Meera Shekar - Academia.edu (original) (raw)

Papers by Meera Shekar

Health, nutrition, and population series, Jun 23, 2006

This series is produced by the Health, Nutrition, and Population Family (HNP) of the World Bank's... more This series is produced by the Health, Nutrition, and Population Family (HNP) of the World Bank's Human Development Network. The papers in this series aim to provide a vehicle for publishing preliminary and unpolished results on HNP topics to encourage discussion and debate. The findings, interpretations, and conclusions expressed in this paper are entirely those of the author(s) and should not be attributed in any manner to the World Bank, to its affiliated organizations or to members of its Board of Executive Directors or the countries they represent. Citation and the use of material presented in this series should take into account this provisional character. For free copies of papers in this series please contact the individual author(s) whose name appears on the paper. Enquiries about the series and submissions should be made directly to the Managing Editor,

The work was task-managed and l e d by Meera Shekar (World BanWHDNHE). Aparnaa Somanathan (World ... more The work was task-managed and l e d by Meera Shekar (World BanWHDNHE). Aparnaa Somanathan (World BanWSASHD) and Lidan Du (consultant) co-authored the report. Sunethra Atukorala, Dariush Akhavan, Lidan Du, N i m a l D. Kasturiaratchi (consultants) and Nistha Sinha (World BanWPRMGE) prepared background papers that provided the report's starting point. A l i s t o f background papers i s attached. Rifat Hassan (World Bank/HDNHE) provided valuable technical inputs, and Alejandro Welch (World BanWSASHD) provided the team editing and logistical assistance. Thanks are due to the many colleagues at the Institute for Health Policy in Sri Lanka who responded to queries with invaluable information. Alicia Hetmer and Rosemary Esber edited the final report. Anabela Abreu (Sector Manager) and Julian Schweitzer (Sector Director) W o r l d BanWSASHD provided unstinting support and guidance in conceptualizing and implementing this work. The work was initiated with steadfast support from the Sri Lanka Country Director Peter Harold and completed under the guidance o f his successor, Naoko Ishii. Michele Gragnolati (World BanWECSHD) provided inputs in the initial stages o f this work, and Kumari Vinodhani Navaratne (World BanWSASHD) provided useful feedback o n the draft report. Chulanganie Lakshmi D e Silva (World Bank/SAREX) provided invaluable support for organizing the initiation workshop in Sri Lanka in July 2006. Kees Kostennans provided comments o n the draft document. Harold Alderman (World BanWAFTHD), L u c Christiaensen (World BanWEASRE) and L u c Laviolette (Micronutrient Initiative) peer-reviewed the report. Development partners in Sri Lanka-UNICEF, WHO, WFP, and UNDP-collaborated in this effort. Their representatives provided feedback o n the concept note and participated in a launch workshop in Sri Lanka in July 2006. The report i s dedicated to the hundreds o f thousands o f malnourished children and women in Sri Lanka whose lives the report's recommendations seek to improve.

Wasting (low weight-for-height) occurs when children lose weight rapidly, generally from low calo... more Wasting (low weight-for-height) occurs when children lose weight rapidly, generally from low caloric intake and/or repeated infections; it is an indicator of acute undernutrition. In 2012, the World Health Assembly agreed to a global target to reduce and maintain childhood wasting to less than 5 percent by 2025 (WHO 2012); this target was incorporated into Sustainable Development Goal 2 (United Nations 2015a). The target focuses on reducing the prevalence of wasting and, consequently, on preventing and treating wasting. However, to date, evidence of how to prevent wasting is limited and inconclusive, making it impossible to estimate the costs of reaching the global wasting target. In order to reach the target, effective strategies are needed to treat current cases and to prevent future cases of wasting.

