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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 »


HIV Testing, Behavior Change, and the Transition to Adulthood in Malawi
Beegle, Kathleen, Michelle Poulin, and Gil Shapira

For young adults living in countries with AIDS epidemics, getting an HIV test may influence near-term decisions, such as when to leave school, when to marry, and when to have a first child. These behaviors, which define the transition from adolescence to adulthood, have long-term implications for well-being and directly affect a person’s risk of contracting HIV. Using an experimental design embedded in a panel survey from Malawi, this study assesses how HIV voluntary counseling and testing of young adults affects these decisions. The results show a negligible intent-to-treat effect of HIV testing on behaviors. There is some suggestive evidence, however, of a differential response by wealth and by prior beliefs about one’s HIV status.

Protecting child nutritional status in the aftermath of a financial crisis: Evidence from Indonesia
Giles, John, and Satriawan, Elan

In response to concerns over the vulnerability of the young in the wake of Indonesia's 1997–1998 economic crises, the Government of Indonesia implemented a supplementary feeding program to support early childhood nutritional status. This paper exploits heterogeneity in duration of program exposure to evaluate the impact of the program on children aged 6 to 60 months. By examining differences in nutritional status of treated younger children and a placebo group of older children, the analysis finds that the program improved the nutritional status of treated children, and most significantly, led to 7 and 15% declines in rates of moderate and severe stunting, respectively, for children aged 12 to 24 months who were exposed to the program for at least 12 months over two years.

Using provider performance incentives to increase HIV testing and counseling services in Rwanda
de Walque, D., Gertler, P.J,, Bautista-Arredondo, S., Kwan, A., Vermeersch, C., de Dieu Bizimana, J., Binagwaho, A., Condo, J.

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.

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.


How Effective Are Efforts to Raise Voluntary Enrollment in Health Insurance?
Winter 2015
An experiment in the Philippines suggests that achieving universal health coverage through voluntary enrollment will not be easy.

How Insecure Property Rights Affect Migration in China
Winter 2015
Land tenure insecurity reduced the rate of migration from rural to urban areas in China during the 1990s and early 2000s.

Can incentives lead to sustained impacts? The case of rewarding safe sex.
Damien de Walque, January 2015
Economists believe that incentives matter and that they can be used for changing people’s behaviors. Incentives are used for encouraging school attendance and performance or for increasing the coverage and quality of health care delivery. But a recurrent question is what happens once the incentives are discontinued? Are the incentives’ effects going to be sustained even after their payment is stopped because individuals would have been nudged towards a different behavior? Or are those effects going to die down and disappear once incentives are removed? The answer to that question has obvious consequences in terms on long run sustainability and cost effectiveness of incentive schemes.

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?

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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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Women left behind? poverty and headship in Africa
Annamaria Milazzo and Dominique van de Walle
This paper is motivated by two stylized facts about poverty in Africa: female-headed households tend to be poorer, and poverty has been falling in the aggregate since the 1990s. These facts raise two questions: How have female-headed households fared? And what role have they played in Africa's impressive recent aggregate growth and poverty reduction? Using data covering the entire region, the paper reexamines the current prevalence and characteristics of female-headed households, and asks whether their prevalence has been rising over time, what factors have been associated with such changes since the mid-1990s, and whether poverty has fallen equi-proportionately for male- and female-headed households. Rising gross domestic product has dampened rising female headship.
Working Paper 7331, June 2015

Unbundling institutions for external finance: worldwide firm-level evidence
Stephen Knack Xu and L. Colin Xu
The empirical literature on institutions and development has been challenged on grounds of reverse causality, measurement error in institutional indicators, and heterogeneity. This paper uses firm-level data across countries to confront these challenges. Instead of analyzing ultimate outcomes, such as income levels where institutional quality is likely endogenous, the focus is on firm-level external finance. Moreover, institutions are “unbundled” to explore how various types of institutions affect external finance differently. The paper documents that micro firms have significantly less access to external finance than small and medium firms.
Working Paper 7287, June 2015

Delivering education: a pragmatic framework for improving education in low-income countries
Tahir Andrabi, Jishnu Das, Asim Ijaz Khwaja
Even as primary-school enrollments have increased in most low-income countries, levels of learning remain low and highly unequal. Responding to greater parental demand for quality, low-cost private schools have emerged as one of the fastest growing schooling options, challenging the monopoly of state-provided education and broadening the set of educational providers. Historically, the rise of private schooling is always deeply intertwined with debates around who chooses what schooling is about and who represents the interests of children. This time is no different. But rather than first resolve the question of how child welfare is to be adjudicated, this paper argues instead for a `pragmatic framework’. In this pragmatic framework, policy takes into account the full schooling environment—which includes public, private and other types of providers—and is actively concerned with first alleviating constraints that prohibit parents and schools from fulfilling their own stated objectives.
Working Paper 7277, May 2015

World Bank policy lending and the quality of public sector governance
Lodewijk Smets and Stephen Knack
This study investigates the impact of World Bank development policy lending for public sector governance on the quality of public sector management and institutions. The World Bank’s Country Policy and Institutional Assessments (CPIA) are used to measure the latter, the study considers only policy conditions targeted at improvements in those areas. The analysis uses a comprehensive country-year panel data set of aid receiving-countries and finds a significant and inverse U-shaped effect of public sector conditions on the quality of public sector governance. For most observed values in the data, the impact is positive, but it turns negative beyond a value of 80 conditions. At that point, the predicted CPIA score is about 0.25 point (0.3 standard deviation) higher than with zero conditions.
Working Paper 7267, May 2015


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: 2015-07-02

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