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Publication
Private Voluntary Health Insurance : Consumer Protection and Prudential Regulation
(Washington, DC: World Bank, 2012-05-14)Health care expenditures can be financed through a mix of public resources and private spending. Private spending is a much larger share of total health spending in low- and middle-income countries than in higher income countries. Moreover, a significant percentage of private spending in those countries is out-of-pocket direct payments for health care services by individuals. Out of pocket expenditures account for more than 60 percent of the total health care spending in low-income countries and 40 percent of total health care spending in middle-income countries. A growing number of low- and middle-income governments are considering private health insurance as a way of both reducing the risk that individuals will have a catastrophic financial burden and achieving other public health care goals. Among these goals are reducing the financial burden on overstretched public health financing, achieving more equitable access to health care, and improving quality and efficiency in the delivery of health care services. An important component of a successful private health insurance market, however, is its legal framework. As discussed in detail later in this book, countries regulate insurance companies to counter systemic market failures that lead to an inefficient and inequitable market. In particular, insurance laws are designed to prevent insurers from becoming insolvent and from engaging in unfair practices and discriminatory behavior. When private health insurance serves as a significant source of financing in a nation's health care system, usually insurance laws also include a range of consumer protection laws that enhance both access to the services covered by private health insurers and the adequacy of the benefits provided by the insurer. This chapter provides a general overview of private health insurance. It begins with a discussion of the definition of private health insurance and the potential roles of private health insurance as part of a nation's health care financing system. In addition, the chapter reviews the variety of entities that sell private health insurance. -
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Nonfinancial Defined Contribution Pension Schemes in a Changing Pension World : Volume 1. Progress, Lessons, and Implementation
(Washington, DC: World Bank, 2012)Pensions and social insurance programs are an integral part of any social protection system. Their dual objectives are to prevent a sharp decline in income and protect against poverty resulting from old age, disability, or death. The critical role of pensions for protection, prevention, and promotion was reiterated and expanded in the new World Bank 2012-2022 social protection strategy. This new strategy reviews the success and challenges of the past decade or more, during which time the World Bank became a main player in the area of pensions. But more importantly, the strategy takes the three key objectives for pensions under the World Bank's conceptual framework coverage, adequacy, and sustainability and asks how these objectives and the inevitable difficult balance between them can best be achieved. The ongoing focus on closing the coverage gap with social pensions and the new outreach to explore the role of matching contributions to address coverage and/or adequacy is part of this strategy. This comprehensive anthology on nonfinancial defined contribution (NDC) pension schemes is part and parcel of the effort to explore and document the working of this new system or reform option and its ability to balance these three key objectives. This innovative, unfunded individual accounts scheme provides a promising option at a time when the world seems locked into a stalemate between piecemeal reform of ailing traditional defined benefit plans or their replacement with prefunded financial account schemes. The current financial crisis, with its focus on sovereign debt, has enhanced the attraction of NDC as a pension scheme that aims for intra and intergenerational fairness, offers a transparent framework to distribute economic and demographic risks, and, if well designed, promises long-term financial stability. Supplemented with a basic minimum pension guarantee, explicit noncontributory rights, and a funded pillar, the NDC approach provides an efficient framework for addressing poverty and risk diversification concerns. -
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Diaspora for Development in Africa
(World Bank, 2011-04-26)The diaspora of developing countries can be a potent force for development for their countries of origin, through remittances, but also, importantly, through promotion of trade, investments, research, innovation, and knowledge and technology transfers. This book brings relevant experience from both developed and developing countries to bear on issues confronting today's governments in linking with their diaspora. The chapters present different approaches used by countries that have tried to maximize the possible gains from migration by engaging more comprehensively with different diaspora groups and individuals. Some African countries are pursuing policies to develop links with Africans abroad, either to encourage them to return or to use their skills, knowledge, or financial capital to foster African development. The book discusses concrete examples of diaspora initiatives that are being implemented in Africa. There are comprehensive reviews on how the diaspora can promote trade and investment linkages. Some developing countries are using dual citizenship to deepen ties with their diaspora. The book directly addresses the issues of remittances-linked financial instruments, investments by the diaspora, diaspora bonds, contributions of skilled and unskilled diaspora in transferring knowledge, analytical research on return migration, and concrete circular migration experiences. There is a need to have a better understanding of these initiatives and to see whether they can be scaled up or replicated in other countries worldwide. -
