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This volume presents a broad sweep of modern economic history underpinning aid, trade, development and globalization in the last half century and the salient challenges facing the global community today. The author draws on his long years as an academic and development practitioner to recommend what needs to be done to cope with the backsliding of the fight against global poverty, fractured geopolitics and the threats to the multilateral economic order. The new, revised edition analyses how unilateralism, rising protectionism and the Covid-19 pandemic seriously threaten global sustainable development. It concludes with recommendations on the policy changes needed to make globalization more equitable and development more sustainable. This book will be of interest to researchers and students of economic development and economic history, as well as all those concerned about global inequality and sustainability. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.
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The objective was to determine the prevalence of household food insecurity (FI) in Latin America and the Caribbean (LAC) during the COVID-19 pandemic. Secondary analysis was performed using the waves 1 to 3 of the 2020 COVID-19 High Frequency Phone Surveys in 13 LAC countries. The countries with the highest FI in the first wave were Honduras (60.3%), Peru (58.1%) and Ecuador (57.9%). Likewise, the countries with the greatest differences in the prevalence of FI between the first and last waves in percentage points (PP) were Peru (-29), Guatemala (-27.7) and Bolivia (-21.8). LAC countries face a great burden of FI.Copyright © 2022 Taylor & Francis Group, LLC.
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According to World Bank statistics in 2019, Indonesia ranked two in the average unemployment rate with 5.28% in South East Asia. Although the unemployment rate can be reduced by an equitable distribution of human resource empowerment and national development, the global pandemic COVID-19 made a major impact on increasing the rate of unemployment. This paper tests the spatial autocorrelation on the average unemployment in Indonesia using Ordinary Least Squares (OLS) and Moran's I. The OLS method was used to examine the effects that affect the unemployment rate using an independent variable. In contrast, the Moran's I used to prove the existence of spatial effect on the level of movement in Indonesia. From the experiment, there are four variables that influence the unemployment rate by using the OLS modeling method. The Moran's I test showed a p-value = 0.006 with α = 0.05. Therefore, there is a spatial autocorrelation between provinces in Indonesia. In addition, the model is tested using the Variance Inflation Factor. The model showed a VIF score ¡10, therefore there is no collinearity and the assumption is fulfilled. The model is also being tested using dwtest, bptest, and Lilliefors test. The result showed p-value = 0.6231 for dwtest, p-value = 0.932 for bptest, and p-value = 0.08438 for Lilliefors test.. © 2022 IEEE.
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Objectives: The COVID-19 pandemic has highlighted the need for sustainable and resilient healthcare systems to protect population health. This requires measuring the relative progress of health systems towards becoming more sustainable and resilient. In this research, we design, construct and estimate a country-level healthcare system sustainability and resilience index (HSSRI) that reflects and combines the two dimensions. Method(s): The HSSRI aims to summarise the performance of a health system in the different domains contributing to its sustainability and resilience. These domains are: i) health system governance, ii) health system financing, iii) health system workforce, iv) medicines and technologies, v) health service delivery, vi) population health and social determinants, and vii) environmental sustainability. As part of our analyses, we conduct a rapid evidence assessment to identify indicators reflecting the domains included in the sustainability and resilience dimensions. We assess the domain indicators' suitability by the quantity and quality of the literature supporting their inclusion. The variables in each indicator are extracted from publicly available data sources, such as the OECD, World Bank, and others. The period covered is from 2000 to 2020. Weighted means of the indicators are used to construct the domains' indices in each dimension. We apply a geometric mean to combine the domain indices into one final index. Result(s): The HSSRI is piloted using data from five high-income countries, providing a credible instrument for measuring and reporting healthcare system sustainability and resilience. The results enable policy-makers and stakeholders to observe how different domains of sustainability and resilience have evolved across countries and time. Conclusion(s): The HSSRI will facilitate better understanding and monitoring of the healthcare system's relative weaknesses and strengths, and empower policy-makers to design interventions that improve its resilience and sustainability.Copyright © 2022
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We research the antecedents of relative success among small and medium enterprises (SMEs) in avoiding temporary or permanent closure during the COVID‐19 pandemic. We investigate the roles of firm‐specific resources and state support policies in influencing SME fortunes, in a sizeable group of European countries covered in the World Bank Enterprise Survey. Using resource dependency, Varieties of Capitalism and Systems theories, we find that innovative capacities, institutional connectedness, governance, and management experience were major antecedents of success across all SMEs. Significant differences in outcomes were found between SMEs operating in old and new EU member states, and non‐EU countries.
