Browsing by Subject "low- and middle-income countries"
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Item Open Access Building a safety culture in global health: lessons from Guatemala.(BMJ global health, 2018-01) Rice, Henry E; Lou-Meda, Randall; Saxton, Anthony T; Johnston, Bria E; Ramirez, Carla C; Mendez, Sindy; Rice, Eli N; Aidar, Bernardo; Taicher, Brad; Baumgartner, Joy Noel; Milne, Judy; Frankel, Allan S; Sexton, J BryanProgrammes to modify the safety culture have led to lasting improvements in patient safety and quality of care in high-income settings around the world, although their use in low-income and middle-income countries (LMICs) has been limited. This analysis explores (1) how to measure the safety culture using a health culture survey in an LMIC and (2) how to use survey data to develop targeted safety initiatives using a paediatric nephrology unit in Guatemala as a field test case. We used the Safety, Communication, Operational Reliability, and Engagement survey to assess staff views towards 13 health climate and engagement domains. Domains with low scores included personal burnout, local leadership, teamwork and work-life balance. We held a series of debriefings to implement interventions targeted towards areas of need as defined by the survey. Programmes included the use of morning briefings, expansion of staff break resources and use of teamwork tools. Implementation challenges included the need for education of leadership, limited resources and hierarchical work relationships. This report can serve as an operational guide for providers in LMICs for use of a health culture survey to promote a strong safety culture and to guide their quality improvement and safety programmes.Item Open Access Climate Finance for Just Transitions: Building Low-Carbon Development Pathways in an Age of US-China Rivalry(2022-09-14) Phillips, Jonathan; Ewing, Jackson; Rao, Abhay; Teji, Liilnna; Plutshack, Victoria; Jeuland, MarcThis paper investigates challenges throughout the international climate finance landscape and recommends pathways for how investments into low- and middle-income countries (LMICs) can more effectively drive low-carbon development. The paper focuses on three issue areas: (1) aligning national climate strategies and international finance, (2) finding avenues for positive climate finance outcomes in an era of growing rivalry between Chinese and Group of Seven—particularly US—public financiers, and (3) reforming major climate finance practices and institutions to more effectively cater to the needs of LMIC stakeholders. This paper is part of a series of work under the New Frontiers in Climate Finance project, led by the James E. Rogers Energy Access Project, which is scoping the challenges and opportunities inherent to climate finance in LMICs, and seeking to help increase the scale and transformational impact of climate finance to these economies. The project aims to mobilize key stakeholder organizations around a common vision for aligning the tools of development finance with the needs and strategies of LMICs, and to build low-carbon development pathways that support poverty alleviation while reducing the next global wave of greenhouse gas emissions.Item Open Access Do Public Works Programs Have Sustained Impacts? A Review of Experimental Studies from LMICs(The World Bank Research Observer, 2024) Bagga, Aanchal; Holmlund, Marcus; Khan, Nausheen; Mani, Subha; Mvukiyehe, Eric; Premand, PatrickAbstract Many low- and middle-income countries (LMICs) have introduced public works programs that offer temporary cash-for-work opportunities to poor individuals. We review experimental evidence on the impacts of public works programs on participants over the short and medium run, providing new insights on whether they have sustained impacts. Our findings show that public works mainly increase employment and earnings during the program. Short-term positive effects tend to fade in the medium run, except in a few cases in which large impacts on savings or investments in self-employment activities are also observed. We find evidence of improvements in psychological well-being and women's empowerment in some cases, but not systematically, and with limitations in measurement. In some contexts, public works programs also improve market wages, affecting both participants and non-participants. We conclude by outlining directions for future research.Item Open Access Energy Transitions at a Crossroads: Balancing Growth, Decarbonization, and Development(2024-10-25) Zembilci, Eilish; Ewing, JohnCan low- and middle-income countries meet human development imperatives while decommissioning fossil fuel infrastructure or avoiding further fossil fuel development? A high-level panel at Climate Week NYC 2024—moderated by Jackson Ewing and featuring executive in residence Alix Peterson Zwane alongside global investment leaders—attempted to address just that. Moving forward will require a new kind of bargain between developed and developing countries that increases state capacity for energy transitions in emerging markets while securing supportive commitments from wealthier countries. This path should be more than developed countries simply dictating the terms of development and should instead be locally led, demand-driven plans that reflect national priorities.Item Open Access Profits and Productivity: Stimulating Electricity Demand in Low-Income Settings(2019-06-03) Plutshack, Victoria; Phillips, JonathanAs electricity companies in low- and middle-income countries move deeper into rural regions, the cost of new connections generally increases while the electricity demanded by these new customers remains lower than urban and peri-urban customers. This is a challenging dynamic for utilities looking to sustain their financial health as well as for governments tasked with engineering viable strategies for achieving universal electrification. Off-grid platforms like solar home systems and minigrids have entered this market, developing innovative approaches to serving these populations that promise to scale up to help meet the needs of the one billion people around the world still lacking electricity access. The creative partnerships and complementary services these off-grid providers are pursuing provide important lessons for larger utilities. Yet the primary driver for new electricity connections—the grid—will continue