Promoting Healthy Living and Aging in Central America : Multi-sectoral Approaches to Prevent Chronic Noncommunicable Diseases

Non-communicable diseases (NCDs) are the main cause of death and disability in Central America. However, communicable diseases and maternal and child conditions remain important causes of death and disability as well as injuries. With the aging of...

Full description

Bibliographic Details
Main Authors: Bonilla-Chacin, Maria Eugenia, Vásquez, Luis T. Marcano
Format: Working Paper
Language:English
en_US
Published: World Bank, Washington, DC 2013
Subjects:
NCD
STD
TB
Online Access:http://documents.worldbank.org/curated/en/2012/03/16750912/promoting-healthy-living-aging-central-america-multi-sectoral-approaches-prevent-chronic-non-communicable-diseases
http://hdl.handle.net/10986/13580
id okr-10986-13580
recordtype oai_dc
repository_type Digital Repository
institution_category Foreign Institution
institution Digital Repositories
building World Bank Open Knowledge Repository
collection World Bank
language English
en_US
topic ABNORMALITIES
ACCESS TO HEALTH CARE
ADOLESCENCE
ADOLESCENTS
ADULT POPULATION
AGING
ALCOHOL ABUSE
ALCOHOL CONSUMPTION
ALCOHOLIC
ALCOHOLIC BEVERAGES
ASTHMA
BEHAVIOR CHANGE
BIRTHS
BLINDNESS
BOTH SEXES
BREAST
BREAST CANCER
BREASTFEEDING
BULLETIN
BURDEN OF DISEASE
CANCERS
CARDIOVASCULAR DISEASES
CAUSES OF DEATH
CERVICAL CANCER
CHILD CARE
CHILD MORTALITY
CHILDHOOD
CHILDREN PER WOMAN
CHOLESTEROL
CHRONIC CONDITION
CHRONIC CONDITIONS
CHRONIC DISEASE
CHRONIC DISEASES
CHRONIC MALNUTRITION
COLON CANCER
COMMUNICABLE DISEASES
COMMUNITY HEALTH
COMPLICATIONS
CONGENITAL ABNORMALITIES
CORONARY HEART DISEASE
CRIME
DANGERS
DEATH RATE
DEATH RATES
DEATHS
DEMOGRAPHIC CHANGE
DEMOGRAPHIC CHANGES
DEMOGRAPHIC TRANSITION
DEPENDENCY RATIOS
DEPRESSION
DIABETES
DIABETES MELLITUS
DIAGNOSIS
DIET
DIETS
DIGESTIVE SYSTEM
DISABILITIES
DISABILITY
DISEASE BURDEN
DISEASE CONTROL
DISEASE RISK FACTORS
DOUBLE BURDEN
DRUG ABUSE
DRUGS
DURATION OF DISEASE
EARLY ADOLESCENCE
EARLY DETECTION
ELDERLY
ELDERLY POPULATION
ENDOCRINE DISORDERS
ENERGY INTAKE
EPIDEMIC
EPIDEMIOLOGICAL PROFILE
EPILEPSY
FAMILIES
FEMALE
FEMALES
FERTILITY RATE
FERTILITY RATES
FITNESS
FOREIGN DIRECT INVESTMENT
GANGRENE
GENDER
GIRLS
GLOBAL HEALTH
HEALTH CARE
HEALTH CONDITIONS
HEALTH INTERVENTIONS
HEALTH MINISTRIES
HEALTH PROBLEMS
HEALTH PROFESSIONALS
HEALTH SECTOR
HEALTH SERVICES
HEALTH STATUS
HEALTH SURVEILLANCE
HEALTH SYSTEMS
HEALTHY BEHAVIORS
HEALTHY LIFE
HEALTHY LIFESTYLES
HEART DISEASE
HIGH BLOOD PRESSURE
HIGH DEATH RATES
HIGH-RISK
HIGH-RISK POPULATIONS
HIV/AIDS
HORMONE
HOSPITALIZATIONS