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Leveraging Migration for Africa : Remittances, Skills, and Investments
(World Bank, 2011-04-26)International migration has profound implications for human welfare, and African governments have had only a limited influence on welfare outcomes, for good or ill. Improved efforts to manage migration will require information on the nature and impact of migratory patterns. This book seeks to contribute toward this goal, by reviewing previous research and providing new analyses (including surveys and case studies) as well as by formulating policy recommendations that can improve the migration experience for migrants, origin countries, and destination countries. The book comprises this introduction and summary and four chapters. Chapter one reviews the data on African migration and considers the challenges African governments face in managing migration. Chapter two discusses the importance of remittances, the most tangible link between migration and development; it also identifies policies that can facilitate remittance flows to Africa and increase their development impact. Chapter three analyzes high-skilled emigration and analyzes policies that can limit adverse implications and maximize positive implications for development. Chapter four considers ways in which Africa can leverage its diaspora resources to increase trade, investment, and access to technology. -
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Migration and Remittances Factbook 2011 : Second Edition
(World Bank, 2011)There are more than 215 million international migrants in the world. Recorded remittances received by developing countries, estimated to be US$325 billion in 2010, far exceed the volume of official aid flows and constitute more than 10 percent of gross domestic product (GDP) in many developing countries. Migration and remittances factbook 2011 provides a comprehensive picture of emigration, skilled emigration, immigration, and remittance flows for 210 countries and 15 country groups, drawing on authoritative, publicly available data. The current edition of the factbook updates the information in the popular 2008 edition with additional data for 71 countries collected from various sources, including national censuses, labor force surveys, population registers, and other national sources. In addition, it provides selected socioeconomic characteristics such as population, labor force, age dependency ratio, gross national income (GNI) per capita, and poverty headcount for each country and regional grouping. More frequent and timely monitoring of migration and remittance trends can provide policy makers, researchers, and the development community with the tools to make informed decisions. The factbook makes an important contribution to this effort by providing the latest available data and facts on migration and remittance trends worldwide in a comprehensive and readily accessible format. -
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Global Marketplace for Private Health Insurance : Strength in Numbers
(Washington, DC: World Bank, 2010)The development challenges of addressing health problems in low- and middle-income countries are daunting but not insurmountable. There are now known and affordable interventions to deal with many aspects of the HIV/AIDS crisis as well as the continued challenge posed by malaria and other major infectious diseases. Three major development objectives of health insurance in low- and middle income countries are highlighted in this volume: securing sustainable financing for health care providers that serve the health needs of vulnerable populations; providing financial protection against the impoverishing cost of illness; and reducing social exclusion from organized health financing and delivery systems. Private health insurance schemes can address the needs of the poor and other vulnerable populations with appropriate combinations of subsidies, risk pooling, household savings, and user charges. The authors of this book argue in favor of a multipillar approach to health care financing in low- and middle-income countries that combines these instruments in addressing the underlying development objectives described above, while putting a strong emphasis on private voluntary health insurance. In this way, private means can make a significant contribution to public ends. -
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Characterizing the HIV/AIDS Epidemic in the Middle East and North Africa : Time for Strategic Action
(World Bank, 2010)Despite a fair amount of progress on understanding human immunodeficiency virus (HIV) epidemiology globally, the Middle East and North Africa (MENA) region is the only region where knowledge of the epidemic continues to be very limited, and subject to much controversy. It has been more than 25 years since the discovery of HIV, but no scientific study has provided a comprehensive data-driven synthesis of HIV/AIDS (acquired immunodeficiency syndrome) infectious spread in this region. The current report provides the first comprehensive scientific assessment and data-driven epidemiological synthesis of HIV spread in MENA since the beginning of the epidemic. It is based on a literature review and analysis of thousands of widely unrecognized publications, reports, and data sources extracted from scientific literature or collected from sources at the local, national, and regional levels. The recommendations provided here focus on key strategies related to the scope of this report and its emphasis on understanding HIV epidemiology in MENA as a whole. The recommendations are based on identifying the status of the HIV epidemic in MENA, through this synthesis, as a low HIV prevalence setting with rising concentrated epidemics among priority populations. General directions for prevention interventions as warranted by the outcome of this synthesis are also discussed briefly, but are not delineated because they are beyond the scope of this report. This report was not intended to provide intervention recommendations for each MENA country. -
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Designing and Implementing Health Care Provider Payment Systems : How-To Manuals
