Safer Deliveries in Sierra Leone

Data from the World Health Organization show that Sierra Leone has the highest rate of maternal mortality of any country in the world, with 2,100 maternal deaths per 100,000 live births (compared, for example, with 11 in the US and 7 in Canada). The New York Times reports on a new internationally-funded program in Sierra Leone to waive fees for pregnancy and delivery in order to improve birth outcomes.

Sierra Leone is at the vanguard of a revolution — heavily subsidized for now by international donors — that appears to be substantially lessening health dangers here in one of the riskiest countries in the world for pregnant women and small children.

Country after country in sub-Saharan Africa has waived medical fees in recent years, particularly for women and children, and while experts acknowledge that many more people are getting care, they caution that it is still too early to declare that the efforts have measurably improved health on the continent.

In Sierra Leone, though, it seems clear that lives are being saved, providing an early and concrete lesson about the impact of making health care free for the very poor and vulnerable.

By waiving the requirement for payments — which sometimes amount to hundreds of dollars and clearly represent the main barrier to using health facilities — the government here appears to have sharply cut into mortality rates for pregnant women and deaths from malaria for small children.

Educating Our Way Out of the Great Recession

There is no question in my mind that the single most important thing a person can acquire in life is a good education. But as college professor, I can easily be accused of bias on this issue, so it was good to read Nicolas Kristof's Op-Ed piece in today's New York Times, in which he laments that the Great Recession is taking its toll on our nation's greatest asset--our educational system.

The United States supports schools in Afghanistan because we know that education is one of the cheapest and most effective ways to build a country.

Alas, we’ve forgotten that lesson at home. All across America, school budgets are being cut, teachers laid off and education programs dismantled...The Center on Education Policy reports that 70 percent of school districts nationwide endured budget cuts in the school year that just ended, and 84 percent anticipate cuts this year.

And he hits a target close to my home:

The Dangers of Demographic Deception

I have already commented on the tendency of cities to think that they have been under-counted by the census--although there is never a complaint about over-counting. Mark VanLandingham, a demographer at Tulane University, has a very good Op-Ed piece in today's New York Times pointing out the dangers of over-estimating the population. 

Such overestimates have been especially problematic for New Orleans. According to the original census estimates for 2007, the city’s population stood at 239,124, which independent sources, like voter turnout and death records, indicate was a reasonable guess. But after heavy lobbying from then-Mayor Ray Nagin’s office — claiming the bureau’s methods missed large numbers of poor residents — the number was revised upward by about 20 percent, to 288,113.

A similarly successful challenge to the 2008 initial estimate led to yet another substantial uptick; combined, these revised estimates put the city on pace to recover almost all the residents it had lost after Hurricane Katrina within a few years.