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Publication
Private Sector Engagement for Tuberculosis Elimination: India’s Journey from Pilots to National Scale-Up (2012–2021)
(Washington DC, 2023-03-30) World BankTuberculosis (TB) is a leading cause of illness and death worldwide. India accounts for 26 percent of the world’s TB burden; hence, the significance of India’s role in achieving the global elimination of TB cannot be overstated. India has a mixed health care system comprising a vertical program-oriented public health care system and a fragmented private health care system, which drives out-of-pocket expenditures by households. Approximately 80 percent of TB patients start their diagnostic and treatment journey in the private sector, and nearly 50 percent continue their treatment there. Thus, private sector engagement (PSE) is an essential intervention for the Indian context. PSE is an important pathway for the government of India to achieve national TB targets. Since the mid-1990s, the National Tuberculosis Elimination Program (NTEP) has been implementing various PSE activities, in some cases with support from development partners. Most early PSE projects and interventions yielded poor-to-mixed results and did not impact the quality of private sector care. From 2012, NTEP began to scale up innovative approaches with support from development partners. Encouraging results from the pilots were instrumental in convincing policy makers and program managers to transition and integrate financing for newer PSE models into India’s domestic budgets. The program has successfully transitioned and institutionalized various PSE models. This working paper examines and documents early experiences and lessons from India’s TB PSE journey. While it is still too early to evaluate the impact of the transition, the story of how India transitioned from pilots to national scale-up holds lessons for other health programs and countries with similar TB burdens. -
Publication
Doing Business in the European Union 2021: Austria, Belgium and the Netherlands (with focus on the Netherlands)
(Washington DC, 2023-03-23) World BankDoing Business provides objective measures of business regulations and their enforcement across one hundred ninety-one economies. It is founded on the principle that economic activity benefits from clear rules: rules that allow voluntary exchanges between economic actors, set out strong property rights, facilitate the resolution of commercial disputes, and provide contractual partners with protections against arbitrariness and abuse. This report highlights divergences in regulatory performance including in the implementation of the regulatory framework at the local level among ten Dutch cities. It analyzes the regulatory hurdles faced by entrepreneurs and suggests ways to make it easier to do business across the five areas benchmarked by providing good practice examples from the Netherlands and other EU member states. -
Publication
Nature-Based Solutions for Climate Resilience in the World Bank Portfolio
(Washington DC, 2023-03-21) World BankCountries are facing increasingly complex climate-related challenges, which undermine resilience and require integrated and innovative solutions. Nature-based solutions (NBS) have emerged as cost-effective alternatives to conventional gray infrastructure, delivering greater resilience in the longer term and providing a host of additional benefits. NBSs are defined as actions to protect, conserve, restore, sustainably use and manage natural or modified terrestrial, freshwater, coastal and marine ecosystems, which address social, economic and environmental challenges effectively and adaptively, while simultaneously providing human well-being, ecosystem services and resilience and biodiversity benefits. NBSs that are used with the explicit objective of reducing climate and disaster risks are called NBS for climate resilience. Related terms could include eco-DRR (disaster risk reduction), NBS for disaster risk management, or ecosystem-based adaptation. However, NBSs for climate resilience also provide other benefits such as provision of food or drinking water or opportunities for recreation and climate regulation. NBSs for climate resilience are applied across different geographies. As GPNBS scales-up its effort to provide targeted support to World Bank task teams and clients, monitoring and tracking the NBS footprint in the World Bank’s portfolio will remain a key tool. This paper aims to inform World Bank and GFDRR leadership, donors, clients, and the global community on the World Bank’s progress in mainstreaming NBS for climate resilience, and to inform decisions on targeting capacity building efforts and technical support to operations. -
Publication
Personal Income Tax Piggybacking