Information and communication technologies (ICT) for health or eHealth solutions hold great poten... more Information and communication technologies (ICT) for health or eHealth solutions hold great potential for generating systemic efficiencies by strengthening five critical pillars of a health system: human resources for health, supply chain management, health care financing, governance and service delivery, and infrastructure. This report describes the changing landscape of eHealth initiatives through these five pillars, with a geographic focus on Sub-Saharan Africa. This report further details seven criteria, or prerequisites, that must be considered and addressed in order to effectively establish and scale up ICT-based solutions in the health sector. These criteria include infrastructure, data and interoperability standards, local capacity, policy and regulatory environments, an appropriate business model, alignment of partnerships and priorities, and monitoring and evaluation. In order to bring specific examples of these criteria to light, this report concludes with 12 specific cas...

The COVID-19-related economic crisis and food- and health-system disruptions threaten to exacerba... more The COVID-19-related economic crisis and food- and health-system disruptions threaten to exacerbate undernutrition in low- and middle-income countries (LMIC). We used three modelling tools (MIRAGRODEP, Lives Saved Tool, and Optima Nutrition Tool) to estimate impacts on child stunting, wasting, and mortality, maternal anemia, children born to low BMI women, and future productivity losses for three scenarios across 2020–2022 (n = 118 LMICs). We also estimated the additional cost of mitigation for six nutrition interventions to maximize non-stunted and alive children. By 2022 COVID-19 could result in an additional 9.3 million wasted and 2.6 million stunted children, 168,000 additional child-deaths 2.1 million maternal anemia cases, 2.1 million children born to low BMI women and US$29.7 billion future productivity losses due to excess stunting and child mortality. An additional $1.2 billion per year is needed to mitigate these effects. Governments and donors must maintain nutrition as a...

Obesity: Health and Economic Consequences of an Impending Global Challenge, 2020

An Investment Framework for Nutrition: Reaching the Global Targets for Stunting, Anemia, Breastfeeding, and Wasting, 2017

Anemia is a widespread public health problem with vast human, social,and economic consequences. T... more Anemia is a widespread public health problem with vast human, social,and economic consequences. This brief summarizes the financing needs and expected health and economic impacts of meeting the anemia target.The analysis presented in An Investment Framework for Nutrition estimates the financing needs and impact of scaling up a minimum core set of interventions for preventing anemia that (1) are applicable to all countries, (2) have a strong evidence base for effectiveness, and (3) together can plausibly achieve the proposed target. The analysis focuses on the costs and potential impacts of a package of primarily preventive nutrition-specific interventions that have proven efficacy. The scale-up of the preventative package aims to reach all women, including those with anemia. Treatment of anemia through the health system, while important, is not costed in this analysis. Achieving the global target of reducing anemia in women would require an additional $12.9 billion in domestic gover...

In 2012, the World Health Assembly set the target of increasing the rate of exclusive breastfeedi... more In 2012, the World Health Assembly set the target of increasing the rate of exclusive breastfeeding in the first six months to at least 50 percent (from 38 percent) by 2025 (WHO 2012). This summary describes the estimated resources required to achieve this target, and the impact that this investment is expected to have on nutrition, health, and economic outcomes.

SSRN Electronic Journal, 2021

Health, Nutrition and Population (HNP) Discussion Paper This series is produced by the Health, Nu... more Health, Nutrition and Population (HNP) Discussion Paper This series is produced by the Health, Nutrition, and Population Global Practice of the World Bank. The papers in this series aim to provide a vehicle for publishing preliminary results on HNP topics to encourage discussion and debate. The findings, interpretations, and conclusions expressed in this paper are entirely those of the author(s) and should not be attributed in any manner to the World Bank, to its affiliated organizations or to members of its Board of Executive Directors or the countries they represent. Citation and the use of material presented in this series should take into account this provisional character. The World Bank does not guarantee the accuracy of the data included in this work. The boundaries, colors, denominations, and other information shown on any map in this work do not imply any judgment on the part of The World Bank concerning the legal status of any territory or the endorsement or acceptance of such boundaries.

