UN Human Development Research Articles

Food Insecurity Individual Experience: A Comparison of Economic and Social Characteristics of the Most Vulnerable Groups in the World

Being at the core of sustainable growth, food insecurity is one of the most important issues in determining a country’s level of development. The first aim of this paper is to compare food insecurity in different subpopulations across countries. The second goal is to assess which factors affect individual food insecurity in the world, while taking into account the level of a country’s development. This has not been possible until very recently. Through the FAO Food Insecurity Experience Scale (FIES) module of the Gallup World Poll, the same information has been collected with an identical methodology and instrument all over the world of more than 150 thousand individuals from 147 countries. Food insecurity presents marked differences depending on the level of development of the country under consideration. To take this into account, countries have been grouped together using a cluster analysis, based on the indicators from the UN Human Development Index. The model was estimated by means of an ordered logistic regression, both at the global level and for each group of countries. The model permits identification of the economic, social, and demographic characteristics related to food insecurity. Level of education, composition and number of children in the household, and location of dwellings had a significant impact on the risk of food insecurity. These results provide valuable insight into the phenomenon and can support policies aimed at ending hunger and improving the well-being of population.

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

SummaryBackgroundSurgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world.MethodsThis international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231.FindingsBetween Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p<0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p<0·001).InterpretationCountries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication.FundingDFID-MRC-Wellcome Trust Joint Global Health Trial Development Grant, National Institute of Health Research Global Health Research Unit Grant.

Stories of tragedy, trust and transformation? A case study of education-centered community development in post-earthquake Haiti

Haiti’s catastrophic earthquake of 2010 left approximately 200,000 people dead, 1.5 million homeless and most government buildings destroyed. Even pre-disaster, Haiti’s outcomes on the UN Human Development Index were among the lowest in the world, and since the quake the country has fallen into further decline. Today, most Haitians continue to lack basic services, struggle with daily survival, and confront daunting challenges in their change efforts. Many have called for reconstruction of society, and argue that local civil society organizations should lead the way in these efforts by valuing local knowledge, and building on small-scale community successes. This research investigates one community’s change efforts toward a new form of community development and potential pathway to transformation in Haiti. We aim to apply learning from this case to inform development practice and policy in Haiti and similar contexts.The case study community, Bellevue-La-Montagne, is applying an education-centered community development approach which has placed construction of a new school and education at the heart of collaborative rebuilding efforts by local residents and organizations, primarily Haiti Partners. Education and participatory practices are embedded in all aspects of the community development, including: social entrepreneurship, healthcare, environmental stewardship, community agriculture, planning and construction. These efforts involve participation of people and organizations (local and international) in dialogical negotiations that aim to share power and build capabilities of local people, and to create, change, or preserve structures and institutions consistent with the interests of local people. Participatory and phronesis research methodologies reveal nuanced understandings of the community development and its meaning for local people. In spite of substantial progress in development projects, findings reveal tension points that potentially threaten long-term sustainability, such as: the highly fragile nature of state-society relations, lack of a sense of agency of local people despite strong levels of participation, and differences between outcomes for the community as a whole and individual households.Moving from revealed community change in this case to a broader and deeper social transformation will require key ‘levers of transformation’, identified in this case as: 1) education; 2) place identity, networks, and research; 3) social entrepreneurship and social innovation; and 4) state-society trust and accountability. These levers can be activated through participatory and education-centered community development strategies that provide important roles for local people and civil society, and a nuanced role for international organizations which is sensitive to power dynamics. Such development strategies would give ‘voice’ to communities in their struggles for change. Strengthening, networking and scaling community level innovation that shows promise of transformation, such as the case of Bellevue-La-Montagne, would contribute to Haiti’s attempts to forge a new narrative, and to evolving international development planning policy and practice.

