Low Income Countries Research Papers (original) (raw)

The external debt burden of many low-income developing countries has increased significantly since the 1970s. Developments in a sample of ten countries show that the main factors behind the buildup of debt were (1) exogenous (adverse terms of trade shocks or weather), (2) a lack of sustained macroeconomic adjustment and structural reforms, (3) nonconcessional lending and refinancing policies of creditors,

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- Geography, Economics, Civil War, External Debt

Introducing systems-oriented design for complex societal contexts in design engineering education Abstract Faced with large-scale wicked problems that include global warming, resource depletion, poverty and humanitarian emergencies, society needs new and more appropriate reasoning models. In particular, these problems pose unfamiliar challenges in contexts with poor financial and infrastructural resources. Systems-oriented design (SOD) is widely recognised as one promising approach that can support design engineers in addressing these complex societal problems. This paper explores the application of SOD in the development of product-service system (PSS) concepts by student teams in a multidisciplinary master course. The resulting twelve concepts were analysed using a case study approach and protocol analysis, describing the advantages and context-and process-related challenges of using SOD. From an educational perspective, the results demonstrate that while SOD provides students wi...

- by Jan Carel Diehl
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- Product Service Systems, Low Income Countries
- by Helen Abadzi
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- Literacy, Non-Governmental Organizations (NGOs), Education For All, Illiteracy

Surgical 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. This 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 e...

- by Elaine Borg
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- Surgery, Collaboration, Medical Microbiology, General Surgery

Postnatal depression is an important public health problem worldwide. Recent evidence suggests that rates may be relatively higher in developing countries. We aimed to explore the prevalence of postnatal depression and its association with social support and other risk factors in a sample of Pakistani women. Population-based survey of 149 women at 12 weeks postnatal using the Edinburgh Postnatal Depression Scale (EPDS), Multidimensional Scale of Perceived Social Support (MSPSS) and Personal Information Questionnaire (PIQ). Thirty six percent women scored > or =12 on EPDS. High depression score was associated with lower social support, increased stressful life events in the preceding year and higher levels of psychological distress in the antenatal period. There is a high prevalence of postnatal depression in Pakistani women. Early interventions should be developed that target the antenatal period and strengthen social support networks in women at risk.

- by Nusrat Husain
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- Psychology, Early Intervention, Poverty, Mental Health

Background: Universal salt iodation will prevent iodine deficiency disorders (IDD). Globally, salt-iodation technologies mostly target large and medium-scale salt-producers. Since most producers in low-income countries are small-scale, we examined and improved the performance of hand and knapsack-sprayers used locally in Tanzania. Methods: We studied three salt facilities on the Bagamoyo coast, investigating procedures for preparing potassium-iodate solution, salt spraying and mixing. Different concentrations of solution were prepared and tested using different iodation methods, with the aim of attaining correct and homogeneous iodine levels under real-life conditions. Levels achieved by manual mixing were compared to those achieved by machine mixing. Results: The overall median iodation level in samples of salt iodated using previously existing methods was 10.6 ppm (range 1.1-110.0 ppm), with much higher levels in the top than the bottom layers of the salt bags, p < 0.0001. Experimentation using knapsack-sprayers and manual mixing led to the reliable achievement of levels (60.9 ppm ± 7.4) that fell within the recommended range of 40-80 ppm. The improved methods yielded homogenous iodine concentrations in all layers of salt-bags (p = 0.58) with 96% of the samples (n = 45) falling within 40-80 ppm compared to only 9% (n = 45) before the experiment and training (p < 0.0001). For knapsack-spraying, a machine mixer improved the iodine levels and homogeneity slightly compared to manual mixing (p = 0.05). Conclusion: Supervised, standardized salt iodation procedures adapted to local circumstances can yield homogeneous iodine levels within the required range, overcoming a major obstacle to universal salt iodation.

- by philip momburi
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- Tanzania, Small and Medium scale Enterprises, Medicine, Quality Control

Because, globally, HIV is transmitted mainly by sexual practices and intravenous drug use and because of a long asymptomatic period, healthcare-associated HIV transmission receives little attention even though an estimated 5.4% of global HIV infections result from contaminated injections alone. It is an important personal issue for healthcare workers, especially those who work with unsafe equipment or have insufficient training. They may acquire HIV occupationally or find themselves before courts, facing severe penalties for causing HIV infections. Prevention of blood-borne nosocomial infections such as HIV differs from traditional infection control measures such as hand washing and isolation and requires a multidisciplinary approach. Since there has not been a review of healthcare-associated HIV contrasting circumstances in poor and rich regions of the world, the aim of this article is to review and compare the epidemiology of HIV in healthcare facilities in such settings, followed...

