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Background Inadequate access to services for breastfeeding counseling results in poor breastfeeding practices and adverse health consequences. Although poor access to breastfeeding counseling services is a major challenge, its magnitude and determinantes are not well studied in developing countries. Therefore, this study assessed the magnitude and determinants of poor access to breastfeeding counseling services among lactating mothers who had optimal antenatal care follow-up in Sub-Saharan Africa. Methods Data from the recent Demographic and Health Surveys, involving a total of 289,929 women, were used for analysis. The determinants of poor access to breastfeeding counseling services were examined using a multilevel mixed-effects logistic regression model. Significant factors associated with poor access to breastfeeding counseling services were declared significant at p -values < 0.05. The adjusted odds ratio and confidence interval were used to interpret the results. A model with the lowest deviance and highest log likelihood ratio was selected as the best-fit model. Results In Sub-Saharan Africa, nearly one in two women with optimal antenatal care follow-up had poor access to breastfeeding counseling services. Maternal age (AOR = 1.18, 95% CI: 1.02, 1.38), maternal education (AOR = 1.128, 95% CI: 1.22, 1.35), distance to health facility (AOR = 1.17, 95% CI: 1.13, 1.21), media exposure (AOR = 1.12, 95% CI: 1.08, 1.17), wealth index (AOR = 1.05, 95% CI: 1.00, 1.10), place of delivery (AOR = 4.31, 95% CI: 4.11, 4.52), PNC (AOR = 3.92, 95% CI: 3.78, 4.07), mode of delivery (AOR = 1.88, 95% CI: 1.76, 2.02), birth interval (AOR = 1.12, 95% CI: 1.07, 1.17), residence (AOR = 1.14, 95% CI: 1.09, 1.18), community poverty (AOR = 1.09, 95% CI: 1.03, 1.15), community institutional delivery (AOR = 1.06, 95% CI: 1.01, 1.12), country category (AOR = 2.23, 95% CI: 2.10, 2.37), had higher odds of poor access to breastfeeding counseling services. Conclusions Poor access to breastfeeding counseling services among lactating mothers was found to be high. Both individual and community-level factors were determinants of poor access to breastfeeding counseling services. The Ministry of Health in Sub-Saharan Africa should give attention to those women who have not had a postnatal check-up and give birth at home while designing policies and strategies.

Foreign direct investment and private capital flows are highly concentrated geographically, with almost half of them reaching five top destinations. These flows tend to evade many high-risk countries. Regulatory and contractual risks, particularly in infrastructure, have inhibited investments in many parts of the developing world. A core objective of the World Bank Group (WBG) has been to support the flow of private investment for development; guarantees and insurance have been among the instruments that the WBG has used to pursue this objective. This study examines three main questions: • Should the WBG be in the guarantee business? • Have guarantee instruments in the three WBG institutions been used to their potential as reflected in WBG expectations and perceived demand? • Is the WBG appropriately organized to deliver its range of guarantee products in an effective and efficient manner?

Carbapenem-resistant Enterobacterales are defined as Enterobacterales which are resistant in vitro to any carbapenem antimicrobial or are documented to produce a carbapenemase. They are a serious public health threat and are listed as critical pathogens on the World Health Organization’s (WHO) list of priority pathogens. Critical pathogens are antibiotic resistant pathogens which pose the highest threat to public health due to limited treatment options, high disease burden, high rates of treatment failure, high transmissibility, increased healthcare costs and increasing trends in antibiotic resistance, with few or no promising antibiotic candidates in the research and development pipeline. When treatment failure due to CRE occurs, physicians are left with few antibiotic alternatives, most of which have high toxicity profiles. While CRE are of public health importance, globally, their problem is exacerbated in Low and Middle Income Countries (LMICs) due to reasons such as poor diagnostic microbiology capacity, data gaps due to poor surveillance structures, inadequate antibiotic treatment options and poor infection prevention and control protocols and ultimately poor patient outcomes. Also, rising rates of CRE infections and infections caused by other multidrug resistant (MDR) organisms could result in a failure to achieve the health related sustainable development goals, due to increased healthcare costs, poverty and reduced productivity. Efforts to adequately combat CRE infections in LMICs must therefore involve context specific and sustainable solutions. The aim of this review, therefore, is to discuss the challenge of CRE in LMICs and offer recommendations to curb the menace posed by CRE.