Innovating green products as a mean to alleviate poverty in Upper Egypt

Abstract Beginning from August 2010, EGYCOM decided to devote its efforts to combat poverty in Upper Egypt. Based on the UN Human Development report for Egypt, EGYCOM found that 762 of the poorest villages are in the governorates of Assuit, Sohag and Menya in Upper Egypt. Of those 44% are in Menya alone. Poverty has alarming consequences, one of which is migration of youth to big cities or abroad in search for regular wages and better life. A team of 22 members undertook additional research and developed a point system to evaluate the poorest 10 villages in Menya governorate, and the final result pointed to the village of Al Qayat. Palm trees were recognized as an abundant unutilized resource in the village. Many households owned palm trees, and they are an important economic resource for the villagers. In addition, villagers possess a rich cultural and technical heritage, being an accumulation of centuries of their interaction with local resources for the satisfaction of their basis needs. Yet, the drastic change of life style in the village has decreased the need of palm secondary products. This, in turn, has led to the neglect of regular pruning of palm, which has resulted in the increase of danger of fire in palm gardens, as well as the infestation by the red palm weevil threatening the life of the palm. Here innovation has emerged as a necessity to rediscover those neglected palm secondary products with the purposed of alleviating poverty in the villages. New techniques and machinery have been innovated to suit the conditions of work in the village. A wide array of techniques and machining have been innovated for the transformation of palm midribs into strips and mats of regular dimensions to be used as a substitute for imported wood. In order to reach the market, it was necessary to close the loop of innovation. Here the intervention of designers was crucial. Four renounced designers have joined our endeavors by designing new marketable products from palm midrib mats using the uniqueness of palm midrib texture-in comparison with wood- as a competitive advantage. The joint synergetic interaction between the project team responsible for technology development and machine design, on one hand, and the creative product designers, on the other hand, has resulted in successful participation in international furniture and building materials exhibitions paving the route for marketing of palm midrib green products in the local and international markets.

Rethinking Global Business Ethics: The North‐South Paradigm

AbstractThis paper looks at the changes that have taken place during the past three decades in developing countries (the South) as reported in the 2013 UN Human Development Report and how they affect the obligations of multinationals from developed countries (the North). It argues that the changes call for greater attention to the growing North‐South paradigm and its implicit Respect‐cooperation model rather than the still dominant Developed/Developing Nations paradigm and its Dependency‐victim model. It examines some of the rethinking such a paradigm change makes in approaching poverty reduction and corporate social responsibility.

Vom sanktionierten Pariastaat zum Joint-Venture der Welt. Aspekte der ökonomischen Dynamik Myanmars

Abstract Due to its internationally accompanied opening policies, Myanmar’s present economic situation is unique even on a global scale. The present contribution addresses the question if the ranking of Mynamar on position 150 of the UN Human Development Index indeed reflects the country’s economic situation. The paper investigates the historical developments in Myanmar after 1948, the Western sanctions regime after 1988, the integration into ASEAN, the present framework for ‘doing business’, and the dynamics of foreign capital and domestic labor conditions. The paper concludes that the years of political isolation and repression still inhibit the country’s fast economic progress. The future welfare of this politically disrupted country so rich in natural resources does not only depend on its government and its ascending civil society, but also on FDI by foreign companies.

Correlation and causation between the UN Human Development Index and national and personal wealth and resource exploitation

Human development is increasingly on global policy agendas, in particular related to the Sustainable Development Goals. Here, the UN Human Development Index is analysed for correlation and causation with economic and resource parameters using novel quantitative techniques. Global datasets at national resolution are used to explore correlation and causation with the HDI. The whole HDI is not correlated to national totals of wealth or resource use, but is strongly correlated to personal wealth and resource use. The multi-spatial convergence cross mapping method is adapted to shed light on causation in this system. It is shown that the HDI is tightly linked to the economy and to personal resource use. Analysis of the HDI sub-indices reveals subtleties easily overlooked. For example, it is shown that access to water and electricity strongly influence GNI. It is shown that simple resource accumulation/exploitation is less important in determining HDI growth than personal wealth and access to resources. That is, equitable distribution is more effective than gross accumulation in influencing the HDI. Strong feedback means that investments in water treatment and distribution networks, for example, will have strong effects on HDI change, a conclusion that may play an important role in national developmental policy debate.

