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The study aimed to assess the impact of the COVID-19 pandemic on the financial condition and mortality in Polish voivodeships. To achieve this objective, the relationship between the number of deaths before and during the pandemic and the financial condition of the provinces in Poland was studied. The study covered the years 2017–2020, for which a one-way ANOVA was used to verify whether there was a relationship between the level of a province’s financial condition and the number of deaths. The results of the study are surprising and show that before the COVID-19 pandemic, there was a higher number of deaths in provinces that were better off financially, but the relationship was not statistically significant. In contrast, during the pandemic, a statistically significant strong negative correlation between these values was proven, which, in practice, shows that regions with better financial conditions had a higher number of deaths during COVID-19.

В данной статье авторами проведено исследование состояния сферы здравоохранения отдельных стран (США, Китай, Германия, Франция, Италия), включая Россию; сопоставлены ключевые показатели оценки систем здравоохранения (уровень финансирования данной сферы, объемы коечного фонда, численность врачей, численность населения в целом) перед началом мировой угрозы в виде пандемии COVID 19. Авторами проанализирована динамика заболеваемости и смертности от коронавирусной инфекции в указанных странах и сделаны выводы о готовности систем здравоохранения отдельных стран оказывать качественное медицинское обслуживание населения, предотвращая по возможности негативные риски от распространения пандемии. Для проведения исследования, представленного в статье, использованы официальные данные по ряду стран для сопоставления данных, международные базы данных по распространению коронавирусной инфекции. Для написания данной статьи использовались методы анализа, логики, системного подхода и интерпретации полученных данных., In this article, the authors conducted a study of the state of health of individual countries (USA, China, Germany, France, Italy), including Russia; the associated key indicators for assessing health systems (level of funding for the spheres, the volume of hospital beds, number of doctors, the population as a whole) before the global threat of pandemic COVID-19. The authors analyzed the dynamics of morbidity and mortality from coronavirus infection in these countries and made conclusions about the readiness of the health systems of individual countries to provide high-quality medical care to the population, preventing, if possible, negative risks from the spread of the pandemic. To conduct the study presented in the article, we used official data for a number of countries to compare data, international databases on the spread of coronavirus infection. To write this article, we used methods of analysis, logic, and a systematic approach.

The number of deaths from the coronavirus disease 2019 (COVID-19) differs dramatically by country. The surprisingly low number of deaths from COVID-19 in several East Asian countries is a puzzle and we propose a different explanation for the variation in the number of deaths by country, the geographical distance from an epicenter of COVID-19. Combined with the gross domestic product for each country, we can explain the country variation in the number of deaths for more than 100 countries surprisingly well. By introducing these control variables, we can also correctly estimate the impacts of policy response and social/economic conditions. Adjusted by the gravity control variables, the difference in the number of deaths in European and American countries and East Asian countries becomes much smaller, from a factor of several hundred to a single digit, proposing a simple but powerful solution to the puzzle.

Предложен аналитический метод расчёта динамики эпидемических процессов. Метод основан на аппроксимации фактических временных зависимостей числа инфицированных людей, числа выздоровевших людей и числа умерших людей предложенными функциями, которые содержат четыре параметра. Значения этих параметров вычисляются методами оптимизации. Проведены расчёты для Москвы и Московской области. Совпадение расчётных и фактических значений хорошее. В Москве пройден максимум прироста числа инфицированных (плато) и затем пройден пик эпидемии (максимальное число болеющих) и сейчас уменьшается прирост числа инфицированных, снижается численность больных. Похожая ситуация и в Московской области. Сделан прогноз развития эпидемии.

The article presents the results of a comparative analysis of the structure, volumes and levels of mortality of the population in the territory of the Moscow Oblast of the Russian Federation in the first half of 2018-2020, which indicate that the decrease in total mortality by 2.4% in 2019 was replaced by its growth by 15.0% in 2020 More than 90% of the total increase in mortality was recorded in April- June. The proportion of COVID-19 as the cause of death was 10.5% in the second quarter of the year, and the share of COVID-19 in the increase in mortality by month was 24.7% in April, 46.5% in May and 58.4% in June with an average value of 41.3%. By classes of diseases, the most intensive increase in mortality was from diseases of the respiratory system (by 41.4%), mental and behavioral disorders (by 35.9%), diseases of the nervous system (by 17.4%) and diseases of the digestive system (by 15,2%). The largest increase in mortality for these classes of diseases was also noted in the second quarter of the year, with peaks in May 2020.

Pour la premiere fois, une analyse statistique du nombre de deces dus aux activites de Boko Haram est fournie. L'analyse est basee sur des distributions discretes nouvellement proposees. Les distributions sont adaptees aux donnees en utilisant la methode du maximum de vraisemblance. La distribution discrete de Chen est trouvee pour donner le meilleur ajustement. Ses parametres sont autorises a varier lineairement avec le temps pour capturer la variabilite dans le nombre de deces resultant des attaques de Boko Haram. Les predictions sont donnees en termes de nombre futur possible de deces. En tant que sous-produit, certaines proprietes fondamentales de la distribution discrete de Chen sont fournies.