- by Peter Barss
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- Epidemiology, Injury Prevention, Medicine, Prevention

This paper examines whether poor and vulnerable groups in society share in the benefits of a foreseen economic expansion in the demand for fruit, vegetables and flowers from consumers at home and abroad. Primary survey data is collected on the differentiated position of low-income households in different supply structures (with varying levels of vertical coordination) and markets (national, regional and international markets). The data support the following hypotheses: (i) For many resource-poor agents, horticulture-related activities make substantial contributions to their livelihood security-certainly in the short term. (ii) Farming, trading services, small-scale retail, and farm labour are activities to which members of resource-poor and economically vulnerable households have the best access given their endowments. (iii) A move from food production for home consumption towards cash crops or off-farm labour is supported when there are sufficient options to reduce livelihood risk in the household. (iv) Both value creation and the generation of opportunities for (self-) employment in domestic marketing channels are substantial, and possibly outweigh the economic impact of overseas export marketing. Policy support is best tailored to specific conditions and specific actors to achieve a maximum impact on poverty alleviation. For that purpose, a three-tiered grouping of marketing channels for livelihood development is proposed.

- by Derek Eaton
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- International Marketing, Vietnam, Food Security, Value Creation

Pharmacoeconomics constitutes an area of health care research that assesses and compares the costs and outcomes related to drug therapy. The article's main aim is to stress the importance of the use of pharmacoeconomic research and pharmacoeconomics education in Yemen and in the curriculum carried out in Yemeni pharmacy schools. The article talks about the concept, the importance of pharmacoeconomics in low-income countries, the contributions made by pharmacoeconomics to pharmacy practice, pharmacy education in Yemen and the need to have proper pharmacoeconomics in Yemen. Conclusively, the Pharmacoeconomic research if implemented in Yemen, it will play an increasingly important role in making critical decisions concerning options that can be made regarding drug therapies and pharmaceutical services. Also, Pharmacists and future pharmacists should have a fundamental understanding of pharmacoeconomic concepts and the research methods employed to use the information gained from this rapidly growing field most effectively. To cite this review article

There has been a growing conversation about the revival of Manufacturing to push back growing inequality and reduce poverty. We discuss the pathways by which a higher share of the Manufacturing sector in GDP may bring about lower poverty incidence while a higher share of Services may have the opposite effect. We first compare the poverty reduction experiences of the Philippines whose growth has been largely Services-led in the last two decades with that of China and Vietnam, whose growth have, for the most part, been Manufacturing-led. We then present evidence based on cross-country panel data for low income countries that the Manufacturing share in GDP exhibits a significant negative association with poverty incidence while the higher Services share exhibits a significant positive association with poverty incidence. Low income countries seeking more inclusive growth may do better if they privilege their Manufacturing sector over the Services sector.

- by Raul V Fabella
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- Services, Manufacturing, Quality of Growth, Industrial Structures

The past decade has recorded remarkable interest in socioeconomic inequalities in health care. A multivariate analysis of the World Health Survey data for Burkina Faso was conducted using STATA. This included questions on household economic factors, perceived need, and access to health care. Poverty was defined using Principal Components Analysis. There was no significant difference in perceived need on the basis of poverty or gender. The less poor accessed health care more than the poor, but this difference was significant only among males. Respondents who lived in urban areas accessed health care more than those in rural areas, but this difference was significant only among females. We argue that health care financing arrangements affect self-reported need and access to health care. Even when they perceive need, the poor do not access care, probably because of cost, exacerbated by non-availability of readily accessible health care facilities.