(World Bank, Washington, DC, 2023-03-17) Chattha, Muhammad Khudadad ; Blum, Jürgen René ; Kelly, RoyPersonal income tax (PIT) piggybacking is a local surcharge levied by Subnational government (SNGs) on top of the taxable personal income or on the personal income tax liability already being levied by the central government. In contrast to tax sharing arrangements, piggybacking provides more SNG autonomy since the SNG is granted the power to set and levy the piggybacking rate, typically within certain bounds established by the central government, thereby strengthening the accountability between SNGs and their residents. Different versions of PIT piggybacking have been implemented largely in high-income countries, including Denmark, Norway, US, Canada, Spain, and Portugal. Croatia, a middle-income country, has adopted a PIT piggybacking system. While PIT piggybacking is an important source of SNG revenue in these countries, if Indonesia were to adopt a PIT piggyback, it would be one of the first few major middle-income countries to do so. -
Publication
Stocktaking of Adaptive Social Protection and Disaster Risk Management
(Washington DC, 2023-03-13) World BankIn today’s global environment, countries face various shocks, such as natural hazards, economic and health crises, conflict, violence, and forced displacement. Disasters triggered by natural hazards cause billions of dollars in damage per year, and these disasters, and their costs, are increasing because of population growth, rapid and unplanned urbanization, low quality infrastructure, and ineffective disaster risk governance. Climate change is expected to increase the frequency and intensity of hydro meteorological natural hazards, exacerbating disaster damages and losses and disproportionately affecting low-income countries. The objectives of this note are to provide a brief overview of the ASP concept and framework, outline synergies between ASP and disaster risk management (DRM) to build resilience to disaster and climate shocks and highlight current practices that take advantage of synergies between SP and DRM to develop and implement components for effective ASP systems. The note is based on a review of the GFDRR’s portfolio of grants supporting DRM and SP activities. The case studies highlight the operational experiences of World Bank–financed projects that have benefitted from GFDRR grants to contribute to risk-informed ASP. These experiences are expected to help DRM and SP practitioners and policy makers initiate discussions and design ASP programs that increase disaster resilience. -
Publication
Wage Bill and Employment Diagnostic: Key Drivers and Policy Recommendations
(Washington, DC: World Bank, 2022-12-15) World BankThe Palestinian Authority’s (PA) spending on the public sector wage bill has increased significantly over the years, despite reform efforts, and is higher than wage spending in all comparator countries. Based on this report’s findings, the main driver of wage bill growth for the PA has been the increase in salaries of public employees, through the channel of allowances, rather than growth in employment itself. Notably, the ministries of health and education represent the largest share of wage bill spending and they have also seen the largest salary increases over time, most of which have been in the form of allowances. In terms of territorial distribution, the West Bank has been responsible for a larger share of wage bill growth compared to Gaza. If the PA does not address the core drivers of wage spending, its wage bill is likely to become even more fiscally unaffordable. World Bank simulations show that reforms that are based on a hybrid approach and that address both employment and wage growth can result in better outcomes as they can deliver significant fiscal savings for the PA. This report has focused mainly on key drivers of wage bill and employment growth across the public sector and has provided related recommendations. However, the team acknowledges that the PA is rightly trying to grapple with issues surrounding furloughed employees in Gaza specifically. Further analysis would need to be carried out on this issue. The World Bank team stands ready to provide further support in this area as well as on all issues described in earlier sections of this report. -
Publication
Understanding Migration in North Central America Countries: El Salvador, Guatemala, Honduras, and Nicaragua
(Washington, DC: World Bank, 2022-12-13) World BankThis report explores different aspects of migration flows from North Central America countries, specifically from El Salvador, Guatemala, Honduras, and Nicaragua. It provides an in-depth socioeconomic characterization of migrant households (those with a migrant household member) in these four countries, using the latest available data at the household level. Moreover, it provides a profile of migrants themselves, both as reported by their household members in their country of origin and by themselves in the United States - the main destination for North Central American migrants, except for Nicaraguans. In addition, the report explores some of the main factors behind the decision to migrate (referred as push and pull factors). The report examines three push factors that have been traditionally linked to migration flows in the region: (i) limited economic opportunities and low living standards; (ii) natural hazards, usually linked to climate change; and (iii) violence. Finally, it explores some of the pull factors that seem to attract migrants from these countries to the United States, including labor market outcomes and access to services. This analysis of who migrates and why can help inform policies and programs at the national, bilateral, and regional level. In turn, this can assist in maximizing the net benefits of migration, helping migrants as well as their respective countries of origin and destination. -