Trafik kazalarının sayısının tahmin edilmesi ulaştırma politikalarının geliştirilmesine yön veren önemli çalışmalardandır. Makro düzeyde karayollarında meydana gelen kaza sayısı üzerinde etkili olan birçok değişken mevcuttur. Bu çalışmada, nüfus, taşıt sayısı, sürücü sayısı, taşıt-kilometre makro değişkenleri bağımsız değişken olarak düşünülmektedir. Bu makro değişkenler kullanılarak tahmin edilen yıllık kaza sayısı, ölüm sayısı ve yaralı sayısı bağımlı değişkendir. Bu çalışmada kullanılan veriler ABD eyaletlerine ait 1988-2016 yıllarına ait verilerdir. Bu çalışmada çok değişkenli regresyon yöntemleri ile oluşturulan tahmin modeli, logaritmik regresyon, yapay sinir ağları (YSA) ve Bulanık Mantık (BM) ile karşılaştırılmaktadır. Çok değişkenli lineer regresyon modelinin, lineer, interaction, quadratic ve purequadratic türleri uygulanmaktadır. Modeller arası karşılaştırmalar korelasyon katsayısı (R), yüzde hataların ortalaması (YHO) ve hataların karesinin ortalaması (HKO) ile yapılmaktadır. Kaza sayısı tahmini için yapılan analizler sonucunda çok değişkenli lineer regresyon yöntemlerinden, lineer regresyon modelinin R değeri 0,8577, YHO değeri %4,8027, HKO değeri 14501376454,2255 olarak hesaplanmaktadır. İnteraction regresyon modelinin R değeri 0,9692, YHO değeri %2,0864, HKO değeri 3326475148,8991 olarak hesaplanmaktadır. Purequadratic regresyon modelinin R değeri 0,9672, YHO değeri %2,1795, HKO değeri 3540099887,9246 olarak hesaplanmaktadır. Quadratic regresyon modelinin R değeri 0,9889, YHO değeri %1,4379, HKO değeri 1214042257,7187 olarak hesaplanmaktadır. Logaritmik regresyon modeli sonucu elde edilen R değeri 0,8502, YHO değeri %4,8007 ve HKO değeri 15243601485,0837 olarak hesaplanmaktadır. YSA analiz sonucu elde edilen R değeri 0,9816, YHO değeri %1,6463 ve HKO değeri ise 2152002423,0350 olarak hesaplanmaktadır. BM analiz sonucu elde edilen R değeri 0,8869, YHO değeri %5,7766 ve HKO değeri ise 16956785090,7348 olarak hesaplanmaktadır. Yaralı sayısı tahmini için yapılan analizler sonucunda, lineer regresyon modelinin R değeri 0,9390, YHO değeri %4,5540, HKO değeri 21634202561,6271 olarak hesaplanmaktadır. İnteraction regresyon modelinin R değeri 0,9934, YHO değeri %1,4955, HKO değeri 2420035918,9591 olarak hesaplanmaktadır. Purequadratic regresyon modelinin R değeri 0,9925, YHO değeri %1,6821, HKO değeri 5340363074,3138 olarak hesaplanmaktadır. Quadratic regresyon modelinin R değeri 0,9951, YHO değeri %0,6148, HKO değeri 600590065,7349 olarak hesaplanmaktadır. Logaritmik regresyon modeli sonucu elde edilen R değeri 0,9481, YHO değeri %4,1322 ve HKO değeri 18549631727,8743 olarak hesaplanmaktadır. YSA analiz sonucu elde edilen R değeri 0,9860, YHO değeri %2,4522 ve HKO değeri 6268315631,2724 olarak hesaplanmaktadır. BM analiz sonucu elde edilen R değeri 0,9518, YHO değeri %5,0739 ve HKO değeri 26260831083,4280 olarak hesaplanmaktadır. Ölüm sayısı tahmini için yapılan analizler sonucunda, lineer regresyon modelinin R değeri 0,9971, YHO değeri %0,6600, HKO değeri 99919,4830 olarak hesaplanmaktadır. İnteraction regresyon modelinin R değeri 0,9994, YHO değeri %0,2926, HKO değeri 19416,1569 olarak hesaplanmaktadır. Purequadratic regresyon modelinin R değeri 0,9993, YHO değeri %0,3437, HKO değeri 25040,2321 olarak hesaplanmaktadır. Quadratic regresyon modelinin R değeri 0,9996, YHO değeri %0,2071, HKOdeğeri 13087,7865 olarak hesaplanmaktadır. Logaritmik regresyon modeli sonucu elde edilen R değeri 0,9972, YHO değeri %0,6375 ve HKO değeri 96023,6160 olarak hesaplanmaktadır. YSA analiz sonucu elde edilen R değeri 0,9972, YHO değeri %0,3949 ve HKO değeri 98718,9991 olarak hesaplanmaktadır. BM analiz sonucu elde edilen R değeri 0,9437, YHO değeri %4,4421 ve HKO değeri 4737707,4473 olarak hesaplanmaktadır. Yapılan analizler sonucunda kaza, yaralı ve ölüm sayılarının tahmininde en iyi sonuçları veren model quadratic regresyon modeli olarak bulunmaktadır., Estimating the number of traffic accidents is one of the important studies that guide the development of transportation policies. At the macro level, there are many variables that affect the number of road accidents. In this study, population, number of vehicles, number of drivers, vehicle-kilometers which are the macro variables, are considered as independent variables. The number of accidents, the number of deaths, and the number of injureds, which are dependent variable,s are estimated by using these macro variables. The data used in this study are from the years 1988-2016 of the US states. In the study, the prediction model generated by multivariate regression methods is compared with logarithmic regression, artificial neural networks (ANN) and Fuzzy Logic (FL). Linear, interaction, quadratic and purequadratic types of multivariate linear regression model are applied. Comparisons between the models are made with the correlation coefficient (R), the mean of the percentage errors (MPE) and the mean square of the errors (MSE). As a result of the analyzes conducted for the estimation of the number of accidents, the R value of the linear regression model is 0.8577, the MPE value is 4.8027% and the MSE value is 14501376454,2255. Interaction regression model R value is 0.9692, MPE value is 2.0864%, MSE value is calculated as 3326475148,8991. Purequadratic regression model R value is 0.9672, MPE value is 2.1795%, MSE value is calculated as 3540099887,9246. The R value of the quadratic regression model is 0.9889, the MPE value is 1.4379% and the MSE value is 1214042257,7187. R value obtained as a result of logarithmic regression model is calculated as 0.8502, MPE value is 4,8007% and MSE value is calculated as 15243601485,0837. R value obtained from ANN analysis is calculated as 0.9816, MPE value is calculated as 1.6463% and MSE value is calculated as 2152002423,0350. The R value obtained by the FL analysis is 0.8869, the MPE value is 5.7766% and the MSE value is calculated as 16956785090.7348. As a result of the analyzes conducted for estimating the number of injured, R value of linear regression model is calculated as 0.9390, MPE value is 4.5540% and MSE value is calculated as 21634202561,6271. The R value of the interaction regression model is 0.9934, the MPE value is 1.4955%, the MSE value is calculated as 2420035918,9591. Purequadratic regression model R value is 0.9925, MPE value is 1.6821%, MSE value is calculated as 5340363074,3138. The R value of the Quadratic regression model is calculated as 0.9951, the MPE value is 0.6148% and the MSE value is 600590065,7349. R value obtained as a result of logarithmic regression model is calculated as 0.9481, MPE value is calculated as 4,1322% and MSE value is calculated as 18549631727,8743. The R value obtained from ANN analysis is calculated as 0.9860, MPE value is calculated as 2.4522% and MSE value is calculated as 6268315631,2724. The R value obtained by FL analysis is calculated as 0.9518, MPE value is 5.0739% and MSE value is calculated as 26260831083,4280. As a result of the analyzes made for the estimation of the number of deaths, the R value of the linear regression model was calculated as 0.9971, the MPE value was 0.66600% and the MSE value was calculated as 99919.4830. Interaction regression model R value is 0.9994, MPE value is 0.2926%, MSE value is calculated as 19416,1569. Purequadratic regression model R value is 0.9993, MPE value is 0.3437%, MSE value is calculated as 25040,2321. The R value of the quadratic regression model is 0.9996, the MPE value is 0.2071%, and the MSE value is 13087.7865. R value obtained as a result of logarithmic regression model is calculated as 0.9972, MPE value is 0.6375% and MSE value is calculated as 96023,6160. R value obtained from ANN analysis is calculated as 0.9972, MPE value is calculated as 0.3949% and MSE value is calculated as 98718,9991. The R value obtained by the FL analysis is 0.9437, the MPE value is 4.4421% and the MSE value is 4737707,4473. As a result of the analyzes, the model which gives the best results in the estimation of accident, injured and death numbers was found as quadratic regression model.

