Are the debates on water privatization missing the point? Experiences from Africa, Asia and Latin America

This paper has two principal aims: first, to unravel some of the arguments mobilized in the controversial privatization debate, and second, to review the scale and nature of private sector provision of water and sanitation in Africa, Asia and Latin America. Despite being vigorously promoted in the policy arena and having been implemented in several countries in the South in the 1990s, privatization has achieved neither the scale nor benefits anticipated. In particular, the paper is pessimistic about the role that privatization can play in achieving the Millennium Development Goals of halving the number of people without access to water and sanitation by 2015. This is not because of some inherent contradiction between private profits and the public good, but because neither publicly nor privately operated utilities are well suited to serving the majority of low-income households with inadequate water and sanitation, and because many of the barriers to service provision in poor settlements can persist whether water and sanitation utilities are publicly or privately operated. This is not to say that well-governed localities should not choose to involve private companies in water and sanitation provision, but it does imply that there is no justification for international agencies and agreements to actively promote greater private sector participation on the grounds that it can significantly reduce deficiencies in water and sanitation services in the South.

India’s disappearing common lands: fuzzy boundaries, encroachment, and evolving property rights

Opportunistic land encroachment occurs in many low-income countries, gradually yet pervasively, until discrete areas of common land disappear. This paper, motivated by field observations in Karnataka, India, demonstrates that such an evolution of property rights from common to private may be efficient when the boundaries between common and private land are poorly defined, or ‘‘fuzzy.’’ Using a multi-period optimization model, and introducing the concept of stock and flow enforcement, I show how effectiveness of enforcement effort, whether encroachment is reversible, and punitive fines, influence whether an area of common land is fully defined and protected or gradually or rapidly encroached.

A review of the spatial economics of non-timber forest product extraction: implications for policy

Patterns of forest cover and forest degradation determine the size and types of ecosystem services forests provide. Particularly in low-income countries, nontimber forest product (NTFP) extraction by rural people, which provides important resources and income to the rural poor, contributes to the level and pattern of forest degradation. Although recent policy, particularly in Africa, emphasizes forest degradation, relatively little research describes the spatial aspects of NTFP collection that lead to spatial degradation patterns. This paper reviews both the spatial empirical work on NTFP extraction and related forest degradation patterns, and spatial models of behavior of rural people who extract NTFPs from forest. Despite the impact of rural people's behavior on resulting quantities and patterns of forest resources, spatial–temporal models/patterns rarely inform park siting and sizing decisions, econometric assessments of park effectiveness, development projects to support conservation, or REDD protocols. Using the literature review as a lens, we discuss the models' implications for these policies with particular emphasis on effective conservation spending and leakage.

Mapping the trickle out benefits of social and environmental enterprises: a pilot study of an East African eco business

• Objectives The objective of this paper is to propose a framework for mapping the sustainable development and poverty alleviation impacts of social and environmental enterprises in Africa. This framework is then piloted with reference to an East African Ecobusiness. • Prior Work This paper is based on data collected as part of a wider research project examining social and environmental enterprises across the 19 countries of Southern and Eastern Africa. In total, the sustainable development and poverty alleviation impacts of 20 in-depth case studies in 4 countries are being examined. • Approach Data was collected using in-depth interviews with multiple stakeholders associated with the case study business. Secondary materials were also analysed and a quantitative survey of customers undertaken. • Results In addition to their impacts on the environment, African eco businesses can also have substantial social, economic and wider poverty alleviation impacts. This paper maps the impacts of a case study East African ecobusiness, as part of developing a social and environmental enterprise impact framework for Africa and the wider developing world. In our case study, positive and negative impacts are identified, while questions are raised in relation to tradeoffs between social and environmental objectives and temporal dimensions of impact. The usefulness of existing frameworks for understanding the social, environmental and development impacts of these kinds of organisations are also considered. • Implications This paper outlines the necessity of building an African-centric impact map to capture the multi-level poverty alleviation and sustainable development impacts of social and environmental enterprise activity in developing world environments. The framework proposed also offers guidance to businesses operating in Africa about the factors that might be considered as part of their wider social and environmental responsibilities. • Value Assessing the impact of social and environmental enterprises, especially as a route to development within low income countries, is receiving increasing attention in academia and beyond. This paper presents a useful contribution to the scarce literature on social and environmental enterprises in Africa.