A Global Cancer Project Map Integrating Global Cancer Statistics to Guide International Efforts

Abstract 39 Background: In response to the growing burden of cancer, Global Oncology, Inc., and the National Cancer Institute Center for Global Health launched a free, online, interactive map, the Global Cancer Project Map (GCPM) [ http://gcpm.globalonc.org ], to allow policy makers, researchers, and civil society around the world to search this central repository of international cancer control and research projects. The GCPM serves to catalyze collaboration in cancer research and clinical care, as well as inform research and care gaps. Methods: In addition to search options by project attributes, the GCPM provides map overlays of epidemiological measures using IARC’s GLOBOCAN cancer-specific estimates of incidence, prevalence, and mortality, cancer disability--adjusted life years, and UN Human Development Index country values. Currently, the map displays projects with international collaborators collated from the NCI, NCI-Designated Cancer Centers, UICC and ASCO. Results: The GCPM search options offer countless angles of looking at projects worldwide. Of the 1,479 currently-mapped projects, 44.8% have investigators or collaborators in less-developed countries (LDCs) (as defined by the UN). Of the 1218 with a project type classification, 104 relate to capacity building and/or training, with 69 of these projects (66.3%) occurring in LDCs. Utilizing the cancer type search options, the GCPM currently displays 54 cervical cancer projects with LDC collaborators, where the cervical cancer mortality age--standardized risk is more than 2.5 times higher for LDCs than more-developed countries. Conclusions: The GCPM is a real-time needs assessment tool to allow the cancer community to visualize international efforts in cancer control and link need to action. To better address the growing burden of cancer, the partnership is actively seeking collaboration and additional project submissions. Utilized with cancer statistic overlays, the GCPM can help develop regional priorities in cancer research and control. Funding: This project has been funded in whole or in part with federal funds from the National Cancer Institute, National Institutes of Health, under Contract No. HHSN261200800001E. The content of this publication does not necessarily reflect the views or policies of the Department of Health and Human Services, nor does mention of trade names, commercial products, or organizations imply endorsement by the U.S. Government. AUTHORS’ DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST: Ali Chisti No relationship to disclose Nour Sharara No relationship to disclose Manaswi Gupta No relationship to disclose Jane Craycroft No relationship to disclose Ilyana Rosenberg Employment: Connance, Inc., Hayes Management Consulting Camille Morgan No relationship to disclose Kalina Duncan No relationship to disclose Rachel Abudu No relationship to disclose Billy Andre No relationship to disclose Shannon Silkenson No relationship to disclose Jennifer Silva No relationship to disclose Ami Bhatt No relationship to disclose Ted Trimble No relationship to disclose Franklin Huang Stock or Other Ownership: GlaxoSmithKline, Abbvie

Oil in Niger: A foundation for promise or a new resource curse?

It is no secret that many poor, oil-rich countries struggle to develop. This paper offers initial reflections on the case of Niger, long one of the largest uranium producers in the world but which has recently begun to extract oil. Despite being a top-five global producer of uranium for decades, Niger remains near the bottom of the UN Human Development Index. Will a more diversified extractive industries portfolio which now includes oil help to offset or simply perpetuate the country's resource curse?

The Legal basis of the Election System of the Swiss Confederation

This article focuses on general characteristics and legal basis of the election system of the Swiss Confederation - the member-state of the United Nations, which ranks ninth place in the world in the Human Development Index according to the UN Human Development Report of 2013. The author examines and analyzes the federal election legislation and the election legislation of the cantons, highlights its main characteristics and principles, as well as analyzes the relation between the federal and the cantonal election law. Special emphasis is paid to the rules of the election results appeal, as well as to the legal liability for electoral violations. Thus, the basis of democratic elections are ensured by transparency of the electoral process and mechanisms for the protection of citizens’ constitutional rights.

