Abstract

Infrastructure plays a key role in promoting economic growth and opportunities.In particular, the efficient provision of basic infrastructure services, like water and sanitation, is a key ingredient in fostering a country's social and economic development. Previous studies have found that infrastructure has a positive impact on output, and can improve economic opportunity, including health and education for the poor, particularly in developing countries. In Argentina, a 2005 study, found that child mortality fell by 8 percent in areas that had experienced improved coverage and quality of basic water and sanitation through utility reform, with most of the reduction occurring in low-income areas where the water network expanded the most. More generally, Fay and Morrison found that allowing the poorest quintile in developing countries the same access to basic services as the richest quintile would reduce child mortality by 8 percent and child under development by 14 percent. Calderon and Serven also found a significant positive impact of infrastructure access and quality on overall inequality. Furthermore, the book sheds some light on how to address the main challenge for the future which may be to attract specialized operators to the smaller municipalities which do not currently have them. For that purpose in Colombia, for example, over the last two years, the policy framework has been focused on promoting the sector's development, by using the departments as the intermediate institutional level between the National Government and the municipalities, to formulate programs with regional impact and promote comprehensive investment plans. Document type: Book

Abstract

Globally, an estimated 24 percent of the disease burden (healthy life years lost) and an estimated 23 percent of all deaths (premature mortality) are attributable to environmental risks (World Health Organization, or WHO 2006). The burden of disease is unequally shared, with the children and the poor being particularly affected. Among children between the ages 0 and 14, the proportion of deaths attributable to environmental risks, such as poor water and sanitation, indoor air pollution and vector-borne diseases, is estimated to be as high as 36 percent (WHO 2006). Several key messages have emerged from the process of putting together this study: (i) environmental health risks impose a significant burden on Nicaraguas economy, amounting to 2.6 billion Nicaraguan Cordoba (NIO) or 2.4 percent of the countrys Gross Domestic Product (GDP), and result in premature deaths and infections, especially in children under five; (ii) cost-effective interventions to address these environmental health risks exist and should be prioritized in Nicaragua; (iii) country-specific health and environmental data are somewhat limited, especially in the case of air quality, and data collection and monitoring need to be further strengthened; and (iv) the capacity of Ministry of Environment and Natural Resources (MARENA) and Ministry of Health (MINSA) staff to conduct environmental health costing analysis needs to be strengthened through proper training.