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.
Poverty and health
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.
A new report by Transparency International (TI) has lashed out at some of the world's poorest countries for an ‘ongoing humanitarian disaster’, and deplored the wealthiest for not doing enough to help. At the launch of their 2008 Corruption Perceptions Index (CPI) on 23 September in Berlin, TI said: ‘In the poorest countries, corruption levels can mean the difference between life and death, when money for hospitals or clean water is in play, but even in more privileged countries, with enforcement disturbingly uneven, a tougher approach to tackling corruption is needed.’ The 2008 CPI is a composite index, drawing on different expert and business surveys. It scores 180 countries (the same number as in 2007) on a scale from 0 (highly corrupt) to 10 (very clean). Denmark, New Zealand and Sweden share the highest score at 9.3, followed immediately by Singapore at 9.2. Bringing up the rear is Somalia at 1, slightly trailing Iraq and Burma at 1.3 and Haiti at 1.4.
As care and antiretroviral treatment (ART) for people living with HIV become widely available, the number of people accessing these resources also increases. Despite this exceptional progress, the estimated coverage in low- and middle-income countries is still less than half of all people who need treatment. In addition, treatment discontinuation and non-adherence are still concerns for ART programs. This study assessed the costs of a program providing food assistance to patients with HIV in Sofala province, Mozambique, in 2009. The authors performed a retrospective analysis of the costs of providing food assistance, based on financial and economic costs. The food distribution program was found to carry significant costs at $288 per patient over 3 months. To assess whether it provides value for money, the study results should be interpreted in conjunction with the program’s impact, and in comparison with other programs that aim to improve adherence to ART. The authors' costing analysis also revealed important management information, indicating that the program incurred relatively large overhead costs.
Coronavirus has increased demand for and consumption of water in households. At the same time this presents Water scarcity presents a challenge for women in rural areas and informal settlements. Rural women walk up to 30 kilometres to fetch water from rivers, dams and boreholes. This may mean that some rural family members minimise use of the water; exposing them to health risks. Urban slum women now spend up to an extra Kenya Sh120 daily on water, and those that can't afford to buy are reported to resort to the polluted city river. This article highlights the experiences of women in rural and urban Kenya in gathering water needed for their work and families in light of COVID-19. It illustrates the lived experience of additional burdens that the pandemic now places on them, affecting their livelihoods and their physical and mental wellbeing.
Cultivating Unemployment takes a hard look at the realities of rural economies in South Africa and begins to grapple with the policy implications of these realities. The video shows the challenges and difficulties involved in creating rural economies that can multiply benefits for rural dwellers.
Imbawula Trust, a Johannesburg based cultural association says culture has a great role to play in the fight of Africa’s poverty. They said the African continent had great potential to develop if citizens were inspired by their cultural and social customs which are 'vital in the development of peoples mental and social stability'.
Before his death in April 2012, Malawi's former president Bingu wa Mutharika resisted calls by the International Monetary Fund (IMF) to devalue the Malawian kwacha as a way to boost exports, arguing that poor people would be negatively impacted. His decision alienated external funders, who withdrew support. Malawi's new president, Joyce Banda, has moved quickly to restore relations with funders, in part by meeting the IMF's conditions for a support package. On 7 May 2012, she devalued the kwacha by nearly 50% and untied the currency from the dollar. External funders have started responding, with the World Bank reportedly working on a package to help poor Malawians cope with the effects of devaluation and the United Kingdom (UK) agreeing to unlock aid frozen in 2011. The UK's International Department for International Development (DFID) are reported to have pledged to release an initial £30 million (US$47.3 million) tranche of urgent funding, of which £10 million ($15.8 million) will be used to support Malawi's healthcare system, and £20 million will go to towards stabilising the economy. The implications for household poverty of the measures funded are as yet not reported.
Considering the high levels of chronic poverty in the Southern Africa region, and the ongoing impact of HIV/AIDS, safety net programmes will be required to support the poorest in the community over the long term. Cash-based transfers to supplement income are likely to be the most efficient and appropriate means of doing this, though in-kind safety nets, such as vouchers for education or health costs, or for subsidised agricultural inputs, will also be suitable in some circumstances.
This paper contributes to a nascent scholarly discussion of sex and gender as determinants of health. Health is a composite of biological makeup and socioeconomic circumstances. Differences in health and illness patterns of men and women are attributable both to sex, or biology, and to gender, that is, social factors such as powerlessness, access to resources, and constrained roles. Using examples such as the greater life expectancy of women in most of the world, despite their relative social disadvantage, and the disproportionate risk of myocardial infarction amongst men, but death from MI amongst women, the independent and combined associations of sex and gender on health are explored. A model for incorporating gender into epidemiologic analyses is proposed.