to play an important role in closing the access gap, especially in places where serving commercial, industrial, and other productive loads is a priority. Countries with national utility companies facing massive debt, stagnant revenue, and overcapacity must develop strategies for maintaining fiscal health, ideally in a manner that facilitates rural income growth and development. This brief provides a snapshot of the relevant demand-stimulating lessons learned in the off-grid space as well as those that have been pursued by governments and utilities in the past order to help answer the critical questions: What is preventing rural customers from increasing their electricity demand? How can governments, utilities, NGOs, and companies come together to foster the greater use of energy services?Item Open Access Resilience Monetization and Credits Initiative: A Background Paper(2024-05-23) Al-Mashat, Rania; Jeuland, Marc; Puri, Jyotsna; Vieira, Pablo; Aboulatta, Mahinour; Ahmad, Saib; Chowdhury, Jahan-Zeb; Diaz-Herrera, Alejandro; Elsharief, Mirna; Farghal, Farida; Phillips, Jonathan; Tawfik, Nada; Teji, Liilnna; von Glahn, DrewAddressing climate change requires urgent and innovative action aimed at both mitigating its effects and addressing its most severe impacts. However, current investment levels are insufficient to match the escalating climate risks and damages. Despite the annual target of $100 billion established at the 2009 United Nations Climate Change Conference/Conference of Parties, climate finance directed to low- and middle-income countries continues to lag behind stated goals. Adaptation efforts are especially underfunded, with investment falling short by a significant margin, estimated at 5 to 10 times the actual need. This document has been developed as part of an endeavor to propose an innovative solution—the Resilience Monetization and Credit Initiative— aimed at bridging the gap in resources made available to those most urgently in need of climate adaptation finance. Under this initiative, resilience credits are introduced as a novel asset class designed to align public and private capital to deliver improved resilience to the communities most vulnerable to climate impacts, while also ensuring equitable benefit sharing. This paper is part of a series of work under the Resilience Monetization and Credit Initiative project, led by the James E. Rogers Energy Access Project, which aims to close the finance gap for those urgently needing climate adaptation finance by developing innovative methods to measure and monetize adaptation and resilience benefits.Item Open Access Taxes and Subsidies and the Transition to Clean Cooking: A Review of Relevant Theoretical and Empirical Insights(2022-11-22) Das, Ipsita; Jeuland, Marc; Plutshack, Victoria; Zong, JiahuiUnited Nations Sustainable Development Goal 7.1 sets a target of ensuring universal access to affordable, reliable, and modern energy services by 2030. Unfortunately, many low- and middle-income countries (LMICs) are well off course to meet this target, especially with respect to access to clean cooking energy. Though many challenges impede progress, cost barriers are perhaps most significant. This report discusses the role of subsidy and tax policies—levied on both the supply and demand side of this market—in affecting progress toward universal access to clean cooking in LMICs. Moreover, we also combat a common myth among those opposing subsidies for clean cooking: we show that a “fear of spoiling the market” with such incentives finds little empirical support in the literature. This report offers recommendations to policy makers, in addition to a case study on clean cooking transitions in Nepal.Item Open Access The Role of Taxes and Subsidies in the Clean Cooking Transition: A Review of Relevant Theoretical and Empirical Insights(2022-07-21) Das, Ipsita; Jeuland, Marc; Plutshack, VictoriaUnited Nations Sustainable Development Goal (SDG) 7.1 sets a target of ensuring universal access to affordable, reliable, and modern energy services by 2030. Unfortunately, many low- and middle-income countries (LMICs) are well off course to meet this target, especially with respect to access to clean cooking energy. Though many challenges impede progress toward use of modern and sustainable energy for cooking purposes, cost barriers are perhaps most significant. Against this backdrop, this brief discusses the role of subsidy and tax policies—levied on both the supply and demand side of this market—in affecting progress toward universal access to clean cooking in LMICs. Moreover, combating a common myth among those opposing subsidies for clean cooking, the brief demonstrates that a “fear of spoiling the market” with such incentives finds little empirical support in the literature. Based on theory and evidence discussed in additional detail, this brief offers recommendations to policy makers.Item Open Access The True Cost of Solar Tariffs in East Africa(2019-02-05) Fetter, Rob; Phillips, JonathanOver a billion people around the world continue to lack access to basic electricity, many of them unlikely to be connected to the grid for years or decades. Pay-as-you-go solar home systems (SHS)—kits that consumers can frequently purchase on credit that include a small solar panel, battery, light bulbs and wires, phone charging equipment, and sometimes televisions and other appliances—have quickly become a viable, private sector-driven solution that empowers consumers to take control of their energy future. Many low- and middle-income governments look to import duties and value-added taxes (VAT) to fund critical government services and the bulk of SHS equipment is produced in China. As sales of systems have grown, the question of how these systems should be treated under border taxation regimes has become a prominent issue. To better understand the trade-offs at stake, actual sales data for 700,000 units of solar home systems was collected from Uganda and Kenya, countries with vibrant SHS markets and where the border tariff debate looms large. The data was analyzed to measure the price sensitivity of consumers of two different SHS product lines in order to better understand the impact of tariffs on system sales as well as broader ramifications for households, electrification goals, and government revenue. More about this project can be found on the Energy Access Project site.