Alexander Moradi and Kalle Hirvonen
African adult populations are remarkably tall for the low income levels that prevail at the country level. The average African woman is about 158.5 cm tall, whereas the low gross domestic product per capita would lead us to expect a mean height more similar to the shortest populations in the world, about 4 cm shorter. This is the case in spite of the fact that indicators of socioeconomic status and height are positively correlated within each country. The chapter also shows that the physical stature of African children fit well into the global income–height relationship. Hence, we conclude that the anomaly in the income–height nexus at country level appears to originate between childhood and adulthood. We present evidence for considerable catch-up growth involving entire populations. We discuss possible reasons for this catch-up growth including genetics, and, above all, better nutrition and health conditions during adolescence.
Elizabeth Frankenberg, Jessica Ho, and Duncan Thomas
With populations aging and the epidemic of obesity spreading across the globe, global health risks are shifting toward noncommunicable diseases. Innovative biomarker data from recently conducted population-representative surveys in lower, middle, and higher income countries are used to describe how four key biological health risks—hypertension, cholesterol, glucose, and inflammation—vary with economic development and, within each country, with age, gender, and education. As obesity rises in lower income countries, the burden of noncommunicable diseases will rise in roughly predictable ways, and the costs to society are potentially very large. Investigations that explain cross-country differences in these relationships will have a major impact on advancing the understanding of the complex interplay among biology, health, and development.
Claudio de Moura Castro
This chapter examines the evolution of education in Brazil over the long term. It is established that historical circumstances allied to successive policy failures help account for Brazil’s disappointing performance in the educational field in international comparative terms. In 1920, the system covered 9% of school-age children, 26% by 1950 and, more recently, 98% of 6–14-year-old children have been covered. The acceleration in growth, particularly since the 1950s, has been an impressive achievement. The latest records indicate that 71% of the relevant age cohort finishes basic education. Secondary education is completed by 51%. Compared to the past, this is quite an achievement. Compared to world or even Latin American standards, these results are mediocre at best. The available tests indicate weak performance. The chapter highlights the kinds of issues that will need to be addressed if this situation is to be tackled adequately.
This chapter discusses dimensions of inequality in sub-Saharan Africa and their causes. It starts with a review of the empirical evidence about inequality during the colonial period as well as the post-independence era. Then it discusses the forces that determine inequality change, focusing on factor accumulation and structural change. Next it considers the relationship between inequality and growth, the role of agriculture in the development process, the relationships between ethnicity and social stratification and governance, and external influences on inequality. The chapter concludes with some comments on what policy interventions can do to reduce inequality.
Francisco H. G. Ferreira
Adrian Towse, Eric Keuffel, Hannah E. Kettler, and David B. Ridley
This article sets out the context for the problem of insufficient affordable medicines to address health issues in developing countries. It also highlights some of the drivers of recent positive trends. It then detail policies and proposals that are intended to increase access to global medicines (i.e., those with a developed country market) by lowering prices, including differential pricing, compulsory licensing, and donations. Finally, it considers policies that are aimed at encouraging the development of new medicines for neglected diseases (i.e., those prevalent only in lower-income countries) by reducing company-borne costs and risks or by expanding the expected revenue for the manufacturer through increased product demand. In particular, it describes “push” mechanisms that subsidize research inputs and “pull” mechanisms that reward research output.
Daniel Jong Schwekendiek
Body mass index, weight, and stature are reliable indicators of biological living standards. Although most studies in anthropometric history focus on Western nations, East Asian countries are of great interest as well because one-fifth of the world’s population lives in this region. This chapter reviews studies that focus on the anthropometric history of China, Japan, and Korea. Although the anthropometric measurements of contemporary urban Chinese equal those of Japan and South Korea, its rural population lags far behind. However, their anthropometric status is superior to that of North Korea, which has the worst economic performance in East Asia. Differences between the two Koreas cannot be explained by genetic predispositions alone. Japan’s anthropometrics have not matched its increasing economic power, but the quantity and quality of food intake in Japan differs from that of the rest of East Asia, suggesting that differences in food culture may account for these variations.
Moramay Lopez Alonso
This chapter examines scholarship in the field of economics and human biology from the pre-Columbian era to the present in the context of Latin America. This literature’s main themes consider the evolution of living standards in the very long run to shed light on the advantages and disadvantages of the human social development and organization process. The author examines how, through historical anthropometric studies, one can assess changes in biological standards of living to understand how they were affected by economic development in different Latin American regions. These studies confirm that anthropometric indicators are a proxy of living standards and inequality. This literature also adds to the comprehension of synergies between health and nutrition indicators and economic performance among different population groups; it shows that findings generated from this research can lead to public policy recommendations to address growing challenges in public health, such as obesity and diabetes.
Jean-Claude Berthélemy and Josselin Thuilliez
Malaria still claims a heavy human and economic toll, specifically in sub-Saharan Africa. Even though the causality between malaria and poverty is presumably bi-directional, malaria plays a role in the economic difficulties of the region. This chapter provides an analysis of the economic consequences of malaria (with an emphasis on human capital accumulation and productivity), and a discussion of policies aimed at reducing its incidence. A major initiative has been the distribution of insecticidal bed-nets at a highly subsidized price. An economic-epidemiology model is used to explain why such policy is doomed to fail in presence of a very high poverty incidence, as observed in the African region.
