| This research program spans the full gamut of human development (HD) — 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. Research Manager: Adam Wagstaff HD Quarterly Update: html | pdf | previous issues
PSG Biannual Update: html | pdf | previous issues |
Conducting Ethical Economic Research: Complications from the Field
May 2013 - This essay discusses practical issues confronted when conducting surveys as well as designing appropriate field trials. First, it looks at the challenge of ensuring transparency while maintaining confidentiality. Second, it explores the role of trust in light of asymmetric information held by the surveyor and by the respondents as well as the latter's expectations as to what their participation will set in motion. The authors present case studies relevant to both of these issues. Finally, they discuss the role of ethical review from the perspective of research conducted through the World Bank.
Working Paper 6446 Building or Bypassing Recipient Country Systems: Are Donors Defying the Paris Declaration?
April 2013 - The 2005 Paris Declaration committed donors to increased use by donors of recipient country systems for managing aid, particularly in recipient countries with higher-quality systems. This study investigates the degree to which donors’ use of country systems is in fact positively related to their quality, using indicators explicitly endorsed for this purpose by the Paris Declaration and covering the 2005-2010 period. Tests confirm a positive and significant relationship that is robust to corrections for potential sample selection, omitted variables, and endogeneity bias. Findings suggest that donors have modified at least some of their aid practices in ways that build rather than undermine administrative capacity and accountability mechanisms in recipient countries.
Working Paper 6423 Using Provider Performance Incentives to Increase HIV Testing and Counseling Services in Rwanda
February 2013 - Paying for performance (P4P) provides financial rewards to medical care providers for improvements in performance measured by specific utilization and quality of care indicators. In 2006, Rwanda began a paying for performance scheme to improve health services delivery, including HIV/AIDS services. This study examines the scheme's impact on individual and couples HIV testing and counseling, using data from a prospective quasi-experimental design. The study finds a positive impact of P4P with an increase of 6.1 percentage points in the probability of individuals having ever been tested. Larger impacts are found for married individuals. The P4P impact is also larger for the probability that both partners have ever been tested, especially among discordant couples in which only one of the partners is HIV positive.
Working Paper 6364 Previous Working Papers
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 | Adam Wagstaff. Were Gordon Brown and I right? Were poor children actually left behind by the Millennium Development Goals for education?
June 2013 - It’s quite fun being picked up by a prime minister. Not literally of course. Unless you happen to be a baby seized from your mother’s arms during an election campaign, in which case it must be rather exciting, and quite possibly the highlight of the day. No, I mean being picked up in print. Jishnu Das. A Data Guide to Sir Michael Barber’s “The Good News from Pakistan”
June 2013 - Shanta’s blog reported on Sir Michael Barber’s approach to implementing service delivery or “Deliverology”. Sir Michael was back at the World Bank on June 6th to present “The Good News from Pakistan”, where he outlined the impressive changes in Punjab, Pakistan as a result of his leadership in delivering deliverology. As a discussant, with Dhushyanth Raju’s inputs (Dhushyanth is a Senior Economist in the World Bank's South Asia education team), I examined and triangulated the existing data. Despite my original excitement about the method and the results after reading the report, I am reluctantly forced to conclude that at the moment the data do not support the report’s claims (see my presentation) Adam Wagstaff. Cost-effectiveness vs. universal health coverage. Is the future random?
May 2013 - I've been blogging a bit about Universal Health Coverage (UHC) recently. In my "old wine in a new bottle" post, I argued that UHC is ultimately about ensuring that rich and poor alike get the care they need, and that nobody suffers undue financial hardship from getting the care they need. In my "Mrs Gauri" post, I used my colleague Varun Gauri's mother as a guinea pig to see whether the general public feels that UHC is a morally powerful concept and whether it could be expressed in a way that the general public would find accessible. Shanta Devarajan and Jishnu Das. User fees and abuser fees
April 2013 - If user fees for health have been so vilified (including in comments on this blog), why are we bringing the subject up again? Because new evidence calls into question the prevailing view, namely that removing user fees leads to: (i) increased use of health services and hence to (ii) improved health outcomes. Confirming (i), the recent literature shows that (ii) does not always follow.
