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The Sh!t Factor in Malnutrition: More Evidence For Why We Need a Holistic Development Strategy

March 27, 2012 in MDG 1 (Poverty & Hunger), MDG 4 (Child Mortality), Uncategorized

Today, the Hunger and Undernutrition Blog saw a guest post from Christopher Juan Costain of the World Bank’s Water and Sanitation Program in South Asia. His main point being that sanitation has historically been largely overlooked as a contributing factor to child malnutrition. Yet, in fact, it is not only a player in it, but investing in better sanitation is economically one of the most cost effective ways to lower instances of undernourishment. Here are some selected sh!t related facts and figures:

Photo by mvcorks, Flickr

  • 51% of people India practice open defecation. This is highly linked to malnutrition since around 50% of the consequences of under-nutrition can be attributed to poor environmental health conditions, which result in diseases such as diarrhoea, environmental enteropathy, and nematode infections
  • In fact, 25% of all child stunting, can be attributed to having experienced more than 5 episodes of diarrhoea
  • Environmental enteropathy means that the faecal matter ingested by kids in large quantities because of poor sanitation damages the stomach wall and causes poorer absorption of nutrients
  • Just getting people to use toilets reduced instances of diarrhoea by 36%
  • Installing simple latrines is cheap and accessible (those interested should check out the work done by the comically named The World Toilet Organisation, WTO).

The simple take away from this is that development desperately needs a more holistic approach rather than one that has clear set, but undeniably separate goals. This is something that I have argued before and is something that is evident here.

Tackling malnutrition would have positive effects on educational attainment and future job and work prospects too, as it is well documented that poor nutrition leads to lower concentration, retention and general energy levels of children. Not to mention the number of school days they are likely to miss if suffering from diarrhoea and other sanitation-food related inflictions.

The post MDG framework should focus on the interconnectivity of ‘development problems’ and seek system-wide solutions.

By Ioulia Fenton, Online Lead, Generation Development 

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Where are the healthcare workers?

August 18, 2011 in Economics, International Development, MDGs, United Nations

One of the many striking omissions from the current set of MDGs is no real consideration for the severe lack of healthcare workers (doctors, nurses, technicians, support workers, skilled birth attendants, pharmacists, therapists etc etc) in low and middle income countries. Even with aspirational targets that the current MDGs set, many of them (4, 5 & 6 especially, but arguably 1 and 3 as well) cannot be reached with the current shortage of healthcare workers. Below are four maps, from the amazing Worldmapper, that show the countries of the world resized in proportion to what they are measuring. The two comparisons I have made are deaths from diarrhoeal disease Vs. physicians working and maternal mortality Vs. number of midwives.

Deaths from diarrhoeal disease (2002)

Number of physicians working (data from 2004)

Maternal Mortality (data from 2000)

Midwives working (Data from 2006)

These maps are amazing because they produce an undeniable truth when confronted with images as stark as this. The fact that the problem of recruiting, training and retaining healthcare workers has been lost in the overall international development picture. There is little hope to make a real tangible difference to health outcomes in international development without a significant focus on health workers. In my own opinion this should be a core component of any MDG replacements post 2015.

Fortunately there are some organizations working on this problem (but no nearly enough). Combining the need for health workers with an MDG target, skilled birth attendants to combat maternal mortality for example, can allow organisations to secure funding. The UN Population Fund considers skilled birth attendants “the single most critical intervention for securing safe motherhood”.

[youtube=http://www.youtube.com/watch?v=hFcqSs5NK1Y]

However simply training healthcare workers is not enough. The provision and support of healthcare workers needs to be sustainable, with lasting funding. The Tropical Health Education Trust (THET) here in the UK does some amazing  work in promoting links between institutions to encourage the exchagne of knowledge and experience in order to train more healthcare workers. More organisations simply arrange to send doctors or nurses overseas for short periods of time, to help with a particular issue. Although this has some value, it is automatically limited as it is not sustainable.

Many high income countries are also guilty of ‘stealing’ workers from low income countries. This ‘brain drain’ is a problem, but it should not be solved by restricting workers freedom of movement, but by supporting, nurturing and paying healthcare workers well enough to be able to stay where they are most needed.

From an interesting World Bank Publication.

 

Merlin, the health NGO, has an excellent campaign supporting health workers called “Hand Up for Health Workers” to try and recruit and train more healthcare workers for where they are needed. So please go and sign their petition!

[youtube=http://www.youtube.com/embed/9UbPSJCHgLE]

The brain drain must end, and doctors, nurses and other health professionals working in the places where they are most needed must be supported, paid, safe and well trained. This should be enshrined in international policy, and should be essential in any MDG replacement framework.

What’s your experience?

Tim

[email protected]

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Youth, Ideas and Innovation – the Future of the MDGs.

