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Publication
Macroeconomic Effects of Financing Universal Health Coverage in Armenia
(World Bank, Washington, DC, 2021-06-08)Armenia has made significant progress in improving population health outcomes over the past two decades. However, essential health care for non-communicable diseases (NCDs) is underutilized in part due to the cost of access. Armenia has also committed as a signatory to the Sustainable Development Goals, to making progress towards Universal Health Coverage (UHC). This commitment involves guaranteeing access to essential health care for all its citizens. The Ministry of Health (MoH) has developed a concept note for the introduction for Universal Health Insurance that proposes to mobilize additional revenue through payroll taxes or higher budgetary allocations to the sector. However, the Ministry of Finance (MoF) has noted that revenue mobilization options should ideally demonstrate positive returns in terms of economic growth and employment. Therefore, at the request of the MoH, the World Bank has modeled the macroeconomic impacts of options to increase domestic resource mobilization to finance universal access to essential health services in the basic benefits package. The analysis assumes that through UHC reforms that mobilize additional public spending, the government would cover the cost of ninety-five percent of household needs for health care from 2021 to 2050, and that the increase in the demand for care will be supported by improvements in supply-side efficiency. The results suggest that increasing direct taxes is better than increasing indirect taxes as the former are less distortionary and cause smaller allocative inefficiencies. -
Publication
Reforming the Basic Benefits Package in Armenia: Modeling Insights from the Health Interventions Prioritization Tool
(World Bank, Washington, DC, 2021-03-26)Armenia is an upper-middle-income (UMI) country in the South Caucasus region. The Coronavirus (COVID-19) pandemic and a regional crisis have resulted in the real economy's contraction following rapid growth in the past five years. Improving access to high-quality health care is essential for responding to non-communicable diseases (NCDs) and preventing mortality from infectious diseases in Armenia. Armenia is faced with the challenge of achieving Universal Health Coverage (UHC) when funding for health services faces downward pressures due to a donor funding transition, the Coronavirus (COVID-19) pandemic, and regional conflict. This report is part of the World Bank’s technical support toward universal health coverage in Armenia, which includes advisory services and analytics aimed at supporting the government’s efforts to expand access to high-quality health care. The report draws on the Health Interventions prioritization tool to optimize allocations across essential health services in the basic benefits package and estimate the potential impact of these allocations on population health. -
Publication
Survive, Learn, Thrive: Strategic Human Capital Investments Toward a More Prosperous and Inclusive Armenia
(World Bank, Washington, DC, 2020-09)Human capital – the knowledge, skills, and health that people accumulate over their lives and that enable them to realize their potential as productive members of society – is an important contributor to the wealth of all nations regardless of their income status. A child born in Armenia today will be 57 percent as productive when she grows up as she could be if she received a full education and was completely healthy. This reflects the existence in Armenia of deficiencies in its schooling, student performance on harmonized tests, and the protection from non-fatal health risks that it provides beyond childhood. These gaps in human capital formation have negative implications for the economy. The 2013-2014 National Competitiveness Report of Armenia highlighted that insufficient human capital is a binding constraint to the country’s growth. If Armenia ensured full education and complete health in the long run, the per capita Gross Domestic Product could be 1.75 times higher. -
Publication
Invitations and Incentives for Primary Care Screenings in Armenia
(World Bank, Washington, DC, 2020)Since 2011, the Armenian government has implemented a national performance-based financing scheme which has given financial incentives to providers for screening the population, including for hypertension and diabetes. In addition, there have been investments in training health workers on clinical guidelines and mass media campaigns to increase demand. Personal invitations from family physicians prompted users to consider their need for screening, but attendance also depended on the personal value on one’s health and the perceived health benefits of screening. Global experience indicates that conditional financial incentives can increase preventive health care use by removing resource constraints to adopting healthy behaviors and by helping overcome issues of bounded rationality or willpower. Messaging interventions, including mass media messages and personal invitations, can also increase preventive health care use by reducing obstacles to change, adjusting perceptions of social norms, or associating the desired behavior with valued outcomes.This study estimates the impact of demand-side financial incentives and invitations from a family physician on primary care screening attendance rates and examines potential mechanisms of action. -