Reaching the underbanked and unbanked in subsistence markets at the nexus of the formal and informal economy

It is estimated that globally over 2 billion people do not have a bank account, with many more in the developed and developing worlds ‘under-banked’, meaning they have limited access to financial services. Reaching the unbanked and underbanked with appropriate financial services is widely recognised as critical for future global economic growth and prosperity. Drawing upon multidimensional understandings of poverty, and framed by literature on poverty pools, traps and cycles, this paper explores the use of financial products and services in the developing world and critically reflects on their potential role in poverty alleviation and wider sustainable development. Discussions are illustrated with reference to qualitative empirical research undertaken in East and Southern Africa, and a sense-making of the lived financial experiences of low income individuals, households and communities.

Financial services for the poor within the formal/informal nexus in sub-Saharan Africa

This paper draws upon fieldwork undertaken across Kenya, Zambia, Mozambique and South Africa to present a reflective overview of the use of financial services amongst the poorest members of society. It considers the role that access to a portfolio of financial products and services may have as a contributory factor in poverty alleviation, but also how inappropriate use of these mechanisms may exacerbate a descent into poverty. This work draws upon the notions of poverty pools and the rise of fall of low income households in and out of poverty, alongside the contributory nature of vicious cycles of economic and political poverty. Drawing on fieldwork experiences it presents a synopsis of the types of financial mechanisms commonly in use on the African continent, as well as examples of public, private and civil society partnerships that are producing services specifically tailored for those in extreme and absolute poverty.

Insiders, outsiders, and the role of local enforcement in forest management: an example from Tanzania

In low-income countries, both nearby local villagers, “insiders”, and non-locals, “outsiders”, extract products from protected forests even though their actions are illegal. Forest managers typically combine enforcement and livelihood projects offered to nearby communities to reduce this illegal activity, but with limited budgets cannot deter all extraction. We develop a game theoretic model of a forest manager's decision interacting with the extraction decisions of insiders and outsiders. Our analysis suggests that, depending on the relative ecological damage caused by each group, budget-constrained forest managers may reduce total forest degradation by legalizing “insider” extraction in return for local villagers' involvement in enforcement activities against outsiders.

Love of reading: the evaluation of KidsREAD programme in Singapore

In Singapore about 20% of families are considered to be socio-economically disadvantaged. Children from these families have been identified as having reading difficulties when they enter primary school. Recognizing that children from these families have limited access to reading materials, the National Library Board, in partnership with local community clubs and family service centres, has established the KidsREAD literacy programme where volunteers, mostly university and college students, help children between 4 and 8 years of age overcome some of their reading problems. The KidsREAD clubs aim to “promote the love of reading and cultivate good reading habits among all young Singaporeans, in particular children from low-income families” (National Library Board, 2005). This paper presents an evaluation of the KidsREAD clubs with regard to children’s attitudes towards reading. It explores the differences in children’s reading attitudes at the beginning of the programme and half way through the programme. The study was carried out in three representative clubs. This paper evaluates the attitudes of 65 children towards the clubs and the activities conducted at the clubs. It outlines the children’s beliefs about reading and the extent to which they value reading. It further explores how much KidsREAD clubs have influenced their attitudes towards reading in general and their enjoyment of reading in particular.

Environmental conditions and rodent infestation in Campo Limpo district, Sao Paulo municipality, Brazil

Rodents are involved in the transmission to human beings of several diseases, including liptospirosis, which shows high lethality rates in Sao Paulo municipality. Despite this, few studies have assessed the relationship existing between urban environmental conditions and building rodent infestation. With the purpose of clarifying this relationship, an analysis has been conducted in order to quantify the influence of environmental factors upon rodent infestation on a low-income district. Diagnosis of the environmental situation has been performed to evaluate the frequency according to which harborage, food and access sources occur, and a survey on infestation rates in 2175 dwellings in the area studied. The logistic regression analysis showed that among the environmental variables, the one that showed the closest association with rodent infestation was access; followed by harborage, and food. It was concluded that poor socioeconomic and environmental conditions in the area propitiate the occurrence of high rodent infestation rates.