- by daniel allotey
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- Poverty, Health Care, Principal Component Analysis, Health Disparities
- by Lawrence Gostin
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- International Law, Human Rights, Migration, Global Health

Around the world, in high- and low-income countries alike, mental illness and high-risk behaviors contribute to profound suffering and loss at the level of the individual and the state. In the case of China as in other developing countries, gains made in the areas of economics, technology, education, and overall standard of living are being offset by a rise in

- by Arthur Kleinman
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- Social Change, Health Care, Social Support, Economic Development

Purpose. Appropriate wheelchairs for basic mobility needs are still not commonly available in low-income countries, although several organizations are working toward this goal. After basic mobility is secured it is important to provide more diverse assistive technology to allow people with disabilities to more completely participate in society and live healthy lives. Our goal was to design an affordable sports wheelchair that would allow individuals in low-income countries to participate in basketball. Methods. Design requirements established for the sports wheelchair included: removable anti-tippers, adjustable tension backrest, 24 00 wheels, adjustable seat dump, variable camber, 4 00 casters, fore-aft axle position, removable bumpers, height adjustable footrest, four wheels, single anti-tipper (pivot), cost less than $125 without wheels, 16 00 seat width and backrest height, and nylon upholstery. The wheelchair was designed using 3D modeling, standard materials, and standard tools.

- by Rory Cooper
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- Developing Countries, Disability, Basketball, Wheelchairs

Problem During the 1990s, the Sudan began several initiatives to establish new medicine-financing mechanisms as part of the health reform process. Initial seed stocks were provided to each hospital. Unfortunately these facility-based funds did not regenerate and the hospitals were left without funds for medicines. The Revolving Drug Fund (RDF) was established in 1989 to facilitate access to medicines in health facilities in Khartoum state. Approach This study used quantitative and qualitative research techniques to collect data from health-care providers and users to evaluate the experience of operating an RDF in Khartoum state. Data from personal observations and from archival and statistical records were also analysed. Seven health facilities were sampled for this research. Local setting The Ministry of Health has a policy to expand the RDF to the whole country and has already commenced roll-out to seven more states. This policy is based on the experience of the RDF within Khartoum state. Relevant changes Khartoum state has a high (97%) level of availability of essential medicines and this is attributed to the RDF. The RDF medicines were mostly considered affordable by users and very few (6%) patients failed to obtain the prescribed medicines for financial reasons. Lessons learned The RDF could be successfully replicated in other states of the Sudan and in low-income countries with similar contexts on condition that they meet success factors, such as gradual implementation, political commitment and availability of hard currency. Une traduction en français de ce résumé figure à la fin de l'article. Al final del artículo se facilita una traducción al español.

This paper explores the choices faced by developing country governments that have received substantial revenues from natural resources. The economic principles underlying the choices between consumption, domestic investment, and the accumulation of foreign assets are analysed. The priority should be to use revenues to promote growth and investment in the domestic economy and thereby put consumption on a rapid growth path, although absorptive capacity may constrain the scope for doing this in the short run. Foreign asset accumulation should be used primarily to smooth volatility, rather than to build up a long-term sovereign wealth fund. Trade-offs between private and public spending channels are examined from both an economic and political economy standpoint.

- by Tony Venables
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- Political Economy, Developing Country, Absorptive Capacity, Natural Resource

This paper calculates Theil's entropy index to measure the extent of productivity differences across 92 countries for the period from 1970 to 2003. While there is evidence of increasing differences in productivity across these countries, we observe different patterns when we group the countries by income levels. These differences seem to be decreasing among middle income developing and developed countries whereas they seem to be widening among low and high income developing countries. The results of our multivariate time series analysis also suggest that FDI increases productivity differences among low and high income developing countries whereas GDI reduces these differences among low income countries in the long-run. Granger causality test results indicate that while an increase in GDI leads to a decline in growth of trade, a higher growth of trade appears to be important for attracting FDI to middle income countries. Furthermore, a reduction in productivity differences and a higher FDI growth lead to higher growth of trade in developed countries.

- by Gouranga Das
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- Economics, Foreign Direct Investment, Entropy, Developing Country

Many low-income countries are implementing non-profit medical insurance to increase access to health services, especially among low-income households, and to raise additional revenue for financing public health services. This paper estimates the effect of insurance on outof-pocket health expenditures using the Vietnam Living Standards Surveys for 1993 and 1998 and appropriate models for panel data. Our findings suggest that health insurance reduces health expenditure when unobserved heterogeneity is accounted for. Failure to capture unobserved heterogeneity produces contrary results that are consistent with previous cross-sectional studies in the literature. After accounting for unobserved heterogeneity, we also find that the reduction in expenditure is more pronounced for individuals with lower incomes, but the benefits are modest in the range of 17 to 20%.

