In September 2015, the Sustainable Development Goals (SDGs) are being adopted as the world’s shared global economic, social, and environmental agenda through 2030. They will build upon the Millennium Development Goals (MDGs), a set of development targets that gradually became the common reference point for global policy efforts after being established at the U.N. Millennium Summit in September 2000.

The 17 SDGs reflect the complexity of the world’s challenges. On one level, they focus on finishing the job of the MDGs, i.e., the “second half” of eliminating extreme poverty. On another, they broaden the agenda to include global priorities not addressed by the MDGs, such as inequality, infrastructure, and peace and justice, alongside a better articulation of global environmental priorities. They also break down the barriers between developed and developing countries, setting out a universal agenda through which global absolutes are married with country-specific contexts.

A considerable amount of public dialogue will be required to translate the international agreements into practical forms of implementation. Analysis, deliberation, and debate will need to span public officials, academic communities, and engaged citizens alike.

To that end, it is a useful juncture to take stock of the recent history of MDG-focused public conversations and how they might inform opportunities for the SDGs. In this paper, we do so by examining three categories of print publications: major English-language newspapers; leading academic journals across a variety of relevant disciplines; and policy research papers produced by the World Bank, Asian Development Bank, and Inter-American Development Bank.

In evaluating these publications, we ask three simple questions:

1. Have there been discernible trends in media references to the MDGs—by year, publication, and geography?
2. Have there been discernible trends in MDG references across academic journals and disciplines?
3. How does the early pattern of MDG media references compare to the emerging early pattern of SDG media references?

For context, this paper does not aim to present a complete assessment of all MDG-related public media conversations. Instead, it focuses on the frequency of MDG references across articles published by a cross section of prominent newspapers, academic journals, and multilateral development bank research papers. Note that the search procedure does not require the MDGs to be the actual focus of an article in order to be counted; rather, the MDGs need only to be mentioned. The methodology thereby reflects an expansive notion of “MDG coverage,” the term we use in this paper to include both articles that might concentrate on the MDGs as objectives and those that might simply mention the MDGs as a reference point.

The paper proceeds in six sections. Following this introduction, Section II describes data sources and methods. Results begin in Section III, which considers MDG coverage in major newspapers. Section IV considers a cross section of prominent academic journals. Section V examines research papers produced by multilateral development banks. Section VI presents a brief discussion and conclusion.

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Bangladesh is at a critical juncture in the development of its education system. In 2013 the government decided to nationalize more than 26,000 nongovernment schools (about 25 percent of all primary schools) in an attempt to fulfill the vision laid out in its National Education Plan to “create unhindered and equal opportunities of education for all.” This includes “access of all sections of children to primary education irrespective of ethnicity, socioeconomic conditions, physical or mental challenges and geographical differences.” This report assesses how Bangladesh is faring and how it is allocating its financial resources to achieve this vision of universal primary education.

Bangladesh has made impressive progress in such key development areas as improving the provision of services, lowering the rate of child mortality and reducing the number of people living in impoverished conditions. Two decades of steady growth have contributed to these achievements, and Bangladesh is now ranked as one of the highest improvers on the UN’s Human Development Index. The fact that broad-based progress has been sustained within a challenging political context has been noted as a “development surprise.”

Bangladesh has seen unprecedented expansion in access to primary education during the past two decades, spurred on by strong national policies and effective education programs. In 1990 just over twothirds of its primary-age children were enrolled in primary school, while today there is near-universal education. Particularly striking have been gains in girls’ education. Today, there are more girls in primary schools than boys. Progress has also been made in access to schooling in marginalized areas. In the 1990s and 2000s this expansion was led by nonstate providers, and more recently by the government.

Today the education system includes more than 100,000 schools run by a large variety of public, private, NGO and religious providers, overseen by a complex bureaucracy involving multiple ministries. The management of the education system is highly centralized, and education delivery is overseen by numerous deconcentrated administrative units, with local subdistricts (upazilas) playing a major role in the education administration. Because of the importance of the upazilas for education delivery, this paper examines the performance of the education system using upazilas as the unit of analysis. Our analysis includes 503 upazilas.

Bangladesh’s recurrent public spending in primary education has been largely pro-poor. Public spending per child in the poorest quintile of upazilas was 30 percent higher than in the wealthiest quintile. This is a remarkable achievement. A positive relation was also found between the education input indicators and access indicators, suggesting that improvements in education inputs have had good results in getting more children into schools and improving equal access to primary education. In 70 percent of upazilas, average gross enrollment rates (GERs) are above 95 percent, and 40 percent of upazilas have reached the government target rate of 105 percent. The GER is still lower in poorer areas, however, at an average of 101 percent in the poorest quintile of upazilas, compared with 107 percent in the wealthiest quintile.

Despite good results in improving access to primary education, Bangladesh’s pro-poor spending has not translated into better overall education outcomes, and inequities continue to exist. While children are enrolling in school, average dropout rates are above 30 percent in nearly two-thirds of all upazilas. Poor areas score worse, with an average dropout rate of nearly 35 percent in the poorest quintile. Consistent learning outcome data across upazilas do not exist, but the National Student Assessment also confirms significant gaps between poorer and wealthier students in terms of learning achievements for Bangla language instruction and mathematics. Underlying these persistent disparities in education outcomes are inequities in accessibility, infrastructure and teaching inputs.

