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Human Development and Public Services

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This research program spans the full gamut of human development — education, health, labor markets, and social protection. It examines the performance of the sectors in terms of levels and inequalities in utilization, quality and outcomes, as well as methods for improving performance, whether aimed at households, service providers, politicians and policymakers, or donors.    More »


Monitoring Progress towards Universal Health Coverage at Country and Global Levels
Boerma, T., P. Eozenou, D. Evans, T. Evans, M. P. Kieny, A. Wagstaff

Universal health coverage (UHC) has been defined as the desired outcome of health system performance whereby all people who need health services (promotion, prevention, treatment, rehabilitation, and palliation) receive them, without undue financial hardship. UHC has two interrelated components: the full spectrum of good-quality, essential health services according to need, and protection from financial hardship, including possible impoverishment, due to out-of-pocket payments for health services.

Progress on Global Health Goals: are the Poor Being Left Behind?
Adam Wagstaff, Caryn Bredenkamp and Leander R. Buisman
World Bank Research Observer 29(2): 1-26.August 2014.

We examine differential progress on health Millennium Development Goals (MDGs) between the poor and the better off within countries. Our findings are based on an original analysis of 235 DHS and MICS surveys spanning 64 developing countries over the 1990–2011 period. We track five health status indicators and seven intervention indicators from all four health MDGs. In approximately three-quarters of countries, the poorest 40 percent have made faster progress than the richest 60 percent on MDG intervention indicators.

The Law’s Majestic Equality? The Distributive Impact of Judicializing Social and Economic Rights
Daniel M. Brinks and Varun Gauri
Perspectives on Politics 12(2):375-393. June 2014.

While many find cause for optimism about the use of law and rights for progressive ends, the academic literature has long been skeptical that courts favor the poor. We show that, with the move toward a robust “new constitutionalism” of social and economic rights, the assumptions underlying the skepticism do not always hold. Our theories must account for variation in the elite bias of law and litigation.

Intergenerational Mobility and Interpersonal Inequality in an African Economy
Sylvie Lambert, Martin Ravallion, Dominique van de Walle
Journal of Development Economics June 2014.

How much economic mobility is there across generations in a poor, primarily rural, economy? How much do intergenerational linkages contribute to current inequality? We address these questions using original survey data on Senegal that include a sub-household measure of consumption for cells within the household.


Deworming improves child cognition. Eventually
Owen Ozier, October 16, 2014
You could be forgiven if you found deworming to be something of an enigma. Some have hailed it as one of the most cost effective interventions for improving school participation in developing countries. Yet two recent review papers, drawing together the lessons from many studies, find insignificant effects of deworming on learning specifically and only uncertain evidence on cognition more generally. How could this be?

From “Power to the People” to “Information is Power”
Damien de Walque, October 2014
Poor quality plagues public service provision in many developing countries. For example, doctors in Tanzania completed less than 25% of the essential checklist for patients with malaria, a disease that is endemic in the country. Indian doctors asked an average of one question per patient (“What’s wrong with you?”).

We just learned a whole lot more about achieving Universal Health Coverage
Adam Wagstaff, August 2014
Subsidized health insurance is unlikely to lead to Universal Health Coverage (UHC); insurance coverage doesn’t always improve financial protection and when it does, doesn’t necessarily eliminate financial protection concerns; and tackling provider incentives may be just as – if not more – important in the UHC agenda as demand-side initiatives.

Inequality of opportunity: the new motherhood and apple pie?
Adam Wagstaff and Ravi Kanbur, August 2014
On the face of it, questioning the usefulness of “inequality of opportunity” seems about as wrongheaded as questioning the merits of family vacations, Thanksgiving or dessert trolleys. What’s not to like about it?

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Youth Employment in SSAYouth Employment in Sub-Saharan Africa
January 2014 - The report examines obstacles faced by households and firms in meeting the youth employment challenge. It focuses primarily on productivity, in agriculture, in nonfarm household enterprises (HEs), and in the modern wage sector, because productivity is the key to higher earnings as well as to more stable, less vulnerable, livelihoods. To respond to the policy makers' dilemma, the report identifies specific areas where government intervention can reduce those obstacles to productivity for households and firms, leading to brighter employment prospects for youth, their parents, and their own children.

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Risking Your Health: Causes, Consequences, and Interventions to Prevent Risky Behaviors
November 2013 – Individuals all over the worlds engage in behaviors that are risky for their health: smoking, drugs, alcohol, unhealthy food, and risky sexual encounters. They increasingly affect the health of individual and their populations. This report examines the causes, consequences and interventions to prevent these growing threats.

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The Elderly and Old Age in Rural ChinaThe Elderly and Old Age Support in Rural China
March 2012 - This book examines projected demographic changes that will affect the economic well-being of China’s rural elderly over the next 20 years, taking into account both China’s sharp demographic transition and the continued migration of young adults to cities. The projected old age dependency ratio of 34 percent in China’s rural areas by 2030 suggests that support of the elderly is likely to be an increasing burden on China’s families.

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Village Political Economy, Land Tenure Insecurity, and the Rural to Urban Migration Decision: Evidence from China
John Giles and Ren Mu
This paper investigates the impact of land tenure insecurity on the migration decisions of China's rural residents. A simple model first frames the relationship among these variables and the probability that a reallocation of land will occur in the following year. After first demonstrating that a village leader's support for administrative land reallocation carries with it the risk of losing a future election, the paper exploits election-timing and village heterogeneity in lineage group composition and demographic change to identify the effect of land security.
Working Paper 7080, November 2014

Exploiting Externalities to Estimate the Long-Term Effects of Early Childhood Deworming
Owen Ozier
This paper investigates whether a large-scale deworming intervention aimed at primary school pupils in western Kenya had long-term effects on young children in the region. The paper exploits positive externalities from the program to estimate the impact on younger children who did not receive treatment directly. Ten years after the intervention, large cognitive effects are found -- comparable to between 0.5 and 0.8 years of schooling -- for children who were less than one year old when their communities received mass deworming treatment.
Working Paper 7052, October 2014

Who Benefits from Government Health Spending and Why? A Global Assessment
Adam Wagstaff, Marcel Bilger, Leander R. Buisman, , Caryn Bredenkamp
This paper uses a common household survey instrument and a common set of imputation assumptions to estimate the pro-poorness of government health expenditure across 69 countries at all levels of income. On average, government health expenditure emerges as significantly pro-rich, but there is heterogeneity across countries: in the majority, government health expenditure is neither pro-rich nor pro-poor, while in a small minority it is pro-rich, and in an even smaller minority it is pro-poor.
Working Paper 7044, September 2014

Information is power: experimental evidence on the long-run impact of community based monitoring
Martina Bjorkman Nyqvist, Damien de Walque, Jakob Svensson
This paper presents the results of two field experiments on local accountability in primary health care in Uganda. Efforts to stimulate beneficiary control, coupled with the provision of report cards on staff performance, resulted in significant improvements in health care delivery and health outcomes in both the short and the longer run. Efforts to stimulate beneficiary control without providing information on performance had no impact on quality of care or health outcomes.
Working Paper 7015, August 2014


Publications (2008-2015)

Boogle map of the countries covered by selected research
The map shows research on human development by research department staff, 2008-2015.


Research Manager

Adam Wagstaff
Adam Wagstaff

Last updated: 2015-01-20

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