In this presentation, the author argues that investing in family planning is the single most strategic, low cost, high impact and quick win strategy to achieving economic, social and political transformation. The author reviews several instruments for investing in family planning in Uganga, such as the National Development Plan (2010–2014), which has clear targets for family planning and focuses on investing in ‘demographic window’ (when the proportion of population of working age group is particularly prominent in a country), and the Medium Term Expenditure Framework, to which the government should link National Development Programme targets and in which the appropriate sectors should be prioritised to bring about investment. The Annual Health Sector budget allocation is reported to have been relatively stagnant for FP over the years and must be increased. In addition, government needs to monitor whether or not the allocated funds are actually spent on FP.
Equity in Health
According to this presentation, over the long run, the importance of within-country inequalities has decreased and the importance of between-country inequalities has increased, while the global division between countries is actually greater than that between social classes. The presentation refers to two factors affecting an individual’s levels of wealth: citizenship premium and parental premium. According to citizenship premium, if the mean income of country where you live increases by 10%, your income goes up by about 10% too (called ‘unitary elasticity’). The parental premium states that, if your parents are one income class higher, your income increases by about 10.5% on average. In terms of global inequality of opportunity, country of citizenship explains 60% of variability in global income, while citizenship and parental income class combined explain more than 80%. In conclusion, if most of one’s income is determined by citizenship, then there is little equality of opportunity globally and citizenship may be regarded as a rent (unrelated to individual effort or whether or not the individual deserves it or not).
Using social tables, the author estimates global inequality (inequality among world citizens) from the early 19th century until the 21st century. The analysis shows that the level and composition of global inequality have changed over the past two centuries. The level has increased, reaching a high plateau around the 1950s, and the main determinants of global inequality have become differences in mean country incomes rather than inequalities within nations. The inequality extraction ratio (the percentage of total inequality that was extracted by global elites) has remained surprisingly stable, at around 70% of the maximum global Gini co-efficient, during the past 100 years.
In this interview with Archbishop Ndungane, president and founder of African Monitor, he assesses the outcomes of the United Nations Summit on the Millennium Development Goals (MDGs). On the positive side, he welcomes the fact that the outcome document is comprehensive, touching on almost everything that needs to be addressed if MDGs are to be met, with commitments that are measurable and therefore can be tracked. The specific amounts committed by specific stakeholders is also a step in the right direction, according to him. Clause 23 (c) makes specific reference to the promotion of national food security strategies that strengthen support for smallholder farmers and contribute to poverty eradication. This is key to poverty eradication, particularly where without exception, 70% of the population in rural areas depend on agriculture for their livelihood. According to the Archbishop also commendable are the specific focus on maternal and child health, the references to lessons learnt, particularly the issue of supporting community-led strategies; and the commitment to strengthening the statistical capacity to produce reliable and disaggregated data. He also pointed out a number of concerns about the Summit, in the lack of any guarantee that the concrete commitments will go beyond mere ‘lip service’; the lack of clear mechanisms for enforcement; and the repetition of principles that have proved difficult to operationalise without new angles on how they are going to be implemented in reality. Finally, although there are specific commitments, world leaders need to find mechanisms to reinvigorate and stimulate the local energies, initiatives and actions which are people-driven. They should look beyond 2015 and work for sustainable solutions.
The General Assembly adopted this outcome document at the sixty-fifth session of the General Assembly on the Millennium Development Goals, held in September 2010. It reaffirms the United Nations’ commitment to achieving the Millennium Development Goals (MDGs) and calls on all stakeholders, including civil society, to enhance their role in national development efforts as well as their contribution to achieving the MDGs. The resolution indicates that there has been a mix of successes and failures in achieving the MDGs, with uneven progress and many remaining challenges and opportunities. It recognises that developing countries have made significant efforts towards achieving the MDGs and have had major successes in realising some of the targets of the MDGs, such as combating extreme poverty, improving school enrolment and child health, reducing child deaths, expanding access to clean water, improving prevention of mother-to-child transmission of HIV, expanding access to HIV prevention, treatment and care, and controlling malaria, tuberculosis and neglected tropical diseases. However, much more needs to be done to reach the MDGs, as progress has been uneven among regions and between and within countries. Hunger and malnutrition rose again from 2007 through 2009, partially reversing prior gains. There has been slow progress in reaching full and productive employment and decent work for all, advancing gender equality and the empowerment of women, achieving environmental sustainability and providing basic sanitation. New HIV infections still outpace the number of people starting treatment. In particular, the Assembly criticised the slow progress that has been made in improving maternal and reproductive health.
In this presentation, the author argues that meeting unmet need for family planning services in Kenya could help the country ‘significantly’ generate resources and save costs to achieve universal primary education, reduce child mortality, improve maternal health, ensure environmental sustainability, and help combat HIV and AIDS, malaria and other diseases. It draws on research to show that greater access to FP information and services in Kenya could contribute directly to the country’s attainment of Millennium Development Goals 4 and 5 (to reduce child mortality and improve maternal health).