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PurposeThis study examines the survival probability of the firms during the COVID-19 pandemic and identifies the effects of pandemic-era business strategies on firm survival across sectors and sizes.Design/methodology/approachThis study combines World Bank Enterprise Survey data with three consecutive follow-up COVID-19 survey data. The COVID-19 surveys are the follow-up surveys of WBES, and they are done at different points of time during the pandemic. Both WBES and COVID-19 surveys follow the same sampling methods, and the data are merged based on the unique id number of the firms. The data covers 12,551 firms from 21 countries in different regions such as Africa, Latin America, Central Asia and the Middle East. The study applies Kaplan–Meier estimate to analyze the survival probability of the firms across sectors and sizes. The study then uses Cox non-parametric regression model to identify the effect of business strategies on the survival of the firms during the pandemic. The robustness of the Cox model is checked using the multilevel parametric regression model.FindingsThe study's findings suggest that a firm's survival probability decreases during the pandemic era. Manufacturing firms have a higher survival probability than service firms, whereas SMEs have a higher survival probability than large firms. During the pandemic period, business strategies significantly boost the probability of firm survival, and their impacts differ among firm sectors and sizes. Several firm-specific factors affect firm survival in different magnitudes and signs. Except in a few cases, the findings also indicate that one strategy positively moderates the influence of another strategy on firm survival during a pandemic.Originality/valueCOVID-19 pandemic has drastically affected the business across the globe. Firms adopted new business processes and strategies to face the challenges created by the pandemic. The critical research question is whether these pandemic-era business strategies ensure firms' survival. This study attempts to identify the effects of these business strategies on firms' survival, focusing on a comprehensive firm-level data set that includes firms from different sectors and sizes of countries from various regions.
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Introduction: The Latin American Dialysis and Renal Transplantation Registry (LADRTR), founded in 1991, has collected data and reports on patients receiving kidney replacement therapy (KRT) since 1993. The main goals of the LADRTR is to promote the development of national registries, consolidate a data system for KRT in Latin America (LA), return the data provided by nephrologist to the different stakeholders that participate in the decision making process, while contributing to the universal knowledge of prevention, incidence and evolution of the disease in the region. This summarizes the registry data for 2020. Method(s): Participating countries complete an annual survey collecting aggregated data on incident and prevalent patients on KRT in all modalities. The different treatment modalities considered were hemodialysis (HD), peritoneal dialysis (PD) and living functioning kidney graft (LFG). National gross domestic product per capita (GDP, expressed in US dollars) and life expectancy at birth (LEB) corresponding to the year 2020 were collected from the World Bank Data Bank. Prevalence and incidence were compared with previous years and were also correlated with GDP and LEB. Result(s): On 31 December 2020 the prevalence of KRT in LA was 848 per million population (pmp), which shows a drop in the rate compared to the previous year (Figure 1). The prevalence ranged from 2129 pmp in Puerto Rico to 111 pmp in Nicaragua. Eight countries had a rate >700 pmp (Argentina, Brazil, Chile, Colombia, Ecuador, Panama, Puerto Rico and Uruguay). The states of Mexico, Jalisco and Aguas Calientes, also had a rate >700 pmp (Figure 2). Regarding treatment modality, 67,0% of the prevalent patients were treated with HD (n= 290 099) and 9.3% with PD (n= 40 450) while 23,6% of the patients had an LFG (n= 102772). The total unadjusted incidence rate of patients that started KRT was 158 pmp. The majority of the patients started KRT with HD modality, while only 6,08% used PD, varying the rate of incidence from 477 pmp in Jalisco and Aguas Calientes to 2 pmp in Bolivia. The kidney transplant rate in the region was 15 pmp, showing a drop from the previous year, and 89% of KT were from a deceased donor (Figure 3). The total prevalence of KRT correlated positively with GDP per capita (r 2 = 0.6, P < 0.01) and LEB (r 2 = 0.27, P < 0.05). The overall unadjusted mortality rate was 18%, cardiac disease was the leading cause of death (31%), followed by infectious diseases (21%) and other causes (16%). [Formula presented] [Formula presented] [Formula presented] Conclusion(s): For the first time in the last decade the overall prevalence and kidney transplant rate decreased, being this associated with COVID-19 pandemic. Although the incidence and prevalence of KRT in the LA region have increased over the years, there is still a need to improve accessibility to KRT, develop programs that facilitate better control of risk factors, early diagnosis and the treatment of chronic kidney disease, as well as the implementation of an effective kidney transplant program, to reduce the gap that exists between the countries of LA. No conflict of interestCopyright © 2023
