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Alderman H.,The World Bank
Journal of Nutrition | Year: 2010

Models of climate change predict increased variability of weather as well as changes in agro-ecology. The increased variability will pose special challenges for nutrition. This study reviews evidence on climate shocks and nutrition and estimates the economic consequences in terms of reduced schooling and economic productivity stemming from nutritional insults in childhood. Panel data covering up to 20 y indicate that that short-term climate shocks have long-term impacts on children that persist, often into their adult lives. Other studies document the potential for relief programs to offset these shocks providing that the programs can be implemented with flexible financing, rapid identification of those affected by the shock, and timely scale-up. The last of these presumes that programs are already in place with contingency plans drawn up. Arguably, direct food distribution, including that of ready-to-use therapeutic food, may be part of the overall strategy. Even if such programs are too expensive for sustainable widespread use in the prevention of malnutrition, scalable food distribution programs may be cost effective to address the heightened risk of malnutrition following weather-related shocks. © 2010 American Society for Nutrition. Source


Kessides I.N.,The World Bank
Energy Policy | Year: 2013

Pakistan is facing a severe electricity crisis due to a persistent and widening gap between demand and available system generating capacity. The worsening of power shortages has become a major political issue, reflecting the hardships for individuals and businesses. It threatens to undermine the credibility and legitimacy of government and to further stress the social fabric of the country. The power crisis did not emerge suddenly. It is the direct result of imprudent and reckless energy policies over the last three decades. These policies have impeded the development of cheap and abundant domestic energy sources. They have also resulted in very inefficient fuel-mix choices, compromising energy and economic security. Pakistan's energy bankruptcy is ultimately due to massive institutional and governance failure. This paper analyzes the problems confronting Pakistan's electricity sector and identifies the key elements of a potential policy response to address the country's severe power crisis. © 2012 Elsevier Ltd. Source


Ahlroth S.,The World Bank
Resources, Conservation and Recycling | Year: 2014

In environmental impact assessment of policies and product design results need to be presented in a comprehensible way to make alternatives easily comparable. One way of doing this is to aggregate results to a manageable set by using weighting methods. Valuing the environmental impacts can be a challenging task that can also be quite time-consuming. To the aid of practitioners, several weighting sets with readily available weights have been developed over the last decade. The scope and coverage of these sets vary, and it is important to be aware of the implications of using different valuation methods and weighting sets. The aim of this paper is to map valuation and weighting techniques and indicate the methods that are suitable to use, depending on the purpose of the analysis. Furthermore, we give an overview over sets of generic values or weights and their properties, and give an illustration of how different sets may influence the results. It is very useful to use several weighting sets, and discuss the results thoroughly. It is often a very interesting and fruitful exercise to see if and how the results differ, why they differ, and which one seems to be the best alternative to base any recommendation on. The example provided in this article demonstrates that looking at aggregate results is not enough. Since many weighting sets are not sufficiently transparent as to how they are constructed and what their impact categories actually include, a general recommendation is to provide weighting sets with a declaration of content, providing a clear picture of what is included and what is not, and a recommendation of suitable uses of the weighting set. © 2013 Elsevier B.V. Source


There is evidence that HIV prevention programs for sex workers, especially female sex workers, are cost-effective in several contexts, including many western countries, Thailand, India, the Democratic Republic of Congo, Kenya, and Zimbabwe. The evidence that sex worker HIV prevention programs work must not inspire complacency but rather a renewed effort to expand, intensify, and maximize their impact. The PLOS Collection “Focus on Delivery and Scale: Achieving HIV Impact with Sex Workers” highlights major challenges to scaling-up sex worker HIV prevention programs, noting the following: sex worker HIV prevention programs are insufficiently guided by understanding of epidemic transmission dynamics, situation analyses, and programmatic mapping; sex worker HIV and sexually transmitted infection services receive limited domestic financing in many countries; many sex worker HIV prevention programs are inadequately codified to ensure consistency and quality; and many sex worker HIV prevention programs have not evolved adequately to address informal sex workers, male and transgender sex workers, and mobile- and internet-based sex workers. Based on the wider collection of papers, this article presents three major clusters of recommendations: (i) HIV programs focused on sex workers should be prioritized, developed, and implemented based on robust evidence; (ii) national political will and increased funding are needed to increase coverage of effective sex worker HIV prevention programs in low and middle income countries; and (iii) comprehensive, integrated, and rapidly evolving HIV programs are needed to ensure equitable access to health services for individuals involved in all forms of sex work. © 2015 David Wilson. Source


Kim J.Y.,The World Bank | Farmer P.,Brigham and Womens Hospital | Porter M.E.,Harvard University
The Lancet | Year: 2013

Initiatives to address the unmet needs of those facing both poverty and serious illness have expanded significantly over the past decade. But many of them are designed in an ad-hoc manner to address one health problem among many; they are too rarely assessed; best practices spread slowly. When assessments of delivery do occur, they are often narrow studies of the cost-effectiveness of a single intervention rather than the complex set of them required to deliver value to patients and their families. We propose a framework for global health-care delivery and evaluation by considering efforts to introduce HIV/AIDS care to resource-poor settings. The framework introduces the notion of care delivery value chains that apply a systems-level analysis to the complex processes and interventions that must occur, across a health-care system and over time, to deliver high-value care for patients with HIV/AIDS and cooccurring conditions, from tuberculosis to malnutrition. To deliver value, vertical or stand-alone projects must be integrated into shared delivery infrastructure so that personnel and facilities are used wisely and economies of scale reaped. Two other integrative processes are necessary for delivering and assessing value in global health: one is the alignment of delivery with local context by incorporating knowledge of both barriers to good outcomes (from poor nutrition to a lack of water and sanitation) and broader social and economic determinants of health and wellbeing (jobs, housing, physical infrastructure). The second is the use of effective investments in care delivery to promote equitable economic development, especially for those struggling against poverty and high burdens of disease. We close by reporting our own shared experience of seeking to move towards a science of delivery by harnessing research and training to understand and improve care delivery. © 2013 Elsevier Ltd. Source

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