This study contributes to the literature on legal institutions and determinants of adult mortality. The paper explores the relationship between the presence of domestic violence legislation and women-to-men adult mortality rates. Using panel data for about 95 economies between 1990 and 2012, the analysis finds that having domestic violence legislation leads to lower women-to-men adult mortality rates. According to conservative estimations, domestic violence legislation would have saved about 33 million women between 1990 and 2012. The negative relationship between domestic violence legislation and women-to-men adult mortality rates is robust to several checks and also confirmed using the instrumental variables approach.

Did unemployment in the Great Recession hurt people's health? The broad answer is no: job losses have statistically insignificant impacts on mortality. The exogenous sources of job losses in a U.S. county is the tradable job losses driven by external demand collapses during the Great Recession. The insignificant relationship holds for males and females, for all age groups, and for almost all categories of mortality. Three important exceptions are Alzheimer's, poisoning, and homicide.

Country-level longitudinal data at three-year intervals over 1990--2004 are used to analyze the factors affecting emigration of physicians from Sub-Saharan countries and the effects of this medical brain drain on life expectancy and number of deaths due to AIDS. Data are compiled on emigrating African physicians from 16 receiving Organisation for Economic Co-operation and Development (OECD) countries. A comprehensive longitudinal database is developed by merging the medical brain drain variables with recent data on HIV prevalence rates, public health expenditures, physicians' wages, and economic and demographic variables. A triangular system of equations is estimated in a random effects framework using five time observations for medical brain drain rates, life expectancy, and number of deaths due to AIDS, taking into account the interdependence of these variables. Lower wages and higher HIV prevalence rates are strongly associated with the brain drain of physicians from Sub-Saharan African to OECD countries. In countries in which the HIV prevalence rate exceeds 3 percent, a doubling of the medical brain drain rate is associated with a 20 percent increase in adult deaths from AIDS; medical brain drain does not appear to affect life expectancy. These findings underscore the need to improve economic conditions for physicians in order to retain physicians in Sub-Saharan Africa, especially as antiretroviral treatment becomes more widely available. Copyright The Author 2008. Published by Oxford University Press on behalf of the International Bank for Reconstruction and Development / the world bank . All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org, Oxford University Press.

Diseases of the pancreas and periampullary region form an important clinical group of malignant and also benign diseases which still carry relatively high morbidity and mortality rates. Pancreatic ductal adenocarcinoma, in particular, is associated with very poor outcome as the number of new cases per year is just slightly higher than the number of deaths from this disease. Therefore, treatment of these conditions should always be based on both the highest level of evidence and technical expertise. Surgery for diseases of the pancreas and periampullary region has evolved substantially during the last 15 years and several new surgical techniques have been described. According to recent randomized trials and advances in medical treatment, several surgical dogmas have been refuted. The majority of patients with pancreatic and periampullary cancer at the time of diagnosis have advanced disease. However, in specialized centers, 10–15% of the patients with these malignances are suitable for resection. In these centers, the morbidity and mortality associated with major pancreatic resection have been reduced considerably in recent years. It is an undisputed fact that pancreatic resection ranks as one of the most, if not the most, complicated and technically challenging surgical procedures. It not only is a demanding technical exercise but also exerts a substantial logistical strain on healthcare resources. The group from Heidelberg addressed the importance of vascular resections during pancreatic surgery. The limits of resection in patients with pancreatic and periampullary cancers have been extended. The recently published consensus paper by the International Study Group for Pancreatic Surgery (ISGPS) provided up-to-date definitions of borderline and extended resections. These definitions help clinicians worldwide to apply extended surgical approaches to an increasing number of surgical candidates. These procedures include vascular and multivisceral resections. When dictated by tumor involvement, resection of portal and superior mesenteric and splenic veins should be performed routinely in patients if the patient's general condition allows and there are no major comorbidities. The decision for arterial resections should be strictly individualized. This type of surgery should be reserved for fit, younger patients, with preoperative careful examination of all aspects of this extended surgery. The majority of patients with infiltration of coeliac trunk or superior mesenteric artery should be considered for neoadjuvant therapy and then reevaluated for postponed surgical intervention and resection of infiltrated vessels. D. Hartmann and H. Friess addressed the current status of the role of the surgery in the treatment of chronic pancreatitis. Surgical intervention in patients with chronic pancreatitis is mainly performed to resolve the complications of disease. In the majority of patients, intractable pain is the major indication for surgery, although jaundice, duodenal obstruction, and portal vein thrombosis are not rare. The goal of the surgery is pain reduction and management of complications, while preserving exocrine and endocrine pancreatic function and improving quality of life. Timing of surgery is an important feature during the prolonged natural history of the disease. New findings support early surgery for