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Publication(Washington, DC: World Bank, 2023-10-03)Sri Lanka’s longstanding structural weaknesses plunged the country into a severe economic crisis in 2022. The economy has shown initial signs of stabilization, albeit at a low-level equilibrium, in the first half of 2023. Swift and sufficiently deep debt restructuring is needed to restore Sri Lanka’s debt sustainability and regain access to international financial markets.
Effect of a Lottery Intervention on Gender-Based Violence among Female Sex Workers in Dar es Salaam, Tanzania: Results from a Randomized Trial(World Bank, 2023-10-02)Financial incentives are a promising approach for HIV prevention. Some studies have shown that financial incentive interventions aimed to promote positive health and social behaviors have mixed or harmful effects on gender-based violence, and little is known about their effects among higher risk groups such as female sex workers. To address this gap, this study investigated the relationship between a lottery-based incentive and gender-based violence among female sex workers in Dar es Salaam, Tanzania. Data were analyzed from the RESPECT II trial, which enrolled 2,206 female sex workers in Dar es Salaam, Tanzania, to evaluate the effect of a lottery-based incentive on HIV and sexually transmitted infections. Participants were randomized in a one-to-one ratio to: (1) the basic test group (control), which provided baseline testing and counseling for HIV and sexually transmitted infections and bi-weekly text messages on safe sex practices; or (2) the lottery group, which included the basic test group intervention plus entry into a weekly random lottery for an award of 100,000 Tanzanian shillings conditional on negative tests for sexually transmitted infections (syphilis and trichomonas vaginalis). An intent-to-treat analysis was conducted to estimate differences in physical and sexual gender-based violence (overall), and intimate partner violence and non-partner violence between treatment arms at endline, with estimates expressed as unadjusted prevalence differences with 95 percent confidence intervals. Adjusted estimates controlled for baseline reports of violence. Multiple imputation and inverse-probability of treatment weighting were used to account for missing data. Causal, population-level impacts were estimated using g-computation. Gender-based violence, intimate partner violence, and non-partner violence declined in both treatment arms over the study period among the sample of 1,117 female sex workers retained at endline. The lottery group had a lower prevalence of gender-based violence overall, intimate partner violence, and non-partner violence compared to control at endline; however, the differences were not statistically significant. The results indicate that the lottery intervention had no effect on violence outcomes among endline participants in the RESPECT II trial. These results suggest that this economic approach does not pose additional risks of violence in the context of sex work; however, they must be interpreted with caution due to high attrition in the study sample. Additional research is warranted to examine how this incentive mechanism impacts violence for female sex workers.
Publication(World Bank, Washington, DC, 2023-10-02)This study investigates how the landscape of sex work in Dar es Salaam, Tanzania, evolved in the context of the COVID-19 epidemic. Using a mixed-methods approach, the analysis triangulates data from quantitative and qualitative sources to quantify shifts in income, demand, and client frequency and describe female sex workers’ perspectives on their work environment. The COVID-19 restrictions introduced in early 2020 resulted in dramatic decreases in sex work income, leading to extreme financial vulnerability, food insecurity, and challenges in meeting other basic needs such as paying rent. However, in a 2021 follow-up survey, sex workers reported the summer of 2021 as a key turning point, with the demand for sex work rebounding to closer to pre-pandemic levels. Notably, despite the average number of unique weekly clients not yet having fully rebounded, by 2021 the price per client and the total monthly sex work income had returned to pre-pandemic levels. This may potentially be explained by an increased number of repeat clients, which represented a larger proportion of all clients during the COVID-19 pandemic.
Publication(World Bank, Washington, DC, 2023-10-02)Disability benefits provide social insurance against the risk of losing working capacity, as well as an important source of income for individuals with disabilities. They are also costly and tend to reduce labor supply. Although spending can be contained by careful targeting, correcting past flaws in eligibility rules or assessment procedures may entail welfare costs. This paper studies a major reform in Hungary that reassessed the health and working capacity of a large share of beneficiaries. Leveraging age and health cutoffs in the reassessment, the paper estimates employment responses to loss or reduction of benefits. The findings show that among those who left disability insurance due to the reform, 58 percent were employed in the primary labor market, 6 percent participated in public works, and 36 percent were out of work without benefits in the post-reform period. The consequences of leaving disability insurance differed sharply by pre-reform employment status. Among the beneficiaries who were employed in the pre-reform year, 81 percent worked, while only 33 percent of those without pre-reform employment did. The gains of the reform in activating beneficiaries were small and strongly driven by pre-reform employment status. This points to the importance of combining financial incentives with broader labor market programs that increase employability.
Publication(World Bank, Washington, DC, 2023-10-02)Promoting women’s socioeconomic empowerment means increasing women’s control over the resources and decisions that are important for their well-being. Achieving these goals requires engaging men, since men often have influence over the lives of women in t heir households and communities. This overview examines evidence on the effectiveness of three different types of approaches that have been tested: Adding an engaging men intervention to complement a program designed to support women’s individual economic activities: Studies of these interventions show mixed results. Some have had success while others highlight the risk that this type of intervention could reduce women’s autonomy; Complementing support for household production or consumption with programming that encourages cooperative management or joint planning: These types of interventions are promising, especially for increasing women’s role in the management of household resources, although they have had limited impact on women’s individual-level economic outcomes; and Encouraging men to recognize or enhance their wives’ rights to ownership of important assets: There is very limited research available on this category of intervention, although available evidence is promising. Additional research in other contexts is necessary.