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Policymakers are convening at the Global Conference on Primary Health Care in Astana to mark the 40th anniversary of the Declaration of Alma-Ata and renew their commitments to building strong primary health care (PHC) systems. While there has been tremendous progress in deploying PHC services to improve health outcomes in low- and middle-income countries, there are major gaps between aspirations and reality. The renewed global commitment in Astana is an opportunity to underscore why and how a proactive focus on PHC can be central to the UHC2030 agenda.
This event co-hosted by the Center for Global Development (CGD), John Snow, Inc. (JSI), and Primary Health Care Performance Initiative (PHCPI) will assess major outcomes emerging from Astana, provide a reality check on challenges countries are facing, and reflect on the role of the global health community going forward.
Join us for two back-to-back panels (agenda and speaker list below) that will bring programmers, planners, and implementers together with funders, policymakers, and global health financing experts to discuss why strong PHC matters for UHC; the key barriers, including policy and implementation challenges; as well as ideas to ensure greater equity, quality, and efficiency in PHC. Read more on CGD's work on PHC here.
Conversation: Why Is It So Hard to Achieve Strong Primary Health Care?(9:30 – 9:50am)
Amanda Glassman, Chief Operating Officer and Senior Fellow, CGD Lauren Weber, Public Health Policy Reporter, HuffPost
Panel 1: PHC 40 Years On: What Works and What Needs to Happen Next (9:50 – 10:35am)
Nabeela Ali, Country Representative in Pakistan, JSI Clinton de Souza, Director of Public Health, Imperial Logistics Binyam Fekadu Desta, DCOP for USAID Transform: PHC project/JSI lead Rose Macauley, Country Representative in Liberia, JSI
Panel 2: PHC Measurement for Improvement and Accountability (10:45 – 11:30am)
Ariana Childs Graham, Director of Primary Health Care Initiative, PAI Vin Gupta, Assistant Professor of Global Health, IHME; Non-Resident Fellow, CGD Natela Ménabde, Executive Director of the WHO Office at UN, WHO Jeremy Veillard, Program Manager for PHCPI, World Bank
Janeen Madan Keller, Center for Global Development Beth Tritter, Primary Health Care Performance Initiative Craig Burgess, John Snow, Inc.
In a recent paper, Kate Ambler and coauthors studied the impact of one-season cash transfers for agricultural investment in Senegal and Malawi, using data from a randomized control trial (RCT) in each country. They found evidence that transfers reduced both the number of decision makers and female decision making in Senegal in the short-run, particularly for measures directly related to agriculture. However, the effects disappeared two years after the transfers. Conversely, the authors find transfers in the Malawi program led to robust transitory increases in these measures, seeing a greater impact related to the number of decision makers in the household persisting after two year period. Join us for the latest CGD Invited Research Forum to discuss these opposing findings on the effects of cash transfers on household decision making.
Indian agriculture remains vulnerable to the vagaries of weather, and the looming threat of climate change may expose this vulnerability further. Using district-level data on temperature, rainfall and crop production, Siddharth Hari’s paper first documents a long-term trend of rising temperatures, declining average precipitation and increase in extreme precipitation events. One key finding is that the impact of temperature and rainfall are felt only in the extreme: when temperatures are much higher, rainfall is significantly lower, and the number of “dry days” greater is than normal. He also finds that these impacts are significantly more adverse in unirrigated areas (and hence rainfed crops) compared to irrigated areas. Can policy makers react to the challenges of climate change and find ways to get “more crop for every drop?"
Estimating intergenerational mobility in developing countries is difficult because matched parent-child income records are rarely available and education is measured very coarsely. In particular, there are no established methods for comparing educational mobility for subsamples of the population when the education distribution is changing over time.
In their recent paper, Sam Asher and coauthors present new methods and new administrative data to overcome this gap, and study intergenerational mobility across groups and across space in India. They find that the intergenerational mobility for the population as a whole has remained constant since liberalization, but cross-group changes have been substantial. Rising mobility among historically marginalized "Scheduled Castes" is almost exactly offset by declining intergenerational mobility among Muslims, a comparably sized group that has few constitutional protections. These findings contest the conventional wisdom that marginalized groups in India have been catching up on average. The paper also explores heterogeneity across space, generating the first high-resolution geographic measures of intergenerational mobility across India, with results across 5600 rural subdistricts and 2300 cities and towns.