Vasectomy within the public health services in Campinas, Sao Paulo, Brazil

Objective: To describe some of the characteristics of men who underwent a vasectomy in the public health network of Campinas, Sao Paulo, Brazil. Methods: A descriptive study including 202 men randomly selected from a list of all the men vasectomized between 1998 and 2004 in the public health network. Results: Most of the men were 30 years of age or older when vasectomized, had completed elementary school and had two or more children of both sexes. Most of the men came from the lowest income segment of the population: 47.6% in 1998-1999 and 61.3% in 2003-2004. Although the men knew various contraceptive methods, 51.2% reported that their partners were using combined oral contraceptives at the time of surgery. Most men initially sought information on vasectomy at health-care clinics where care was provided by a multidisciplinary team; most received counselling, however, 47.9% of the men waited more than 4 months for the vasectomy. Conclusions: The profile of the vasectomized men in this study appears to indicate that the low-income population from Campinas, Sao Paulo, Brazil has access to vasectomy; however, the waiting time for vasectomy reveals that difficulties exist in obtaining this contraceptive method in the public health service.

Health care providers' perceptions of and attitudes towards induced abortions in sub-Saharan Africa and Southeast Asia : a systematic literature review of qualitative and quantitative data.

BACKGROUND: Unsafe abortions are a serious public health problem and a major human rights issue. In low-income countries, where restrictive abortion laws are common, safe abortion care is not always available to women in need. Health care providers have an important role in the provision of abortion services. However, the shortage of health care providers in low-income countries is critical and exacerbated by the unwillingness of some health care providers to provide abortion services. The aim of this study was to identify, summarise and synthesise available research addressing health care providers' perceptions of and attitudes towards induced abortions in sub-Saharan Africa and Southeast Asia. METHODS: A systematic literature search of three databases was conducted in November 2014, as well as a manual search of reference lists. The selection criteria included quantitative and qualitative research studies written in English, regardless of the year of publication, exploring health care providers' perceptions of and attitudes towards induced abortions in sub-Saharan Africa and Southeast Asia. The quality of all articles that met the inclusion criteria was assessed. The studies were critically appraised, and thematic analysis was used to synthesise the data. RESULTS: Thirty-six studies, published during 1977 and 2014, including data from 15 different countries, met the inclusion criteria. Nine key themes were identified as influencing the health care providers' attitudes towards induced abortions: 1) human rights, 2) gender, 3) religion, 4) access, 5) unpreparedness, 6) quality of life, 7) ambivalence 8) quality of care and 9) stigma and victimisation. CONCLUSIONS: Health care providers in sub-Saharan Africa and Southeast Asia have moral-, social- and gender-based reservations about induced abortion. These reservations influence attitudes towards induced abortions and subsequently affect the relationship between the health care provider and the pregnant woman who wishes to have an abortion. A values clarification exercise among abortion care providers is needed.

Knowledge translation in Uganda : a qualitative study of Ugandan midwives' and managers' perceived relevance of the sub-elements of the context cornerstone in the PARIHS framework

BACKGROUND: A large proportion of the annual 3.3 million neonatal deaths could be averted if there was a high uptake of basic evidence-based practices. In order to overcome this 'know-do' gap, there is an urgent need for in-depth understanding of knowledge translation (KT). A major factor to consider in the successful translation of knowledge into practice is the influence of organizational context. A theoretical framework highlighting this process is Promoting Action on Research Implementation in Health Services (PARIHS). However, research linked to this framework has almost exclusively been conducted in high-income countries. Therefore, the objective of this study was to examine the perceived relevance of the subelements of the organizational context cornerstone of the PARIHS framework, and also whether other factors in the organizational context were perceived to influence KT in a specific low-income setting. METHODS: This qualitative study was conducted in a district of Uganda, where focus group discussions and semi-structured interviews were conducted with midwives (n = 18) and managers (n = 5) within the catchment area of the general hospital. The interview guide was developed based on the context sub-elements in the PARIHS framework (receptive context, culture, leadership, and evaluation). Interviews were transcribed verbatim, followed by directed content analysis of the data. RESULTS: The sub-elements of organizational context in the PARIHS framework--i.e., receptive context, culture, leadership, and evaluation--also appear to be relevant in a low-income setting like Uganda, but there are additional factors to consider. Access to resources, commitment and informal payment, and community involvement were all perceived to play important roles for successful KT. CONCLUSIONS: In further development of the context assessment tool, assessing factors for successful implementation of evidence in low-income settings--resources, community involvement, and commitment and informal payment--should be considered for inclusion. For low-income settings, resources are of significant importance, and might be considered as a separate subelement of the PARIHS framework as a whole.

