Insights into plant growth could curb need for fertilizers

New insights into how plants regulate their absorption of an essential nutrient could help avoid pollution caused by excess use of fertiliser.

The findings could lead to the development of crop varieties that need less of the primary nutrient – nitrogen – than conventional crops. It could also inform how much nitrogen should be added to plant feed.

This would allow optimum plant growth without producing excess nitrogen in run-off from fields, which is a major source of water pollution. Read more

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A Model of Health

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By Corey Binns

In 2013, Ratan Kunwar was
stirring a pot of lentils to feed
her family for dinner when
she knocked over the pot. It
fell onto her arms, chest, and abdomen.
Her skin was scalded and raw. Kunwar, a
28-year-old mother of two sons—a baby and
a three-year-old—lives in the Nepali village
of Mastamandu.
After the accident, she was
turned away from one hospital because she
couldn’t afford treatment, and she assumed
that she would endure her injuries forever.
Her arm itched and burned. At night, the
pain kept her awake. She had trouble farming,
cooking food, and washing clothes for
her family. She couldn’t comb her own hair.
She was unable to hold her baby.

Three months after the injury, Kunwar
arrived at a hospital run by a nonprofit organization
called Possible. The organization
posted Kunwar’s story on an affiliated crowdfunding
site, and before long people from
around the world had contributed enough
to pay for her skin-graft surgery. Since the
surgery, every aspect of Kunwar’s life has
improved. Most important, she can now hold
her infant son in her arms. “That’s a classic
example of why taking a comprehensive approach
to health care matters, because conditions
as simple as a burn or fracture can
destroy people’s lives,” says Mark Arnoldy,
cofounder and CEO of Possible.

Kunwar is one of more than 173,000
patients whom Possible (formerly Nyaya
Health) has helped treat since 2008. That
year, a trio of friends from the Yale School of
Medicine—Jason Andrews, Sanjay Basu, and
Duncan Maru—along with local clinicians,
started providing care out of a grain shed in
the Achham district of Nepal. At that time,
the people of Achham lived a 36-hour bus
ride away from a major health care center.

Today, Possible operates a sophisticated
health care delivery system that functions
on top of the Nepali government’s existing
infrastructure. The organization follows
a hub-and-spoke model: It runs a hospital
and a network of clinics, and it supports
them by managing a team of community
health workers. It treats patients who
suffer from a variety of maladies, and it
treats them free of charge. In addition,
Possible has built a referral program for
patients with complex care needs. “It’s a
model that’s neither private sector nor public
sector, but a combination of the two,”
says Arnoldy. Unlike some efforts to deliver
health care in developing countries,
moreover, the Possible model doesn’t have
a limited scope. “It’s not just for certain
conditions, like HIV or maternal health,”
Arnoldy notes. It is, he says, “a health care
system [like] we would expect to have here
in the United States.”

Hub and Spoke

Bayalpata Hospital serves as Possible’s hub
for clinical care and organizational operations.
The Nepali government built the
hospital in 1979 and then abandoned it for
30 years. Possible refurbished the crumbling
buildings and took over management
of the facility in 2009, and since then providers
there have treated more than 44,000
patients. Kunwar delivered her second baby
at Bayalpata.

Nepal offers an opportune setting in
which to build a delivery model based on
combining public and private resources.
The Nepali constitution includes a provision
that guarantees free health care for
patients who live in poverty. Each of Nepal’s
75 districts has its own public hospital, more
than 13,000 government-run clinics dot the
country’s rural landscape, and the government
maintains a network of 50,000 women
who act as community health volunteers.
Yet the Ministry of Health and Population
spends only about half its budget each year.
That’s because of gaps in the “absorptive
capacity of the government’s health care
system,” says Maru, who serves as chief
programs officer of Possible. “There’s a real
interest in public-private partnerships on
the part of politicians and the funders in
the Ministry of Health.”

Maru and other members of the Possible
team have worked with those officials to create
the Possible delivery framework. Amit
Aryal, a technical expert for the Ministry
of Health and Population, praises the comprehensiveness
of that framework. “In my
mind, [Possible is] really taking health care
to the people and not waiting for them to
come to the hospital,” says Aryal.