Publication
Realizing Armenia's High-Tech Potential
(World Bank, Washington, DC, 2020-01)Armenia's economy is heavily reliant on domestic demand, which is itself driven by remittances that support local construction and consumption. Armenia will need to shift to an export led strategy if it is to move from middle income to high-income status. Because Armenia is a landlocked country with comparatively high trading costs in physical goods, high-tech digital exports will continue to be key to Armenia's growth. This report seeks to identify strategic opportunities for Armenia’s private sector in high-tech global value chains (GVCs) and also highlights reforms that could support Armenia’s evolution. The study builds on the FY18 Armenia Systematic Country Diagnostic, which identifies value-chain development as a core building block for sectoral growth. Although the report is targeted at policy makers in the Armenian government, sectoral development strategies rely heavily on strong private sector engagement and open public-private dialogue. Armenia's tech community may therefore also take interest in this analysis. -
Publication
Early Childhood Development Services in Armenia: Diagnostic Report
(World Bank, Washington, DC, 2019-08-28)This report assesses the key constraints on the supply of (quantity and quality) and demand for early childhood development (ECD) services for pregnant women and children under the age of five in Armenia and puts forth recommendations on how to improve access to ECD services for poor and socially vulnerable families. The government of the Republic of Armenia, with support from the World Bank and other development partners, is currently expanding the existing social work system in Armenia to more actively link vulnerable families to ECD services. A specific objective of the report is to inform the design of this expansion. The World Bank team carried out a survey of ECD services providers in the four marzes of Ararat, Gegharkunik, Lori and Yerevan. The report draws heavily on the findings of this facility survey, the Integrated Living Conditions Survey (ILCS) 2017,3 the Social Snapshot and Poverty in Armenia, the Armenia Demographic and Health Survey (DHS) 2015-16 (NSS 2017), and on other ECD-related studies conducted in Armenia. The report’s assessment and recommendations are also grounded in global evidence on ECD. This evidence highlights the importance to human development of receiving nurturing care in the early years. There is robust evidence that early experiences shape the brain’s structure and functioning, and that deprivations during the prenatal period and early childhood can have substantial negative impacts on later cognitive ability and educational achievement. Early childhood development services that promote nurturing care during this period are cost effective, and programs for disadvantaged children during early childhood have a higher rate of return than programs introduced later in life. Services with proven benefits to ECD include antenatal care, promotion of child nutrition and micronutrient supplementation, parenting education, and preschool education. Global evidence points to specific interventions in each area that have proven impact. -
Publication
Armenia: Better Understanding International Labor Mobility
(World Bank, Washington, DC, 2019-06)Armenia has experienced massive outflows of its people over years. Emigrants’ share of the Armenian population stood at approximately thirty-two percent in 2017, according to migration data from the United Nations (UN). Half of Armenian emigrants reside in Russia. Other key destinations include Azerbaijan, the United States and Ukraine. Recent migration is primarily temporary labor migration, unlike the permanent emigration that occurred in the 1990s. Remittances resulting from migration constitute important support to the welfare of households and the domestic economy. Nevertheless, the effects of remittances and migration on labor markets are not fully understood. As migration is likely to continue, such questions are still timely and relevant. The Russian-Armenian University (RAU) survey data indicate that about as many people would like to migrate as are current first-time migrants. This policy brief aims to explore and address the two questions about migration and its effects on the labor market in Armenia. It uses data from the household migration surveys conducted by the RAU over the three-year period of 2015-2017. The brief describes the general landscape of temporary labor migration and presents relevant policy recommendations. -
Publication
Country Partnership Framework for the Republic of Armenia for the Period FY19-FY23