pain management in chronic pancreatitis patients, since early surgical intervention is associated with an improved postoperative pain relief, a reduced risk of pancreatic insufficiency, and decreased reintervention rates in comparison to conservative step-up approaches. Duodenum-preserving pancreatic head resections (including Beger, Frey, and Berne procedures) seem to be superior in peri- and postoperative outcome parameters and quality of life compared to partial pancreatoduodenectomy (Whipple procedure) while being equally effective in postoperative pain relief, overall health, and postoperative endocrine sufficiency. Organ-sparing operation at the right point of time carries a better outcome than performing an extended resection as a last resort once all therapeutic options are exhausted. An early timing of surgical therapy is crucial for the outcome of patients with painful CP and the indication of surgery should be considered early once symptoms are unambiguous. The group from Verona evaluated technical aspects, indications, and results of the application of Radiofrequency Ablation (RFA) and Irreversible Electroporation (IRE) on locally advanced pancreatic cancer (LAPC). RFA and IRE are the most frequently applied ablative techniques for the management of locally advanced pancreatic cancer. These techniques are versatile, since they can be performed at laparostomy, or via laparoscopic, endoscopic, or percutaneous routes. It has been demonstrated that their use is safe; however, since serious adverse events can occur, they are best performed at high volume centers and by high volume surgeons. The application of RFA and IRE is recommended in a multidisciplinary decision-making setting and they should be used especially on locally advanced tumors that have not demonstrated a propensity to metastasize. That said, properly designed studies are still needed to assess their efficacy. Finally, one of the most intriguing aspects of the application of RFA and IRE is their presumed stimulation of the immune system against the cancer. Once this aspect is further clarified and possibly confirmed, their use within the natural history of pancreatic cancer will become clearer. The group from Glasgow described the treatment of infected necrotizing pancreatitis. Treatment of acute pancreatitis is currently based on the definitions set forth in the 2012 Revised Atlanta Classification. Since the PANTER trial, there is now consensus that a “step-up approach” starting with catheter drainage and, if needed, followed by minimally invasive necrosectomy is the preferred treatment approach to infected necrotizing pancreatitis. The most commonly used minimally invasive strategies for necrosectomy are transgastric necrosectomy, percutaneous necrosectomy, and video-assisted retroperitoneal debridement (VARD). The recently completed TENSION trial compared transgastric necrosectomy with VARD within a “step-up approach,” but the final results are awaited. The advantage of transgastric necrosectomy is that it minimizes the risk of a pancreatocutaneous fistula which can be very problematic in case of “central gland necrosis.” The major disadvantage of transgastric necrosectomy is that multiple, often lengthy, procedures are required, whereas, with VARD via a 3–5 cm incision, only 1-2 procedures are sufficient in the majority of patients. Percutaneous necrosectomy probably holds the middle ground between these two options and several large series have described good outcomes. The group from Belgrade overviewed the role of interventional treatment of abdominal compartment syndrome (ACS) during severe acute pancreatitis (SAP). Some unresolved questions persist which include the role of medical treatment and the indications for and the timing of interventional techniques. Currently, there is no unanimity of opinion regarding surgical or other interventional treatments for ACS during the course of SAP. Critically ill patients with acute pancreatitis have a considerable risk for developing intra-abdominal hypertension. Routine measurement of intra-abdominal pressure is recommended, allowing the identification of patients at risk of abdominal compartment syndrome. First line therapy for this life-threatening complication is conservative treatment aiming to decrease IAP and to restore organ dysfunction. If nonoperative measures are not effective, early abdominal decompression is mandatory. Percutaneous catheter drainage should be the first step in interventional treatment which can relieve ACS. When ACS persists, surgery is indicated. Timing of abdominal decompression also remains uncertain in the treatment of these patients. However, the Finnish group published their experience with 26 patients regarding early and late decompression. Results clearly showed that early decompression (first 4 days) was associated with a significantly lower mortality rate, compared with late decompression (after 4 days). Midline laparostomy seems to be the method of choice, although full-thickness transverse subcostal bilateral laparostomy, subcutaneous linea alba fasciotomy, and fasciotomy of the anterior rectus abdominis sheath have been described as alternative options. Since laparostomy carries significant morbidity, randomized studies are needed to establish firm advantages over other techniques. Better understanding of pathophysiology of diseases of the pancreas and periampullary region has led surgeons to change some traditional surgical approaches and develop new innovative techniques. Technological advances which have improved the safety and efficacy of pancreatic surgery have been performed mainly in selected high volume centers. In order to improve both quality of life and duration of survival for our patients, novel surgical techniques should become more widely available and accepted. Studies with sound design and statistical methodology are urgently needed. In the present special issue, the authors have addressed new understanding of the pathophysiology of diseases of the periampullary region and pancreas. They have focused their interest in evidence-based, novel surgical techniques and approaches and challenging clinical settings have been emphasized. Dejan Radenkovic Michael B. Farnell Claudio Bassi Marc Besselink

