Mathauer I.,World Health Organization |
Behrendt T.,German Society for International Cooperation
BMC Health Services Research | Year: 2017
Background: Contributory social health insurance for formal sector employees only has proven challenging for moving towards universal health coverage (UHC). This is because the informally employed and the poor usually remain excluded. One way to expand UHC is to fully or partially subsidize health insurance contributions for excluded population groups through government budget transfers. This paper analyses the institutional design features of such government subsidization arrangements in Latin America and assesses their performance with respect to UHC progress. The aim is to identify UHC conducive institutional design features of such arrangements. Methods: A literature search provided the information to analyse institutional design features, with a focus on the following aspects: eligibility/enrolment rules, financing and pooling arrangements, and purchasing and benefit package design. Based on secondary data analysis, UHC progress is assessed in terms of improved population coverage, financial protection and access to needed health care services. Results: Such government subsidization arrangements currently exist in eight countries of Latin America (Bolivia, Chile, Colombia, Costa Rica, Dominican Republic, Mexico, Peru, Uruguay). Institutional design features and UHC related performance vary significantly. Notably, countries with a universalist approach or indirect targeting have higher population coverage rates. Separate pools for the subsidized maintain inequitable access. The relatively large scopes of the benefit packages had a positive impact on financial protection and access to care. Discussion and Conclusion: In the long term, merging different schemes into one integrated health financing system without opt-out options for the better-off is desirable, while equally expanding eligibility to cover those so far excluded. In the short and medium term, the harmonization of benefit packages could be a priority. UHC progress also depends on substantial supply side investments to ensure the availability of quality services, particularly in rural areas. Future research should generate more evidence on the implementation process and impact of subsidization arrangements on UHC progress. © 2017 World Health Organisation.
Eisenack K.,Carl von Ossietzky University |
Moser S.C.,Susanne Moser Research and Consulting |
Hoffmann E.,Institute for Ecological economics Research |
Klein R.J.T.,Stockholm Environment Institute |
And 5 more authors.
Nature Climate Change | Year: 2014
The concept of barriers is increasingly used to describe the obstacles that hinder the planning and implementation of climate change adaptation. The growing literature on barriers to adaptation reveals not only commonly reported barriers, but also conflicting evidence, and few explanations of why barriers exist and change. There is thus a need for research that focuses on the interdependencies between barriers and considers the dynamic ways in which barriers develop and persist. Such research, which would be actor-centred and comparative, would help to explain barriers to adaptation and provide insights into how to overcome them. © 2014 Macmillan Publishers Limited.
Kalk A.,German Society for International Cooperation |
Paul F.A.,Formerly MSc Student in Development Management |
Grabosch E.,Consultant in Pediatrics
Tropical Medicine and International Health | Year: 2010
The study analyses strengths and weaknesses of the 'Paying For Performance' (P4P) approach rolled out in the Rwandan health sector since 2002. It uses three research methods: A cross-sectoral literature review on P4P, its history and its context; 69 mostly semi-structured interviews conducted in Rwanda; and an analysis of factors eventually confounding the impact evaluation of the Rwandan P4P approach. It is argued that P4P approaches can be traced backed in written form over four millennia and that considerable negative effects are reported throughout history. All side effects were found again in various forms in the Rwandan health sector. One particular side effect -'gaming'- seriously threatens to affect the quality of health services. It is argued that P4P implicitly (and unintentionally) promotes a questionable concept of human 'labour' and that its focus on improving indicators rather than systemic changes can be regarded as vertical and counter-productive. Two alternatives to the current P4P system are briefly depicted, and further research on the described challenges is recommended. © 2009 Blackwell Publishing Ltd.
Schmeier S.,German Society for International Cooperation
International Journal of River Basin Management | Year: 2015
ABSTRACT: River basin organizations (RBOs) have become a key feature of international water resources governance, providing riparian states with multiple means for overcoming collective action problems that emerge due to the transboundary nature of resources. However, little is known about the RBOs themselves, especially with regard to their organizational structure as well as the mechanisms they actually employ for governing water resources. This paper presents a comprehensive overview of the institutional design of all international RBOs by summarizing the empirical data available through the RBO Institutional Design Database in the context of the Transboundary Freshwater Dispute Database. It contributes to both water resources governance research, requiring institutional design data in order compare different RBOs or to comprehensively assess the contributions RBOs can make to better governing shared watercourses, as well as policy, facing the challenge of establishing new or reforming existing RBOs for more sustainable water resources governance in shared basins. © 2014, © 2014 International Association for Hydro-Environment Engineering and Research.
Suding P.H.,German Society for International Cooperation
Energy Policy | Year: 2011
This paper discusses Egypt's recent energy sector and policy developments against objectives and issues of the energy policy strategy adopted in 2007. It reviews energy supply and demand, pricing and subsidies as well as institutional arrangements and respective reform projects from the perspective of assessing achievements. It identifies the consequences of the policy and the long-term outlook and reports on the internal policy struggle. The policy strategy of 2007 is directed at energy security, social and industrial development. Environmental or climate objectives play no role. Energy efficiency is at best considered an instrument. The implementation of the strategy has been successful on the supply side, but not on the demand side. Price reform, refocusing subsidies and sector reform were not achieved. This has negatively affected energy efficiency and diversification, energy availability and supply security, the State budget and the sector's financial capacity. It causes rising energy import requirements and increasing risks to the current account balance. In spite of that, "old guard" and industrial establishment favour the resource-based development based on cheap energy and protract price reform, whereas another group of businessmen wants a sustainable development concept and monetize the oil and gas production to invest in Egypt's competitiveness. © 2010 Elsevier Ltd.