Accessing health care can be nearly impossible
for people in Nepal who live far from
cities. The average Nepali pregnant woman,
for example, will walk more than four hours
to deliver her baby in a hospital. To help remedy
that situation, Possible has transformed
six underperforming government clinics into
high-quality birthing centers. “If we’re going
to solve the access problem, we need to
get that [local clinic] tier of the health care
system working at a very high level of performance,”
Arnoldy says.

To improve primary and preventive
care, Possible is strengthening the government-managed cadre of community health
volunteers. That effort involves training
volunteers to encourage patients to visit
Possible facilities for follow-up care. It also
involves training volunteers to keep records
of all pregnancies and illnesses. In addition,
Possible has developed a network of
paid community health workers who track
health information and provide services at
the household level. It’s “the health care
system’s responsibility to reach out and
to make sure [that patients] continue to
be engaged in the system and are getting
the care they need,” Maru says.

The value of the hub-and-spoke model
is especially evident when it comes to treating
conditions such as neonatal jaundice.
Trained health workers who operate in clinics
and out in villages are able to screen infants
for that disease. “With [the Possible]
model, fewer infants will fall through the
cracks,” says Garrett Spiegel, a product manager
at D-Rev, a company that partners with
Possible to provide phototherapy and jaundice
management at Bayalpata Hospital.
Instead, he explains, properly diagnosed
infants are “brought in to the health center before the jaundice progresses to a level
where their brain is permanently damaged.”

Possible holds itself to a high standard of
care and applies rigorous evaluation to its
operations. “The way we measure our success
has changed, as the scale of operation
has grown,” says Arnoldy. Epidemiologists
from the Division of Global Health Equity
(DGHE) at Brigham and Women’s Hospital
in Boston work with Possible to track a variety
of performance indicators: the number
of days that surgical services are available to
patients, the percentage of chronic-disease
cases that community health workers treat,
and so forth. (Maru is a faculty researcher
at DGHE.)

Cost control is another goal that Possible
leaders take seriously. Their long-term aim
is to limit per-patient expenditures to less
than $50 per year, and so far they have kept
that figure to less than $20. By comparison,
annual per capita health care spending in
the United States comes to about $8,000.

Change and Challenge

In early 2014, Arnoldy led the organization
through a rebranding initiative that
resulted in a new website, a new logo, and
a new name. The original name—Nyaya
Health—was hard to spell, hard to pronounce,
and hard to promote. Over time,
the Nyaya brand had also become more and
more restrictive. “For us, this is about way
more than the name, look, feel, and colors,”
says Arnoldy. “Our team thought we had a
shrinking window of opportunity to communicate
why we exist and how our health
care model works. We had to make a move
before we got too big and [the old name]
became too cemented into the identity of
the organization.”

To continue growing under its own identity,
Possible has sought revenue from a broad
range of sources. At this stage, the organization
receives most of its funding from
donors such as the Good Works Institute,
Greatergood.org, and Rotary International.
But Arnoldy
foresees a time when the Nepali
government might become its largest funder.
In 2013, the government invested cash and in-kind contributions worth $270,000, up
from $110,000 in 2011. (That year, Possible
had annual revenues of about $1.25 million.)
Along with land, infrastructure, and other
forms of in-kind support, the government
has provided a large supply of pharmaceuticals
to Possible through the public-sector
supply chain. “We have a quickly growing
relationship on that front that makes us believe
that this is very much possible to do on
a large scale,” says Arnoldy.

In partnership with the crowdfunding
sites Watsi.org and Kangu.org, Possible has
also created an online medical referral network.
“Before this model, we had to turn
patients away,” says Arnoldy. Now when
patients come to Bayalpata Hospital
or to
a clinic with complex care needs, Possible
can tell their story on the Web, and anyone
with Internet access can then help
fund their care with a donation of $10 or
more. In December 2013, Possible received
a Sappi Ideas That Matter Award valued at
$43,000, and with that money it launched
CrowdFundHealth.org—a site that integrates
the Possible referral network with
the Watsi and Kangu sites. (In its first 14
weeks, CrowdFund Health raised enough
money to provide $112,000 worth of treatments
to 120 patients.)