Recent surveys show considerable progress in maternal and child health in Ethiopia. The improvement has been in health outcomes and health services coverage. The study examines how different groups have fared in this progress. It tracked 11 health outcome indicators and health interventions related to millennium development goals one, four, and five. These are stunting, underweight, wasting, neonatal mortality, infant mortality, under -five mortality, measles vaccination, and full immunization, modern contraceptive use by currently married women, antenatal care visits, and skilled birth attendance. Trends in rate differences and rate ratios are analyzed. The study also investigates the dynamics of inequalities, using concentration curves for different years. In addition, a decomposition analysis is conducted to identify the role of proximate determinants. The study finds substantial improvements in health outcomes and health services. Although there still exists a considerable gap between the rich and the poor, the study finds some reductions in inequalities of health services. However, some of the improvements in selected health outcomes appear to be pro-rich.

In 2000, the United Nations (UN) Member States pledged to work towards a series of Millennium Development Goals (MDGs), including the target of a three-quarters reduction in the 1990 maternal mortality ratio (MMR; maternal deaths per 100 000 live births), to be achieved by 2015. This target (MDG 5A) and that of achieving universal access to reproductive health (MDG 5B) together formed the two targets for MDG 5: Improve maternal health. In the five years counting down to the conclusion of the MDGs, a number of initiatives were established to galvanize efforts towards reducing maternal mortality. These included the UN Secretary-General’s Global Strategy for Women’s and Children’s Health, which mobilized efforts towards achieving MDG 4 (Improve child health) as well as MDG 5, and the high-level Commission on Information and Accountability (COIA), which promoted “global reporting, oversight, and accountability on women’s and children’s health”. Now, building on the momentum generated by MDG 5, the Sustainable Development Goals (SDGs) establish a transformative new agenda for maternal health towards ending preventable maternal mortality; target 3.1 of SDG 3 is to reduce the global MMR to less than 70 per 100 000 live births by 2030.