(Washington, DC: World Bank, 2009)This volume grows out of an initiative in the World Bank on resource allocation and purchasing ('RAP'), which started in 2000, and continues to publish articles and books related to strategic purchasing. The initiative emerged from such questions in developing economies as: why do individuals need help in purchasing health services from providers? Is the 'middleman' really necessary? Can people not just buy health services in the same way they would go to the local market to buy bread, milk, or fruit, especially since, throughout most of history that is what most people did? When sick, they contacted local healers directly. Public policy historically was limited largely to protecting the sick against charlatans and was enforced through ethical codes such as the Hippocratic Oath. There was no expensive technology, and most serious conditions led to death. Loss of employment and burial costs were the most expensive parts of illness. With industrialization and the scientific revolution, all this changed. As understanding about the causes, prevention, and treatment of illness expanded, interventions become more complex and expensive. Health care was no longer the exclusive domain of traditional healers. Partly because of the complexities involved, the World Bank's new health, nutrition, and population strategy has noted that 'countries increasingly not only want to know what to do (with health systems) but also how to do it, particularly how to design and manage the transition from current to reformed systems.' This volume is a step in that direction, to help countries design, manage, and implement reforms related to strategic purchasing with an emphasis on changing their provider payment systems. -
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Namibia: Country Brief
(World Bank, 2009)Namibia is a large country in Southern Africa that borders the South Atlantic Ocean, between Angola to the north and South Africa to the south. With a surface area of 824,290 square kilometers, it is similar in size to Mozambique and about half the size of the U.S. state of Alaska. Namibia has a small population of approximately 2.1 million people. It is also one of the least densely populated countries in Sub-Saharan Africa, with an average density of approximately 2.5 people per square kilometer, compared to 34 people per square kilometer for the region as a whole. Namibia was the last colonized country in Sub-Saharan Africa to become independent. After nearly 70 years of South African rule, Namibia gained its independence on March 21, 1990. Until 1990, Namibia's official languages were German, Afrikaans, and English. Following independence, English became the official language, although it is the first language of only a very small percentage of Namibians. Oshiwambo dialects are the mother tongue of approximately half of the population. Namibia, a lower-middle-income country, has one of the highest levels of per capita income in Sub-Saharan Africa. Namibia is one of very few countries in Sub-Saharan Africa that maintains a social safety net for the elderly, the disabled, orphans and vulnerable children, and war veterans. It also has a social security act that provides for maternity leave, sick leave, and medical benefits. Namibia has one of the most productive fishing grounds in the world. The fishing industry is an important source of foreign exchange and a significant employer. The tourism industry in Namibia is similar in size to that in Botswana and is the country's third-largest foreign exchange earner. Namibia is one of the largest producers of gem quality diamonds in the world. It is estimated that 98 percent of its mined diamonds are gem quality. In 2006, almost half of total production was recovered from offshore sources. Namibia is the driest country in Sub-Saharan Africa, with deserts occupying much of the country. It has no perennial rivers or any other permanent water bodies. Due to the low and erratic rainfall and scarce ground and surface water, less than five percent of the country is arable, including through irrigation. Namibia was the first country in the world to incorporate environmental protection into its constitution. Nearly six percent of its land is nationally protected, including large portions of coastal areas within the Namib Desert. -
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Tanzania: Country Brief
(World Bank, 2009)The name Tanzania is a portmanteau of Tanganyika, the mainland, and Zanzibar, the nearby archipelago in the Indian Ocean. The two united to become the United Republic of Tanzania in 1964. With a surface area of 947,300 square kilometers, Tanzania is comparable in size to Nigeria and is slightly more than twice the size of the U.S. state of California. Tanzania's population of approximately 40.4 million (as of 2007) is the second largest in East Africa, after Ethiopia's. Dar es Salaam, the most populous city, contains approximately 2.7 million people and accounts for most commercial activity. Swahili (or Kiswahili) and English are the two official languages of Tanzania. A large number of local languages are also spoken. In Zanzibar, Arabic is commonly used. Agriculture remains the mainstay of Tanzania's economy, accounting for one-quarter of gross domestic product (GDP) and approximately 80 percent of employment. Tanzania is endowed with mineral and natural resources, including gold, diamonds, and several other precious and semiprecious stones. The blue gemstone tanzanite is found only in Tanzania. Tanzania accounted for almost two percent of world gold production as of 2006. Tanzania has a long history of hosting refugee's fleeing civil wars in nearby countries. As of January 2008, there were more than 380,000 refugees living in Tanzania, predominantly from Burundi and the Democratic Republic of Congo. Tanzania is an up-market tourism destination. The country is endowed with a variety of tourism assets, including seven United Nations Educational, Scientific, and Cultural Organization (UNESCO) world heritage sites and numerous wildlife parks, beach resorts, coral reefs, and spectacular scenic mountain views.