International elite, or global citizens? Equity, distinction and power: the International Baccalaureate and the rise of the South

The 2013 UN Human Development report predicts the middle classes of ‘The South’ a five-fold increase by 2030. Globalisation has resulted in national conceptions of business: education and identity being in flux. Emerging middle classes of the South are already embracing international forms of education for instrumental reasons of advantage and distinction. The International Baccalaureate (IB) curriculum continues to experience a strong growth in this area and appears to offer a globalised and international form of education, which may offer the chance of educating a global citizen, despite the fact that it is much valued for the relative advantage it may offer. This article reviews the data surrounding the rise of the South and explores the identity of the IB, as it exists in international schools, particularly the dilemma between its internationalist and the globalist outlook. The theory of Pierre Bourdieu facilitates a critical examination of the role of global citizenship education in this paradigm, and the instrumental role it may play in conferring symbolic capital and distinction on this form of social reproduction. Finally, Global Citizenship Education in IB curricula represents a pastoral (religious) component as is common in elite school systems, yet in its globalised form: secular and inclusive whilst equitable and distinct.

INFORMAL HEALTH ECONOMICS IN UKRAINE

BACKGROUND. In 2013 Ukraine ranks 78 place according to UN Human Development Index scoring. While education HDI components take the country forward, life expectancy at birth, in contrary, takes it backwards. The latter is due to violation of the constitutional right of Ukrainian citizens on equal access to health care. GOAL. To analyze the main reason of this situation – stream widespread of the informal payments for medical care and shadow health economics as a whole. MATERIAL AND METHODS. UN, State Statistics Service and National Bank of Ukraine statistical data. RESULTS. Provision of medical services in the state health care in exchange for payments by patients (informal economics or gray market) is a part of the shadow economics in Ukraine. Its external causes – monopoly of the multinational pharmaceutical corporations in the world economy, their pressure on the national market and behavior of physicians, globalization and offshore. Internal reasons – use of public resources for big business purposes, high rate of shadow schemes in national economy and health system, low level of health financing and salaries of medical workers. Informal health economics entails significant costs: productive – used public resources and time for private goals of physicians; transaction – increases the asymmetry of information about the quality of medical care, social – forms in the public sector quasiprivate market for medical services with all its negative externalities. СONCLUSIONS. In order to reduce informal health economics in Ukraine it is necessary to: abandon the oligarchic model of the national economy, improve the tender legislation and eliminate corruption in the purchase of medicines and equipment, substantially increase health care financing and restructuring, create an independent judicial system for protecting patients’ rights, introduce compulsory social health insurance, support non-profit medical associations. Keywords: shadow economics, informal health economics, “gray market, health care financing.

Rethinking Foreign Aid for Fragile States

Many fragile states experienced conflict and its adverse impact on poverty and development at the end of the Cold War in the late 1980s. The conflict-trap on development and global security concern spawned empirical research on how policies should be distinctive in the conflict-affected and post-conflict recovery to avoid the recurrence of conflicts. The literature on aid effectiveness in fragile states is relatively limited in comparison to a much larger body of literature on aid effectiveness for all aid recipients. In this paper, we apply cluster analysis and robust regression to a set of OECD-DAC-designated fragile states to explore the effect of aid on development, measured by income, per capita income and by the UN Human Development Index, taking into account the interaction of weak institutional factors, and low absorptive capacity of aid associating with state fragility. The empirical results suggest positive relationship between aid and indicators of development, such as income and human development index.

Characteristics and comprehensiveness of adult HIV care and treatment programmes in Asia-Pacific, sub-Saharan Africa and the Americas: results of a site assessment conducted by the International epidemiologic Databases to Evaluate AIDS (IeDEA) Collaboration.