Health, Nutrition, and Population, 2006

This series is produced by the Health, Nutrition, and Population Family (HNP) of the World Bank's... more This series is produced by the Health, Nutrition, and Population Family (HNP) of the World Bank's Human Development Network. The papers in this series aim to provide a vehicle for publishing preliminary and unpolished results on HNP topics to encourage discussion and debate. The findings, interpretations, and conclusions expressed in this paper are entirely those of the author(s) and should not be attributed in any manner to the World Bank, to its affiliated organizations or to members of its Board of Executive Directors or the countries they represent. Citation and the use of material presented in this series should take into account this provisional character. For free copies of papers in this series please contact the individual author(s) whose name appears on the paper. Enquiries about the series and submissions should be made directly to the Managing Editor,

Information and communication technologies (ICT) for health or eHealth solutions hold great poten... more Information and communication technologies (ICT) for health or eHealth solutions hold great potential for generating systemic efficiencies by strengthening five critical pillars of a health system: human resources for health, supply chain management, health care financing, governance and service delivery, and infrastructure. This report describes the changing landscape of eHealth initiatives through these five pillars, with a geographic focus on Sub-Saharan Africa. This report further details seven criteria, or prerequisites, that must be considered and addressed in order to effectively establish and scale up ICT-based solutions in the health sector. These criteria include infrastructure, data and interoperability standards, local capacity, policy and regulatory environments, an appropriate business model, alignment of partnerships and priorities, and monitoring and evaluation. In order to bring specific examples of these criteria to light, this report concludes with 12 specific cas...

The objective of this report is twofold: first, to update the data relating to child under nutrit... more The objective of this report is twofold: first, to update the data relating to child under nutrition (stunting and underweight) in the original series reports, by using the new international child growth standards; and second, to provide information on overweight and obesity, which were not included in the original series reports. At the time the original reports were designed, concern about malnutrition in low- and middle-income countries focused primarily on under nutrition. Since then, interest in overweight and obesity has risen sharply, calling for data on these as well as on under nutrition. Tables containing prevalence figures are presented in part one of this reports. For all the child nutrition indicators, both the values based on the old growth references and those based on the new World Health Organization (WHO) standards are provided, allowing readers to assess the impact of the introduction of the new standards on prevalence rates. Standard errors for those prevalence f...

Health, nutrition, and population series, Jun 23, 2006

This series is produced by the Health, Nutrition, and Population Family (HNP) of the World Bank's... more This series is produced by the Health, Nutrition, and Population Family (HNP) of the World Bank's Human Development Network. The papers in this series aim to provide a vehicle for publishing preliminary and unpolished results on HNP topics to encourage discussion and debate. The findings, interpretations, and conclusions expressed in this paper are entirely those of the author(s) and should not be attributed in any manner to the World Bank, to its affiliated organizations or to members of its Board of Executive Directors or the countries they represent. Citation and the use of material presented in this series should take into account this provisional character. For free copies of papers in this series please contact the individual author(s) whose name appears on the paper. Enquiries about the series and submissions should be made directly to the Managing Editor,

The work was task-managed and l e d by Meera Shekar (World BanWHDNHE). Aparnaa Somanathan (World ... more The work was task-managed and l e d by Meera Shekar (World BanWHDNHE). Aparnaa Somanathan (World BanWSASHD) and Lidan Du (consultant) co-authored the report. Sunethra Atukorala, Dariush Akhavan, Lidan Du, N i m a l D. Kasturiaratchi (consultants) and Nistha Sinha (World BanWPRMGE) prepared background papers that provided the report's starting point. A l i s t o f background papers i s attached. Rifat Hassan (World Bank/HDNHE) provided valuable technical inputs, and Alejandro Welch (World BanWSASHD) provided the team editing and logistical assistance. Thanks are due to the many colleagues at the Institute for Health Policy in Sri Lanka who responded to queries with invaluable information. Alicia Hetmer and Rosemary Esber edited the final report. Anabela Abreu (Sector Manager) and Julian Schweitzer (Sector Director) W o r l d BanWSASHD provided unstinting support and guidance in conceptualizing and implementing this work. The work was initiated with steadfast support from the Sri Lanka Country Director Peter Harold and completed under the guidance o f his successor, Naoko Ishii. Michele Gragnolati (World BanWECSHD) provided inputs in the initial stages o f this work, and Kumari Vinodhani Navaratne (World BanWSASHD) provided useful feedback o n the draft report. Chulanganie Lakshmi D e Silva (World Bank/SAREX) provided invaluable support for organizing the initiation workshop in Sri Lanka in July 2006. Kees Kostennans provided comments o n the draft document. Harold Alderman (World BanWAFTHD), L u c Christiaensen (World BanWEASRE) and L u c Laviolette (Micronutrient Initiative) peer-reviewed the report. Development partners in Sri Lanka-UNICEF, WHO, WFP, and UNDP-collaborated in this effort. Their representatives provided feedback o n the concept note and participated in a launch workshop in Sri Lanka in July 2006. The report i s dedicated to the hundreds o f thousands o f malnourished children and women in Sri Lanka whose lives the report's recommendations seek to improve.

