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Mr. Giorgio Brosio
,
Mr. Ehtisham Ahmad
, and
Ms. Maria Gonzalez
This Working Paper should not be reported as representing the views of the IMF. The views expressed in this Working Paper are those of the author(s) and do not necessarily represent those of the IMF or IMF policy. Working Papers describe research in progress by the author(s) and are published to elicit comments and to further debate. A politically driven and ambitious decentralization program implemented by the authorities since the late 1990s has had mixed results in terms of enhancing service delivery. Paradoxically, concerns with the results of service delivery, partially driven by donors' requirements, have resulted in a deconcentrated system relying on conditional grants and unfunded mandates. This has reduced the incentives, responsibility, and ownership for local authorities to improve service delivery. Crucially, for functions where the local authorities have had full responsibility, better service quality has resulted than in those areas in which there are overlapping responsibilities between the center and the local authorities.
Maureen Lewis

This paper reviews the resurgence of Latin America. The paper highlights that much of the region has witnessed a swift and robust recovery from the successive financial crises of 2001–02. Within two years, the region’s economic growth reached 5.6 percent in 2004, a 24-year high. Growth rates of about 4 percent in 2005 and 3¾ percent projected for 2006 are well above historical averages. Mexico and South American countries have gained, in particular, from the surge in fuel, food, and metals prices, and have generally been able to exploit these opportunities by expanding production.

Mr. Andrew Berg
and
Zia Qureshi

This paper explores why increased aid flows require economic policymakers to confront some specific issues. Ensuring that increased aid promotes growth and reduces poverty is certainly the most important task. Empirical studies offer only mild support for aid-boosting growth. However, one study suggests that once one excludes the aid flows aimed at political and humanitarian goals, a positive net effect is observed for the remaining aid focused on economic objectives. This paper also outlines the roles to be played by development partners for making the aid being properly utilized for boosting growth.

International Monetary Fund

Abstract

The past century has been marked by rapid advances in human welfare. People in most parts of the world are healthier and are living longer. While this trend is likely to continue, hopes are fading in some regions where progress slowed or stopped in the1990s, primarily as a result of the AIDS epidemic. This compilation of articles published over the past five years in the pages of F&D looks at the important links between health and economic progress. Articles range over a variety of topics, from the Millennium Development Goals and their health-related targets for 2015 to the economics of tobacco control. Several articles examine the impact of AIDS and the global reaction, while others look at debt and the intellectual property aspects of health care.

Mr. Markus Haacker

Abstract

This paper analyzes the macroeconomics of HIV/AIDS. The paper highlights that the mortality and morbidity associated with AIDS make it unlike most other types of sickness and disease. The paper describes the most common approaches used in accounting for growth in the context of an HIV/AIDS epidemic. The impact of HIV/AIDS on education and the accumulation of human capital is discussed. The paper also discusses the impact of HIV/AIDS on the public sector, and elaborates certain demographic events specific to the HIV/AIDS pandemic.

Shatayanan Devarajan
and
Ritva Reinikka-Soininen

This paper highlights that the Washington Consensus helped fill the need for an economic policy framework following the discrediting of central planning and import-substitution trade strategies. Latin American governments championed the Consensus in the early 1990s, and the policy agenda delivered some of the things it was supposed to—healthier budgets, lower inflation, lower external debt ratios, and economic growth. But unemployment rose in many countries and poverty remained widespread, while the emphasis on market openness made states vulnerable to the side effects of globalization.

Mrs. Ritha S. Khemani
,
Mr. Sanjeev Gupta
,
Mr. Calvin A McDonald
,
Mr. Louis Dicks-Mireaux
, and
Marijn Verhoeven

Abstract

As part of its mandate, the IMF seeks to create the conditions necessary for sustained high-quality growth, which encompasses a broad range of elements. These include sound macroeconomic policies, growth-enhancing structural reforms, good governance, and such social policies as cost-effective social safety nets and targeted social expenditures. This paper reviews the IMF's policy advice in two key areas of social policy: social safety nets and public spending on education and health care. It was initiated as part of the work by the World Bank and IMF to strengthen the poverty focus of adjustment programs in low-income countries, in particular within the framework of the Initiative for Heavily Indebted Poor Countries (HIPCs).

International Monetary Fund

This Selected Issues paper and Statistical Appendix analyzes poverty and social development in Uganda. The paper reviews recent poverty and inequality trends, examines how poor people are coping with risk and vulnerability, analyzes the relationship between economic growth, structural reform and poverty, and describes the government policies in these areas. The paper also provides a brief overview of major institutional developments in Uganda’s financial sector since 1993 with regard to the legal, accounting, and general regulatory framework in which financial institutions operate.

Mr. Markus Haacker

Abstract

It is now 20 years since the first cases of acquired immune deficiency syndrome (AIDS) were discovered in sub-Saharan Africa. At the beginning of the third decade of the global pandemic, AIDS has reversed gains in life expectancy and improvements in child mortality in many countries; mortality among the population aged 15–49 has increased manyfold, even in countries with modest epidemics.1 AIDS is the leading cause of mortality among adults (WHO, 2004). According to estimates by the Joint United Nations Programme on AIDS (UNAIDS), as of the end of 2003, over 20 million people had died of AIDS. Some 38 million people are estimated to be living with the human immunodeficiency virus (HIV), the virus that causes AIDS, the overwhelming majority of whom—over 90 percent—are in the developing world.

Mr. Markus Haacker

Abstract

Any discussion of the impact of acquired immune deficiency syndrome (AIDS) on health care systems must distinguish between treatment of the opportunistic illnesses associated with AIDS and treatment directed at the underlying cause, namely, the human immunodeficiency virus (HIV). Treatment of opportunistic illnesses can alleviate suffering but typically extends life by only months. Treatment that controls the HIV in the patient’s body, called antiretroviral therapy or ART, can be much more successful, adding years to life expectancy.