Intermediação de mão-de-obra no SINE-RS em uma perspectiva de sistema público de emprego

Este estudo trata da análise do desempenho da intermediação de mão-deobra, que se constitui em um dos instrumentos das políticas públicas de emprego do âmbito do Sistema Nacional de Emprego (SINE). O estudo tem o propósito de identificar os fatores de sucesso e insucesso deste serviço, assim como de sugerir linhas de ação para a melhoria do mesmo. Para alcançar este fim, foram ouvidos os três principais atores do processo de intermediação de mão-de-obra da Unidade Central do SINE de Porto Alegre: trabalhadores, empresas e funcionários do SINE. A intermediação de mão-de-obra ganha destaque quando o Estado passa a ser pressionado para apresentar soluções aos graves problemas do desemprego e às suas conseqüências negativas para as pessoas. Dessa forma, os Estados nacionais têm revalorizado as políticas voltadas para o mercado de trabalho. O novo nessas políticas é a constituição de sistemas públicos de emprego com o propósito de articular a intermediação, o seguro-desemprego e a qualificação profissional. Frente às dimensões e às características do desemprego, de longa duração, a intermediação assume papel estratégico para auxiliar, com agilidade, o desempregado a encontrar uma nova colocação no mercado de trabalho e, ainda, por deter mais informações sobre a demanda e a oferta de trabalho, ela tem as melhores condições de encaminhar esses trabalhadores à qualificação profissional e para alternativas de geração de emprego e renda. Os resultados da pesquisa evidenciam a importância do SINE para uma grande parcela de trabalhadores de baixa renda, para os quais o mesmo representa a principal alternativa de aproximação com o mercado de trabalho. Por outro lado, apontam limites do SINE para realizar a intermediação de mão-de-obra de forma 6 mais ágil e qualificada. Também evidenciam-se limites de gestão, de estrutura e de operacionalização que o SINE deve superar, dentre os quais destaca-se a desarticulação no processo de atendimento aos trabalhadores e às empresas e entre os instrumentos de política do SINE.

Infecção por HELICOBACTER PYLORI em crianças com dor abdominal crônica e sua associação com a gastrite endoscópica nodular