Shukla A.,German Society for International Cooperation
Green Energy and Technology | Year: 2015
The energy demand in India is growing at a very fast rate, the present energy generation could not be able to keep pace with this increasing demand with energy shortage of 6.2 % and peak shortage of 2.3 %. To address the increasing gap between demand and supply, there is an urgent need to bridge the gap through energy efficiency and integration of renewable energy in the energy mix of the country. This paper presents a new concept in Indian building sector which addresses the energy efficiency through Trigeneration technology. A gas engine with natural gas is used to produce power, and the waste heat for producing cooling and heating through Vapor Absorption Machine (VAM) and hot water recovery from low temperature (LT) jacket water respectively. This increases the efficiency up to 85 % or even more as compared to the conventional methods of power production. The present paper discusses one such case study on a pilot project implemented under the Indo-German Energy Program. The pilot project is funded by the German Federal Ministry of Environment, Nature Conservation, Building and Nuclear Safety (BMUB) and is the first project completed successfully under International Climate Initiative (IKI) of BMUB in India. This paper presents the information on the techno-economics of the pilot project at New Delhi. © 2015, Springer India.
Estomata M.T.L.,German Society for International Cooperation
34th Asian Conference on Remote Sensing 2013, ACRS 2013 | Year: 2013
The major setback of mapping forest cover using optical imagery for tropical countries is persistent cloud cover, which is also the case for Leyte Island, Philippines. Thus, Synthetic Aperture Radar (SAR) data acquired by the Advanced Land Observing Satellite (ALOS) Phased Array type Lband Synthetic Aperture Radar (PALSAR) sensor system was used to produce forest cover and forest cover change for years 2007 and 2010. Coconut palm, forest and non-forest/agriculture were the target classes classified to further explore separating coconut palm from forest, which is usually difficult for the said study area. Three different supervised classification algorithms were tested namely: Maximum Likelihood (MLC), Neural Network (NNC) and Support Vector Machine (SVM). The overall accuracies of the forest cover maps for 2010 using MLC, NNC and SVM were 75.63% (κ=0.63), 89.45% (κ=0.84) and 88.27% (κ=0.82), respectively. Copyright © (2013) by the Asian Association on Remote Sensing.
Neussner O.,German Society for International Cooperation
Proceedings of the 5th International Disaster and Risk Conference: Integrative Risk Management - The Role of Science, Technology and Practice, IDRC Davos 2014 | Year: 2014
Tropical cyclone Haiyan was the deadliest natural disaster in Philippine history since reliable recording started. Though official count of fatalities does not distinguish between different causes for the loss of live such as high wind speeds, landslides, river floods or storm surge an analysis of the geographic location of fatalities strongly suggests that about 95% were victims of storm surge on Leyte island where the majority of casualties happened. As the typhoon was forecasted days before it made landfall on 8 November 2013 and public warnings were issued well in advance, including storm surge, the question arises of why was early warning not effective in the coastal areas? An assessment of the causes identifies three main reasons why many residents of coastal areas stayed in the danger zone when the storm surge occurred. First, government agencies grossly underestimated the inundation area. Official hazard maps show only a fraction of the actual inundated area as storm surge prone. Some evacuation centres were located near the shore and many people died in them. Second, all residents of the coastal areas received warnings, but those were in most cases not clear and serious enough to make people understand that their lives are in real danger. Third, many residents of the coastal areas were resistant to follow official evacuation advice. There were many reasons given in interviews reaching from the fear of looting, to disbelieve in the governmental warning and fatalistic attitudes. Lessons learned from the assessment include an urgent need to improve hazard maps, review the location of evacuation centres, clarity of warnings (including colour coded alert levels, evacuation routes), the need for forced evacuations and an information campaign to reduce resistance of the population to evacuate.
Sharma D.,TERI University |
Tomar S.,German Society for International Cooperation
Environment and Urbanization | Year: 2010
If climate change is perceived as a global threat, this can mean that too little attention is paid to the ways in which it affects local populations and settlements. This also means too little attention to the importance of locally driven adaptation, both to reduce risks and to be better prepared to cope with consequences. This paper reviews the many initiatives underway in India that respond to climate change, and discusses what else is needed to mainstream effective adaptation, as well as identifying what currently constrains this. It also discusses how adaptation has to be mainstreamed within urban development and urban governance. Most municipal authorities in India are already grappling with large deficits in infrastructure and services and do not see climate change adaptation as a priority or as their responsibility. However, their attention may be engaged if they can see the co-benefits between adaptation and measures to address development and environmental health concerns. © 2010 International Institute for Environment and Development (IIED).
Gonner C.,German Society for International Cooperation
Society and Natural Resources | Year: 2011
This long-term study analyzes the dynamic patterns of resource use and income generation among Dayak Benuaq forest users in Indonesian Borneo. While swidden agriculture provides food for Benuaq families at a subsistence level and safeguards their survival-especially during times of uncertainty-financial income is generated from various forest products and off-farm activities. The Benuaq "surf" on "waves of opportunities" by frequently switching from one income source to another; their decisions are influenced by resource availability, market prices, seasonality, and individual cash demand. This flexible approach, combined with swidden agriculture as a safety net, has proven to be a resilient and efficient strategy to cope with external shocks and to sustain local livelihoods. © 2011 Taylor & Francis Group, LLC.