Wasting (low weight-for-height) occurs when children lose weight rapidly, generally from low calo... more Wasting (low weight-for-height) occurs when children lose weight rapidly, generally from low caloric intake and/or repeated infections; it is an indicator of acute undernutrition. In 2012, the World Health Assembly agreed to a global target to reduce and maintain childhood wasting to less than 5 percent by 2025 (WHO 2012); this target was incorporated into Sustainable Development Goal 2 (United Nations 2015a). The target focuses on reducing the prevalence of wasting and, consequently, on preventing and treating wasting. However, to date, evidence of how to prevent wasting is limited and inconclusive, making it impossible to estimate the costs of reaching the global wasting target. In order to reach the target, effective strategies are needed to treat current cases and to prevent future cases of wasting.

Information and communication technologies (ICT) for health or eHealth solutions hold great poten... more Information and communication technologies (ICT) for health or eHealth solutions hold great potential for generating systemic efficiencies by strengthening five critical pillars of a health system: human resources for health, supply chain management, health care financing, governance and service delivery, and infrastructure. This report describes the changing landscape of eHealth initiatives through these five pillars, with a geographic focus on Sub-Saharan Africa. This report further details seven criteria, or prerequisites, that must be considered and addressed in order to effectively establish and scale up ICT-based solutions in the health sector. These criteria include infrastructure, data and interoperability standards, local capacity, policy and regulatory environments, an appropriate business model, alignment of partnerships and priorities, and monitoring and evaluation. In order to bring specific examples of these criteria to light, this report concludes with 12 specific cas...

The COVID-19-related economic crisis and food- and health-system disruptions threaten to exacerba... more The COVID-19-related economic crisis and food- and health-system disruptions threaten to exacerbate undernutrition in low- and middle-income countries (LMIC). We used three modelling tools (MIRAGRODEP, Lives Saved Tool, and Optima Nutrition Tool) to estimate impacts on child stunting, wasting, and mortality, maternal anemia, children born to low BMI women, and future productivity losses for three scenarios across 2020–2022 (n = 118 LMICs). We also estimated the additional cost of mitigation for six nutrition interventions to maximize non-stunted and alive children. By 2022 COVID-19 could result in an additional 9.3 million wasted and 2.6 million stunted children, 168,000 additional child-deaths 2.1 million maternal anemia cases, 2.1 million children born to low BMI women and US$29.7 billion future productivity losses due to excess stunting and child mortality. An additional $1.2 billion per year is needed to mitigate these effects. Governments and donors must maintain nutrition as a...

Obesity: Health and Economic Consequences of an Impending Global Challenge, 2020

An Investment Framework for Nutrition: Reaching the Global Targets for Stunting, Anemia, Breastfeeding, and Wasting, 2017

Anemia is a widespread public health problem with vast human, social,and economic consequences. T... more Anemia is a widespread public health problem with vast human, social,and economic consequences. This brief summarizes the financing needs and expected health and economic impacts of meeting the anemia target.The analysis presented in An Investment Framework for Nutrition estimates the financing needs and impact of scaling up a minimum core set of interventions for preventing anemia that (1) are applicable to all countries, (2) have a strong evidence base for effectiveness, and (3) together can plausibly achieve the proposed target. The analysis focuses on the costs and potential impacts of a package of primarily preventive nutrition-specific interventions that have proven efficacy. The scale-up of the preventative package aims to reach all women, including those with anemia. Treatment of anemia through the health system, while important, is not costed in this analysis. Achieving the global target of reducing anemia in women would require an additional $12.9 billion in domestic gover...