Overcrowded classrooms and difficult-to-reach school locations are common, especially in poor upazilas. Nationwide, over 15 million children—97 percent of preprimary and primary students in schools with information on class size—are in overcrowded classrooms (i.e., average room size per student is below the target of 1.18 square meters). Even after accounting for double shifting, more than three-quarters of all students are in overcrowded classrooms, with low contact hours for teaching and learning. In poorer upazilas, schools are also often not located in—or easily accessible from—remote communities, and overall infrastructure conditions are inadequate. In the poorest quintile of upazilas, fewer than 20 percent of schools had electricity.

An adequate supply of qualified teachers remains a problem across a broad range of upazilas. Average pupil/teacher ratios were above the national target of 46 students per teacher in about 60 percent of all upazilas. The poorest quintile performed worse (at an average of 53 students per teacher, compared with 48 pupils per teacher in wealthier upazilas). But teacher qualifications were found to be higher in poorer areas. This seems to be due to the higher share of government-supported schools, which tend to have teachers with relatively higher qualifications. Following stipends, spending on teacher salaries is the second most important driver of Bangladesh’s pro-poor spending patterns.

The quality and equity challenges facing Bangladesh’s education system are caused by a number of complex and interrelated factors, including entrenched socioeconomic disparities. But we also find a number of shortcomings in Bangladesh’s primary education financing that should be addressed to encourage further progress. We find that overall low levels of spending, declining stipend values and capital investments favoring wealthier areas exacerbate the disadvantages of the poor. In addition, complex and incremental education financing models and a lack of attention to the impact of education financing have limited the government’s ability to effectively target the needs of the poor.

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INTRODUCTION

Two years ago, in a rural community in Kwara State, Nigeria, we met Fatima a 62 year old grandmother who was struggling to care for herself and her two granddaughters aged three and nine. The children had been left with Fatima when their parents went to Lagos to look for work. Shortly thereafter, Fatima became ill, leaving her unable to work selling her homemade soybean cakes in the market for an income. She was forced to borrow money from other family members to pay for her medical expenses. When she could no longer borrow money she had to reduce spending on food items for herself and her grandchildren to buy medicine from the local medicine vendor in her village. Fatima, as the majority of poor Nigerians, was not covered by Nigeria’s National Health Insurance Scheme (NHIS) because she is not formally employed. She was suffering from severe hypertension, both of her granddaughters were malnourished and the youngest was suffering from malaria when a Hygeia Community Health Care (HCHC) enrollment officer arrived in her community a year later. By enrolling in the HCHC health insurance plan supported by the Dutch Health Insurance Fund (HIF) and implemented by PharmAccess, a nongovernmental organization (NGO), Fatima was able to receive the care that she and her granddaughter needed in the clinic, which had already been upgraded through the same program. With the appropriate treatment, her health stabilized and soon she was able to get back to work, earn a livelihood and care for her granddaughters.

Fatima’s story is not uncommon in Nigeria and many other parts of the developing world. The inability to pay for health care expenses, which forces people to reduce spending on food or other basic needs, and the lack of access to quality care are unfortunately common realities seen by many poor and underprivileged. Falling ill can have devastating and long-lasting consequences especially for poor households, both through income loss and high medical expenditures. Data suggest that more than 150 million people globally suffer financial catastrophe every year due to out-of-pocket health expenditures. Nigeria has among the highest out-of-pocket health spending and poorest health indicators in the world. 

Most people would agree with the idea that all individuals should have access to health services and should not face financial hardship as a result of health care costs. Universal health coverage (UHC), the concept that encompasses these goals, has gained wide attention and support in recent years. How to achieve UHC however, is a more complex question with a variety of disparate viewpoints. In this paper, we discuss UHC in the context of Nigeria, a middle-income country that nevertheless is facing enormous health challenges. We discuss the constraints that have prevented Nigeria from attaining UHC to date. We then present promising evidence from large and small-scale insurance interventions in other parts of the developing world. Next, we describe a public- private partnership model of community-based health insurance currently operating in Nigeria and other parts of Africa and show evidence of the program’s ability to increase health care utilization, provide financial protection and improve health status in target communities. We contend that UHC in Nigeria can only be achieved by addressing both supply and demand-side constraints simultaneously. The solution must also include building on existing public and private institutions and informal networks, leveraging existing capital, and empowering clients and local communities. An innovative model such as the one presented here that has been implemented successfully in one Nigerian state, could be replicated in others; tackling this challenge one state at a time, to eventually achieve the goal of access to health care and financial protection for all.