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Introduction: Access to safe, effective, quality, and affordable essential medicines (EM) for all is one of the World Health Organization's Sustainable Development Goals for health. However, access to EM for the treatment of non-communicable diseases (NCDs) is lacking in many low-income (LICs) and lower-middle income countries (LMICs). Chronic kidney disease (CKD) is often a downstream consequence of other NCDs, such as diabetes (DM) and cardiovascular disease (CVD), further exacerbating the economic burden on healthcare systems and societies. In nephrology, access to EM is especially important to reduce the risk of CKD progression because kidney replacement therapy is unavailable or cost-prohibitive in many regions of the world. As members of the International Society of Nephrology (ISN) Emerging Leaders Program 2021 cohort, we conducted a scoping review to assess the breadth of evidence regarding EMs for management of CKD and related NCDs, with identification of barriers to EM access as one of our main aims. Method(s): We included English-language articles of any study design that addressed barriers to accessing essential medicines in populations with CKD (all stages, causes, and ages), CVD, hypertension, and/or DM. All ISN geographical regions and World Bank income categories were considered. We searched MEDLINE, EMBASE, Web of Science and Cochrane Central Register of Controlled Trials to May 2021. Titles and abstracts were screened, and full texts were retrieved for potentially relevant publications. Each full-text article was assessed for inclusion. For included articles, data extraction was performed with a standardized form using Covidence software. Each step was performed by one reviewer and checked by a 2nd reviewer. Applying an ecological model, barriers were categorized as occurring at the national/health policy level, regional level, organization level, provider level, or patient level. Result(s): Ninety-six publications addressed barriers to access to essential medicines, including LICs (16 articles), LMICs (43 articles), upper-middle income countries (25 articles), high-income countries (10 articles), plus 21 articles which did not specify countries. Most publications assessed barriers at the health policy-level, which included high EM prices in the setting of current patent laws;lack of effective systems for public procurement of EM, resulting in large out-of-pocket household expenditure for medicines in LIC/LMIC;inefficient distribution systems with multiple price mark-ups;and lack of regulatory systems, giving rise to counterfeit medications. Regional-level barriers included lack of governance of supply chain logistics, lack of regional coordination, and poor transportation infrastructure, especially in rural settings. Organization-level barriers included medication stock-outs at facilities, and health care worker shortages. Provider-level barriers included irrational prescribing, lack of CKD identification, and poor communication with patients. Patient-level barriers included poverty, informational barriers/health literacy, and negative perception of generic medicines (Figure). [Formula presented] Conclusion(s): Barriers to accessing EM exist at several levels, particularly the health system-level, and affect LICs and LMICs disproportionately. This scoping review serves as an initial step towards designing implementation studies to address barriers to improve EM access. Conflict of interest Potential conflict of interest: MMMY has a consultancy agreement with George Clinical and served on a CKD advisory board sponsored by AstraZenecaCopyright © 2023
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Small and medium-sized manufacturing enterprises, the backbone of the Southeast Asian economy, are struggling to operate and maintain profitable growth in the face of the COVID-19 epidemic. During the recovery process, technological and non-technological innovation is a major factor in enterprise efficiency and profitability. However, it is unclear what drives manufacturing enterprises to innovate in technological and non-technological approaches and how they choose to implement innovation to keep their businesses growing and successful. Therefore, to answer this issue, this research develops and empirically tests a model based on dynamic capabilities and innovative perspectives utilizing World Bank Enterprise Survey data from 789 manufacturing enterprises in Southeast Asian countries. The hierarchical regression model assists create prediction equations to test technological and non-technological innovation as the mediators of structural reconfiguration and innovation investment on firm performance. The results reveal that structural reconfiguration and innovation investment impact technological and non-technological innovation. Additionally, structural addition and investment in formal R&D have a moderated impact on technological innovation. Finally, firm performance may be boosted by organizational innovation. © The Author(s) 2022.