Background: The perception within literature and populace is that the private for-profit sector is for the rich only, and this characteristic results in behaviours that hinder advancement of Universal health coverage (UHC) goals. The context of Northern Uganda presents an opportunity for understanding how the private sector continues to thrive in settings with high poverty levels and history of conflict. Objective: The study aimed at understanding access mechanisms employed by the formal private for-profit providers (FPFPs) to enable pro-poor access to health services in post conflict Northern Uganda. Methods: Data collection was conducted in Gulu municipality in 2015 using Organisational survey of 45 registered formal private for-profit providers (FPFPs),10 life histories, and 13 key informant interviews. Descriptive statistics were generated for the quantitative findings whereas qualitative findings were analysed thematically. Results: FPFPs pragmatically employed various access mechanisms and these included fee exemptions and provision of free services, fee reductions, use of loan books, breaking down doses and partial payments. Most mechanisms were preceded by managers' subjective identification of the poor, while operationalisation heavily depended on the managers' availability and trust between the provider and the customer. For a few FPFPs, partnerships with Non-governmental organisations (NGOs) and government enabled provision of free, albeit mainly preventive services, including immunisation, consultations, screening for blood pressure and family planning. Challenges such as quality issues, information asymmetry and standardisation of charges arose during implementation of the mechanisms. Conclusion: The identification of the poor by the FPFPs was subjective and unsystematic. FPFPs implemented various innovations to ensure pro-poor access to health services. However, they face a continuous dilemma of balancing the profit maximization and altruism objectives. Implementation of some pro-poor mechanisms raises concerns included those related to quality and standardisation of pricing.

Pro-poor land access for physical development is hindered by communal land conflicts in most developing countries like Nigeria, thereby inducing homelessness. As the capital city of the then Eastern Region of Nigeria, Enugu has witnessed communal land conflicts and associated challenges in urban expansion, infrastructure development and land-use planning. This study examines the dynamics of communal land conflicts, land access challenges and their socio-economic implications in Enugu, Nigeria. It highlights the role of the Church in promoting social inclusion and advocating for pro-poor initiatives. A mixed-methods approach was employed, combining primary data from 40 respondents through structured interviews and observations, alongside secondary data from government reports, academic literature and church records. The study revealed systemic inefficiencies in land administration, driven by dual frameworks combining formal laws and informal practices. Key issues included the exploitation of compulsory acquisition laws, the marginalisation of vulnerable groups and the proliferation of informal settlements. The Church emerged as a significant actor, contributing to peacebuilding and community development through its socio-economic initiatives, advocacy for justice and grassroots engagement. The study concludes that integrating the Church into land governance frameworks presents a unique opportunity to resolve communal land conflicts, address systemic exclusions and promote sustainable urban development.ContributionThe study, among others, recommends harmonising formal and informal land systems, empowering marginalised groups, upgrading informal settlements and leveraging the Church’s moral authority and resources to foster equitable land access and social inclusion.

The report is organized around three chapters, in addition to this overview, each one dealing with an excluded group: Scheduled Tribe (ST), Scheduled Caste (SC), and women. The objective is to provide a diagnostic of how the three excluded groups under analysis have fared along various development indicators during a period of rapid economic growth in the national economy. In seeking this objective, the report also addresses correlates and the processes that explain how and why these groups have fared the way they have over a period of time. Chapter two in this report focuses on the Adivasis or STs. In most analyses, this topic is addressed after the Dalits, but the author has placed it first for analytical and organizational purposes. There are two reasons for this: tribal groups are not strictly within the caste system, and the bonds of rituals do not affect their relations with the world in general. Also the report shows that outcomes among Adivasis are among the worst, despite considerable variation across places of residence and tribal groupings. Finally, Chapter three focuses on Dalits, a term that has united the SCs in a process that is more empowering than the process of identification by individual names, which have been and continue to be associated with ritually impure occupations.

