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In 1997 the committee published Reproductive Health in Developing Countries: Expanding Dimensions, Building Solutions, a report that recommended actions to improve reproductive health for women around the world. As a follow- on activity, the committee proposed an investigation into the social and economic consequences of maternal morbidity and mortality. With funding from the William and Flora Hewlett Foundation, the Andrew W. Mellon Foundation, and the U.S. Agency for International Development, the committee organized a workshop on this topic in Washington, DC, on October 19-20, 1998. The Consequences of Maternal Morbidity and Maternal Mortality assesses the scientific knowledge about the consequences of maternal morbidity and mortality and discusses key findings from recent research. Although the existing research on this topic is scarce, the report drew on similar literature on the consequences of adult disease and death, especially the growing literature on the socioeconomic consequences of AIDS, to look at potential consequences from maternal disability and death.
Because of the HIV/AIDS epidemic, Sub-Saharan African populations are challenged with increasing adult mortality rates that have potentially profound economic implications. Yet, little is known about the impact of adult deaths in African households. Using panel data from Tanzania, Beegle explores how prime-age adult mortality affects the time allocation of surviving household members and the portfolio of household farming activities. The author analyzes farm and chore hours across demographic groups and finds small and insignificant changes in labor supply of individuals in households experiencing a prime-age adult death. While some farm activities are temporarily scaled back and wage employment falls after a male death, households did not shift cultivation toward subsistence food farming and did not appear to have reduced their diversification over income sources more than six months after a death.This paper - a product of the Poverty Team, Development Research Group - is part of a larger effort in the group to better measure and understand the economic impact of HIV/AIDS.
The evaluation of reproductive, maternal, newborn, and child health (RMNCH) by the Disease Control Priorities, Third Edition (DCP3) focuses on maternal conditions, childhood illness, and malnutrition. Specifically, the chapters address acute illness and undernutrition in children, principally under age 5. It also covers maternal mortality, morbidity, stillbirth, and influences to pregnancy and pre-pregnancy. Volume 3 focuses on developments since the publication of DCP2 and will also include the transition to older childhood, in particular, the overlap and commonality with the child development volume. The DCP3 evaluation of these conditions produced three key findings: 1. There is significant difficulty in measuring the burden of key conditions such as unintended pregnancy, unsafe abortion, nonsexually transmitted infections, infertility, and violence against women. 2. Investments in the continuum of care can have significant returns for improved and equitable access, health, poverty, and health systems. 3. There is a large difference in how RMNCH conditions affect different income groups; investments in RMNCH can lessen the disparity in terms of both health and financial risk.
The debate on fiscal policy in Europe centers on how to let automatic stabilizers work while achieving fiscal consolidation. There is significant agreement on the importance of using fiscal policy as a counter-cyclical instrument, as monetary policy can no longer play this role. In contrast, most of the discussion on fiscal policy in Latin America and the Carribean region (LAC) deals just on solvency issues, largely ignoring the effects of the economic cycle. This is surprising as LAC economies are much more volatile than their European counterparts and have been generally applying pro-cyclical fiscal policies that exacerbate volatility. Some analysts and policymakers appear to think that counter-cyclical fiscal policies are a luxury that only industrial countries can indulge in or, at least, that LAC countries (with the exception of Chile) that have successfully put in place a counter-cyclical fiscal policy need to deal first with pressing adjustment and solvency issues before they attempt to reduce the highly pro-cyclical character of their fiscal policies. The author argues that this is a major mistake because the costs of pro-cyclical fiscal policies in LAC are huge in growth and welfare terms, especially for the poor, and because pro-cyclical policies and rules tend to develop a deficit bias, thus ending up being nonsustainable and noncredible. Perry illustrates both propositions. He then examines the causes of the pro-cyclicality of fiscal policies in LAC and discusses how well-designed fiscal rules may help to deal with the political economy and credibility factors behind pro-cyclicality. He also examines conflicts between flexibility and credibility in rules, showing how a good design can both facilitate the operation of automatic stabilizers while at the same time supporting solvency goals and enhancing credibility. Perry evaluates the experience with different fiscal rules and institutions in LAC to see the extent they have helped or can help to achieve the twin goals of avoiding deficit and pro-cyclical biases.