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GDP scenarios are major drivers of climate change and climate change mitigation assessment studies. In this paper, a major update of the SSP GDP projections is presented. By using the most recent economic data and short-term projections by the World Bank and International Monetary Fund, the update captures changes in the system of national accounting and purchasing power parities, as well as the impact of the Covid 19 pandemic. Harmonization between the data and the original end-of-the century SSP projections was carried out in terms of GDP per capita in order to preserve the underlying narrative of income convergence. The result is a set of projections compatible with the most recent data and the SSP narratives. A comparison of DICE models calibrated to the original and updated SSP2 GDP per capita projections illustrates how significant the impact of an update of income data on integrated assessment results can be. The estimated global social costs of carbon in 2015 and 2030 rose by almost 30%. © 2023 Elsevier B.V.
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The COVID-19 pandemic has led to an urgent need in emerging economies to quickly identify vulnerable populations that do not live within access of a health facility for testing and vaccination. This access information is critical to prioritize investments in mobile and temporary clinics. To meet this need, the World Bank team sought to develop an open-source methodology that could be quickly and easily implemented by government health departments, regardless of technical and data collection capacity. The team explored use of readily available open-source and licensable data, as well as non-intensive computational methodologies. By bringing together population data from Facebook's Data for Good program, travel-time calculations from Mapbox, road network and point-of-interest data from the OpenStreetMap (OSM), and the World Bank's open-source GOSTNets network routing tools, we created a computational framework that supports efficient and granular analysis of road-based access to health facilities in two pilot locations—Indonesia and the Philippines. Our findings align with observed health trends in these countries and support identification of high-density areas that lack sufficient road access to health facilities. Our framework is easy to replicate, allowing health officials and infrastructure planners to incorporate access analysis in pandemic response and future health access planning. © National Academy of Sciences: Transportation Research Board 2022.