This chapter reviews the progress and remaining challenges in terms of raising educational quantity and quality in Latin America, focusing on primary and secondary (K-12) schooling, setting aside issues related to higher education or early childhood development. It makes the case that, in terms of quantity, the region has made substantial strides. The remaining challenges revolve around reducing delayed entry, repetition, and dropout rates. The policy outlook in this area provides some grounds for optimism, as many governments are already implementing interventions (e.g. conditional cash transfers) that have been credibly evaluated and shown to be effective at tackling these issues. Beyond this, the policy outlook in this area offers less to be optimistic about, as little is known regarding how to raise educational quality, and this knowledge base is likely to improve only slowly.
Female heights matter. They matter for girls’ and women’s health and productivity, as a measure of inequality, and—significantly—as a bridge transferring welfare across generations. This chapter examines some of the early historiography on female stature and summarizes the historical evidence. The focus then shifts to how we understand the growth of girls versus boys and the methods used to measure historical populations. The chapter then outlines some of the risks of being stunted, identified in a set of empirical relationships among height, weight, morbidity, and mortality that are a function of both age and sex. The chapter then looks at the unique role of mothers and the way their stature not only records the accumulated experience of their own nutrition and welfare history, but how it intimately shapes the generations to come, critically influencing future economic performance.
Juliet U. Elu and Gregory N. Price
Willem H. Buiter and Urjit R. Patel
This article considers India's experience with fiscal (responsibility) rules during the past decade. The article first provides an analytical foundation on how to think about debt sustainability in the Indian context. It argues that the fiscal space “vacated” in recent years by states has been usurped by the central government. The recommendations of the 13th Finance Commission regarding a roadmap for fiscal consolidation are also examined numerically—something that would be useful to policy makers. Some of the dimensions along which the assessment of fiscal rules takes place—for fiscal policy in Indian going forward—include scope for eliciting time-consistent behavior, features that encourage countercyclical behavior and safeguards against political opportunism.
Jishnu Das and Jeffrey Hammer
This article argues that despite high private expenditures on health in India, policy discourse reflects a constant preoccupation with the public sector. Even historically, envisioning a universal system of health care, the main focus of public health policy—like schooling policy—has been better “access” to public primary health care centers. This focus has been unduly narrow with little attention paid to understanding the behavior of health providers, or conducting a serious outcome evaluation of any of the components of the link from which health services can be availed, be they primary care centers or superspecialty hospitals. The article argues that “access” is not the binding constraint in the provision of primary health care in India. The problem is the quality of care provided both in the public and private sector. It also suggests how standard measures of “quality” can be directly counterproductive. The key focus should be on how health policy affects the quality of services and how to make this a starting point for future policy formulations.
This article focuses on the limited attention paid to the economic dimensions of low- and middle-income countries (LMICs) health systems relative to those of high-income countries, and the restricted evidence base. The aim is to provide an economic analysis of LMIC health systems and policy implications, and to interpret the relevance to LMIC settings. It analyzes the economic dimensions of health systems in LMIC, including how they differ from those of high-income countries. It helps to identify distinctive characteristics of low- and middle-income countries that affect the policy recommendations that can be derived from the application of economic thinking to their health systems. Finally, it discusses the key areas of debate that remain unresolved.
This chapter examines the relationship between health, growth and development in Africa using evidence assembled from micro- and macroeconomic studies over the period 1960–2000. This evidence is briefly compared with situations in other world regions. The period 1960–2000 is unique for Africa’s health profile because of the sharp increase and reversal in the population health witnessed at the time. By the end of 1990s, health indicators for many African countries were approaching or already below the levels for the 1970s. There is need to investigate reasons for such catastrophic reversal in health fortunes in Africa so that policy measures can be taken to avoid human suffering of similar magnitudes in the future.
There has been a sustained increase in economic growth in Africa since the mid-1990s. However, most economies have not yet experienced transformation to greater productivity and global competitiveness. It is argued by some experts that what Africa needs are the industrial policy strategies that have transformed East Asian economies. Such policies are associated, in their initial phase, with autocratic regimes. On the other hand, it is widely believed that it is the liberalization of African political and economic systems that made possible today’s “rising” or “emergent” Africa. A contrary hypothesis has been advanced by one group of scholars that a new form of political and economic governance—developmental patrimonialism as exemplified by the Rwandan and Ethiopian governments—suggests a better pathway from poverty to inclusive growth. This paper examines these contrasting arguments. It concludes with the need for greater discussion and research on developmental governance and the building of coherent and effective democratic states.
This article attempts to understand a significant puzzle in the political economy of infrastructure spending in India: the coexistence of low public spending on infrastructure (as a proportion of the total budget) in Indian states, and low efforts to secure private participation for greater investments, despite large demand from citizens for infrastructure services. A broader attempt of the article is to identify the key political constraints to effective infrastructure policies. The argument is based on two separate assumptions—one, on the division of voters between organized interest groups that seek rents, and unorganized swing voters who seek general benefits from public goods; and two, on the degree to which different kinds of public spending programs can be used for rent-seeking versus vote-buying, with infrastructure projects more suited to the former and broader poverty alleviation programs to the latter.
Growth has been high and widespread in the last decade in Africa. Whether this shift in Africa’s fortune has impacted poverty has been a subject of controversy. This chapter brings into focus recent evidence on the pace of poverty reduction in Africa and addresses the question of whether Africa is too poor to grow. The findings points to credible evidence that poverty has declined significantly since the 1990s but at a lesser speed than growth in per capita GDP. More importantly, global poverty tends to respond much more strongly to shifts in sector of employment, particularly to increase in employment in the industrial sector, than to increase in mean income. In Africa the closing of the gap in living standars between a large traditional and informal sector and a dynamic modern sector will remain the most effective way to achieve poverty reduction. Challenges of structural transformation and its attendant benefits are discussed using emerging thinking on industrial policies to achieve inclusive growth in Africa.