Wednesday 14 April 2010
Are the world's poor leading ever improving lives?
We have seen several pieces of evidence this year that, contrary to popular belief and even contrary to some aggregate GDP statistics, the lives of the global poor - with some notable exceptions - seems to be improving significantly. Here is more evidence to that effect - despite the huge increase in the global population and the rise of HIV, maternal deaths have fallen to about 342,900 in 2008 from 526,300 in 1980. Besides the obvious good news (and, indirectly, the implication about the effectiveness of certain policies), the other striking point of this article was how some groups actually try to suppress favourable information about good development outcomes. What do you think? Is this justified on the grounds that good news might make people relax?
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Though maternal death rates might have fallen since the 1980s, good news are not all providing evidence for an improved underlying health system as such. Problems in maternal and child health care are remaining such as amongst others high urban mortality rates (Montgomery 2009). Likewise, though the aggregate of news might be positive, the access to health care is still a remaining issue that requires further attention and a differentiated view.
ReplyDeleteIn terms of suppression of favourable information, when it comes to policies or health measures, information is crucial but not always showing the entire picture yet used in a favourable way. For instance as per my own experience information about failures of traditional birth attendants (untrained) has been generalised to all traditional birth attendants (TBAs) in Malawi. This was used to implement a long-term policy reform of the role of traditional birth attendants but not showing the entire picture of the situation in different districts. Likewise, reduced cases of mortality through trained TBAs and mortality cases in hospital are kept silent to justify the new national policy. Hence, information favourable or not needs to be looked at in the single country cases before judging the development.
Success stories regarding mortality rate changes have various origins. While policy influence might be a possible cause of a reduction, it can also be a driver of risk of access to care as such, as in the case of Nkhotakota (Malawi) alike other mechanisms and behavioural changes might be important drivers of the reduction. It is key not to suppress but also not to overvalue information and take it as a justification to reduce effort but rather a justification to continue. Especially considering the discrepancies of access to maternal care in many developing countries.