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Available evidence suggests that poverty levels in Guatemala are higher than other Central American countries, with data for 2000 showing over half of all Guatemalans (about 6.4 million people) living in poverty, with about 16 per cent classified as living in extreme poverty. This report provides a multi-dimensional analysis of poverty in the country, using both quantitative and qualitative data, as well as examining the impact of government policies and spending on the poor. Policy options and priorities for poverty reduction strategies are identified under the key challenges of building opportunities and assets, reducing vulnerabilities, improving institutions and empowering communities.
"The prevalence of child undernutrition in India is among the highest in the world, nearly double that of Sub-Saharan Africa, with dire consequences for morbidity, mortality, productivity and economic growth. Drawing on qualitative studies and quantitative evidence from large household surveys, this book explores the dimensions of child undernutrition in India and examines the effectiveness of the Integrated Child Development Services (ICDS)program, India's main early child development intervention, in addressing it. Although levels of undernutrition in India declined modestly during the 1990s, the reductions lagged behind those achieved by other countries with similar economic growth. Nutritional inequalities across different states and socioeconomic and demographic groups remain large. Although the ICDS program appears to be well-designed and well-placed to address the multi-dimensional causes of malnutrition in India, several problems exist that prevent it from reaching its potential. The book concludes with a discussion of a number of concrete actions that can be taken to bridge the gap between the policy intentions of ICDS and its actual implementation."
Indigenous people constitute a large portion of Latin America's population and suffer from severe and widespread poverty. They are more likely than any other groups of a country's population to be poor. This study documents their socioeconomic situation and shows how it can be improved through changes in policy-influenced variables such as education. The authors review the literature of indigenous people around the world and provide a statistical overview of those in Latin America. Case studies profile the indigenous populations in Bolivia, Guatemala, Mexico and Peru, examining their distribution, education, income, labour force participation and differences in gender roles. A final chapter presents recommendations for conducting future research.
It has been more than 20 years since Brazil's 1988 Constitution formally established the Unified Health System (Sistema Unico de Saude, SUS). Building on reforms that started in the 1980s, the SUS represented a significant break with the past, establishing health care as a fundamental right and duty of the state and initiating a process of fundamentally transforming Brazil's health system to achieve this goal. This report aims to answer two main questions. First is have the SUS reforms transformed the health system as envisaged 20 years ago? Second, have the reforms led to improvements with regard to access to services, financial protection, and health outcomes? In addressing these questions, the report revisits ground covered in previous assessments, but also brings to bear additional or more recent data and places Brazil's health system in an international context. The report shows that the health system reforms can be credited with significant achievements. The report points to some promising directions for health system reforms that will allow Brazil to continue building on the achievements made to date. Although it is possible to reach some broad conclusions, there are many gaps and caveats in the story. A secondary aim of the report is to consider how some of these gaps can be filled through improved monitoring of health system performance and future research. The introduction presents a short review of the history of the SUS, describes the core principles that underpinned the reform, and offers a brief description of the evaluation framework used in the report. Chapter two presents findings on the extent to which the SUS reforms have transformed the health system, focusing on delivery, financing, and governance. Chapter three asks whether the reforms have resulted in improved outcomes with regard to access to services, financial protection, quality, health outcomes, and efficiency. The con
Ending poverty and stabilizing climate change will be two unprecedented global achievements and two major steps toward sustainable development. But the two objectives cannot be considered in isolation: they need to be jointly tackled through an integrated strategy. This report brings together those two objectives and explores how they can more easily be achieved if considered together. It examines the potential impact of climate change and climate policies on poverty reduction. It also provides guidance on how to create a “win-win†? situation so that climate change policies contribute to poverty reduction and poverty-reduction policies contribute to climate change mitigation and resilience building. The key finding of the report is that climate change represents a significant obstacle to the sustained eradication of poverty, but future impacts on poverty are determined by policy choices: rapid, inclusive, and climate-informed development can prevent most short-term impacts whereas immediate pro-poor, emissions-reduction policies can drastically limit long-term ones.
Privatization and the New Medical Pluralism is the first collection of its kind to explore the contemporary terrain of healthcare in Guatemala through reflective ethnography. This volume offers a nuanced portrait of the effects of healthcare privatization for indigenous Maya people, who have historically endured numerous disparities in health and healthcare access. The collection provides an updated understanding of medical pluralism, which concerns not only the tensions and exchanges between ethnomedicine and biomedicine that have historically shaped Maya people’s experiences of health, but also the multiple competing biomedical institutions that have emerged in a highly privatized, market-driven environment of care. The contributors examine the macro-structural and micro-level implications of the proliferation of non-governmental organizations, private fee-for-service clinics, and new pharmaceuticals against the backdrop of a deteriorating public health system. In this environment, health seekers encounter new challenges and opportunities, relationships between the public, private, and civil sectors transform, and new forms of inequality in access to healthcare abound. This volume connects these themes to critical studies of global and public health, exposing the strictures and apertures of healthcare privatization for marginalized populations in Guatemala.