Publication
Fragility, Conflict, and Violence in Middle-Income Countries
(Washington, DC: World Bank, 2022-12) World BankFragility, conflict, and violence (FCV) in middle-income countries is one of today’s major development challenges. It is commonly assumed that low-income countries are more prone to FCV than middle-income ones. Yet over the past decade, more people have been killed from political violence and homicides in middle-income countries than low-income ones. This report outlines the extent of the issue, mapping patterns of violence and conflict in middle-income countries. Drawing on a series of case studies, it looks at how the World Bank has worked on FCV in middle-income countries, what the challenges have been, and what has worked. It puts forward ideas on how the World Bank and other development actors can work more effectively on FCV in middle-income countries. -
Publication
An Overview of World Bank Group Digital Governance and GovTech Projects
(Washington, DC, 2022-12) World BankThe World Bank Group (WBG) has been financing digital governance (DG) solutions for decades. The construction of the GovTech Maturity Index (GTMI) is based primarily on the WB’s GovTech dataset, which is publicly available through the WBG data catalog. As a part of the 2022 update, the database includes the mapping of investments already presented in seven categories into four GovTech focus areas together with the costs, durations, and outcomes ratings of completed activities to complement key project data extracted from the WBG operations portal. This brief presents an overview of the DG and GovTech investments that support various sector reforms based on the latest extended version of the database so as to assist practitioners in the design of new digital transformation projects. The database and this brief can also help WBG staff involved in digital transformation initiatives when it comes to learning more about relevant investments, reviewing project documents - such as project appraisal documents, Implementation Completion and Results Reports, and Independent Evaluation Group review - and expanding and customizing the dataset for various needs such as operational support, project design, research, monitoring and quality assurance, and training. The database is expected to be updated annually depending on the availability of resources. -
Publication
Adapting to Natural Disasters in Africa: What’s in it for the Private Sector?
(Washington, DC, 2022-11) Bari, Mounir ; Dessus, SébastienThe private sector has an indispensable role to play in advancing climate adaptation and resilience building. The need for private sector solutions to address climate change impacts is even more pronounced in Africa given its sizable needs for adaptation and the limited fiscal space of most African states to adapt and build resilience to climate and disaster risks. However, mobilizing private investment in adaptation is made complicated by the difficulty for firms of measuring and internalizing the opportunity cost of no adaptation, and by limited practical knowledge on the bankability and cost-effectiveness of adaptation solutions. This paper tries to fill some of these knowledge gaps, first by assessing the economic costs of floods and droughts – the two most economically and socially damaging natural disasters in Africa; and second by measuring the upfront private investments needed in each African country to offset the losses induced by these disasters, assuming that such investments would generate a sufficient economic return. Using the traditional dynamic Solow model, we estimate the potential for private investment in adaptation to natural disasters in Africa by estimating the short- and long-term impact of floods and droughts on per capita GDP growth. As opposed to the more commonly used approaches of estimating the impact of natural disasters on productive assets, our methodology is very practical as it focuses on economic flows rather than stocks, is not data demanding, and does not require complex economic or environmental modelling, and can thus easily be applied on a large number of African countries to estimate the private investment potential in adapting to floods and droughts. Our empirical results suggest that the private sector could have an interest in investing up to about hundred billion cumulatively over the next twenty years, or five billion per year, to adapt to the current frequency and severity of floods and droughts in Africa. As such, our estimate corresponds to only a small fraction of what is projected by more traditional estimates which include public good requirements, cover a broader set of natural disasters and climate stressors, may project increases in the severity of natural disasters, and retain sometimes higher ambition than just to offset consequences of natural disasters. Nevertheless, our estimate is significant and well above current levels, especially in African countries most prone to floods and droughts.