Poverty and health

Combating poverty and inequality: Structural change, social policy and politics
United Nations Research Institute for Social Development: 2010

This report seeks to explain why people are poor and why inequalities exist, as well as what can be done to rectify these injustices. It explores the causes, dynamics and persistence of poverty; examines what works and what has gone wrong in international policy thinking and practice; and lays out a range of policies and institutional measures that countries can adopt to alleviate poverty. It notes that current approaches to reducing poverty and inequality fail to consider key institutional, policy and political dimensions that may be both causes of poverty and inequality, and obstacles to their reduction. Moreover, when a substantial proportion of a country’s population is poor, it makes little sense to detach poverty from the dynamics of development. For countries that have been successful in increasing the well-being of most of their populations over relatively short periods of time, the report shows, progress has occurred principally through State-directed strategies that combine economic development objectives with active social policies and forms of politics that elevate the interests of the poor in public policy. The report is structured around three main issues, which, it argues, are the critical elements of a sustainable and inclusive development strategy: patterns of growth and structural change (whether in the agricultural, industrial or service sectors) that generate and sustain adequately paid jobs; comprehensive social policies that are grounded in universal rights and that support structural change, social cohesion and democratic politics; and protection of civic rights, activism and political arrangements that ensure that States are responsive to the needs of citizens and that the poor have some influence in how policies are made.

COMESA customs union: an assessment of progress and challenges for Eastern and Southern Africa's poor
Mambara JL, Trade and Development Studies Centre - Trust, Zimbabwe, 2007

COMESA's goal is the establishment of a free trade area, a customs union, a common market and ultimately an economic union. COMESA is home to 10 of the poorest countries in the world - Angola, Burundi, Ethiopia, Malawi, Mozambique, Rwanda, Somalia, Sudan, Zaire and Zambia. This paper examines the impact of COMESA on the poor. The report finds that while COMESA has liberalised trade in goods and services generally, there is now an urgent need to liberalise intra-regional trade in services and improve relations among its members. Conflicts in COMESA are unsustainable and strong
implementation mechanisms are needed to address non-tariff barriers and other trade restrictions within the region, with decisions on how transfer of sovereignty in some areas of trade policy to regional institutions is done in relation to SADC and COMESA.

Comment on the Millenium Challenge Corporation (MCC) Lesotho compact funding lack of focus on human resource capacity and health systems
Lynch S: Medecins Sans Frantiers (Lesotho)

Medicins Sans Frontiers comment on limitations in the Millenium Challenge Corporation funding of poverty reduction programmes. They note that the allocation of funding almost entirely to capital costs with no resources for recurrent costs, such as salaries, will constrain implementation in low income countries.

Further details: /newsletter/id/32453
Commentary on WHO proposal at World Health Assembly 2012: Draft implementation plan on maternal infant and young child nutrition
Global Health Watch: 2 April 2012

In this article, Global Health Watch provides an analysis of WHO’s ‘Draft implementation plan on maternal infant and young child nutrition’ (shown also in this section of the newsletter) . While it welcomes the evidence-based approach adopted in the draft, it argues that the plan fails to deal with the intersection of trade relations and nutrition, and steers clear of the challenges to be faced in building a regulatory framework to regulate transnational agribusiness and food corporations at global and country level. This is especially problematic at the moment, as new provisions are being inserted into preferential trade agreements to provide transnational corporations with powerful new defences against regulation at both the national and international levels. Global Health Watch argues that that nutrition needs to be understood in the context of food security (and insecurity). Food security in Africa is jeopardised by speculation in food commodities, which was the main contributor to a 50% rise in food prices in 2008, as well as the diversion of land growing food to growing biofuels. Global Health Watch argue that WHO cannot address the issues of trade and the regulation of transnational industry alone but it can take a pro-active stance in working with other competent intergovernmental bodies.