IntroductionHIV care and treatment programmes worldwide are transforming as they push to deliver universal access to essential prevention, care and treatment services to persons living with HIV and their communities. The characteristics and capacity of these HIV programmes affect patient outcomes and quality of care. Despite the importance of ensuring optimal outcomes, few studies have addressed the capacity of HIV programmes to deliver comprehensive care. We sought to describe such capacity in HIV programmes in seven regions worldwide.MethodsStaff from 128 sites in 41 countries participating in the International epidemiologic Databases to Evaluate AIDS completed a site survey from 2009 to 2010, including sites in the Asia-Pacific region (n=20), Latin America and the Caribbean (n=7), North America (n=7), Central Africa (n=12), East Africa (n=51), Southern Africa (n=16) and West Africa (n=15). We computed a measure of the comprehensiveness of care based on seven World Health Organization-recommended essential HIV services.ResultsMost sites reported serving urban (61%; region range (rr): 33–100%) and both adult and paediatric populations (77%; rr: 29–96%). Only 45% of HIV clinics that reported treating children had paediatricians on staff. As for the seven essential services, survey respondents reported that CD4+ cell count testing was available to all but one site, while tuberculosis (TB) screening and community outreach services were available in 80 and 72%, respectively. The remaining four essential services – nutritional support (82%), combination antiretroviral therapy adherence support (88%), prevention of mother-to-child transmission (PMTCT) (94%) and other prevention and clinical management services (97%) – were uniformly available. Approximately half (46%) of sites reported offering all seven services. Newer sites and sites in settings with low rankings on the UN Human Development Index (HDI), especially those in the President's Emergency Plan for AIDS Relief focus countries, tended to offer a more comprehensive array of essential services. HIV care programme characteristics and comprehensiveness varied according to the number of years the site had been in operation and the HDI of the site setting, with more recently established clinics in low-HDI settings reporting a more comprehensive array of available services. Survey respondents frequently identified contact tracing of patients, patient outreach, nutritional counselling, onsite viral load testing, universal TB screening and the provision of isoniazid preventive therapy as unavailable services.ConclusionsThis study serves as a baseline for on-going monitoring of the evolution of care delivery over time and lays the groundwork for evaluating HIV treatment outcomes in relation to site capacity for comprehensive care.

Lessons from an elective in Sierra Leone.

Lessons from an elective in Sierra Leone.

What Affects China's National Image? A cross-national study of public opinion

This paper investigates macro-level sources of variations across countries regrading China's national image, as measured by the proportion of the public in each of 35 countries that expressed a favorable view of China in the 2007 Pew Global Attitudes Survey. It turns out that several expected factors have no significant measurable impact on China's image: not the extent of strategic ties between China and a given country; not the political system of that country; not the extent of Chinese investment in the country; and not the number of Confucius institutes and classrooms in that country. The only macro-level factor we find to affect China's image in a country is that country's level of economic and social development, as measured by the UN Human Development Index. Controlling for the other factors, publics in poor or developing countries are much more likely to have a favorable image of China than publics in economically advanced countries. Some implications of our findings are discussed.

Inequality and the new human development index

Taking as a reference the new human development index introduced by the UN in 2010, we study inequality in the world with respect to achievements in human development. We consider four of the most widely known measures of inequality: the Gini, Theil, Atkinson and Kolm indices. We analyse the evolution of each index over the whole history of UN human development reports (every 5 years, from 1980 to 2010). We find that according to the Gini, Theil and Atkinson measures, the world was significantly more equal in 2010 than in 1980. However, the Kolm index shows that the distribution of human development has worsened.

Scalar Equivalence of OPQ32

Scalar equivalence of Big Five scale scores, derived from OPQ32i data, for over one million people are reviewed in terms of differences between 31 countries involving over 20 different languages. Strong relationships are found between country average scale scores and country standard deviations ( SDs), on the one hand, and two of Hofstede’s cultural dimensions, on the other. Country SDs are also seen to vary with cultural “tightness” ratings. Country-level performance indicators are also examined (the World Economic Forum Global Competitiveness Index and UN Human Development indices). Strong correlations are found between these indicators and both country-level mean personality scores and SDs of personality scores. While Hofstede’s dimensions also predict variation in global competitiveness ( R = 0.66), adding OPQ32 Big Five personality scale data increases the level of prediction to R = 0.84. It is argued that the strength of these relationships with independent country-level metrics supports the view that between-country differences represent true score variance rather than systematic instrument-related biases.

How are we going to rebuild public health in Libya?

How are we going to rebuild public health in Libya?

Social trust and human development

A series of studies connect social trust to economic growth. In this paper, we explore the connection between trust and a broader measure of development, the UN Human Development Index. We find that trust is significantly associated with faster human development in the 1980–2005 period. The impact of trust occurs mainly in less democratic countries.