Today, the most challenging aspect of
Arnoldy’s
job involves retaining qualified providers
who will work in less-than-hospitable
rural areas. Despite offering comfortable
staff housing, high salaries, and a supportive
management culture, leaders at Possible face
environmental and social barriers that hinder
long-term retention of senior staff members.
“And we don’t expect that [problem] to go
away anytime soon,” Arnoldy says.

Another challenge stems from the organization’s
reliance on government funding.
A new group of Nepali political leaders
could easily take that funding away. “We can’t
completely eliminate that risk, the same way
we can’t eliminate the risk that a large-scale
philanthropic funder might do that someday,”
Arnoldy says. “We’ve tried to mitigate
that risk—not by being too big to fail, but by
being too influential to fail.”

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Using Open Data to drive innovation, collaboration and change in India

Open Data has the potential to be a game-changing tool in poverty reduction and economic growth. The World Bank has been actively encouraging governments to become more transparent, more accountable to their citizens, less susceptible to corruption and better at delivering services.We often consult various partners – including governments, organizations and other implementers – on Open Data and its critical role in economic development and growth. The World Bank’s team of information and communication technology (ICT) and open data experts help explore the potential for forecasting national and global trends, while also unlocking opportunities for innovation and improved performance. These consultations serve as a crucial starting point in planning, implementation and correction of many government, private sector and civil society initiatives.

Since 2012, the Bank has organized a series of trainings on open data tools and online resources for users in government, economic research institutes, media, civil society, academia and the private sector. More than 3,000 stakeholders have been trained already in 10+ major cities of India. There is need to take this agenda forward especially in the low-income states where exposure to the Bank’s resources is lower.

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An unlikely incubator for female social entrepreneurs in rural Asia: Libraries

“Being born a girl is worthless,” said Chuna Devi, a Nepalese woman. Because her family didn’t think her education was a priority, she grew up illiterate, herding goats and cows.

Women make up just 24 percent of the formal workforce in South Asia, according to the Wall Street Journal. That represents a huge untapped resource: 336 million women like Chuna could be contributing to their families’ incomes and lifting themselves out of poverty if they had the skills to do so.

Chuna is part of a solution to inequity and poverty that is taking root in some of South Asia’s most remote corners, and it begins with a simple but disruptive idea: going to the library.

For more than two million rural villagers across South Asia, libraries called “READ Centers” have already become a powerful platform for women like Chuna to learn skills, network in her community, and become leaders who change social norms.

At the age of 47, Chuna changed her and her daughters’ lives by learning to read and starting a women’s group. Today, her goal is to convince other women that it’s never too late to learn, earn an income, and change your community.

Watch a three-minute video of Chuna’s story.

Women play a vital role in poor households. As UN Secretary-General Ban Ki-moon put it recently, “Empowering rural women is crucial for ending hunger and poverty. By denying women rights and opportunities, we deny their children and societies a better future.”

A recent UN study shows that if women were given the same access to productive resources as men, it would reduce the number of hungry people in the world by about 12-17 percent. Similarly, USAID stated that women are more likely than men to reinvest in their families’ food security, health, and education (see the infographic here).

Despite the obvious benefits, the road to entrepreneurship is extremely difficult for many women. They often lack the education and skills needed, and face gender discrimination. About 493 million women are illiterate worldwide: more than half of whom live in South Asia. These women rarely have the opportunity to learn at a young age. 130 million girls in South Asia will be married as children by 2030, ending their education and resulting in early pregnancies. As adults, these women often must seek permission from their husbands to leave their homes for reasons other than childcare or agricultural work.

In South Asia, libraries are seen as legitimate, neutral places for women to visit, because they often offer childcare and health services that benefit the family. The READ Centers set up by the non-profit READ Global also help women learn income-producing activities, such as sewing, beekeeping, or mushroom farming. When women learn a trade and start providing income to their families, their husbands often gain trust in the READ Center and give them more freedom. Women can become networked with a community of other women who provide mutual, ongoing support.

Literacy does not necessarily precede economic empowerment. But READ Global has found that these skill sets are mutually reinforcing, and together, they can empower women to change the status quo in their villages.

Just last year, more than 1,700 women like Chuna learned to read through READ Centers in Nepal. Many of them also joined savings cooperatives, often putting away money for the first time in their lives. With 3,339 peers, the women collectively saved $207,382 last year at READ Centers.