HOUSEHOLD INCOME
HOUSEHOLD LEVEL
HOUSEHOLD SURVEYS
HUMAN DEVELOPMENT
HYPERTENSION
ILLNESS
IMPACT ON HEALTH
INFANT
INFECTIOUS DISEASES
INFERTILITY
INFORMATION SYSTEMS
INJURIES
INTERNATIONAL FOOD POLICY RESEARCH INSTITUTE
INTERVENTION
KIDNEY FAILURE
LARGE POPULATION
LAWS
LEISURE TIME
LEVELS OF EDUCATION
LEVELS OF FERTILITY
LIFE EXPECTANCY
LIFESTYLES
LIVER
LIVER CIRRHOSIS
LIVING CONDITIONS
LIVING STANDARDS
LOW BIRTH WEIGHT
LOW FERTILITY
LUNG CANCER
MALNUTRITION
MAMMOGRAMS
MANDATES
MARKETING
MASS MEDIA
MATERNAL AND CHILD HEALTH
MATERNAL MORTALITY
MEAT
MINISTRIES OF HEALTH
MINISTRY OF HEALTH
MORTALITY
MORTALITY RATES
MOTHER
MOTHERS
MUSCULOSKELETAL DISEASES
MYOCARDIAL INFARCTION
NCD
NEOPLASMS
NONCOMMUNICABLE DISEASES
NUTRITION
NUTRITION INFORMATION
NUTRITIONAL DEFICIENCIES
OBESITY
OLDER ADULTS
ORAL CANCER
OSTEOPOROSIS
OVERWEIGHT
PANCREAS
PARASITIC DISEASES
PATIENTS
PATTERNS OF CONSUMPTION
PEER REVIEW
PERINATAL CONDITIONS
PHARYNX
PHYSICAL ACTIVITY
POISONINGS
POLICY CONCERN
POLICY FRAMEWORK
POLICY MAKERS
POLICY RESEARCH
POPULATION GROUPS
POPULATION GROWTH
POPULATION GROWTH RATES
POPULATION INCREASES
POPULATION MOMENTUM
PREGNANCY
PREMATURE DEATH
PREVALENCE
PRIMARY SCHOOL
PROGRESS
PUBLIC AWARENESS
PUBLIC HEALTH
PUBLIC TRANSPORTATION
PURCHASING POWER
PURCHASING POWER PARITY
RECREATIONAL ACTIVITIES
REGIONAL STRATEGIES
REGIONAL STRATEGY
REPLACEMENT LEVEL
REPRODUCTIVE AGE
RESPECT
RESPIRATORY DISEASE
RESPIRATORY DISEASES
RESPIRATORY INFECTIONS
RESTAURANTS
RICHER COUNTRIES
RISK FACTORS
ROAD TRAFFIC
ROAD TRAFFIC ACCIDENTS
RURAL AREAS
SCHOOL HEALTH
SCREENING
SET OF RECOMMENDATIONS
SMOKE-FREE ENVIRONMENTS
SMOKERS
SMOKING
SOCIAL NETWORKS
SODIUM
SPILLOVER
STD
TB
TEENAGERS
THERAPY
TOBACCO
TOBACCO PRODUCTS
TOBACCO USE
TRAFFIC ACCIDENTS
TREATMENT
TUBERCULOSIS
UNINTENTIONAL INJURIES
URBAN AREAS
URBAN DWELLERS
URBAN POPULATION
URBANIZATION
USE OF ALCOHOL
VIOLENCE
VITAL STATISTICS
WALKING
WORKERS
WORKING-AGE POPULATION
WORKPLACE
WORLD HEALTH ORGANIZATION
YOUNG MALES
YOUNG PEOPLE
YOUNG POPULATIONS
YOUTH
YOUTHS
spellingShingle ABNORMALITIES
ACCESS TO HEALTH CARE
ADOLESCENCE
ADOLESCENTS
ADULT POPULATION
AGING
ALCOHOL ABUSE
ALCOHOL CONSUMPTION
ALCOHOLIC
ALCOHOLIC BEVERAGES
ASTHMA
BEHAVIOR CHANGE
BIRTHS
BLINDNESS
BOTH SEXES
BREAST
BREAST CANCER
BREASTFEEDING
BULLETIN
BURDEN OF DISEASE
CANCERS
CARDIOVASCULAR DISEASES
CAUSES OF DEATH
CERVICAL CANCER
CHILD CARE
CHILD MORTALITY
CHILDHOOD
CHILDREN PER WOMAN
CHOLESTEROL
CHRONIC CONDITION
CHRONIC CONDITIONS
CHRONIC DISEASE
CHRONIC DISEASES
CHRONIC MALNUTRITION
COLON CANCER
COMMUNICABLE DISEASES
COMMUNITY HEALTH
COMPLICATIONS
CONGENITAL ABNORMALITIES