(World Bank, Washington, DC, 2019-02-28)The country partnership framework (CPF) for FY19-FY23 outlines a program of support to the Government of Armenia’s vision for a just, inclusive, and citizen-centric Armenia. The World Bank Group (WBG) strategy will capitalize on the new momentum for deeper reforms and commitment to good governance brought about by recent political changes in Armenia to support a rebalancing of the economy toward a new growth model. The CPF presents to focus on: (i) boosting export enablers and firm competitiveness; (ii) enhancing human capital and equity; and (iii) sustainably managing environmental and natural resources. The CPF will seek opportunities under each focus area to incorporate key elements of good governance and inclusion: public accountability and transparency, citizen engagement, gender equity, spatial equity, and digital connectivity. The CPF focus areas were informed by extensive stakeholder consultations with the government, development partners, the private sector, and civil society; by the development challenges and opportunities highlighted in the government program and the WBG’s systematic country diagnostic (SCD) for Armenia. -
Publication
Republic of Armenia Leveling the STEM Playing Field for Women: Differences in Opportunity and Outcomes in Fields of Study and the Labor Market
(World Bank, Washington, DC, 2017-05)This report summarizes the challenges facing Armenian women at school and in the workplace with a special focus on STEM-related employment. As the world transitions to an increasingly digital economy, jobs in science, technology, engineering, and mathematics (STEM) will become a powerful driver of economic growth in the twenty-first century. Changes in economic productivity brought through technological innovation require countries to focus on STEM; these high-productivity fields are increasingly in demand in the global economy, and are the key to competitiveness and gross domestic product (GDP) growth.Parity between men and women was one of the major achievements of socialist regimes in Eastern Europe and Central Cultural stereotypes about the types of work women should engage in and their responsibilities at home present the strongest barrier to equality between women and men in Armenia Asia. Although access, enrolment, and achievement rates are gender-equal in Armenia, women and girls tend to self-select out of STEM education tracks and career fields. At the level of education institutions, policy actions can address issues of access, information, biases, and system-wide changes to promote gender neutrality. In the short term, schools can engage teachers and students in discussions about the benefits of STEM fields of study and careers, encourage girls to embrace their interest in math and science, and provide positive role models of women who work in STEM careers. Policy action can help women make the school-to-work transition and promote their career advancement once they are working. At a national level, policy and regulatory actions can address systemic issues of bias, market failure, and information. Even at this level, some quick wins are feasible. The government may consider whether public information campaigns are needed to promote positive aspects of STEM careers to students in middle school and above, such as greater income, flexibility, and status, as well as launch a media campaign to promote and celebrate positive female role models in STEM. STEM sectors are an important source of growth for Armenia given the country’s geography and closed borders. Also, considering Armenia’s adverse demographic trends, lifting women’s participation in key growth potential sectors, including STEM, is increasingly critical. -
Publication
How the Crisis Changed the Pace of Poverty Reduction and Shared Prosperity: Armenia Poverty Assessment
(World Bank, Washington, DC, 2015-06)This report examines Armenia’s experience in reducing poverty and raising the welfare of the least well-off in the country in the years since 2009. What households spend on consumption is an indicator of their welfare. As the economy recovered from crisis, the least well-off enjoyed some growth in consumption spending, but not as much as in the years up to 2009. Moreover, growth has become less pro-poor in relative terms because the less well-off enjoyed lower growth in consumption than the better-off. As a result, although consumption did translate into a reduction in poverty, inequality is now higher than before 2009. In 2013, 32 percent of Armenia’s population lived below the national poverty line, a poverty rate higher than in pre-crisis years but down from the high of 35.8 percent in 2010. In fact, between 2012 and 2013, poverty reduction seems to have stalled. This report looks at the micro and macro aspects of Armenia’s poverty reduction experience to: (a) describe the key features of post-crisis poverty, inequality, and consumption growth; (b) examine the drivers of poverty reduction in this period; and (c) explore reasons why future growth might not be as pro-poor as in the past.