Development that Works
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    This blog highlights effective ideas in the fight against poverty and exclusion, and analyzes the impact of development projects in Latin America and the Caribbean.
  • Tag: health

    Found 8 posts.

    Lessons from Honduras’ CTT program: conditionalities matter

    By - 3 de May de 2016, 7:00 am

    A successful strategy to reduce poverty in developing nations has been the use of conditional cash transfer (CCT) programs.

    CCTs attempt to reduce poverty while also changing behavior and building human capital by providing families with cash in exchange for certain requirements, such as enrolling their children in school.

    Source: Secretaria de Desarrollo e Inclusión Social del Gobierno de Honduras

    Image: Secretaria de Desarrollo e Inclusión Social del Gobierno de Honduras

    These incentives have been employed effectively to boost school enrollment and attendance, decrease child labor, and encourage the use of preventive health services.

    In Honduras, the Inter-American Development Bank (IDB) has been the main financial and technical partner of a CCT known as Bono Vida Mejor (formerly Bono 10,000).

    Since its inception in 2010, Bono Vida Mejor has benefited 350,000 households. It has contributed to reducing the poverty rate in Honduras and moderately improved school attendance and the rate of health clinic visits for children under 3. Read more…

    When Cholera Strikes: A Coordinated Emergency and Longer-Term Response

    By - 13 de October de 2015, 7:00 am

    by Meri Helleranta

    A rapid response and partnerships between the Haitian Government and key institutions, including the IDB, helped to curb the cholera epidemic, decreasing the number of new cases per week from 14,000 in January 2011 to fewer than 1,000 a year later.

    colera haiti cholera

    Image: IDB

    Five years ago, in October 2010, Haiti was hit by a serious  cholera epidemic. Coming only nine months after the traumatic earthquake, the fast-spreading diarrheal disease—with the ability to kill its victims in just 24 hours—prompted panic.  Within a month, there were over 11,000 confirmed cases and 180 casualties, and those numbers were growing exponentially. Read more…

    Enhanced Conditional Cash Transfers to Boost Health

    By - 30 de March de 2014, 10:51 am

    By Sandro Parodi

    The Dominican Republic Adjusts its Solidaridad  Program to Help the Poor

    Conditional cash transfers programs have proven over the years to be an effective tool to reduce poverty and inequality in the short term. The transfer program in the Dominican Republic introduced in 2005, known as Solidaridad, has had just such positive effects on health, improving the weight and height of children under five years old and helping to reduce teen pregnancies and the probability of young people repeating grades or dropping out of secondary school.

    The IDB has played a key role in supporting the design and implementation of the transfer program as well as other improvements to the Dominican Republic’s social safety net. The country has improved its targeting mechanisms, strengthened the compliance of beneficiaries with their co-responsibilities, enhanced the links between the supply of services and case management, and significantly increased investments to improve the quality of primary health care services.

    To further maximize the impact of Solidaridad, the government, with technical assistance from the IDB, moved in 2012 to consolidate the program with another social program called Progresando, which supports socio-educational interventions. The merger has enabled the conditional cash transfer program to adopt a more systematic approach to improving health education by expanding its geographical reach and boosting the number of case workers working regularly with families through monthly home visits. The ration of households per caseworker has decreased to 50 from 350 before the merge.

    Caseworkers help connect families to a wide range of government social services and also verify whether households are meeting their co-responsibilities, which include sending their children to school and taking them for regular health check-ups.

    The country has also added new features to the program, which is now known as Progresando con Solidaridad. These include helping young people in beneficiary households access job training, and improving the coverage and design of education co-responsibilities in order to encourage teens to stay in school. Monthly stipends have been extended to families in the program with children in school up to 21 years old, and the amount of the stipend is now pegged to grade levels—the more teens advance in secondary school, the greater the stipend their families receive from the program.

    In 2013, the IDB approved another loan to help the Dominican Republic expand the reach of Progresando con Solidaridad, which is now the pillar of the country’s social safety net. The loan will also finance an impact assessment of the revamped conditional cash transfer program to determine whether the recent changes are working. Besides benefiting the Dominican Republic, the findings will provide important lessons for other countries in the region seeking to maximize the development impact of similar programs.

    Findings of Early Childhood Programs in 19 Countries

    By - 29 de March de 2014, 10:38 am

    By Maria Caridad Araujo

    The quality of care and interaction during the first five years of life has a major impact on childhood development and is a critical determinant of a child’s future health, behavior, and intellectual abilities. In Latin America and the Caribbean, access to early childhood programs has increased over the past two decades, particularly for the poor, and preschool services are now available to 69 percent to the population, according to data from the United Nations.

    Despite the increased availability of services, however, no systematic information has been available until recently about these programs. Information is needed not only for policymakers to ensure that the quality of such services is acceptable and regulated, but also for parents themselves to be able to choose the daycare center that is the best fit for their children, close to their home or office, affordable, clean, and well run.

    To better understand the current situation and challenges, the IDB surveyed 42 programs that offer childcare or parenting services in 19 countries in Latin America and the Caribbean. The study mostly examined government programs, although it also looked at services run by civil society organizations and private entities, given their reach in certain regions. The resulting report published in 2013, Overview of Early Childhood Development Services, is the first systematic review of such programs in the region. It focuses on understanding program design, components, coverage, costs, and quality. Data was collected through in-depth interviews with the managers of the programs.