CORONARY HEART DISEASE
CRIME
DANGERS
DEATH RATE
DEATH RATES
DEATHS
DEMOGRAPHIC CHANGE
DEMOGRAPHIC CHANGES
DEMOGRAPHIC TRANSITION
DEPENDENCY RATIOS
DEPRESSION
DIABETES
DIABETES MELLITUS
DIAGNOSIS
DIET
DIETS
DIGESTIVE SYSTEM
DISABILITIES
DISABILITY
DISEASE BURDEN
DISEASE CONTROL
DISEASE RISK FACTORS
DOUBLE BURDEN
DRUG ABUSE
DRUGS
DURATION OF DISEASE
EARLY ADOLESCENCE
EARLY DETECTION
ELDERLY
ELDERLY POPULATION
ENDOCRINE DISORDERS
ENERGY INTAKE
EPIDEMIC
EPIDEMIOLOGICAL PROFILE
EPILEPSY
FAMILIES
FEMALE
FEMALES
FERTILITY RATE
FERTILITY RATES
FITNESS
FOREIGN DIRECT INVESTMENT
GANGRENE
GENDER
GIRLS
GLOBAL HEALTH
HEALTH CARE
HEALTH CONDITIONS
HEALTH INTERVENTIONS
HEALTH MINISTRIES
HEALTH PROBLEMS
HEALTH PROFESSIONALS
HEALTH SECTOR
HEALTH SERVICES
HEALTH STATUS
HEALTH SURVEILLANCE
HEALTH SYSTEMS
HEALTHY BEHAVIORS
HEALTHY LIFE
HEALTHY LIFESTYLES
HEART DISEASE
HIGH BLOOD PRESSURE
HIGH DEATH RATES
HIGH-RISK
HIGH-RISK POPULATIONS
HIV/AIDS
HORMONE
HOSPITALIZATIONS
HOUSEHOLD INCOME
HOUSEHOLD LEVEL
HOUSEHOLD SURVEYS
HUMAN DEVELOPMENT
HYPERTENSION
ILLNESS
IMPACT ON HEALTH
INFANT
INFECTIOUS DISEASES
INFERTILITY
INFORMATION SYSTEMS
INJURIES
INTERNATIONAL FOOD POLICY RESEARCH INSTITUTE
INTERVENTION
KIDNEY FAILURE
LARGE POPULATION
LAWS
LEISURE TIME
LEVELS OF EDUCATION
LEVELS OF FERTILITY
LIFE EXPECTANCY
LIFESTYLES
LIVER
LIVER CIRRHOSIS
LIVING CONDITIONS
LIVING STANDARDS
LOW BIRTH WEIGHT
LOW FERTILITY
LUNG CANCER
MALNUTRITION
MAMMOGRAMS
MANDATES
MARKETING
MASS MEDIA
MATERNAL AND CHILD HEALTH
MATERNAL MORTALITY
MEAT
MINISTRIES OF HEALTH
MINISTRY OF HEALTH
MORTALITY
MORTALITY RATES
MOTHER
MOTHERS
MUSCULOSKELETAL DISEASES
MYOCARDIAL INFARCTION
NCD
NEOPLASMS
NONCOMMUNICABLE DISEASES
NUTRITION
NUTRITION INFORMATION
NUTRITIONAL DEFICIENCIES
OBESITY
OLDER ADULTS
ORAL CANCER
OSTEOPOROSIS
OVERWEIGHT
PANCREAS
PARASITIC DISEASES
PATIENTS
PATTERNS OF CONSUMPTION
PEER REVIEW
PERINATAL CONDITIONS
PHARYNX
PHYSICAL ACTIVITY
POISONINGS
POLICY CONCERN
POLICY FRAMEWORK
POLICY MAKERS
POLICY RESEARCH
POPULATION GROUPS
POPULATION GROWTH
POPULATION GROWTH RATES
POPULATION INCREASES
POPULATION MOMENTUM
PREGNANCY
PREMATURE DEATH
PREVALENCE
PRIMARY SCHOOL
PROGRESS
PUBLIC AWARENESS
PUBLIC HEALTH
PUBLIC TRANSPORTATION
PURCHASING POWER
PURCHASING POWER PARITY
RECREATIONAL ACTIVITIES
REGIONAL STRATEGIES
REGIONAL STRATEGY
REPLACEMENT LEVEL
REPRODUCTIVE AGE
RESPECT
RESPIRATORY DISEASE
RESPIRATORY DISEASES
RESPIRATORY INFECTIONS
RESTAURANTS
RICHER COUNTRIES
RISK FACTORS
ROAD TRAFFIC
ROAD TRAFFIC ACCIDENTS
RURAL AREAS
SCHOOL HEALTH
SCREENING
SET OF RECOMMENDATIONS
SMOKE-FREE ENVIRONMENTS
SMOKERS
SMOKING