In this interview, Patrick Bond discusses the failings of South Africa’s drive towards meeting the Millennium Development Goals (MDGs) and the extent to which the country’s government continues to operate against the interests of its poor majority. According to Bond, South African urban poverty increased from 1993–2008 and rural poverty declined only because more poor people moved to the cities and the welfare grant system was extended. The South African economy is structured so as to generate poverty-expanding 'growth' of GDP (gross domestic product) so, as accumulation of capital occurs in much of South Africa, the rich grow richer and the poor grow poorer. That structuring happens in ways concordant with the speculative, financial-driven and profit-exporting character of capitalism, interrupted only briefly by the great crash of 2008. Most of Pretoria's economic policies amplify this trend because of their neoliberal (pro-business) character, he argues. South Africa cannot be confident of making progress on any MDGs, given the coming austerity associated with a failing global and national 'Keynesian' (deficit-based) macroeconomic strategy that was largely based on white-elephant infrastructure investments. Such spending – especially for now-empty World Cup soccer stadiums costing R22 billion – plus declining state revenues (as profits and taxes fell) moved the national budget from a surplus of around 1% of GDP to more than 7%. What is therefore likely, within five years, is a similar turn by the Treasury to the kind of austerity now being felt in many other countries which ratcheted up their deficits to deal with the crisis. As shown in the recent civil servants' strike, the state is willing to put services mainly utilised by the poor majority – public schools, clinics and hospitals – at risk to maintain some semblance of fiscal discipline, which does not bode well for future state expenditure on MDG-related needs.
Compared with some countries in sub-Saharan Africa, infant mortality rate is relatively high in Tanzania, at 68 per 1000 live births (2004-2005). Studies of factors affecting infant mortality have rarely considered the role of birth order. This study aims to contribute to fill this research gap by determining the risk factors associated with infant mortality in Ifakara in rural Tanzania from January 2005 to December 2007. Data for 8,916 live births born from 1 January 2005 to 31 December 2007 was extracted for analysis. The study found that first and higher birth orders had highest levels of infant death, while mothers younger than 20 years old had the highest infant mortality. From 2005–2007, malaria remained the leading cause of infant death. Giving birth at the hospital was perceived by women to be associated with severe delivery complications. The study recommends that Tanzania’s health systems urgently need strengthening, and efforts should be made to communicate the benefits of health facility deliveries more effectively. Voluntary and community health workers also need to be trained adequately to recognise factors that put infants at risk.
This review uses Millennium Development Goal 5 (reducing the maternal mortality ratio by three quarters and achieving universal access to reproductive health by 2015) to assess global progress in improving maternal health. The main study limitation was a lack of reliable and accurate data on maternal mortality, particularly in developing-country settings where maternal mortality is high. An estimated 358,000 maternal deaths occurred worldwide in 2008, a 34% decline from the levels of 1990. Despite this decline, developing countries continued to account for 99% (355,000) of the deaths, with sub-Saharan Africa and South Asia accounting for 87% (313,000). Overall, it was estimated that there were 42,000 deaths due to AIDS among pregnant women in 2008. About half of those were assumed to be maternal. The contribution of AIDS was highest in sub-Saharan Africa where 9% of all maternal deaths were due to AIDS. These estimates provide an up-to-date indication of the extent of the maternal mortality problem globally. They reflect the efforts by countries, which have increasingly been engaged in studies to measure maternal mortality and strengthen systems to obtain better information about maternal deaths. The modest and encouraging progress in reducing maternal mortality, the review argues, is likely due to increased attention to developing and implementing policies and strategies targeting increased access to effective interventions. Such efforts need to be expanded and intensified, to accelerate progress towards reducing the still very wide disparities between developing and developed worlds.
Save the Children’s research compares mortality rates of poor children and rich children in 32 countries. In many countries that are successfully reducing child mortality, progress is concentrated among the poorest and most disadvantaged children. Conversely, in countries making slow or no progress, disparities in life chances between children from the poorest and richest backgrounds tend to be extreme. Since 1990, the global child mortality rate has declined by 28%, which falls short of the target set by Millennium Development Goal (MDG) 4 (a two-thirds reduction by 2015). Still, many high-mortality countries have substantially reduced child deaths, and 19 of 68 high-priority countries are now expected to meet MDG 4. The findings underscore a great gap in reaching the poorest with essential health care, including pre-and post-natal care, skilled attendance at birth, and low-cost prevention and treatment for the major child killers – pneumonia, diarrhoea, and malaria. Save the Children found inequity in child survival to be a persistent and sometimes growing problem in many of the world’s developing countries, where 99% of all child deaths occur.