- by Wayne Simpson
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- Economics, Health Economics, Health insurance, Vietnam
- by Aminur Rahman
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- Nursing, Bangladesh, Adolescent, Child

Purpose -In 2008, the world had undergone a global economic crisis. Since women always face greater difficulties in obtaining capital than men, the economic crisis had a greater effect on them. The purpose of this paper is to examine the implications of the global crisis for women's entrepreneurship, from the perspective of equality, diversity and inclusion. Design/methodology/approach -The paper reviews studies on gender differences in entrepreneurship, focusing on 2007 and 2008 Global Entrepreneurship Monitor (GEM) studies that examined the rates of entrepreneurship in 43 countries. Findings -The data show that in all 43 countries, the rates of women's entrepreneurship are lower than men's. Furthermore, the percent of women entrepreneurs is higher in countries where the general income per capita is small and where women have no other option for making a living. Research limitations/implications -This surprising finding has been explained as a result of the difference between ''necessity'' and ''opportunity'' entrepreneurship, with necessity entrepreneurship found to be more prevalent among women in poor countries, thus pointing to the role played by inequality and exclusion in women's entrepreneurial inferiority. Practical implications -From the perspective of diversity, equality and inclusion, entrepreneurship can be viewed as a means for inclusion of women and other marginalized groups in countries, especially low-income countries, in which they suffer from lack of equal opportunities and social exclusion. Originality/value -The paper usefully shows how, especially in times of a global crisis, the role played by inequality and exclusion in women's entrepreneurial inferiority has important implications; such as the need to create special funds for women and the importance of establishing social and business networks for women entrepreneurs.

- by Miri Lerner and +1
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- Business Networks, Social Exclusion, Global Entrepreneurship Monitor, Equal Opportunities

A challenge faced by many countries is to provide adequate human resources for delivery of essential mental health interventions. The overwhelming worldwide shortage of human resources for mental health, particularly in low-income and middle-income countries, is well established. Here, we review the current state of human resources for mental health, needs, and strategies for action. At present, human resources for mental health in countries of low and middle income show a serious shortfall that is likely to grow unless eff ective steps are taken. Evidence suggests that mental health care can be delivered eff ectively in primary health-care settings, through community-based programmes and task-shifting approaches. Non-specialist health professionals, lay workers, aff ected individuals, and caregivers with brief training and appropriate supervision by mental health specialists are able to detect, diagnose, treat, and monitor individuals with mental disorders and reduce caregiver burden. We also discuss scale-up costs, human resources management, and leadership for mental health, particularly within the context of low-income and middle-income countries.

- by Harry Minas
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- Psychiatry, Mental Health, Leadership, Health Care
- by Stijn Claessens
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- Political Economy, Nutrition, Poverty, International Trade

Zambia was a middle-income country when it achieved independence from Great Britain in 1964. After decades of international aid Zambia has become a low-income country, and its per capita GDP is only now returning to the levels it had reached over forty years ago. While aid is far from the only variable at work in Zambia's development, its impact has been questionable. This paper examines the issue of aid effectiveness in Zambia, especially in terms of how the incentive structure faced by donors may lead to decreased accountability and inadequate concern for long-term outcomes, rendering aid less beneficial. The paper concludes by proposing a revised approach to the provision and use of international aid in Zambia, as well as in other aid-dependent countries in Sub-Saharan Africa.

- by Monica Beuran
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- Aid effectiveness, Projects, Great Britain, Low Income Countries

A number of low and middle income countries (LMICs) are considering social health insurance (SHI) for adoption into their social and economic environment or striving to sustain and improve already existing SHI schemes. SHI was first introduced in Germany in 1883. An analysis of the German system from its inception up to today may yield lessons relevant to other countries.

- by Rainer Sauerborn
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- Sociology, Anthropology, Poverty, Developing Countries

The objectives of this study were to describe the global profile of biomedical research productivity and to examine any improvement seen in it in the developing world during the period 1990-2000. Biomedical research articles published during 1990-2000 were accessed through the Medline database. The number of (journal) articles originating from each of the countries of the world, normalized to number of publications per million population (PPMP) per year, was elicited. In addition, the time trends of the number of publications in terms of each of the countries, continents, and economic groups were investigated. In terms of continents, North America had the highest number of biomedical PPMP per year (341.33); this was followed by Australia and Oceania (288.35), Europe (136.88), Asia (12.81), South America and Caribbean region (10.80), and Africa (3.50). In total, 52.7% of the countries showed a positive trend over time: 23.3% in South America, 28.9% in Africa, 40.0% in Australia and Oceania, 61.0% in Asia, 84.6% in Europe, and 100% in North America. All the continents except Africa showed a significantly positive trend. The share of the total number of publications went down for Africa (from 1.2 to 0.8%) and up slightly for Asia (from 14.3 to 15.6%) and South America (from 1.3 to 1.8%) during 2000 compared with 1990. The better the economic ranking of a country, the higher the number of biomedical PPMP. The total share of publications coming from low-income countries also fell, from 2% in 1990 to 1.7% in 2000. The imbalance between developed and developing countries in terms of biomedical research is significant. Pragmatic policies should be adopted by the World Bank, World Health Organization, other United Nations bodies, and respective governments to encourage biomedical research in the less-developed parts of the world.