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BACKGROUND: The impact of pandemic has had worse effects in countries with already stretched healthcare resources. study's The study aimed to explore changes in epilepsy care delivery in resource-limited countries during and since the acute phase of the COVID-19 pandemic. METHOD: A cross-sectional survey was conducted in 22 countries among healthcare providers (HCPs) caring for persons with epilepsy (PWE), in collaboration with newly formed global collaborators, the International Epilepsy Equity Group. Findings were compared based on the World Bank Ranking (WBR) and HCPs' practice type. Data were analyzed using Chi-square tests (α = 0.05) and pairwise multiple comparisons with α = 0.017 (Bonferroni adjustment). Open-ended responses were analyzed using thematic analysis. FINDINGS: A total of 241 HCPs participated in the study. Of these, 8.30%, 65.98%, and 21.99% were from high-income (HIC), upper-middle-income (UMIC), and lower-middle-income countries (LMICs), respectively. Among HCPs, 31.12% were adult specialists, and 43.98% were pediatric specialists. During the acute phase of the pandemic, HCPs reported that the major barrier for PWE was difficulty reaching physicians/healthcare providers. Except for difficulty reaching physicians/healthcare providers (WBR P = 0.01 HIC < LMIC), no other significant differences in barriers during the acute phase were observed. Since the acute phase of the pandemic, the major concern for PWE was fear of getting infected with the SARS-CoV-2 virus. Significant differences in concerns since the acute phase included lockdowns (WBR: P = 0.03 UMIC < LMIC), fiscal difficulties (WBR: P < 0.001 UMICs < LMICs, UMICs < HIC; practice type: P = 0.006 adult < others, pediatrics < others), clinic closure (WBR: P = 0.003 UMIC < HIC; practice type: P =< 0.001 adult < others, pediatric < others), and long waiting times (WBR: P = 0.005, LMIC < UMIC, LMIC < HIC; practice type: P = 0.006 pediatric < adults). Diagnostic services, including EEG, MRI, CT (practice type: P < 0.001, adult < others; pediatric < others), and lab work (WBR: P = 0.01 UMIC < HIC), were restricted. The telephone was the most reported teleconsultation method used. Except for SMS/texting (WBR P = 0.02 UMIC < LMIC), there were no significant differences in teleconsultation methods used. DISCUSSION: There is a high probability that the initial wave and consequent reduction of in-person care, restriction of health services, and fiscal difficulties affecting all involved in care delivery, led to the disruption of epilepsy care. Additional support are needed in resource-limited countries to cope with future pandemics.
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Public debt levels in sub-Saharan Africa rose sharply in the wake of the global financial crisis, and a number of countries are now classified by the World Bank and International Monetary Fund as at high risk of debt distress. By contrast with the debt crisis of the 1980s and 1990s, however, concerns were not region wide as recently as early 2020, and the policy environment for growth remains robust for the majority of countries in the region. The external environment nonetheless poses a set of region-wide risks that include the economic effects of the COVID-19 pandemic and are exacerbated by the increase in market-based debt and the retreat of the Paris Club among official creditors. Changes in perceived creditworthiness can now drive distress, and new challenges of creditor coordination will complicate the debt restructuring process. We motivate a research agenda that focuses on development assets at risk as rising debt service obligations crowd out development as well as operational and maintenance budgets. Preserving and enhancing these assets, which include advances in human capital and infrastructure and an improved investment environment, should be a central objective of domestic policy actions, preventative debt restructurings and institutional approaches to debt distress. © 2021 The Author(s). Published by Oxford University Press on behalf of the Centre for the Study of African Economies.
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This article reviews Bretton Woods Institutions' approach to public services, including during the recent COVID-19 crisis. Drawing on the specific case of IMF and World Bank's response to the multiple crisis triggered by the pandemic, it shows that there is a discourse-practice disjuncture in the institutions approach to public services as they continue to favour austerity and market-oriented solutions for the delivery of public services. The article therefore seeks to demystify the Bretton Woods institutions rhetoric and demand the adoption of a different way of understanding public services, and social policy more broadly.
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Oman has performed very well in the healthcare sector since 1970, it has achieved great heights in healthcare delivery. As per world bank data 2020, Oman has achieved 99% in providing basic sanitation services among its citizen and it has maintained this level since 2015.[1]. Centre of Studies Research-CSR-MOH has prepared a strategic plan “Health Vision 2050 for Health Research “to make Oman a regional leader in the Research & Development of Health Sector. As per this document, its mission is to provide a platform and conduct Research in the healthcare sector to address and prioritize healthcare services and reduce inequality in healthcare services among its citizen. This can be a major boost and contribute to socioeconomic development irrespective of the income among the Omani citizen. [2]. For any country to become prosperous needs a large pool of human capital, which can be achieved by providing good education and cheap health services to its citizen. Efficient human capitols lead to a good economy which further leads good GDP for any country. We can say the GDP of any country and its human capital complement each other. In this research paper, I have studied and analyzed the “Income & Expenditure” dataset from the data portal offal Al-Dakhliyah region of Oman, Health Vision document-2050, and Oman World Health Survey-2008. As per the report, Oman has scored very well ahead among the Gulf Cooperation Council (GCC) in economic stability, health, civil society, governance, and environment, in current-level Sustainable Economic Development Assessment (SEDA) scores, according to a report.[9]. In this research paper, we have reviewed and studied the impact of family income on sanitation, hygiene, and disease. Qualitative and quantitative methods like data collection using questionnaires, and world bank data and also reviewed various related research papers for our analysis. In this research paper, we have compared pre & post covid impacts on sanitation and hygiene practices among Omani citizens. A systematic review of published literature (2000-2019) evaluating the impact of family income on sanitation, hygiene, and disease. In low-and middle-income families [we used world bank data], we sought to examine the relationship between WASH provisions in healthcare facilities (HCF) and patient satisfaction/care-seeking behavior.[3].