In 1986 Vietnam initiated a transition from a centrally planned economy to a market-oriented economy where the government would keep playing a leading role. These renovation (doi moi) policies were successful at generating economic growth and reducing poverty. In the ten-year socioeconomic strategy endorsed by the Ninth Party Congress in April 2001, the authorities further articulated their development objectives in terms of economic growth and poverty reduction. To reach these objectives, the government indicated that its structural reform priorities were to change Vietnam's trade and financial policies, liberalize the climate for private investment, increase the efficiency of public enterprises, and improve governance. The author argues that the pace of implementation of trade reform-which has been impressive so far-is raising new challenges. On one side, fast liberalization of trade reform may soon conflict with the slow pace of implementation of other reforms, including restructuring of state-owned enterprises and state-owned commercial banks. On the other side, Vietnam would greatly benefit from fast implementation of trade reform and particularly fast accession to the World Trade Organization (WTO), especially after China's recent WTO accession. Auffret concludes that implementation of trade reform will be a testing ground to reveal the extent of Vietnam's commitment to a market-oriented economy.
Citizen feedback is considered an effective means for improving the performance of public utilities. But how well does such information reflect the actual quality of service delivery? Do so-called scorecards or report cards measure public service delivery accurately, or do personal and community characteristics have a significant impact on residents' assessment of service quality? Deichmann and Lall investigate these questions using newly available household survey data on access to and satisfaction with selected public services in two Indian cities-Bangalore and Jaipur. They develop a framework where actual levels of services received, as well as expectations about service performance, influence a household's satisfaction with service delivery. The authors find that satisfaction increases with improvements in the household's own service status, a finding that supports the use of scorecard initiatives. But the results also suggest that a household's satisfaction is influenced by how service quality compares with that of its neighbors or peers and by household level characteristics such as welfare and tenure status. This implies that responses in satisfaction surveys are at least in part determined by factors that are unrelated to the service performance experienced by the household.
How does economic geography influence industrial production and thereby affect industrial location decisions and the spatial distribution of development? For manufacturing industry, what are the externalities that matter, and to what extent? Are these externalities spatially localized? The authors answer these questions by analyzing the influence of economic geography on the cost structure of manufacturing firms by firm size for eight industry sectors in India. The economic geography factors include market access and local and urban externalities-which are concentrations of own-industry firms, concentrations of buyer-supplier links, and industrial diversity at the district (local) level. The authors find that industrial diversity is the only economic geography variable that has a significant, consistent, and substantial cost-reducing effect for firms, particularly small firms. This finding calls into question the fundamental assumptions regarding localization economies and raises further concerns on the industrial development prospects of lagging regions in developing countries.
The authors present an empirical analysis of intergenerational links in nonfarm participation with a focus on gender effects. Using survey data from Nepal, the evidence shows that the mother exerts a strong influence on a daughter's employment choice. Having a mother in a nonfarm sector raises a daughter's probability of nonfarm participation by 200 percent. The effects are truly dramatic for skilled nonfarm jobs. Having a mother in a skilled job raises a daughter's probability by 1,200 percent. Having a father in a nonfarm sector, on the other hand, does not have any significant effect on a son's probability of nonfarm participation when the endogeneity of education and assets is corrected for by the two-stage conditional maximum likelihood approach. But a moderate positive intergenerational correlation between fathers and sons exists for skilled jobs.
The Argentine crisis has been variously blamed on fiscal imbalances, real overvaluation, and self-fulfilling investor pessimism triggering a capital flow reversal. The authors provide an encompassing assessment of the role of these and other ingredients in the recent macroeconomic collapse. They show that in the final years of convertibility, Argentina was not hit harder than other emerging markets in Latin America and elsewhere by global terms-of-trade and financial disturbances. So the crisis reflects primarily the high vulnerability to disturbances built into Argentina's policy framework. Three key sources of vulnerability are examined: the hard peg adopted against optimal currency area considerations in a context of wage and price inflexibility; the fragile fiscal position resulting from an expansionary stance in the boom; and the pervasive mismatches in the portfolios of banks' borrowers. While there were important vulnerabilities in each of these areas, neither of them was higher than those affecting other countries in the region, and thus there is not one obvious suspect. But the three reinforced each other in such a perverse way that taken jointly they led to a much larger vulnerability to adverse external shocks than in any other country in the region. Underlying these vulnerabilities was a deep structural problem of the Argentine economy that led to harsh policy dilemmas before and after the crisis erupted. On the one hand, the Argentine trade structure made a peg to the dollar highly inconvenient from the point of view of the real economy. On the other hand, the strong preference of Argentinians for the dollar as a store of value-after the hyperinflation and confiscation experiences of the 1980s-had led to a highly dollarized economy in which a hard peg or even full dollarization seemed reasonable alternatives from a financial point of view.