This article focuses on how water users perceive the state of water security and their concerns about water resources in Baguio City using survey data from 300 poor households. The financial and social aspects of the poor household's access to potable water are described before features of the Baguio Water Code on drinking water quality, water permits and groundwater extraction, and rainwater harvesting are tackled. The high expectations that accompanied the approval of this breakthrough legislation to address the city's long-standing water problems which were only partially met as the key provision on water permits remains unimplemented. Drinking water quality and rainwater harvesting have had some success in implementation. Still more needs to be done through measures that rely on the partnership of the local water utility and the city government offices in order to respond to the need of poor households for clean water.

This report is part of a broader effort by the World Bank Group to understand the motives and challenges of small entrepreneurs in fragile and conflict-affected situations (FCS). The report's key finding is that, compared to entrepreneurs elsewhere, entrepreneurs in FCS have different characteristics, face significantly different challenges, and thus may be subject to different incentives and have different motives. Therefore, it is recommended that both the current analytical approach and the operational strategy of the World Bank be informed by the findings that follow. The report summarizes findings of recent World Bank Enterprise Surveys (ES) conducted across Sub-Saharan Africa (SSA), Asia, and the Eastern Europe and Central Asia (ECA) Region as well as Doing Business indicators and additional World Bank Group studies and field observations. The report finds that the majority of entrepreneurs in FCS countries are small, informal, and concentrated in the trade/services sectors. According to the ES, and after controlling for the level of development (that is, GDP per capita): 1) the average FCS firm in SSA and the ECA Region produces less output than non-FCS firms; 2) the average FCS firm in ECA is by 20 percent less likely to innovate (that is, to introduce/upgrade new products and services) than its non-FCS counterpart; and 3) FCS firms start smaller and grow significantly more slowly, or even shrink (in the number of employees) over time, compared to non-FCS firms in the Regions analyzed. The report also highlights the differences in sector and business environment characteristics between FCS and non-FCS business environments.

Although access to financing in Pakistan is expanding quickly, it is two to four times lower than regional benchmarks. Half of Pakistani adults, mostly women, do not engage with the financial system at all, and only 14 percent have access to formal services. Credit for small- and medium-size enterprises is rationed by the financial system. The formal microfinance sector reaches less than 2 percent of the poor, as opposed to more than 25 percent in neighboring countries. Yet it is the micro- and small businesses, along with remittances, that help families escape the poverty trap and participate in the economy. 'Bringing Finance to Pakistan's Poor' is based on a pioneering and comprehensive survey and dataset that measures the access to financial products by Pakistani households. The survey included 10,305 households in all areas of the country, excluding the tribal regions. The accompanying CD contains summary statistics. The authors develop a picture of access to and usage of financial services across the country and across different population groups, and they identify policy and regulatory priorities. Reform measures in Pakistan have been timely, but alone are not enough; financial institutions have lagged behind in adopting technology, segmenting customer bases, diversifying products, and simplifying processes and procedures. Gender bias and low levels of financial literacy remain barriers, as is geographical remoteness. However, the single strongest cause of low financial access is lack of income—not location, education, or even gender. 'Bringing Finance to Pakistan's Poor' will be of great interest to readers working in the areas of business and finance, economic policy, gender and rural development, and microfinance.

This report summarizes the key themes and findings from three in-depth case studies of EET programs in Ghana, Kenya, and Mozambique. Each case study produced rich information on the programs context, the landscape of programs in each country, and the qualitative insights from local EET stakeholders. This report synthesizes information from across the case studies to analyze the extent to which these countries programs are meeting the needs of local entrepreneurs. It also introduces findings from global EET research to show how programs in the case-study countries relate to what is known about global practice in EET. From this synthesis, the report presents a set of key findings intended to illuminate how EET programs can be better aligned with local needs and promising EET practices globally.