Since 1965 the foreign-born population of the United States has swelled from 9.6 million or 5 percent of the population to 45 million or 14 percent in 2015. Today, about one-quarter of the U.S. population consists of immigrants or the children of immigrants. Given the sizable representation of immigrants in the U.S. population, their health is a major influence on the health of the population as a whole. On average, immigrants are healthier than native-born Americans. Yet, immigrants also are subject to the systematic marginalization and discrimination that often lead to the creation of health disparities. To explore the link between immigration and health disparities, the Roundtable on the Promotion of Health Equity held a workshop in Oakland, California, on November 28, 2017. This summary of that workshop highlights the presentations and discussions of the workshop.
Workers' remittances have become a major source of financing for developing countries and are especially important in Latin America and the Caribbean, which is at the top of the ranking of remittance receiving regions in the world. While there has been a recent surge in analytical work on the topic, this book is motivated by the large heterogeneity in migration and remittance patterns across countries and regions, and by the fact that existing evidence for Latin America and the Caribbean is restricted to only a few countries, such as Mexico and El Salvador. Because the nature of the phenomenon varies across countries, its development impact and policy implications are also likely to differ in ways that are still largely unknown. This book helps fill the gap by exploring, in the specific context of Latin America and Caribbean countries, some of the main questions faced by policymakers when trying to respond to increasing remittances flows. The book relies on cross-country panel data and household surveys for 11 Latin American countries to explore the development impact of remittance flows along several dimensions: growth, poverty, inequality, schooling, health, labor supply, financial development, and real exchange rates.
In response to a request by President Barak Obama on November 24, 2010, the Presidential Commission for the Study of Bioethical Issues oversaw a thorough fact-finding investigation into the specifics of the U.S. Public Health Service-led studies in Guatemala involving the intentional exposure and infection of vulnerable populations. Following a nine-month intensive investigation, the Commission has concluded that the Guatemala experiments involved gross violations of ethics as judged against both the standards of today and the researchers' own understanding of applicable contemporaneous practices. It is the Commission's firm belief that many of the actions undertaken in Guatemala were especially egregious moral wrongs because many of the individuals involved held positions of public institutional responsibility. The best thing we can do as a country when faced with a dark chapter is to bring it to light. The Commission has worked hard to provide an unvarnished ethical analysis to both honor the victims and make sure events such as these never happen again.
This edition of the biennial Poverty and Shared Prosperity report brings sobering news. The COVID-19 (coronavirus) pandemic and its associated economic crisis, compounded by the effects of armed conflict and climate change, are reversing hard-won gains in poverty reduction and shared prosperity. The fight to end poverty has suffered its worst setback in decades after more than 20 years of progress. The goal of ending extreme poverty by 2030, already at risk before the pandemic, is now beyond reach in the absence of swift, significant, and sustained action, and the objective of advancing shared prosperity—raising the incomes of the poorest 40 percent in each country—will be much more difficult. Poverty and Shared Prosperity 2020: Reversals of Fortune presents new estimates of COVID-19's impacts on global poverty and shared prosperity. Harnessing fresh data from frontline surveys and economic simulations, it shows that pandemic-related job losses and deprivation worldwide are hitting already poor and vulnerable people hard, while also shifting the profile of global poverty to include millions of 'new poor.' Original analysis included in the report shows that the new poor are more urban, better educated, and less likely to work in agriculture than those living in extreme poverty before COVID-19. It also gives new estimates of the impact of conflict and climate change, and how they overlap. These results are important for targeting policies to safeguard lives and livelihoods. It shows how some countries are acting to reverse the crisis, protect those most vulnerable, and promote a resilient recovery. These findings call for urgent action. If the global response fails the world's poorest and most vulnerable people now, the losses they have experienced to date will be minimal compared with what lies ahead. Success over the long term will require much more than stopping COVID-19. As efforts to curb the disease and its economic fallout intensify, the interrupted development agenda in low- and middle-income countries must be put back on track. Recovering from today's reversals of fortune requires tackling the economic crisis unleashed by COVID-19 with a commitment proportional to the crisis itself. In doing so, countries can also plant the seeds for dealing with the long-term development challenges of promoting inclusive growth, capital accumulation, and risk prevention—particularly the risks of conflict and climate change.