SOCIAL NETWORKS
SODIUM
SPILLOVER
STD
TB
TEENAGERS
THERAPY
TOBACCO
TOBACCO PRODUCTS
TOBACCO USE
TRAFFIC ACCIDENTS
TREATMENT
TUBERCULOSIS
UNINTENTIONAL INJURIES
URBAN AREAS
URBAN DWELLERS
URBAN POPULATION
URBANIZATION
USE OF ALCOHOL
VIOLENCE
VITAL STATISTICS
WALKING
WORKERS
WORKING-AGE POPULATION
WORKPLACE
WORLD HEALTH ORGANIZATION
YOUNG MALES
YOUNG PEOPLE
YOUNG POPULATIONS
YOUTH
YOUTHS
Bonilla-Chacin, Maria Eugenia
Vásquez, Luis T. Marcano
Promoting Healthy Living and Aging in Central America : Multi-sectoral Approaches to Prevent Chronic Noncommunicable Diseases
geographic_facet Latin America & Caribbean
Central America
relation Health, Nutrition and Population (HNP) discussion paper;
description Non-communicable diseases (NCDs) are the main cause of death and disability in Central America. However, communicable diseases and maternal and child conditions remain important causes of death and disability as well as injuries. With the aging of the population and improvements in the control of infectious diseases, the share of NCDs in the total burden of disease is likely to increase. However, in Central America these diseases cause death at a much younger age than in higher-income countries. It is critical to prevent and control NCDs, both for their impact on health, as well as the economy. When not controlled, they can cause costly hospitalizations and large productivity losses due to absenteeism, disability and premature deaths. Finally, they can impoverish households hit by out-of-pocket payments for health services and drugs. A large share of NCDs can be prevented since they result from exposure to health risk factors such as unhealthy diets, physical inactivity, tobacco use, and the harmful use of alcohol. Central Americans have very high caloric diets that are rich in sodium and refined sugars, and lifestyles that often involve low levels of physical activity. Similarly, large shares of youth in some of the countries smoke, while alcohol consumption among drinkers and the frequency of binge drinking in Nicaragua and Guatemala are very high. Although all countries in the region have introduced multi-sectoral interventions to prevent NCD risk factors, much remains to be done: for example, countries have been more successful controlling smoking than addressing physical inactivity, alcohol abuse and poor diets. The role of the health sector is central to preventing NCDs: It needs to ensure their surveillance, along with the risk factors. In addition, the sector needs to ensure that effective multi-sectoral efforts to prevent these conditions take place.
