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Human Development and Public Services

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Overview

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 »

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Encouraging Health Insurance for the Informal Sector: A Cluster Randomized Experiment in Vietnam
Adam Wagstaff, Ha Thi Hong Nguyen, Huyen Dao and Sarah Bales

Subsidized voluntary enrollment in government-run health insurance schemes is often proposed as a way of increasing coverage among informal sector workers and their families. We report the results of a cluster randomized experiment, in which 3000 households in 20 communes in Vietnam were randomly assigned at baseline to a control group or one of three treatments: an information leaflet about Vietnam's government-run scheme and the benefits of health insurance, a voucher entitling eligible household members to 25% off their annual premium, and both. At baseline, the four groups had similar enrollment rates (4%) and were balanced on plausible enrollment determinants.

Effects of Price, Information, and Transactions Cost Interventions to Raise Voluntary Enrollment in a Social Health Insurance Scheme: A Randomized Experiment in the Philippines
Joseph J. Capuno, Aleli D. Kraft, Stella Quimbo, Carlos R. Tan Jr. and Adam Wagstaff

A cluster randomized experiment was undertaken testing two sets of interventions encouraging enrollment in the Individually Paying Program (IPP), the voluntary component of the Philippines' social health insurance program. In early 2011, 1037 unenrolled IPP-eligible families in 179 randomly selected intervention municipalities were given an information kit and offered a 50% premium subsidy valid until the end of 2011; 383 IPP-eligible families in 64 control municipalities were not. In February 2012, the 787 families in the intervention sites who were still IPP-eligible but had not enrolled had their vouchers extended, were resent the enrollment kits and received SMS reminders.

Assessing Latin America’s Progress Toward Achieving Universal Health Coverage
Adam Wagstaff, Tania Dmytraczenko, Gisele Almeida, Leander Buisman, Patrick Hoang-Vu Eozenou, Caryn Bredenkamp, James A. Cercone, Yadira Diaz, Daniel Maceira, Silvia Molina, Guillermo Paraje, Fernando Ruiz, Flavia Sarti, John Scott, Martin Valdivia and Heitor Werneck

Two commonly used metrics for assessing progress toward universal health coverage involve assessing citizens’ rights to health care and counting the number of people who are in a financial protection scheme that safeguards them from high health care payments. On these metrics most countries in Latin America have already “reached” universal health coverage. Neither metric indicates, however, whether a country has achieved universal health coverage in the now commonly accepted sense of the term: that everyone—irrespective of their ability to pay—gets the health services they need without suffering undue financial hardship.

Does Africa Need a Rotten Kin Theorem? Experimental Evidence from Village Economies
Pamela Jakiela and Owen Ozier

This paper measures the economic impacts of social pressures to share income with kin and neighbors in rural Kenyan villages. We conduct a lab experiment in which we randomly vary the observability of investment returns to test whether subjects reduce their income in order to keep it hidden. We find that women adopt an investment strategy that conceals the size of their initial endowment in the experiment, though that strategy reduces their expected earnings. This effect is largest among women with relatives attending the experiment. Parameter estimates suggest that women anticipate that observable income will be “taxed” at a rate above four percent; this effective tax rate nearly doubles when kin can observe income directly. At the village level, we find an association between willingness to forgo expected return to keep income hidden in the laboratory experiment and worse economic outcomes outside the laboratory.

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Saturday, December 12 was UHC Day. What have we learned in the last 12 months about Universal Health Coverage?
Adam Wagstaff, December 2015
It turns out lots of interesting things happened on December 12. Beethoven had his first lesson in music composition with Franz Joseph Haydn (1792), Washington, D.C. became the capital of the US (1800), Guglielmo Marconi sent the first transatlantic radio signal (1901), Kenya declared independence from the UK (1963), The Beatles played their last UK concert (1965), and Ed Sheeran announced he was “taking a break” from social media (2015). Oh yes, and the UN endorsed a resolution calling for countries to “provide affordable, quality health care to every person, everywhere” (2012). Which makes December 12 UHC Day.

Poverty is falling faster among Africa’s female headed households
Dominique van de Walle, October 2015
A sizeable number of households in Africa today have female heads. Based on the latest Demographic and Health Surveys (DHS), 26% of all households Africa-wide are headed by women. Although there are cross-country differences, the shares both of the population living in female headed households (FHHs) and of households headed by women, have been rising over time. The data show quite clearly that the probability that a woman aged 15 or older heads a household, controlling for her age, has been increasing since the early 1990s in all regions and across the entire age distribution.