    According to the survey, there is a wide range of models currently in place in the region to serve children under age three. In the Andean countries, for example, community-based models have been established where a mother feeds and looks after groups of 8 to 10 children in her own home and is paid by the government (and in some cases by parents). By contrast, in the Southern Cone, services operate largely through formal institutions where children are grouped by age and are cared for by professional educators.

    Early Childcare – The Numbers

    Main Findings

    The study points to the need for early childhood program to increase hiring of qualified professionals and decrease the child–to–adult ratio, a key determinant of quality. In the region, daycare services average six children per caregiver for children under one year of age. That’s double the recommended rate for children in that age group. The region average ratios are also higher than the optimal rates for other age groups.

    More training and better pay is necessary to improve the quality of care. According to the survey, staff are underpaid, and their rudimentary educational credentials and competencies in early childhood development are well below the levels required for such programs. On average, early childhood teachers have completed only 2.6 years of post-secondary education, teaching assistants have barely finished high school, and caregivers have only 10 full years of education, meaning they have not finished high school. To attract qualified professionals, programs should offer competitive salaries and increase training, mentoring, and supervision of staff with low levels of education.

    Increased monitoring of services is needed. Only 44 percent of daycare centers are regularly monitored on matters of safety and hygiene. Since the immune system of young children is still in development, hygiene and security issues pose particular risks for them. The study recommends that countries establish institutional arrangements in which quality standards are defined for the operation of childcare centers. It also recommends that systematic monitoring be put in place for government programs and for private programs.

    Developmental Challenges Faced by Small Children in LAC

    Nutritional services can be channeled through childcare centers. Many countries of the region still face significant challenges in terms of providing adequate nutrition for children up to five years old. Childcare services can do more to ensure that children get the foods and micronutrients they need and have access to growth monitoring, and that families receive nutritional counseling.

    Finally, the findings show that a significant improvement in the quality of childcare services is impossible without a significant budget commitment by the countries to make it happen. There may not be much short-term political gain for authorities to make such a commitment, but the investment is critical to ensure better prospects for children who are the most vulnerable.

    Combating Tropical Diseases with Early Detection and Treatment

    By - 27 de March de 2014, 9:48 am

    By Ignez Tristão

    In the shantytown of Alto do Carroceiro in Recife, Brazil’s fifth largest city, 10-year old Emily Eduarda Belo de Oliveira dreams of one day becoming a teacher, even as she helps her mom take care of four other siblings in their one-bedroom, windowless home. And being poor is not Emily’s only hurdle: she also has leprosy, a disease that, if left untreated, can cause permanent damage to the skin, nerves, limbs and eyes.

    Emily is one of the 100 million people in Latin America and the Caribbean affected by a group of neglected tropical diseases that includes leprosy, elephantiasis, blinding trachoma, and intestinal parasites. This diverse group of infections thrives in conditions of poverty, poor sanitation, unsafe water, and malnutrition.

    The diseases carry a social stigma and rob years of productive life. One of the biggest challenges in overcoming them is to identify them early enough so treatment can begin before their debilitating impact. Diagnosis in public health systems often comes too late because providers are not trained to detect these diseases and their symptoms.

    As a result, in 2010, the IDB joined forces with the Pan American Health Organization and the SABIN Vaccine Institute to launch several demonstration projects in Latin America and the Caribbean to test ways to combat neglected tropical diseases on a regional level. These projects support educational campaigns, community mobilization, and integrated health interventions to identify and treat the diseases. Demonstration projects are currently taking place in Recife, Georgetown, Guyana, Chiapas, Mexico, and in Guatemala and Haiti.


    In Brazil, where 34,000 new cases of leprosy were detected in 2011–the second highest rate of new infections in the world after India–the project supported an education campaign in public schools in impoverished areas of Recife to increase self-reporting and diagnoses of leprosy, elephantiasis, soil-transmitted helminthiasis, and schistosomiasis.

    That was how Emily found out she had the disease. After health educators made a presentation in her school, she realized that a lesion in her leg could be an early sign of leprosy. She filled out a sheet where she carefully described her lesion. Such self-detection forms have made the screening process for potential cases easier for health agents, and in Emily’s case it led to her getting tested for the disease and starting treatment. The methodology has been so successful that the leprosy self-detection form is now being used nationwide.

    Educational campaigns and community mobilization activities have directly benefited more than 17,000 students from 6 to 14 years old in three municipalities of Recife, and have indirectly benefited some 70,000 others. Students in 42 public schools are receiving medications to reduce the prevalence of intestinal parasites.

    With integrated health actions such as that being carried out in Recife, controlling and eliminating neglected tropical diseases in Latin America and the Caribbean is achievable. That means more children like Emily will be able to detect and treat these types of diseases early and go on to have normal and productive lives.

    Key Facts about Neglected Tropical Diseases

    • Over a billion of the world‘s poorest people are affected by such diseases
    • The effects of the diseases are measured in terms of healthy years of life lost as a result of either disability or premature death
    • More people are at risk of neglected tropical diseases than tuberculosis, malaria, and HIV combined
    • Treating most of these diseases is safe, inexpensive, and easy. Many of the medicines needed to treat them are donated by pharmaceutical companies.