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This paper predicts Coronavirus Disease (COVID-19)'s potential influence on the Arab country's economy by using the Autoregressive Integrated Moving Average (ARIMA) model. The world bank offers data of the Arab countries' Gross Domestic Product (GDP) over the period 1960-2019. As we show up at the pinnacle of the COVID-19 pandemic, quite possibly the most critical inquiry going up against us is: what is the potential impact of the progressing crisis on the Arab countries' economic improvement rate? The results have shown that the GDP growth is approximately -3.8% to 1.5% for 2021 and 2022, respectively. The referenced outcomes show that pandemic status significantly affects the Arab world economy special after the energy demand decline, which prompts a fall in oil price. In spite of the fact that the Arab world's financial development is growing again, it is not most likely going to re-visitation of business as usual for quite a while to come. © 2022 Newswood Limited. All rights reserved.
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Background: The United Nations' 2030 Sustainable Development Goals (SDGs) target an end to preventable newborn deaths and a reduction in neonatal mortality rate (< 28 d, NMR) to 12/1,000 live births for all countries. Understanding concurrent trends in country-level, multisectoral factors associated with NMR trends may illuminate opportunities for intervention strategies. Our objective was to explore country-specific trends in NMR from 1990-2019 and identify those countries which contribute to the largest percentage of neonatal deaths in order to focus efforts on reducing NMRs in those specific countries. Unfortunately, due to the COVID-19 pandemic, the 2030 SDGs have been severely impacted. Methods: We created a comprehensive global database of NMR and associated variables that were selected based on literature review and categorized into Population Health, Health Systems, Maternal, Neonatal, and Social factors from 1990 to 2019. Data were compiled from publicly available sources including UNICEF, World Bank, WHO, and OECD. Data were collected and analyzed for 195 countries. NMR trends were analyzed from 1990 to 2019 with more targeted analysis of trends in the last 2 decades from 2000 to 2019. We then performed statistical analyses using the selected variables to compare variable means using t-tests, identify bivariate associations, and generate multivariable regression models. Results: In terms of total deaths, 20 countries contributed 75% of the total 2.5 million neonatal deaths. All of these 20 countries showed decreases in NMR since 1990 (Figure 1). However, only China and Egypt accomplished the UN goal of reducing NMR to 12/1,000 live births. We compared variables associated with NMR in our 20 target countries to the remaining countries and found significant differences between the means for most variables (Table 1). Bivariate regression analyses showed statistically significant associations between NMR trends and changes over time in median income, health care spending, literacy level, maternal mortality ratio, and low birthweight rate. Ultimately the variables maternal mortality ratio change and median income change were selected for multivariable analysis based on collinearity. The multivariate regression model generated using NMR, maternal mortality ratio change, median income change resulted in an r-squared value of 0.54, explaining 54% of the variance in NMR trends. Conclusion: Since 20 countries contribute 75% of the neonatal deaths worldwide, we propose that targeting these 20 countries would have the greatest impact on global neonatal deaths. Future research will focus on identification of country specific barriers and evaluating the countries with greatest NMR improvements to propose effective focused strategies for reducing NMRs in high burden countries. The disparate impact that COVID-19 has had on countries with the highest neonatal mortality burden should be a primary focus of continued public health invention efforts, and is a specific focus of our ongoing research.
