MRU videos on poverty and health

by on December 18, 2012 at 5:57 am in Economics, Education | Permalink

A new set of MRU videos is up.  In these videos, we cover:

·      How the poor spend their money

·      How stress can create a “tax” on the poor’s decision-making, focus, and cognitive abilities

·      Causes of “missing women” in developing countries and what is really the bottom line on this claim

·      The economics of child labor, and what is the nature of the potential market failure when sending children to work

·      How a test involving a pregnant mare’s urine illustrates the value of randomized controlled trials

·      Why private health insurance is relatively rare in poorer developing countries (hint: it’s not adverse selection)

·      Can cash transfers help with low birth weight?

·      How community participation can affect the success of health care programs

·      And finally, the ugly effects of cholera, diarrhea, worms, and HIV/AIDS in developing countries

Click here to get started on these videos, with an introduction to randomized control trials.  Or browse the whole list at MRUniversity.com, click on the Course section on the right to see the menu.

Ray Lopez December 18, 2012 at 9:10 am

A good test of a student’s knowledge is to try and answer these questions before looking at the video. Here is my guess:

“How the poor spend their money” A: FOOD MOSTLY
“How stress can create a “tax” on the poor’s decision-making, focus, and cognitive abilities” A: PROBABLY A SMALL TAX. LIFE IS STRESS AND WITHOUT SOME STRESS ORGANISMS WILL DIE
“Causes of “missing women” in developing countries and what is really the bottom line on this claim” A: PROSTITUTION, MIGRATION? OR PERHAPS INFANTICIDE
“The economics of child labor, and what is the nature of the potential market failure when sending children to work” A: MUCH LIT IN THIS AREA. PARENTS NEED CHILDREN TO WORK OR THEY CANNOT BE FED IS CONVENTIONAL ANSWER.
“How a test involving a pregnant mare’s urine illustrates the value of randomized controlled trials” A: PROBABLY THIS IS THE WELL-KNOWN STATS ANOMALY KNOWN AS “Simpson’s Paradox” (OK I did have to Google that for the name: see Berkeley Gender bias example here: http://en.wikipedia.org/wiki/Simpson%27s_paradox )
“Why private health insurance is relatively rare in poorer developing countries (hint: it’s not adverse selection)” A:POSSIBLY THEY CANNOT EVEN AFFORD THE PREMIUMS? ALSO CULTURALLY DEV COS ARE RISK TAKERS, ESCHEW INSURANCE
“Can cash transfers help with low birth weight?” A: SH IT I DUNNO. I GUESS SO?
“How community participation can affect the success of health care programs” A: I’M GETTING ANSWER FATIGUE…I GUESS IT’s GOOD?
” And finally, the ugly effects of cholera, diarrhea, worms, and HIV/AIDS in developing countries” A: WHEW! AN EASY ONE. ANSWER IS OBVIOUS, BUT I’LL POINT OUT THE CONTROVERSIAL WORM AND ASTHMA TREATMENT: GOOGLE “Helminthic therapy ”

Now I’m off to MRU to see how right (or wrong) I was!

April Harding December 21, 2012 at 10:48 pm

I love your course, but I am terribly disappointed with the health module. The lectures provide no foundational discussion of the links (in either direction; strong or weak) between health & development; no discussion of humanitarian vs development (health) assistance; no discussion of the factors which contribute to, or hamper, the strengthening of a country’s health system over time; no discussion of how aid supports or undermines countries’ health systems. In essence – the development stuff was left out.

Most of the literature presented informs philanthropy/humanitarian aid decision-making (e.g. if my charity aims to save more children should I fund a bednet distribution program or school-based deworming?), not countries’ policies and management (and related challenges) of health systems development.

To put it differently, a comparable treatment of “growth” would have involved presenting the findings of some micro studies on different approaches to retraining unemployed workers, and/or daycare programs to increase employment among single mothers.

The module falls well short of your high content standards.

April Harding December 22, 2012 at 8:26 am

Thanks for letting me know you intend to develop further the health module of your course.
When you do that, you may find this analogy useful to explain the difference between actions seeking to enhance a country’s level of development wrt health and actions seeking simply alleviate a pressing health problem.

Consider a person who upon a physical examination is found to be overweight and have high blood pressure. A simple response prescribes blood pressure medication to reduce blood pressure and its associated risks relatively quickly. This response is analogous to a health problem alleviation action. While it addresses the direct problem, it does not actually improve the individual’s health, and his high blood pressure will return once medication is stopped. In contrast, health development action would entail weight loss, improved diet, and exercise—all of which fundamentally improve health. These activities require a longer-term investment, and more active commitment from the individual, but ultimately produce results that may lead to the end of support (blood pressure medication) and make the system stronger in other ways—improving respiratory function, immune response, overall energy levels, and so on. This analogy illustrates the importance of distinguishing between policies and aid activities which directly alleviate a health problem (for a person or group) and those which aim to alter the person/group/health system/ country in a way which generates a sustained improvement once the intervention/support activity ceases.

This article elaborates this distinction, and I borrowed/ adapted the analogy from it.
Chee, G., N. Pielemeier, et al. (2012). “Why differentiating between health system support and health system strengthening is needed.” Int J Health Planning and Management
http://www.ncbi.nlm.nih.gov/pubmed/22777839

I realize this distinction may seem academic; I assure you it is not. Health aid has shifted strongly toward direct alleviation of health problems in the past 10 years. The programs have saved many lives. However, this shift has had two related negative effects. It has “crowded out” attention to actions that might have generated durable health improvements; and, it contributed to creating highly fragile and dependent structures. When aid levels decline, as they are, rapid losses of achievements (e.g. resurgence of malaria) are likely. Note: I am not referring to the health gains that have been achieved by factors beyond health policy/ health program domain (e.g. higher income; increased education, esp for women). To the degree that policies and aid contributed to durable changes in these areas, the associated health improvements are likely to endure.

Here is a link to an article on the fragility of current malaria programs http://news.sciencemag.org/scienceinsider/2010/12/malaria-report-shows-success-is.html

In the piece, WHO’s Richard Cibulskis, the main author of WHO’s annual malaria report, notes that both Zambia and Rwanda (previous top performers for reductions in malaria) experienced sizable upswings after a period of dramatic success. “It’s worrying that malaria can come back as soon as we take our foot off the accelerator”.

It is worrying indeed.

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