format Publications & Research :: Working Paper
author Bonilla-Chacin, Maria Eugenia
Vásquez, Luis T. Marcano
author_facet Bonilla-Chacin, Maria Eugenia
Vásquez, Luis T. Marcano
author_sort Bonilla-Chacin, Maria Eugenia
title Promoting Healthy Living and Aging in Central America : Multi-sectoral Approaches to Prevent Chronic Noncommunicable Diseases
title_short Promoting Healthy Living and Aging in Central America : Multi-sectoral Approaches to Prevent Chronic Noncommunicable Diseases
title_full Promoting Healthy Living and Aging in Central America : Multi-sectoral Approaches to Prevent Chronic Noncommunicable Diseases
title_fullStr Promoting Healthy Living and Aging in Central America : Multi-sectoral Approaches to Prevent Chronic Noncommunicable Diseases
title_full_unstemmed Promoting Healthy Living and Aging in Central America : Multi-sectoral Approaches to Prevent Chronic Noncommunicable Diseases
title_sort promoting healthy living and aging in central america : multi-sectoral approaches to prevent chronic noncommunicable diseases
publisher World Bank, Washington, DC
publishDate 2013
url http://documents.worldbank.org/curated/en/2012/03/16750912/promoting-healthy-living-aging-central-america-multi-sectoral-approaches-prevent-chronic-non-communicable-diseases
http://hdl.handle.net/10986/13580
_version_ 1764423801821462528
spelling okr-10986-135802021-04-23T14:03:08Z Promoting Healthy Living and Aging in Central America : Multi-sectoral Approaches to Prevent Chronic Noncommunicable Diseases Bonilla-Chacin, Maria Eugenia Vásquez, Luis T. Marcano ABNORMALITIES ACCESS TO HEALTH CARE ADOLESCENCE ADOLESCENTS ADULT POPULATION AGING ALCOHOL ABUSE ALCOHOL CONSUMPTION ALCOHOLIC ALCOHOLIC BEVERAGES ASTHMA BEHAVIOR CHANGE BIRTHS BLINDNESS BOTH SEXES BREAST BREAST CANCER BREASTFEEDING BULLETIN BURDEN OF DISEASE CANCERS CARDIOVASCULAR DISEASES CAUSES OF DEATH CERVICAL CANCER CHILD CARE CHILD MORTALITY CHILDHOOD CHILDREN PER WOMAN CHOLESTEROL CHRONIC CONDITION CHRONIC CONDITIONS CHRONIC DISEASE CHRONIC DISEASES CHRONIC MALNUTRITION COLON CANCER COMMUNICABLE DISEASES COMMUNITY HEALTH COMPLICATIONS CONGENITAL ABNORMALITIES CORONARY HEART DISEASE CRIME DANGERS DEATH RATE DEATH RATES DEATHS DEMOGRAPHIC CHANGE DEMOGRAPHIC CHANGES DEMOGRAPHIC TRANSITION DEPENDENCY RATIOS DEPRESSION DIABETES DIABETES MELLITUS DIAGNOSIS DIET DIETS DIGESTIVE SYSTEM DISABILITIES DISABILITY DISEASE BURDEN DISEASE CONTROL DISEASE RISK FACTORS DOUBLE BURDEN DRUG ABUSE DRUGS DURATION OF DISEASE EARLY ADOLESCENCE EARLY DETECTION ELDERLY ELDERLY POPULATION ENDOCRINE DISORDERS ENERGY INTAKE EPIDEMIC EPIDEMIOLOGICAL PROFILE EPILEPSY FAMILIES FEMALE FEMALES FERTILITY RATE FERTILITY RATES FITNESS FOREIGN DIRECT INVESTMENT GANGRENE GENDER GIRLS GLOBAL HEALTH HEALTH CARE HEALTH CONDITIONS HEALTH INTERVENTIONS HEALTH MINISTRIES HEALTH PROBLEMS HEALTH PROFESSIONALS HEALTH SECTOR HEALTH SERVICES HEALTH STATUS HEALTH SURVEILLANCE HEALTH SYSTEMS HEALTHY BEHAVIORS HEALTHY LIFE HEALTHY LIFESTYLES HEART DISEASE HIGH BLOOD PRESSURE HIGH DEATH RATES HIGH-RISK HIGH-RISK POPULATIONS HIV/AIDS HORMONE HOSPITALIZATIONS HOUSEHOLD INCOME HOUSEHOLD LEVEL HOUSEHOLD SURVEYS HUMAN DEVELOPMENT HYPERTENSION ILLNESS IMPACT ON HEALTH INFANT INFECTIOUS DISEASES INFERTILITY INFORMATION SYSTEMS INJURIES INTERNATIONAL FOOD POLICY RESEARCH INSTITUTE INTERVENTION KIDNEY FAILURE LARGE POPULATION LAWS LEISURE TIME LEVELS OF EDUCATION LEVELS OF FERTILITY LIFE EXPECTANCY LIFESTYLES LIVER LIVER CIRRHOSIS LIVING CONDITIONS LIVING STANDARDS LOW BIRTH WEIGHT LOW FERTILITY LUNG CANCER MALNUTRITION MAMMOGRAMS MANDATES MARKETING MASS MEDIA MATERNAL AND CHILD HEALTH MATERNAL MORTALITY MEAT MINISTRIES OF HEALTH MINISTRY OF HEALTH MORTALITY MORTALITY RATES MOTHER MOTHERS MUSCULOSKELETAL DISEASES MYOCARDIAL