Browsing by Subject "low- and middle-income countries"

Now showing 1 - 5 of 5
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    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 Bryan
    Programmes 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.
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    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, Marc
    This 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.
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    Profits and Productivity: Stimulating Electricity Demand in Low-Income Settings
    (2019-06-03) Plutshack, Victoria; Phillips, Jonathan
    As 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?
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    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, Jiahui
    United 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.
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    The True Cost of Solar Tariffs in East Africa
    (2019-02-05) Fetter, Rob; Phillips, Jonathan
    Over 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.