This paper identifies the low-elevation coastal zone populations and developing regions most vulnerable to sea-level rise and other coastal hazards, such as storm surges, coastal erosion, and salt-water intrusion. The focus is on the rural poor in the low-elevation coastal zone, as their economic livelihoods are especially endangered directly by coastal hazards and indirectly through the impacts of climate change on key coastal and near-shore ecosystems. Using geo-spatially referenced malnutrition and infant mortality data for 2000 as a proxy for poverty, this study finds that just 15 developing countries contain over 90 percent of the world’s low-elevation coastal zone rural poor. Low-income countries as a group have the highest incidence of poverty, which declines somewhat for lower-middle-income countries, and then is much lower for upper-middle-income economies. South Asia, East Asia and the Pacific, and Sub-Saharan Africa account for most of the world’s low-elevation coastal zone rural poor, and have a high incidence of poverty among their rural low-elevation coastal zone populations. Although fostering growth, especially in coastal areas, may reduce rural poverty in the low-elevation coastal zone, additional policy actions will be required to protect vulnerable communities from disasters, to conserve and restore key coastal and near-shore ecosystems, and to promote key infrastructure investments and coastal community response capability.

Policymakers in many countries, including the Russian Federation, are attempting to encourage fertility as part of their response to the challenge of population aging. Whether pro-natalist policies will be effective depends crucially on how well they address the underlying causes of low fertility and barriers to larger family size. While in some countries in Western Europe postponing childbearing and increased childlessness seem to be driving the fertility decline, these factors do not appear to be as influential in Russia. Instead, the problem seems to be the relatively low frequency of second and higher-order births, which persists despite major changes to pro-natalist policies introduced in 2007 and the prevalence of the two-child ideal of family size. This study analyzes current and prospective fertility trends in contemporary Russia, with special attention to second-child birth dynamics and its determinants. Stable employment and accessibility of formal childcare options are found to be factors that are correlated with mothers preferences for additional children and the probability that they will have a second child. In light of this observation and international experience, a menu of policies to improve work-family balance is suggested.

Traditional benchmarks to assess performance rely on unconditional rankings or regional averages. This paper uses a recently developed methodology based on quantile regressions and initial conditions to propose alternative benchmarks for social sectors in Kyrgyz Republic. Covering a wide set of indicators, the analysis reveals mixed results for Kyrgyz Republic. The country has made important strides in many social areas, with outstanding results in reducing child mortality and undernourishment. However, other areas are still key challenges and demand further attention and resources, as evidenced by the underachievement in maternal mortality, educational performance, and increasing informality in labor markets.

Myanmar is a country in transition with great regional diversity. It is still a relatively young country with the highest share of its population at active working age. Myanmar’s more pressing needs are the following: a) reducing the incidence of poverty and improving human development outcomes, with a particular emphasis on reaching the poor and vulnerable. Children from poor families fare worse when it comes to nutrition, and education outcomes; and b) addressing the insecurity of incomes and developing mechanisms to reduce exposure to risks and ability to cope with ill-health, disasters and other shocks. This suggests a critical role for social protectionpolicies and programs in Myanmar’s strategy for poverty reduction and people-centered development.

The evolution of Costa Rica’s social sectors over the past decade has been dichotomous. On the one hand, economic growth has remained relatively high, however poverty and inequality have not declined (moreover, they have increased), and persistent employment challenges remain. On the other hand, the country has continued experiences advances in many social indicators, such as pre-primary and tertiary enrollment rates, access to improved sanitation, and labor force participation, though not in others (secondary school completion, immunizations, employment). Higher economic growth and (to a lesser extent) revenues seem to have allowed a substantial increase in public social spending. Looking forward, the key challenges Costa Rica faces are related to continuing improving the quality and efficiency in the social sectors, while improving targeting to serve the most in need, in a tight and severe fiscal context. To expand coverage of excluded population, priority will have to be given to reallocations and improvements within the spending envelope for the social sectors to maximize impact. With a fiscal deficit of more than 6 percent of GDP, further expanding public social spending is no longer an option and budget cuts are looming. Improvements in public spending management and budget execution, including the need of institutional reform to consolidate programs and improve coordination among executing agencies is equally important. In a country that has long been the champion in expanding universal welfare state, sustainability concerns will imply that hard fiscal decisions would need to be made to increase the social returns of budget allocation.

Developing countries have urbanized rapidly since 1950. To explain urbanization, standard models emphasize rural-urban migration, focusing on rural push factors (agricultural modernization and rural poverty) and urban pull factors (industrialization and urban-biased policies). Using new historical data on urban birth and death rates for seven countries from Industrial Europe (1800–1910) and thirty-five developing countries (1960–2010), this paper argues that a non-negligible part of developing countries’ rapid urban growth and urbanization may also be linked to demographic factors, such as rapid internal urban population growth, or an urban push. High urban natural increase in today’s developing countries follows from lower urban mortality, relative to Industrial Europe, where higher urban deaths offset urban births. This compounds the effects of migration and displays strong associations with urban congestion, providing additional insight into the phenomenon of urbanization without growth.