In 2012, the World Health Assembly set the target of increasing the rate of exclusive breastfeedi... more In 2012, the World Health Assembly set the target of increasing the rate of exclusive breastfeeding in the first six months to at least 50 percent (from 38 percent) by 2025 (WHO 2012). This summary describes the estimated resources required to achieve this target, and the impact that this investment is expected to have on nutrition, health, and economic outcomes.

SSRN Electronic Journal, 2021

Health, Nutrition and Population (HNP) Discussion Paper This series is produced by the Health, Nu... more Health, Nutrition and Population (HNP) Discussion Paper This series is produced by the Health, Nutrition, and Population Global Practice of the World Bank. The papers in this series aim to provide a vehicle for publishing preliminary results on HNP topics to encourage discussion and debate. The findings, interpretations, and conclusions expressed in this paper are entirely those of the author(s) and should not be attributed in any manner to the World Bank, to its affiliated organizations or to members of its Board of Executive Directors or the countries they represent. Citation and the use of material presented in this series should take into account this provisional character. The World Bank does not guarantee the accuracy of the data included in this work. The boundaries, colors, denominations, and other information shown on any map in this work do not imply any judgment on the part of The World Bank concerning the legal status of any territory or the endorsement or acceptance of such boundaries.

Health, Nutrition, and Population, 2006

This series is produced by the Health, Nutrition, and Population Family (HNP) of the World Bank's... more This series is produced by the Health, Nutrition, and Population Family (HNP) of the World Bank's Human Development Network. The papers in this series aim to provide a vehicle for publishing preliminary and unpolished results on HNP topics to encourage discussion and debate. The findings, interpretations, and conclusions expressed in this paper are entirely those of the author(s) and should not be attributed in any manner to the World Bank, to its affiliated organizations or to members of its Board of Executive Directors or the countries they represent. Citation and the use of material presented in this series should take into account this provisional character. For free copies of papers in this series please contact the individual author(s) whose name appears on the paper. Enquiries about the series and submissions should be made directly to the Managing Editor,

Information and communication technologies (ICT) for health or eHealth solutions hold great poten... more Information and communication technologies (ICT) for health or eHealth solutions hold great potential for generating systemic efficiencies by strengthening five critical pillars of a health system: human resources for health, supply chain management, health care financing, governance and service delivery, and infrastructure. This report describes the changing landscape of eHealth initiatives through these five pillars, with a geographic focus on Sub-Saharan Africa. This report further details seven criteria, or prerequisites, that must be considered and addressed in order to effectively establish and scale up ICT-based solutions in the health sector. These criteria include infrastructure, data and interoperability standards, local capacity, policy and regulatory environments, an appropriate business model, alignment of partnerships and priorities, and monitoring and evaluation. In order to bring specific examples of these criteria to light, this report concludes with 12 specific cas...

The objective of this report is twofold: first, to update the data relating to child under nutrit... more The objective of this report is twofold: first, to update the data relating to child under nutrition (stunting and underweight) in the original series reports, by using the new international child growth standards; and second, to provide information on overweight and obesity, which were not included in the original series reports. At the time the original reports were designed, concern about malnutrition in low- and middle-income countries focused primarily on under nutrition. Since then, interest in overweight and obesity has risen sharply, calling for data on these as well as on under nutrition. Tables containing prevalence figures are presented in part one of this reports. For all the child nutrition indicators, both the values based on the old growth references and those based on the new World Health Organization (WHO) standards are provided, allowing readers to assess the impact of the introduction of the new standards on prevalence rates. Standard errors for those prevalence f...