seven years, the Bush administration has launched a revolution in U.S. foreign aid. At no time since the administration of President Kennedy have there been more changes in the volume of aid, in aid's purposes and policies, in its organization, and in its overall status in U.
Girls' education, indisputably crucial to development, has received a lot of attention--but surprisingly little hardheaded analysis to inform practical policy solutions.
The World Bank is assailed by critics on the left, right and center on the grounds it is not effective, not accountable, not democratic or legitimate, and most threatening of all, not relevant in a global economy where private capital, production, and ideas dominate.
Five million people in poor countries are receiving AIDS treatment, but international AIDS policy is still in crisis. Donors are giving less than they had been, even though infections continue unabated, and the number of people dependent on treatment rises each year. This book proposes a feasible medium-term objective for AIDS policy: achieving an "e;AIDS transition,"e; that is, keeping AIDS deaths down by sustaining treatment while pushing new infections even lower, so that the total number of people living with HIV/AIDS begins to decline. How? Through a new, incentive-driven strategy to improve HIV prevention and a sustained effort to get the most from AIDS treatment.
When he began this book in early 2008, Guillermo Perry argued that developing countries remained highly vulnerable to external risks such as commodity price declines, capital flow reversals, and natural disasters.
While great strides have been made to improve health in poor countries, the global supply chain that connects the dots does not work well. This report of the Global Health Forecasting Working Group provides an analysis of the problem and an agenda for action. It offers recommendations that could be implemented by public and private organizations.
Worried about the effect of oil on Alaska, Governor Jay Hammond had a simple yet revolutionary idea: let citizens have a direct stake. This book describes, with brutal honesty, the birth of the Alaska Permanent Fund dividend, which has been paid to each resident every year since 1982.
Beleaguered by mutual recrimination between rich and poor countries, squeezed by the zero-sum arithmetic of a shrinking global carbon budget, and overtaken by shifts in economic and hence bargaining power between these countries, international cooperation on climate change has floundered. Given these three factorswhich Arvind Subramanian and Aaditya Mattoo call the "e;narrative,"e; "e;adding up,"e; and "e;new world"e; problemsthe wonder is not the current impasse; it is, rather, the belief that progress might be possible at all.In this book, the authors argue that any chance of progress must address each of these problems in a radically different way. First, the old narrative of recrimination must cede to a narrative based on recognition of common interests. Second, leaders must shift the focus away from emissions cuts to technology generation. Third, the old "e;cash-for-cuts"e; approach must be abandoned for one that requires contributions from all countries calibrated in magnitude and form to their current level of development and future prospects.
This book tackles the complex issue of how to accelerate economic growth and ensure sustainability in Latin America. It first lays out the framework designed by experts in the economics and politics of growth in the region.
Why is business performance lagging in Africa? To provide answers, this volume focuses on the day-to-day problems that private sector managers and entrepreneurs there encounter.
What should a country do if it suddenly discovers oil and gas? How should it spend the subsequent cash windfall? How can it protect against corruption? How can citizens truly benefit from national wealth? With many of the world's poorest and most fragile states suddenly joining the ranks of oil and gas producers, these are pressing policy questions.Oil to Cash explores one option that may help avoid the so-called resource curse: just give the money directly to citizens. A universal, transparent, and regular cash transfer would not only provide a concrete benefit to regular people, but would also create powerful incentives for citizens to hold their government accountable. Oil to Cash details how and where this idea could work and how policymakers can learn from the experiences with cash transfers in places like Mexico, Mongolia, and Alaska.
Girls have achieved remarkable increases in primary schooling over the past decade, yet millions are still not in school. In their previous book, Inexcusable Absence, Maureen A.
Foreign aid has no shortage of critics. Some argue that it undermines development and inherently does more harm than good; others insist that aid must be seriously reformed to work properly. Cash on Delivery (COD) Aid proposes serious reform to make aid work well by forcing accountability, aligning the objectives of funders and recipients, and sharing information about what works.Public and private aid can improve lives in poor countries, but the willingness of taxpayers and private funders to finance aid programs depends more than ever on showing results. COD Aid is a funding mechanism that hinges on results. At its core is a contract between funders and recipients that stipulates a fixed payment for each unit of confirmed progress toward an agreed-upon goal. Once the contract is struck, the funder takes a hands-off approach, allowing the recipient the freedom and responsibility to achieve the goal on its own. Payment is made only after progress toward the goal is independently verified by a third party. At all steps, a COD Aid program is remarkably transparent: the contract, the amount of progress made, and the payment are disseminated publicly to highlight the credibility of the arrangement and improve accountability to the public. COD Aid is a new approach to foreign aid, but one that complements other aid programs and would ultimately encourage funders and recipients to use existing resources more efficiently. Cash On Delivery Aid: A New Approach to Foreign Aid explains the approach in detail and investigates its application in one sector: education. More specifically, the authors show how foreign aid agencies could use COD Aid to help developing countries achieve universal primary school education. The example illustrates how to deal with potential challenges of the approachchallenges that are no greater than those of traditional aidand includes model term sheets for contracts that could be used for any COD Aid agreement.
Over the past fifteen years, people in low- and middle-income countries have experienced a health revolutionone that has created new opportunities and brought new challenges. It is a revolution that keeps mothers and babies alive, helps children grow, and enables adults to thrive. Millions Saved: New Cases of Proven Success in Global Health chronicles the global health revolution from the ground up, showcasing twenty-two local, national, and regional health programs that have been part of this global change. The book profiles eighteen remarkable cases in which large-scale efforts to improve health in low- and middle-income countries succeeded, and four examples of promising interventions that fell short of their health targets when scaled-up in real world conditions. Each case demonstrates how much effortand sometimes luckis required to fight illness and sustain good health.The cases are grouped into four main categories, reflecting the diversity of strategies to improve population health in low-and middle-income countries: rolling out medicines and technologies; expanding access to health services; targeting cash transfers to improve health; and promoting population-wide behavior change to decrease risk. The programs covered also come from various regions around the world: seven from sub-Saharan Africa, six from Latin America and the Caribbean, five from East and Southeast Asia, and four from South Asia.
Emerging Africa describes the too-often-overlooked positive changes that have taken place in much of Africa since the mid-1990s. In 17 countries, five fundamental and sustained breakthroughs are making old assumptions increasingly untenable.
The last few years have seen a steep decline in the perceived legitimacy of U.S. policies and values in the world. How will the next American president regain the country's power and influence so that it is capable of tackling the global challenges of the 21st century? T he White House and the World explores areas where changes in U.
Making a commitment in advance to buy vaccines if and when they are developed would create incentives for industry to increase investment in research and development.
In this book, Nicolas Van de Walle identifies 26 countries that are extremely poor and grew little if at all in the 1990s. His sample excludes North Korea and countries where civil war explains some of their failure to grow (Afghanistan, Sierra Leone, Sudan, Tajikistan and others).
Throughout the 1990's, privatization of inefficient state-owned enterprises was strongly embraced in developing and transitional economies. Little attention has gone to the distributional implications of the privatization movement, a particularly surprising oversight given the current backlash in many settings against further privatization.
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