And many finally became entrepreneurs: 324 moved from subsistence farming to commercial farming – earning an income from agriculture for the first time. 174 women farmers actually became self-sufficient in their production for the first time, and almost 100 women launched new businesses.

With this new income, the women helped generate almost $140,000 to invest back into the READ Centers and sustain them.

A major challenge in rural development is that efforts often don’t take a holistic approach. Many organizations and government bodies work in a piecemeal fashion: They provide one-off literacy training to women in a community for a few months, for example, and then move on. The women will have taken a huge first step in self-empowerment by learning to read, but they won’t necessarily have the resources or the support network to apply or build on their new skill.

For women like Chuna, libraries like READ Centers can play the role of incubators – not just for businesses, but also for long-term social change. By working with local partners, setting up committees to manage the Centers, and providing a holistic set of training programs over the course of five years, READ Global ensures that rural villagers create local support networks that can sustain themselves in the future.

After Chuna learned to read, she had the confidence to take other trainings in vegetable farming, women’s leadership, health, and mobile technology. She then paid it forward by convincing her friends to join a study group with her, helping them learn to read, and investing in her own daughters’ education.

“I realized that all uneducated women suffer,” Chuna says, “There are a lot of illiterate women in Nepal. I want to tell them that you’re never too old to learn.”

Follow READ on Facebook or twitter @readglobal

Sara Litke is a Global Envision alumnus, and currently serves as marketing and communications manager for READ Global, an international nonprofit organization working in South Asia to provide education and economic opportunity to rural villagers. READ Global received the 2013 UPenn and Wharton School’s Lipman Family Prize, awarded to innovative organizations creating sustainable solutions to significant social and economic challenges.

Meet Chuna Devi, who learned to read at a local library in Nepal founded by READ Global, and went on to take trainings vegetable farming, women’s leadership, health, and mobile technology. She convinced her friends to join study groups, and many have started their own businesses. Photo courtesy READ Global.

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What determines the performance of small enterprises in developing countries? Evidence from the handloom industry in Bangladesh

Family-based traditional microenterprises are abundant in developing countries, and in many cases they are a major source of income and employment for both urban and rural poor. With a few exceptions, however, most of these family-based traditional microenterprises in the rural areas of developing countries seldom grow in terms of enterprises’ size and product quality. Thus, they tend to perform poorly relative to their growth potentials. The development of these family-based microenterprises would be instrumental to employment generation, poverty alleviation and sustainable economic growth in developing countries. Using primary data collected from the traditional handloom industry in Bangladesh, this paper inquires into the development process of family-based traditional microenterprises in developing countries. The paper empirically demonstrates that entrepreneurs’ general human capital acquired by formal education is critically important for the introduction of new and high value-added fashionable products, and, thus, performance of the enterprise.
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Innovation in Industrial Clusters: a Survey of Footwear Companies in Brazil

The aim of this study is to characterize the relationships in innovation and business clustering processes in the productive chain of small and medium enterprises (SME) of Brazil. The object of study are SMEs the local procuctive cluster of the shoes in Franca, State of São Paulo. The conceptual model developed is based on the following constructs: vertical integration, innovation and characteristics of the cluster, and it is focused on identifying the agents that act predominantly in product innovation processes in the cluster. A survey was conducted. It was found that there is cooperation between the companies in the productive arrangement studied, and that shoe manufacturers are those who, predominantly, stimulate innovation within the cluster.
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The Incubation Process and the Strengthening of the Firm: a Study in Brazilian Companies

High mortality rate and an environment in constant change set up a context in which the search for innovation becomes essential to business’ longevity. Incubation has been proposed as an alternative to start-up companies, giving support for their development. Seeking to explore which characteristics enable a firm’s development through incubation, a multiple case studies were performed. Interviews were carried out with two Incubated, and three Graduated companies. Results indicate that the incubation process is important to strengthening of the firm. This was observed when innovative strategies employed by companies were analyzed. Was founded an evolution from Incubated to Graduated. During the incubation process, the companies showed a greater focus on strengthening their knowledge bases, seeking to establish qualification relationships and invest in an innovation strategy based on better human resources allocation while the Graduated ones attempt to achieve further innovation by structuring and coupling their own commercial and R&D departments.
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