- by Mahbubur Rahman
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- Nonparametric Statistics, Bibliometrics, United Nations, Developing Countries

Although prepayment schemes are being hailed internationally as part of a solution to health care financing problems in low-income countries, literature has raised problems with such schemes. This paper reports the findings of a study that examined the factors influencing low enrolment in Tanzania's health prepayment schemes (Community Health Fund). The paper argues that district managers had a direct influence over the factors explaining low enrolment and identified in other studies (inability to pay membership contributions, low quality of care, lack of trust in scheme managers and failure to see the rationale to insure). District managers' actions appeared, in turn, to be at least partly a response to the manner of this policy's implementation. In order better to achieve the objectives of prepayment schemes, it is important to focus attention on policy implementers, who are capable of re-shaping policy during its implementation, with consequences for policy outcomes.

- by Lucy Gilson and +1
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- Program Evaluation, Community Health, Tanzania, Policy Analysis

Sustainable development is frequently an object of standardization, and over 100 000 organizations hold ISO 14001 certificates proving they have legitimate environmental management systems. Guidelines for social responsibility are now the object of standardization, resulting in the upcoming ISO 26000 standard. This paper examines the rationale behind developing ISO 26000, highlighting the tendency to decouple complex CSR issues in the organizational context. This is relevant to current problems of poor working conditions, weak regulatory compliance, and corruption often encountered in the production context in low-income countries. In addition, existing codes of conduct are frequently decoupled from actual organizational performance. We highlight how CSR standardization risks isolating complex and contested social issues, more radical attempts at change conflicting with striving for legitimacy. Like the decontexualizing tendency proceeding from the standardized treatment of complex sustainable development issues in organizations, CSR issues also risk becoming decontextualized with the application of standardized approaches such as the ISO 26000 standard. Copyright © 2009 John Wiley & Sons, Ltd and ERP Environment.

- by Birgitta Schwartz
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- Social Sciences, Corporate Social Responsibility, Legitimacy, Standardization
- by Martin Prince
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- Primary Care, Mental Health, Quality of life, Developing Countries

In a world increasingly affected by global environmental changes, Low Income countries will play an ever more central role in determining the future health of the biosphere. While global use of the biosphere's capacity has increased over the past 45 years, per capita demand for biocapacity, as measured by the Ecological Footprint, has only increased in high-income countries and has remained constant or fallen in middle-and low-income nations. Consumption has increased faster than population in high-income nations, while population growth has been the dominant factor in middle-and low-income countries. Although listed in the middle-income group of countries, China showed atypical trends in the past 45 years, with a rapid increase in per capita Ecological Footprint that outstrip its gains in income. Typical trends were instead noticed for India, whose per person Ecological Footprint has fallen slightly.

Since the end of World War II, a distinct community of organizations has emerged in high-income countries to promote `development' in the low-income countries of Africa, Asia, and Latin America. This paper examines some of the effects of these organizations and the professionals they have produced on international educational norms and conventions, as typified by the 1990 World Conference on Education for All. I suggest that organizational variables, such as professionalism and resource dependence, rather than nation-state interests and dominance alone, explain the standardization of Western models of mass education in international conventions and declarations.

Background: Many countries in middle-and low-income countries today suffer from severe staff shortages and/or maldistribution of health personnel which has been aggravated more recently by the disintegration of health systems in low-income countries and by the global policy environment. One of the most damaging effects of severely weakened and under-resourced health systems is the difficulty they face in producing, recruiting, and retaining health professionals, particularly in remote areas. Low wages, poor working conditions, lack of supervision, lack of equipment and infrastructure as well as HIV and AIDS, all contribute to the flight of health care personnel from remote areas. In this global context of accelerating inequities health service policy makers and managers are searching for ways to improve the attraction and retention of staff in remote areas. But the development of appropriate strategies first requires an understanding of the factors which influence decisions to accept and/or stay in a remote post, particularly in the context of mid and low income countries (MLICS), and which strategies to improve attraction and retention are therefore likely to be successful. It is the aim of this review article to explore the links between attraction and retention factors and strategies, with a particular focus on the organisational diversity and location of decision-making.