Financial incentives in health: the magic bullet we were hoping for?
Adam Wagstaff, September 2015
After years of bad news from developing countries about high rates of health worker absenteeism, and low rates of delivery of key health interventions, along came what seemed like a magic bullet: financial incentives. Rather than paying providers whether or not they show up to work, and whether or not they deliver key interventions, doesn’t it make sense to pay them—at least in part—according to what they do?

Incentives and Teacher Effort
Winter 2015
School survey data from Lao PDR show that nonmonetary incentives can be effective in motivating teachers to increase their effort.

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Right to Work?Poverty in a Rising Africa: Africa Poverty Report
October 2015: According to latest World Bank estimates, the share of Africans who are poor fell from 56% in 1990 to 43% in 2012. The report argues that the poverty rate may have declined even more if the quality and comparability of the underlying data are taken into consideration. However, because of population growth many more people are poor, the report says. The most optimistic scenario shows about 330 million poor in 2012, up from about 280 million in 1990. Poverty reduction has been slowest in fragile countries, the report notes, and rural areas remain much poorer, although the urban-rural gap has narrowed.

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Right to Work?Right to Work? Assessing India's Employment Guarantee Scheme in Bihar
February 2014: India's 2005 National Rural Employment Guarantee Act creates a justiciable "right to work" by promising up to 100 days of wage employment per year to all rural households whose adult members volunteer to do unskilled manual work. Work is provided in public works projects at the stipulated minimum wage. The study finds that the scheme is falling well short of its potential impact on poverty in Bihar. Analysis of the study’s survey data points to a number of reasons. Workers are not getting all the work they want, and they are not getting the full wages due. And participation in the scheme is far from costless to them. Many report that they had to give up some other income-earning activity when they took up work. The unmet demand for work is the single most important policy-relevant factor in accounting for the gap between actual performance and the scheme’s potential impact on poverty.

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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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On the delegation of aid implementation to multilateral agencies
Kurt Annen and Stephen Knack
The rapid growth of trust funds at multilateral development organizations has been widely neglected in the academic literature so far. Using a simple illustrative model, this paper examines the choice by sovereign donors among various trust fund options. The authors contend that the choice among the different trust funds involves a fundamental trade-off: larger funds provide donors with the benefit of burden sharing. Conversely, each donor can better assert its individual preferences in a fund with fewer other donors. The theoretical considerations yield testable implications on a range of factors affecting this fundamental tradeoff, most notably the area of intervention of the trust fund and competing domestic interests of donor countries. Using a sample of World Bank trust funds, the paper examines the participation decisions of Organisation for Economic Co-operation and Development/Development Assistance Committee donors over the past decade.
Working Paper 7455, October 2015

Which donors, which funds? the choice of multilateral funds by bilateral donors at the World Bank
Bernhard Reinsberg, Katharina Michaelowa, and Stephen Knack
The rapid growth of trust funds at multilateral development organizations has been widely neglected in the academic literature so far. Using a simple illustrative model, this paper examines the choice by sovereign donors among various trust fund options. The authors contend that the choice among the different trust funds involves a fundamental trade-off: larger funds provide donors with the benefit of burden sharing. Conversely, each donor can better assert its individual preferences in a fund with fewer other donors. The theoretical considerations yield testable implications on a range of factors affecting this fundamental tradeoff, most notably the area of intervention of the trust fund and competing domestic interests of donor countries. Using a sample of World Bank trust funds, the paper examines the participation decisions of Organisation for Economic Co-operation and Development/Development Assistance Committee donors over the past decade.
Working Paper 7441, October 2015

The impact of violence on individual risk preferences: evidence from a natural experiment
Pamela Jakiela and Owen Ozier
This paper estimates the impacts of secondary school on human capital, occupational choice, and fertility for young adults in Kenya. The probability of admission to government secondary school rises sharply at a score close to the national mean on a standardized 8th grade examination, permitting the estimation of causal effects of schooling in a regression discontinuity framework. The analysis combines administrative test score data with a recent survey of young adults to estimate these impacts. The results show that secondary schooling increases human capital, as measured by performance on cognitive tests included in the survey.
Working Paper 7384, August 2015

The Impact of Secondary Schooling in Kenya: A Regression Discontinuity Analysis
Owen Ozier
This paper estimates the impacts of secondary school on human capital, occupational choice, and fertility for young adults in Kenya. The probability of admission to government secondary school rises sharply at a score close to the national mean on a standardized 8th grade examination, permitting the estimation of causal effects of schooling in a regression discontinuity framework. The analysis combines administrative test score data with a recent survey of young adults to estimate these impacts. The results show that secondary schooling increases human capital, as measured by performance on cognitive tests included in the survey.
Working Paper 7384, August 2015

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Publications (2008-2015)

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The map shows research on human development by research department staff, 2008-2015.

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Last updated: 2016-01-20




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