Communication on humanitarian food assistance
European Council: 31 March 2010

This communication lays out a new policy framework for European Union humanitarian action to strengthen efforts to tackle food insecurity in humanitarian crises. In it, the he European Commission reports its intention to strengthen four pillars of food security in general and emergency settings by increasing availability of food, improving access to food, improving quality and ensuring people eat nutritious food, and boosting the effectiveness of crisis prevention and management. Key points include the benefits of involving beneficiaries in operations and incorporating gender, livelihood and protection considerations in assessing needs and designing and delivering responses. The Commission draws attention to the needs of nutritionally vulnerable groups, including children under-two and pregnant women, while urging for integration of programmes so that needs are addressed holistically, and underlining the importance of linking relief with rehabilitation and development. The framework on food security spells out the need to support agriculture in poor countries to help them reach the UN Millennium Development Goal of halving hunger and poverty by 2015.

Community and faith-based groups lend a hand
id21 Insights 64, November 2006

Several households falling into poverty as a result of HIV/AIDS desperately need support systems. African communities have modified existing safety net mechanisms and pioneered new responses such as home based care programmes, support groups and orphans and vulnerable children initiatives. Safety nets protect people from the worst effects of poverty. They prevent poor households from making hasty decisions to sell productive assets and increase their chances of escaping destitution. But how long can self-resourced initiatives continue to function?

Community Assessment of Food Security and the Social Situation in Zimbabwe

This report is the third of a broader monitoring of food security and social welfare at community level by the Civic Monitoring Programme. Monthly monitoring will be complemented by quarterly monitoring of specific areas of social welfare.

Community concepts of poverty: an application to premium exemptions in Ghana’s National Health Insurance Scheme
Aryeetey GC, Jehu-Appiah C, Kotoh AM, Spaan E, Arhinful DK, Baltussen R, van der Geest S and Agyepong IA: Globalization and Health 9(12), 14 March 2013

In 2009, researchers in Ghana commenced a study to explored the social and relativist dimension of poverty in five communities in the South of Ghana with differing socio-economic characteristics. This research was meant to inform the development and implementation of policies and programmes to identify and target the poor for premium exemptions under Ghana’s National Health Insurance Scheme (NHIS). They employed participatory wealth ranking (PWR) as a qualitative tool for the exploration of community concepts, identification and ranking of households into socio-economic groups. Key informants within the community ranked households into wealth categories after discussing in detail concepts and indicators of poverty. Results showed that community-defined indicators of poverty covered themes related to type of employment, educational attainment of children, food availability, physical appearance, housing conditions, asset ownership, health seeking behaviour, social exclusion and marginalisation. In conclusion, the in-depth nature of the PWR process precludes it from being used in a large national-scale programme such as the NHIS. However, the authors argue that it can provide valuable qualitative input to inform policy and programmes exempting health payments for poor people.

Context matters
Boesen N: Capacity,org 37, September 2009

Context matters with regard to foreign aid. The implications are only slowly coming to the fore: external funders are realising that they will not find a magic wand or global prescription or best practice by which they can unleash the change that will reduce poverty on a significant and sustainable scale. Context – the institutional, social, political, cultural and economic fabric of society – matters, and its significance is much greater than that of aid from external partners. So, the problem for funders in dealing with context seems to be first and foremost dealing with their own context that forces them to try to do more than they objectively can. The challenge is to find ways to change the political and systemic factors that constrain the capacity and willingness of funders to act with modesty, realism and humility. This requires an environment in which their stakeholders are genuinely happy to be small contributors to processes that mainly depend on everything but funders and aid.

Coping with the Challenges of Urbanization in Low Income Areas: An Analysis of the Livelihood Systems of Slum Dwellers of the Wa Municipality, Ghana
Abubakari Abu-Salia R; Kanton Osmannu I; Ahmed A: Current Urban Studies 3(2), 2015

In Ghana, unplanned and spontaneous urbanization has trapped many in slum dwellings with its attendant poverty, insecurity, and poor housing and general environmental conditions. Slum dwellers’ choices of livelihood activities are restricted under various socio-economic and planning constraints. Using mixed methods, this paper explored the conditions under which slum dwellers can maximize the prospects of their environment and minimize the challenges therein. The findings indicate that slum dwellers have a diversity of livelihood assets and potentials, yet limited access to planned adaptation remains a main challenge. Many dwellers result to autonomous supplementary occupations to cope with the challenges of urbanization. The authors argue for a redefinition of the mandate of urban planning, as a response to spontaneous urbanization, and for tools for sustainable livelihood at the local level.

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