July 18, 2011 in International Development, MDGs, Young Professionals, Youth

“Our generation has made a mess of it… the future is in your hands”

Christian du Duve, Scientific American, 3rd July 2011

At the moment it seems to be ideas season, with various conferences and awards taking place to highlight work being undertaken in global health and international development and to consider where the future might be. From the point of view of Generation Development, I am concerned with how these innovations could be translated into international development policy

Grand Challenges Canada recently announced its awards of $2million to what it views as the ‘rising stars’ of global health in Canada. I can highly recommend you check out the videos of the Round 1 grantees on their website. These innovative projects range from wind up fetal heart monitors, an astonishing paper based diagnostic system using bacteriophages instead of antibodies to using tattoo equipment to deliver cutaneous drugs against leishmaniasis, social networking to reduce the spread of HIV in gay men in Ghana, and the development of a free online university to train health workers. These are all inspirational ideas, however is it more important to pick specific interventions around which to form policy, or should international development policy be designed to simply to foster this kind of innovation?

The question remains – what are other countries doing to promote, foster and support young professionals in developing innovative solutions to global health problems. From Generation Development’s point of view we would like to hear from our network how you think this can be encouraged in other countries. Is there a role in a supportive international development policy framework to encourage innovators in both the global north and the global south, and how can this be achieved?

Romain Murenzi, the new director of TWAS (Academy of Sciences for the Developing World), certainly seems to think so in an article published in Nature recently. He talks particularly about an increase in the number of South-North fellowship programmes available for scientists working in low and middle-income countries. However he also rightly points out that science opportunities need to be increased, as does the amount of funding available to support young scientists. Is there a role for this in a post-2015 framework?

Similar topics were covered at the Lindau Nobel Meeting on the future of global health which produced this interesting video talking about how to encourage young African researchers to tackle global health problems:

[youtube=http://www.youtube.com/watch?v=Guqa9skMIiU]

Also covered at the meeting was the issue of population control, and it’s impact on global demographics. Is it going to be population increase, or decline that will cause the greatest problems? Indeed, should population control feature in any MDG replacements? The meeting covered a wide range of topics, including a large section on economics, that can be viewed here and makes for some interesting reading.

But where does that leave us Generation Development people? We are looking at what should replace the MDGs, and ideas are coming at us thick and fast. How do we decide the best way forwards? Should an international development policy environment target specific diseases (malaria for example), or foster research no matter what the disease (funding universities for example), aim for population control, or foster poverty relief through economic policy. I look forward to hearing your views!

Tim

[email protected]

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The Lancet Announcement

July 18, 2011 in International Development, MDGs

The founding of Generation Development (The MDG15 Young Professionals Forum) was originally announced in The Lancet, and the article can be read here.

The announcement founding Generation Development

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An introduction to Generation Development

July 18, 2011 in Economics, International Development, MDGs

Hello and welcome to the first blog of Generation Development! We are incredibly excited about the prospects of mobilising young people and young professionals the whole world over in answering one basic, simple question:

What development agenda should replace the Millennium Development Goals (MDGs) in 2015?

To begin with, we need to know what these goals are, how and why they were created, and what problems there have been with their implementation.

Background to the MDGs

The MDGs were formed in 2000 from a long line of development goal setting, from the Universal Declaration of Human Rights in 1948 to repeated UN Summits on poverty, food and other global issues in the latter half of the 20th century. They include 8 specific development targets across a broad range of social issues including poverty, education, gender, health, environment and international partnerships for development.

It has been suggested the goals mixed a combination of between economic ideology that promotes free trade and markets, and a development approach favoured by wealthy countries and international institutions. Though they can be commended for ushering a new era of support and awareness of the need for global development strategies, there remains still a lack of progress in reaching them after over 10 years.

Many criticisms could be made of why poverty and a lack of basic human needs exist despite the impressive goals agreed on in the MDG framework. A lack of funds, insufficient awareness of the goals at local levels, impossible goals considering local social and political contexts; all of these and more could be levelled at the MDGs’ authors and should be taken into account in any future development framework.

What we are concerned about most though is the extent of grassroots participation in international development goal-setting. For all the talk of global consensus in the MDG framework, we can see now that the priorities of the MDGs were reflections of specific development ideas or campaigns from the 1980s and 1990s. The MDGs were never a bottom-up process of agreeing development needs between different communities and sectors. A grassroots approach to international development strategies then is yet to be realised.

Enter Generation Development!

Our quest to find new ideas for the future of development from young professionals was borne out of a workshop at a student global health conference in November 2010. Participants argued persuasively, over and above the need for improved global frameworks, for the creation of a global forum that seeks the opinions of young professionals of the global South and North to inform future development goal-setting. We created the forum in November 2010 to create a sustainable and inclusive movement that does just this. Our dream was that through discussion, debate and the creation of new and innovative ideas from young people themselves, we could advocate for a new agenda for international development from our political leaders.

Get Involved!

We are now looking for enthusiastic and committed people from all around the world to take Generation Development to the next level. Interested? Then check out our recruitment page for more details.

In the meantime we are starting to assemble the people and materials needed to reach out to young professionals in order to find out their ideas for development. Join our mailing list, follow us on Facebook or Twitter to keep updated and keep visiting our website to keep track of our progress!

Above all, the future of international development policy is entirely in your hands. Join Generation Development to support a new movement of young professionals in creating a bottom-up, effective and sustainable new model for development.

Jonny, Tim, Fraser and the Generation Development team

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