A infecção por Helicobacter pylori (Hp) é uma das infecções bacterianas mais comuns em todo o mundo. As maiores prevalências da infecção foram encontradas nos países em desenvolvimento, onde, em geral são altas já na infância. O método diagnóstico considerado mais acurado para a infecção por Hp, em crianças, é o exame endoscópico com biópsias gástricas. Alguns autores referem que o único aspecto macroscópico que pode predizer a infecção é o da presença de nodosidades na mucosa gástrica. Este aspecto é denominado de gastrite endoscópica nodular. A especificidade da gastrite endoscópica nodular para a infecção por Hp, entretanto, recentemente foi questionada por outros autores. Realizamos um estudo transversal em uma amostra de crianças (um a 12 anos) com dor abdominal crônica, que preenchiam os critérios para a realização de endoscopia digestiva alta, no Hospital da Criança Conceição e no Hospital de Clínicas de Porto Alegre, de setembro de 1997 a setembro de 1999. O objetivo principal foi verificar a associação entre a infecção por Hp e a gastrite endoscópica nodular nessas crianças. A amostra foi constituída de 185 crianças de ambos os sexos, com baixa renda familiar, cujos pais apresentavam baixo nível de escolaridade. Foi realizado estudo histológico das lâminas de biópsia gástrica (no mínimo cinco fragmentos, corados com H-E ou Giemsa), conforme o Sistema Sydney modificado. A infecção por Hp foi caracterizada pela presença de Hp na lâminas de biópsias gástricas dos pacientes e a gastrite folicular, pela presença de folículos linfóides bem formados, em mucosa gástrica inflamada. A prevalência da infecção por Hp nas crianças com dor abdominal crônica foi de 27% (IC 95%: 20,8-34,0). Foi demonstrada uma associação muito forte entre a infecção por Hp e a gastrite endoscópica nodular nessas crianças (P<0,001; RP = 29,7). Houve um aumento da prevalência tanto da infecção por Hp como da gastrite endoscópica nodular com a idade dos pacientes. A gastrite endoscópica nodular , embora tenha demostrado uma baixa sensibilidade (44,0%), apresentou um valor preditivo positivo de 91,7% para a infecção por Hp. Tanto o teste de urease, como a gastrite endoscópica nodular mostraram-se muito específicas, 94,5% e 98,5%, respectivamente, para o diagnóstico da infecção. Quando se combinou o teste de urease com o aspecto de gastrite endoscópica nodular, encontrou-se, uma sensibilidade muito baixa (34,7%), mas uma especificidade de 100% para a infecção por Hp. A sensibilidade do teste de urease, isolado, para a infecção foi de 60,4% e o seu valor preditivo positivo de 80,5%. O aspecto endoscópico (gastrite endoscópica nodular) teve associação com o microscópico (gastrite folicular) (P<0,001). Houve uma forte e significativa associação entre a infecção por Hp e a gastrite crônica ativa ( P<0,001; RP = 10,8). O mesmo foi demonstrado entre a gastrite nodular e a gastrite crônica ativa (P<0,001; RP = 8,6). Também foi verificado um nítido aumento das razões de prevalência da gastrite crônica ativa e da gastrite endoscópica nodular, com a acentuação dos graus de densidade de Hp. Finalmente, foi demonstrada a importante correlação entre o grau de intensidade da gastrite, verificado no exame histológico, e a gastrite endoscópica nodular (r = 0,97; P<0,001). A prevalência da infecção por Hp encontrada em Porto Alegre, nas crianças, foi menor do que a de outras cidades brasileiras e similar àquela registrada em algumas cidades do primeiro mundo. A presença de nodosidade na mucosa gástrica foi a alteração, à endoscopia, mais freqüentemente verificada nas crianças com infecção por Hp. Considerando a baixa prevalência da infecção encontrada na nossa amostra, a presença de gastrite endoscópica nodular significa uma elevada probabilidade de infecção por Hp, dado o alto valor preditivo verificado. O achado negativo para a gastrite endoscópica nodular, entretanto, não exclui a possibilidade da presença de infecção por Hp. Uma maior colonização bacteriana da mucosa gástrica estaria associada ao aparecimento da gastrite endoscópica nodular, já que a sua prevalência aumentou com os graus de densidade de Hp, assim como ocorreu com a gastrite crônica ativa. E quando ocorre, nas crianças, há maior probabilidade de se tratar de uma gastrite mais ativa e mais intensa.

O varejo de alimentos para consumidores de baixa renda no Brasil

Mesmo se considerarmos que significativa parcela da população mundial pertence à baixa renda, relativamente pouco se tem pesquisado sobre esse segmento de mercado. O principal objetivo deste estudo é investigar o varejo de alimentos para consumidores de baixa renda, no Brasil. O trabalho traz uma retrospectiva dos resultados de algumas pesquisas já realizadas sobre o mercado de baixa renda no Brasil, e também apresenta um referencial conceitual para ajudar a ordenar e compreender o comportamento desse segmento no varejo. Foram analisados três diferentes formatos de varejo de alimentos em uma região da periferia de São Paulo, e como suas respectivas propostas de valor são percebidas pelos seus consumidores. Por meio de visitas a essas às lojas e entrevistas em profundidade e discussões em grupo com esses consumidores, começamos a entender porque os novos formatos varejistas desenvolvidos, por grandes empresas globais, especialmente para o segmento de baixa renda, não conseguem satisfazer adequadamente as necessidades desses consumidores, no Brasil. O posicionamento excessivamente voltado para preço baixo desses formatos não entrega uma proposta de valor que seja percebida de forma favorável por esses consumidores. A pesquisa revela esse aparente paradoxo, pois a loja mais bem avaliada e preferida pela maioria dos clientes pesquisados foi aquela com os preços mais altos. Verificou-se como as características peculiares do comportamento do consumidor de baixa renda determinam a sua percepção de valor. Apesar de externarem um discurso racional e destacarem a relevância do fator preço, percebemos que esses consumidores são extremamente influenciados por aspectos percebidos de forma menos conscientes que a loja apresenta, como a disposição dos produtos, a variedade, a comunicação visual, o atendimento, e o respeito com que a loja trata seus clientes.