In the past decade, Latin America and the Caribbean has achieved impressive social and economic successes. For the first time in history, more people are in the middle class than in poverty. Inequality, although still high, declined markedly. Growth, jobs and effective social programs have transformed the lives of millions. In a striking departure from the crisis-prone Latin America of the past, the region has shown it is better prepared to weather the brunt of the global economic slowdown. Now, the region faces the challenge of maintaining and expanding its hard won gains in an adverse context of low growth. This is caused in part by a decrease in commodity prices and reduced economic activity in major commercial partners such as China. In such a scenario, achieving development results - and learning from them - becomes more important. This publication showcases stories about people and how their lives have been improved through better health and education, youth employment, disaster recovery and preparedness, infrastructure, and more.

The health equity and financial protection datasheets provide a picture of equity and financial protection in the health sectors of low- and middle-income countries. Topics covered include: inequalities in health outcomes, health behavior and health care utilization; benefit incidence analysis; financial protection; and the progressivity of health care financing. This report show how health outcomes, risky behaviors and health care utilization vary across asset (wealth) quintiles and periods. Benefit-incidence analysis (BIA) shows whether, and by how much, government health expenditure disproportionately benefits the poor the distribution of subsidies depends on the assumptions made to allocate subsidies to households. This reports whether overall health financing, as well as the individual sources of finance, is regressive (i.e. a poor household contributes a larger share of its resources than a rich one), progressive (i.e. a poor household contributes a smaller share of its resources than a rich one) or proportional.

The health equity and financial protection datasheets provide a picture of equity and financial protection in the health sectors of low-and middle-income countries. Topics covered include: inequalities in health outcomes, health behavior and health care utilization; benefit incidence analysis; financial protection; and the progressivity of health care financing. The tables in this report show how health outcomes, risky behaviors and health care utilization vary across asset (wealth) quintiles and periods. The quintiles are based on an asset index constructed using principal components analysis. Benefit-Incidence Analysis (BIA) shows whether, and by how much, government health expenditure disproportionately benefits the poor. The distribution of subsidies depends on the assumptions made to allocate subsidies to households. Under the constant unit cost assumption, each unit of utilization is assumed to cost the same and is equal to total costs incurred in delivering this type of service divided by the number of units of utilization.

This study on Bangladesh was undertaken to analyze the gender dimensions of climate change and the role of institutions in reducing gender gaps. The study was carried out in 20 sites covering 600 households, from March 2010 to May 2011, using both qualitative and quantitative instruments. This note is organized into five sections. The next section gives an overview of climate change and the gender and institutional context in Bangladesh. The third section presents the key study findings and is divided into three subsections: site- and household-specific vulnerabilities; analysis of gender dimensions of climate change using the household data and four propositions; and description of institutional challenges and gaps in supporting the resilience of women and men. Section four provides examples of adaptation programs in Bangladesh, and section five provides recommendations for enhancing gender-responsive adaptive capacity in Bangladesh.

The authors have analyzed animal health data for the years 2006 through 2009 as reported by the World Organisation for Animal Health (OIE)-the four most recent 'World animal health yearbooks' available when the analysis was prepared. The data covers 176 countries and economies on 71 livestock diseases (30 zoonoses and 41 non-zoonotic diseases) and 8 species or groups of species (cattle, sheep and goat, swine, poultry, equidae, buffalo, cervidae, and camels). Losses due to death, destruction or slaughter were distinguished. In total, the scope of the analysis comprises about 2.7 million data points. On average, over the four years analyzed, the Islamic Republic of Iran, China, and Brazil lost the highest absolute numbers of Livestock Units (LSUs), while Israel, Iran, and Namibia suffered the highest losses relative to their livestock populations. Data need to be interpreted taking into account a potential reporting bias resulting from countries' different levels of reporting transparency and competency. This report is not based on the 'real' world animal health situation, but on the best information available to the authors.

Since 2005, a growing number of vulnerable communities and nations have used the human rights lexicon to argue their case for an urgent and ambitious response to climate change. The purpose of this Social Development Department Working paper is to examine the emergence of a new discourse linking climate change and human rights, and to assess its social and political implications, particularly as they relate to development practitioners. The scope of this paper is to explore what relevance this new discourse has on what David Kennedy calls the 'vocabularies, expertise, and sensibilities' of development practitioners (Kennedy 2005). The methodology for this paper involved interviews with academics and policy practitioners who have shaped this emerging discourse; a wide-ranging literature review of texts relevant to the fields of development, climate change and human rights; discussions with development professionals who have the daily responsibility of operationalizing approaches to reducing vulnerability and building resilience; and finally drawing upon the author's own experience leading the Maldives' government's initiative on the Human Dimensions of Climate Change and as a consultant within the Social Dimensions of Climate Change Cluster of the World Bank's Social Development Department. It is important to stress that this paper is not a legal piece. Human rights are as much about ethical demands, calls for social justice, public awareness, advocacy, and political action as they are concerned with legal norms and rules. Sen has pointed out a 'theory of human rights cannot be sensibly confined within the juridical model in which it is frequently incarcerated' (Sen 2004, 319). Consequently this piece will focus on the wider, political economy aspects of the interface between human rights and climate change. It is further appropriate to state that this is not an advocacy piece. The paper deliberately avoids being normative or prescriptive in recommending a human rights-based approach to developing climate change operations. It does examine why vulnerable populations chose to embrace this approach, why they continue to view it as a transformative strategy, and what some of the successes and challenges have been.