INFARCTION NCD NEOPLASMS NONCOMMUNICABLE DISEASES NUTRITION NUTRITION INFORMATION NUTRITIONAL DEFICIENCIES OBESITY OLDER ADULTS ORAL CANCER OSTEOPOROSIS OVERWEIGHT PANCREAS PARASITIC DISEASES PATIENTS PATTERNS OF CONSUMPTION PEER REVIEW PERINATAL CONDITIONS PHARYNX PHYSICAL ACTIVITY POISONINGS POLICY CONCERN POLICY FRAMEWORK POLICY MAKERS POLICY RESEARCH POPULATION GROUPS POPULATION GROWTH POPULATION GROWTH RATES POPULATION INCREASES POPULATION MOMENTUM PREGNANCY PREMATURE DEATH PREVALENCE PRIMARY SCHOOL PROGRESS PUBLIC AWARENESS PUBLIC HEALTH PUBLIC TRANSPORTATION PURCHASING POWER PURCHASING POWER PARITY RECREATIONAL ACTIVITIES REGIONAL STRATEGIES REGIONAL STRATEGY REPLACEMENT LEVEL REPRODUCTIVE AGE RESPECT RESPIRATORY DISEASE RESPIRATORY DISEASES RESPIRATORY INFECTIONS RESTAURANTS RICHER COUNTRIES RISK FACTORS ROAD TRAFFIC ROAD TRAFFIC ACCIDENTS RURAL AREAS SCHOOL HEALTH SCREENING SET OF RECOMMENDATIONS SMOKE-FREE ENVIRONMENTS SMOKERS SMOKING SOCIAL NETWORKS SODIUM SPILLOVER STD TB TEENAGERS THERAPY TOBACCO TOBACCO PRODUCTS TOBACCO USE TRAFFIC ACCIDENTS TREATMENT TUBERCULOSIS UNINTENTIONAL INJURIES URBAN AREAS URBAN DWELLERS URBAN POPULATION URBANIZATION USE OF ALCOHOL VIOLENCE VITAL STATISTICS WALKING WORKERS WORKING-AGE POPULATION WORKPLACE WORLD HEALTH ORGANIZATION YOUNG MALES YOUNG PEOPLE YOUNG POPULATIONS YOUTH YOUTHS Non-communicable diseases (NCDs) are the main cause of death and disability in Central America. However, communicable diseases and maternal and child conditions remain important causes of death and disability as well as injuries. With the aging of the population and improvements in the control of infectious diseases, the share of NCDs in the total burden of disease is likely to increase. However, in Central America these diseases cause death at a much younger age than in higher-income countries. It is critical to prevent and control NCDs, both for their impact on health, as well as the economy. When not controlled, they can cause costly hospitalizations and large productivity losses due to absenteeism, disability and premature deaths. Finally, they can impoverish households hit by out-of-pocket payments for health services and drugs. A large share of NCDs can be prevented since they result from exposure to health risk factors such as unhealthy diets, physical inactivity, tobacco use, and the harmful use of alcohol. Central Americans have very high caloric diets that are rich in sodium and refined sugars, and lifestyles that often involve low levels of physical activity. Similarly, large shares of youth in some of the countries smoke, while alcohol consumption among drinkers and the frequency of binge drinking in Nicaragua and Guatemala are very high. Although all countries in the region have introduced multi-sectoral interventions to prevent NCD risk factors, much remains to be done: for example, countries have been more successful controlling smoking than addressing physical inactivity, alcohol abuse and poor diets. The role of the health sector is central to preventing NCDs: It needs to ensure their surveillance, along with the risk factors. In addition, the sector needs to ensure that effective multi-sectoral efforts to prevent these conditions take place. 2013-05-28T20:05:34Z 2013-05-28T20:05:34Z 2012-03 http://documents.worldbank.org/curated/en/2012/03/16750912/promoting-healthy-living-aging-central-america-multi-sectoral-approaches-prevent-chronic-non-communicable-diseases http://hdl.handle.net/10986/13580 English en_US Health, Nutrition and Population (HNP) discussion paper; CC BY 3.0 IGO http://creativecommons.org/licenses/by/3.0/igo/ World Bank World Bank, Washington, DC Publications & Research :: Working Paper Publications & Research Latin America & Caribbean Central America