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Objective The primary aim of this study was to portray the level of spread and the dynamic of diffusion of mobile phone technology in sub-Saharan Africa during the last two decades. The secondary aim was to investigate factors related to the use of mobile phone technology in sub-Saharan Africa and to derive profiles of the most suitable areas to conduct mobile phone technology-based research. Methods The present work was based on the data collected by the World Bank database;a collection of public access data derived from yearly surveys conducted at country level. Two methods were applied to perform the selection of variables related to the diffusion of mobile phones in sub-Saharan Africa. Firstly, a Least Absolute Shrinkage and Selection Operator (LASSO) regression was applied. Afterwards, a system of simultaneous equation was applied to estimate the model coefficients and determine the joint statistical significance. Results The number of mobile phones subscriptions in relation to the population of sub-Saharan Africa has increased consistently during the period 2000 to 2010. The rate of mobile phones subscriptions in relation to the population ranged between less than 1% to more than 90%. Urban areas and having a lower number of people leaving in slums seems to be the most suitable places to conduct mobile phone-based interviews. This information is useful in identifying countries and macro areas to conduct mobile phone interviews;and this could be extended to smallest area within a country. Discussion More effort is required to better understand how to identify areas suitable for conducting research using mobile phones and other electronic-based tools. Such an effort should be based on individual level surveys to understand not only the material possibility but also the will to participate to research based on data capturing made by mobile phones and similar tools.
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Background and aims: A global study with equitable participation for cirrhosis and chronic liver disease (CLD) outcomes is needed. We initiated the Chronic Liver disease Evolution And Registry for Events and Decompensation (CLEARED) study to provide this global perspective. Aim to evaluate determinants of inpatient mortality and organ dysfunction in a multi-center worldwide study. Method: We prospectively enrolled pts with CLD/Cirrhosis >18 years without organ transplant or COVID-19 who were admitted non-electively. To maintain equity in outcome analysis, a maximum of 50 pts/site were allowed. Data for admission variables, hospital course, and inpatient outcomes (ICU, death, organ dysfunction [ODF]) were recorded. This was analyzed for death and ODs using significant variables on admission and including World Bank classification of low/middle-income countries (LMIC). A model for in-hospital mortality for all variables during the hospital course, including ODs) was analyzed. Results: 1383 pts (55 ± 13 yrs, 64% men, 39% White, 30% Asian, 10% Hispanic, 9% Black, 12% other) were enrolled from 49 centers (Fig A). 39% were from high-income while the rest were from LMICs. Admission MELDNa 23 (6–40) with history in past 6 months of hospitalizations 51%, infections 25%, HE 32%, AKI 23%, prior LVP 15%, hydrothorax 8% and HCC 4%. Leading etiologies were Alcohol 46% then NASH 23%, HCV 11% and HBV 13%. Most were on lactulose 52%, diuretics 53%, PPI 49% and statins 11%, SBP prophylaxis 16%, beta-blockers 35% and rifaximin 31%. 90% were admitted for liver-related reasons;GI bleed 30%, HE 34%, AKI 33%, electrolyte issues 30%, anasarca 24% and 25% admission infections. In-hospital course: Median LOS was 7 (1–140) days with 25% needing ICU. 15% died in hospital, 3% were transplanted, 46% developed AKI,15% grade 3–4 HE, 14% shock, 13% nosocomial infections and 13% needed ventilation. Logistic Regression: Fig B shows that liver-related/unrelated factors on admission which predicted in-hospital mortality and development of organ dysfunction with MELDNa and Infections being common among all models. Nosocomial infections and organ dysfunctions predicted mortality when all variables were considered. High-income countries had better mortality outcomes likely due to transplant and ICU availability. AUCs were >0.75 (Figure Presented) Conclusion: In this worldwide equitable experience, admission cirrhosis severity and infections are associated with inpatient outcomes, which are greater in low-income settings. Liver-related and unrelated factors and regional variations are important in defining critical care goals and outcome models in inpatients with cirrhosis.