- by Tim Martineau
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- Decision Making, English language, Health Care, Human Resource Management
- by Hugh Waters
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- Information Systems, Marketing, Surgery, Nutrition

Current thinking in major international development agencies construes community-based health insurance (CBHI) as a transitional mechanism to achieving universal coverage for health care in lowincome countries. The policy link between CBHI and universal coverage is implicitly determined by the historical experience of mutual health insurance in countries such as Germany and Japan in the 19 th century, where the socioeconomic context was dramatically different to that of today's much less successful schemes. This paper argues that the economic and health system frameworks employed in the analysis of CBHI have not taken into account context-dependent considerations such as goals, values and power. It is proposed that a critical engagement with social capital theories could contribute to our understanding of why CBHI schemes do not appear on course to develop according to the 19 th century precedent, achieving significant levels of population coverage in a sustainable way.

- by Elias Mossialos
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- Economics, Health Care, Social Capital, Economic Development

Very little information is available on budget and financing of mental health services in the world. During year 2001, WHO collected information from all countries on resources available for mental health care as a part of Project Atlas. The present report seeks to describe the situation regarding federal budgets and financing of mental health care at the country level. It also examines the association between relative allocation of health budget to mental health and mental health policy, programme and resource indicators in 89 countries. The information was collected through a questionnaire (with an accompanying glossary) that was sent to the mental health focal point in the Ministry of Health of each country. Eighty nine countries provided information on their mental health budget as a proportion of health budget. In addition, information was obtained on policy, programme and mental health resource indicators (beds, personnel, services to special population and availability of dru...

- by Benedetto Saraceno
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- Psychology, Mental Health, Health Care, Global Health
- by Helene Barroy
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- Social Movements, Nutrition, Molecular Biology, Primary Health Care
- by John Serieux
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- Low Income Countries

Consumption of cow's milk is recommended in many countries. Observational and intervention studies show that cow's milk most likely has a positive influence on growth in children. The strongest evidence comes from observational studies and intervention studies in low-income countries, but there are also observational studies from high-income countries showing positive associations between milk intake and growth. Milk seems thus to have a specific stimulating effect on linear growth, not only in developing countries with high rates of malnutrition, but also in industrialized countries. However, it is not known which components in milk stimulate growth. Possible components are proteins, minerals, vitamins or combinations of these. Cow's milk proteins have a high protein quality, and whey has a slightly higher quality than casein, according to some indices based on amino acid composition. Studies, mainly from sport medicine, have suggested that whey protein also has the potential to increase muscle mass. Whether whey improves body composition to a larger extent than other milk proteins is not clear. The mechanism behind a possible growth-stimulating effect of milk and milk components is likely to be through a stimulation of insulin-like growth factor-I synthesis and maybe insulin secretion. In conclusion, there is strong evidence that milk stimulates linear growth. The mechanism is not yet clear, and more intervention studies are needed to understand which components in milk are responsible for the growth stimulation. The effects of milk on linear growth and adult height may have both positive and negative long-term implications.

- by Christian Mølgaard
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- Sports Medicine, Child Development, Developing Countries, Child

Exporting fresh flowers is one of very few successful efforts by producers in lowincome countries to compete in international markets of high-value agricultural goods. While this success results from producers' ability to take advantage of their geographic location and access to low labor costs, it may not be sustainable in the long run due to unreliable supply chains and high transportation costs. In this regard, it is important to note that to date, there have not been many studies on the subject.

- by Henry Vega
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- International Marketing, Peru, Agricultural trade, Supply Chain

Although a growing proportion of young people is spending some time in school between puberty and marriage, little research on education in developing countries has been focused on adolescent issues. This article examines the school environment in Kenya and the ways it can help or hinder adolescents. Gender differences are considered with a view toward illuminating some factors that may present particular obstacles or opportunities for girls. Using both qualitative and quantitative data, 36 primary schools in rural areas in three districts of Kenya are studied. These schools are chosen to reflect the spectrum of school quality in the country. The focus in this study is on primary schools because the majority of adolescents in school attend primary school. In these schools, where considerable variation in performance and parental educational status is found, disorganization coexists with strict punishment, minimal comforts are lacking, learning materials are scarce, learning is by rote, and sex education is not provided. In the primary-school-leaving exam, girls' performance is poorer than that of boys. Teachers' attitudes and behavior reveal lower expectations for adolescent girls, traditional assumptions about gender roles, and a double standard about sexual activity.