Previous Blogs & Research Briefs
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Cornoa, L. and D. de Walque (2013). "Socioeconomic determinants of stigmatization and HIV testing in Lesotho." AIDS Care 25(1): 108-113.
HIV/AIDS stigmatizing attitudes and their consequences on preventative behaviors are among the most poorly understood aspects of the AIDS epidemic. This paper analyzes the socioeconomic determinants of discriminating attitudes toward people living with HIV and their implications on the likelihood of HIV testing. These effects are tested using the 2004 and 2009 Demographic and Health Surveys conducted in Lesotho, where HIV/AIDS is a pervasive problem. We find that HIV/AIDS stigmatizing attitudes are negatively associated with education and wealth and positively correlated with Catholic religion for women and traditional circumcision for men. The analysis also shows a negative association between stigmatizing beliefs and the probability of being tested for HIV... Knack, S. and L. Smets (2013). "Aid Tying and Donor Fragmentation." World Development 44: 63–76.
This study analyzes theoretically and empirically the impact of aid fragmentation on donors’ decisions to tie their development aid to purchases from contractors based in their own countries. Building on collective action theory, it argues that a donor with a larger share of the aid market in a country has stronger incentives to maximize the development impact of its aid, by tying less of it. Empirical tests strongly and consistently support the prediction that higher donor aid shares will be associated with less aid tying. This finding is robust to recipient controls, donor fixed effects, and instrumental variables estimation... Pai, M. and J. Das (2013). "Management of Tuberculosis in India: Time for a deeper dive into quality." The National Medical Journal of India 26(2): 1-4.
The diagnosis and treatment of tuberculosis (TB) remains a persistent challenge for health services in India. While the Revised National TB Control Programme (RNTCP) has announced ‘universal access to quality TB diagnosis and treatment for all TB patients in the community’ as its new goal in the new National Strategic Plan (2012–17), there seems to be no clear strategy to systematically measure and document the quality of TB care, in both public and private sectors... Gauri, V. (2013). "Too legal to work." The Indian Express, 1-2.
A highly legalised system of complaints redress may undermine, not enhance, accountability
To err is human, and government officials are human indeed. For that reason, Parliament's consideration of the right of citizens for time-bound delivery of and services bill is a welcome development.
The bill squarely addresses one of the two objectives of grievance redress systems — basic fairness. When someone is unjustly denied something to which they are entitled as a matter of legal or constitutional right, it is crucial for government, as a condition of basic fairness and reciprocity, to facilitate the expression of complaints, and soon upon receiving a well-founded complaint, to fix the problem... Previous Journal Articles
| Localizing Development: Does Participation Work?
November 2012 - The Policy Research Report Localizing Development: Does Participation Work? brings analytical rigor to a field that has been the subject of intense debate and advocacy, and billions of dollars in development aid. It briefly reviews the history of participatory development and argues that its two modalities, community-based development and local decentralization, should be treated under the broader unifying umbrella of local development. It suggests that a distinction between organic participation (endogenous efforts by civic activists to bring about change) and induced participation (large-scale efforts to engineer participation at the local level via projects) is key, and focuses on the challenges of inducing participation.
Order | Download The Elderly and Old Age Support in Rural China. Directions in Development Series
March 2012 - The Elderly and Old Age Support in Rural China 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.
Order | Download Health Equity and Financial Protection: Streamlined Analysis with ADePT Software
May 2011 - ADePT Health is a free-standing computer program that allows users to produce quickly - and with the minimal risk of errors - most tables that have become standard in applied health and equity analysis. ADePT produces summary statistics and charts that allow inequalities to be compared across countries and over time. This manual explains the methods ADePT uses, how to prepare data for it, how to navigate the ADePT interface to generate the desired tables and charts, and how to interpret them.
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Making Schools Work: New Evidence on Accountability Reforms
February 2011 - This book is about the threats to education quality in the developing world that cannot be explained by lack of resources. It reviews the observed phenomenon of service delivery failures in public education: cases where programs and policies increase the inputs to education but do not produce effective services where it counts – in schools and classrooms. It documents what we know about the extent and costs of such failures across low and middle-income countries. And it further develops the conceptual model posited in the World Development Report 2004: that a root cause of low-quality and inequitable public services – not only in education—is the weak accountability of providers to both their supervisors and clients.
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