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INTRODUCTION

In the small village of Hafizibad in Pakistan’s Punjab province, a young girl is using her mobile phone to send an SMS message in Urdu to her teacher. After sending, she receives messages from her teacher in response, which she diligently copies by hand in her notebook to practice her writing skills. She does this from the safety of her home, and with her parents’ permission, during the school break, which is significant due to the insecurity of the rural region in which she lives. The girl is part of a Mobilink-UNESCO program to increase literacy skills among girls in Pakistan. Initial outcomes look positive; after four months, the percentage of girls who achieved an A level on literacy examinations increased from 27 percent to 54 percent. Likewise, the percentage of girls who achieved a C level on examinations decreased from 52 percent to 15 percent. The power of mobile phone technology, which is fairly widespread in Pakistan, appears in this case to help hurdle several education barriers by finding new ways to support learning for rural girls in insecure areas—girls who usually have limited opportunities to attend school and who frequently do not receive individual attention when they do. Often they live in households with very few books or other materials to help them retain over summer vacation what they learned during the school year.

On the other side of the world, in South America, the deployment of technology for education has not been so promising. In Peru, a number of colorful laptops sit in a corner of a classroom covered with dust. Given to the school through a One Laptop Per Child program arranged by the Ministry of Education, the laptops were intended to improve students’ information communication technology (ICT) skills, as well as their content-related skills. Without the proper support for teacher training in how the laptops are used, with no follow-up or repair and maintenance contingencies, and with outdated and bug-infested software, the laptops are seen as unusable and serve little purpose. In this case, technology has not helped improve the educational experience of learners.

Technology enthusiasts have long heralded the power of technology—from the printing press, to blackboards, to the laptop—to transform education. With the rapid expansion of information communication technologies around the globe, there is a high level of interest in harnessing modern technology to help advance the education status of some of the world’s poorest people. However, from Pakistan to Peru and beyond, experience shows that while there are numerous examples of how technology is used to the great benefit of teachers and learners alike, there are also many cases in which it does little to impact educational processes and outcomes. A better understanding of why and under what conditions these divergent outcomes emerge is the central aim of this study.

The potential of technology to help improve education has significance beyond teaching children reading and math. Quality education plays an important role in promoting economic development, improving health and nutrition and reducing maternal and infant mortality rates. Economic growth, for example, can be directly impacted by the quality of the education systems in developing countries. Studies by Hanushek and Woessman show a positive correlation over time between cognitive development, measured by student performance on international assessments, and individual earnings, income distribution and overall economic growth. A study by the International Monetary Fund (IMF) found that Asia’s increased economic performance over Africa and Latin America could be directly attributed to its higher investment in physical and human capital, such as education. Quality education has also been a factor in reducing maternal and infant mortality rates. Over half of the reduction in child mortality worldwide since 1970 is linked to “increased educational attainment in women of reproductive age.” Educated women are also more likely to seek out healthcare for themselves and their families. Studies on maternal health show that 90 percent of women with a secondary education in South and West Asia seek neonatal care, compared with only 50 percent of women with no education.

Our purpose is to provide guidance to non-specialists interested in pursuing technology for educational improvement in the developing world. Outside of a very small group of experts, educators working in and with developing countries rarely have an expertise or even a basic grounding in the wide range of technological innovations and their potential uses for education. Even the most seasoned education expert is likely to stare blankly if terms such as ‘cloud computing’, ‘m-learning’, or ‘total cost of ownership’ are introduced into the conversation. Questions about what technology is available to support education, what its possible benefits are, and how it can be used effectively, can be heard equally in the halls of the ministries of education in developing countries and in those of the headquarters and offices of international funders of education.

Our goal is to answer these questions by providing a broad overview of some of the common education challenges facing the developing world and the range of different technologies that are available to help address them. We look closely at the different enabling conditions that frequently shape the success or failure of technology interventions in education and derive a set of seven basic principles for effective technology use. These principles can provide guidance to decision-makers designing, implementing or investing in education initiatives. In doing so, we look both at the primary and secondary, as well as at the higher levels, of education systems. Using the World Bank classification of low-income and lower middle-income countries we focus our attention on the world’s poorest countries from Sub-Saharan Africa to South and West Asia to the Caribbean.

We focus particularly on the possibilities of recent forms of technology, often known as Information Communication Technology (ICT). ICT refers to technologies that provide access to information through telecommunications. It is generally used to describe most technology uses and can cover anything from radios, to mobile phones, to laptops. Of course, education has used technology for centuries, from blackboards to textbooks, yet in recent history very little has changed in how education is delivered. Teachers in most schools stand at the front of a room, while students sit and listen, sometimes attentively. However, while for many years policymakers have been unconvinced about the usefulness of technology in education—citing multiple examples in which it adds little value—today there is a new focus on its possibilities.

We conclude ultimately that, if smartly and strategically deployed, modern information and communications technology holds great promise in helping bring quality learning to some of the world’s poorest and hardest to reach communities. The strategy for doing so need not emulate the trajectory of educational technology use in wealthier developed nations. Indeed, in some of the most remote regions of the globe, mobile phones and other forms of technology are being used in ways barely envisioned in the United States or Europe. Necessity is truly the mother of invention in these contexts and often leads to creative and promising ends for teachers and learners.

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