- by Karin Hyde and +2
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- Demography, Education, Poverty, Prejudice

ABSTRACT Flows of development financing from the BRICs (Brazil, Russia, India, and China) to low income countries (LICs) have surged in recent years. Unlike aid from traditional donors, BRICs (excluding Russia) view their financing as primarily based on the principles of South-South cooperation, focusing on mutual benefits without attachment of policy conditionality. This paper provides an overview of the philosophies and modalities of BRIC financing and examines their implications for LIC economies and future LIC-BRIC engagement.

- by Nkunde Mwase
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- Developing Country, Low Income Countries, Low Income
- by Jack Glen and +6
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- Information Technology, International Development, International Trade, Telecommunications

Rapid urbanization is taking place especially in low-income countries. Globally, in 1985, 41% of the world population lived in urban areas, and by 2015 the proportion is projected to rise to 60 % . Of this urban population 68 % will be... more

- by Christian Zurbrügg
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- Solid Waste Management, Low Income Countries

Road traffic injuries, a major global public health burden, are concentrated in low-income and middle-income countries. 1 In contrast to highincome countries, pedestrians make up the largest group of road traffic injuries and fatalities in low-and middle-income countries. This article presents an analysis of pedestrian fatalities (2001)(2002)(2003)(2004) in four South African cities. The article describes the magnitude, demographic, and temporal factors associated with pedestrian fatalities and presents a typological analysis to identify particular groups of at risk pedestrians. The analysis can serve to inform the development of prevention programmes tailored to the needs of specific at risk pedestrian groups. Data were obtained from the National Injury Mortality Surveillance System (NIMSS). The results indicated that there were a total of 7433 pedestrian deaths (2001)(2002)(2003)(2004) for the four cities and the majority occurred over weekends. Most (56.7%) were between ages 20 and 44 years. Overall, there were 3.3 male pedestrian deaths for every female pedestrian death, and over half (58%) of the 4004 cases tested were positive for alcohol. A typological analysis identified three categories of pedestrian fatalities: (1) male pedestrian fatalities that showed high levels of alcohol concentrations, (2) female and elderly pedestrian deaths that occurred between 6 AM and midday, and (3) children, adolescents, and young adult pedestrian fatalities that typically occurred during weekday afternoons and evenings. The findings call for multiple strategies for combating pedestrian fatalities.

- by Mohamed Seedat and +1
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- Psychology, Emerging Economies, Public Health, Adolescent

Previous studies generally find mixed empirical evidence on the relationship between government spending and economic growth. In this paper, we re-examine the causal relationship between government expenditure and economic growth by conducting the panel Granger causality test recently developed by and by utilizing a richer panel data set which includes 182 countries that cover the period from 1950 to 2004. Our empirical results strongly support both Wagner's law and the hypothesis that government spending is helpful to economic growth regardless of how we measure the government size and economic growth. When the countries are disaggregated by income levels and the degree of corruption, our results also confirm the bi-directional causality between government activities and economic growth for the different subsamples of countries, with the exception of the low-income countries. It is suggested that the distinct feature of the low-income countries is likely owing to their inefficient governments and inferior institutions.

- by Eric Lin
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- Econometrics, Economic Growth, Applied Economics, Policy modeling
- by Thomas Gaziano
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- Cardiovascular disease, High Blood Pressure, Blood Pressure, Cost effectiveness
- by Maleeha Quershi
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- Development Economics, Rural Development, Applied Economics, IT adoption

1 Effective January 2007, the Discussion Paper series within each division and the Director General's Office of IFPRI were merged into one IFPRI-wide Discussion Paper series. The new series begins with number 00689, reflecting the prior publication of 688 discussion papers within the dispersed series. The earlier series are available on IFPRI's website at www.ifpri.org/pubs/otherpubs.htm#dp.

- by Devesh Roy
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- Food Safety, Collective Action, Pesticide Residues, Agricultural trade