The World Bank and The United Nations Children's Fund (UNICEF) jointly developed this report to calculate the potential human and economic benefits to be gained from increasing nutrition investments in the Kyrgyz Republic. This report provides compelling evidence of the potential to improve health and economic outcomes through scaling up effective nutrition interventions and introducing new proven interventions to reduce the direct causes of under nutrition in order to support the Kyrgyz government's commitment to the well-being and prosperous future of the Kyrgyz people. This situational analysis examines and quantifies the scope of under nutrition in the Kyrgyz Republic by presenting: (1) the epidemiology of under nutrition; (2) an estimate of the health consequences of under nutrition in terms of mortality and disability adjusted life years (DALYs), and the economic losses due to lost workforce and productivity; (3) the health, social protection, and agriculture and food intervention systems relevant to delivering interventions for improving nutrition; (4) the current coverage of nutrition interventions; and (5) the potential economic gains achievable by scaling up effective nutrition interventions. The current context is very favorable for scaling up nutrition interventions in the Kyrgyz Republic. Investing in nutrition has increasingly proven to have excellent development and health returns. The international development community has recognized (1) the need to scale up nutrition interventions; (2) the potential for public-private partnerships; and, (3) a growing consensus around a common framework for action. Reducing under nutrition worldwide is a priority for the World Bank and UNICEF, and also critical to achieving the Millennium Development Goals (MDGs).

This paper is one component of a global study on the Economics of Adaptation to Climate Change (EACC) in developing countries; the focus in this paper is human health. The main human health impacts of climate change are increased incidence of vector-borne disease (malaria), water-borne disease (diarrhea), cardio respiratory diseases, heat- and cold-related deaths, injuries and deaths from extreme weather events (flooding), and a greater prevalence of malnutrition. Adaptation measures comprise all actions taken to reduce, prevent, or treat these additional cases of disease or death, including actions outside the health sector such as disaster reduction programs, food and water security measures, and the provision of infrastructure services. For tractability and to reduce duplication with other components of the EACC study, the scope of this paper is limited to conventional public health adaptation activities, with a focus on malaria and diarrhea. This study also incorporates updates and revisions to the unit cost of prevention and treatment for malaria and diarrhea and updates to the exposure-response functions used to compute the relative risk for malaria.

This case study examines contemporary experiences of conflict in four contexts: Papua New Guinea, with particular reference to the island of Bougainville and the Highlands region; Solomon Islands; and Vanuatu. We find common themes in these experiences, despite the regions famous sociolinguistic diversity, fragmented geography and varied experience of globalization. Melanesia offers distinctive lessons about how conflict may be understood, promoted and avoided. The paper is organized in two broad parts. The first part is contextual. It provides a brief account of conflict and violence in social life before and after colonization. It then tracks, largely chronologically, through the local, national and transnational dimensions of contemporary conflict, how it was avoided, how it has changed, and how it has been managed in different contexts. Particular attention is given to global and regional influences, and to how governments, local people, and external security, development and commercial actors, have worked to mitigate and, at times, exacerbate conflict. The second part of the case study is more analytical. It steps back from the particulars to address themes and propositions in the overall conceptual framing of World Development Report (WDR) 2011 about the nature of conflict, and the underlying stresses and interests that may render it more likely. Part two draws lessons from the histories and contexts discussed in part one. The report organizes these around three themes that reflect views shared with us by people during consultations. The first highlights the need to recognize conflict as an inherent part of social change and thus the need to distinguish between socially generative social contest, and forms of conflict that are corrosive and destructive. The second examines how the ways people 'see' and understand the world directly shapes systems of regulation and 'the rules of the game' and thus directly affect responses to conflict. The third theme argues that capable and legitimate institutions to regulate social contest requires not just capable state institutions, but as much, relationships with local and international agents and organizations operating below and above the state.

Botswana has had a stable democratic government and good governance since independence in 1966. With a sustained high average economic growth (about 9 percent) fueled by the diamond mining industry, it is the only country in Africa listed among the 13 'economic miracles' of the world for 1960-2005. The total fertility rate remains high in Sub-Saharan Africa, with 25 countries showing a rate greater than 5.0. In contrast, Botswana experienced the greatest fertility decline in the region during 1980-2006, with the total fertility rate decreasing from 7.1 in 1981 to 3.2 in 2006. The Botswana national family planning program, judged the strongest in Africa, contributed to this decline. The government strongly committed to meeting family planning needs, integrated maternal and child health/family planning (MCH/FP) and sexually transmitted infection (STI) services in 1973. The government spends about 18 percent of its total budget on health, a higher proportion than the Abuja declaration's target of 15 percent.