C. Journal articles published externally
2,064 items available
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These are journal articles by World Bank authors published externally.
Sub-Saharan Africa
Sub-Saharan Africa, home to more than 1 billion people, half of whom will be under 25 years old by 2050, is a diverse ...
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Publication
Exploring Behavioral Competencies for Effective Medical Practice in Nigeria
(Sage Publications, 2020-12-01)Clinical performance varies due to academic, clinical, and behavioral factors. However, in many countries, selection of medical professionals tends to focus on exclusively academic ability and clinical acumen. Appropriate selection processes for medical professionals should consider behavioral factors, which may vary across contexts. This study was conducted to identify behavioral competencies considered relevant for effective medical practice in Nigeria, by medical students and doctors, and compared with other contexts. This study is one of the few to examine the perspectives of medical students and physicians on behavioral competencies for effective medical practice in an African country. We found differences in the perspectives of medical physicians and students, and in the prioritized competencies across countries. Our study illustrates the need for careful consideration in identifying subject matter experts and in generalizing competencies across contexts. Future research in this field in Nigeria should examine effective ways of testing for key behavioral competencies among medical students and for residency programs. Also, investigating the perspectives of medical faculty and administrators on important competencies, and exploring the generalizability of these competencies across cultures in Nigeria should be considered. -
Publication
Death Registration in Nigeria: A Systematic Literature Review of its Performance and Challenges
(Taylor and Francis, 2020-09-07)Death registration provides an opportunity for the legal documentation of death of persons. Documentation of deaths has several implications including its use in the recovery of inheritance and insurance benefits. It is also an important input for construction of life tables which are crucial for national planning. However, the registration of deaths is poor in several countries including Nigeria. This paper describes the performance of death registration in Nigeria and factors that may affect its performance. We conducted a systematic literature review of death registration completeness in Nigeria to identify, characterize issues as well as challenges associated with realizing completeness in death registration. Only 13.5% of deaths in Nigeria were registered in 2007 which regressed to 10% in 2017. There was no data reported for Nigeria in the World Health Organization database between 2008 and 2017. The country scored less than 0.1 (out of a maximum of 1) on the Vital Statistics Performance Index. There are multiple institutions with parallel constitutional and legal responsibilities for death registration in Nigeria including the National Population Commission, National Identity Management Commission and Local Government Authorities, which may be contributing to its overall poor performance. -
Publication
Predicting Entrepreneurial Success is Hard: Evidence from a Business Plan Competition in Nigeria
(Elsevier, 2019-11)We compare the absolute and relative performance of three approaches to predicting outcomes for entrants in a business plan competition in Nigeria: Business plan scores from judges, simple ad hoc prediction models used by researchers, and machine learning approaches. We find that i) business plan scores from judges are uncorrelated with business survival, employment, sales, or profits three years later; ii) a few key characteristics of entrepreneurs such as gender, age, ability, and business sector do have some predictive power for future outcomes; iii) modern machine learning methods do not offer noticeable improvements; iv) the overall predictive power of all approaches is very low, highlighting the fundamental difficulty of picking competition winners. -
Publication
Education is Forbidden: The Effect of the Boko Haram Conflict on Education in North-East Nigeria
(Elsevier, 2019-11)This paper quantifies the impact of the Boko Haram conflict on various educational outcomes of individuals living in North-East Nigeria during the period 2009–2016. Using individual panel fixed-effects regressions and exploiting over-time and cross-village variation in conflict intensity, we show that conflict reduces school enrollment. The negative effect is larger for children who are no longer of mandatory school age. We do not find differential effects by gender, religion, or type of residential location. Additional results from a difference-in-differences estimation strategy indicate that conflict reduces the years of education completed. -
Publication
The Impact of Monetary Incentives on Referrals by Traditional Birth Attendants for Postnatal Care in Nigeria
(World Bank, Washington, DC, 2019-05-20)Gaps in postnatal care use represent missed opportunities to prevent maternal and neonatal death in sub-Saharan Africa. As one in every three non-facility deliveries in Nigeria is assisted by a traditional birth attendant (TBA), and the TBA’s advice is often adhered to by their clients, engaging TBAs in advocacy among their clients may increase maternal and neonatal postnatal care use. This study estimates the impact of monetary incentives for maternal referrals by TBAs on early maternal and neonatal postnatal care use (within 48 h of delivery) in Nigeria. Overall, 207 TBAs participated in this study: 103 in the treatment group and 104 in the control group. The intervention increased the proportion of maternal clients of TBAs that reported attending postnatal care within 48 h of delivery by 15.4 percentage points [95% confidence interval (CI): 7.9–22.9]. The proportion of neonatal clients of TBAs that reportedly attended postnatal care within 48 h of delivery also increased by 12.6 percentage points [95% CI: 5.9–19.3]. However, providers often did not address the issues that may have led to maternal and newborn postnatal complications during these visits. We show that motivating TBAs using monetary incentives for maternal postnatal care use can increase skilled care use after delivery among their maternal and neonatal clients, who have a higher risk of mortality because of their exposure to unskilled birth attendance. However, improving the quality of care is key to ensuring maternal and neonatal health gains from postnatal care attendance. -
Publication
Health Service Delivery and Political Trust in Nigeria
(Elsevier, 2019-04)Do improvements in health service delivery affect trust in political leaders in Africa? Citizens expect their government to provide social services. Intuitively, improvements in service delivery should lead to higher levels of trust in and support for political leaders. However, in contexts where inadequate services are the norm, and where political support is linked to ethnic or religious affiliation, there may be weak linkages between improvements in service delivery and changes in trust in political leaders. To examine this question empirically, we take advantage of a national intervention that improved health service delivery in 500 primary health care facilities in Nigeria, to estimate the impact of residence within 10 km of one or more of the intervention facilities on trust in the president, local councils, the ruling party, and opposition parties. Using difference-in-difference models, we show that proximity to the intervention led to increases in trust in the president and the ruling party. By contrast, we find no evidence of increased trust in the local council or opposition parties. Our study also examines the role of ethnicity and religious affiliation in mediating the observed increases in trust in the president. While there is a large literature suggesting that both the targeting of interventions, and the response of citizens to interventions is often mediated by ethnic, geographic or religious identity, by contrast, we find no evidence that the intervention was targeted at the president's ethnic group, zone, or state of origin. Moreover, there is suggestive evidence that the intervention increased trust in the president more among those who did not share these markers of identity with the president. This highlights the possibility that broad-based efforts to improve health services can increase trust in political leaders even in settings where political attitudes are often thought to be mediated by group identity. -
Publication
Armed Conflict and Maternal Health Care Utilization: Evidence from the Boko Haram Insurgency in Nigeria
(Elsevier, 2019-04)Retention in maternal health care is essential to decreasing preventable mortality. By reducing access to care, armed conflicts such as the Boko Haram Insurgency (BHI), contribute to the high maternal mortality rates in Nigeria. While there is a rich literature describing the mechanisms through which conflict affects health care access, studies that estimate the impact of conflict on maternal health care use are sparse and report mixed findings. In this study, we examine the impact of the BHI on maternal care access in Nigeria. We spatially match 52,675 birth records from the Nigeria Demographic and Health Survey (NDHS) with attack locations in the Armed Conflict Location and Event Dataset (ACLED). We define BH conflict area as NDHS clusters with at least five attacks within 3000, 5000 and 10,000 m of BH activity during the study period and employ difference-in-differences methods to examine the effect of the BHI on antenatal care visits, delivery at the health center and delivery by a skilled professional. We find that the BHI reduced the probability of any antenatal care visits, delivery at a health center, and delivery by a skilled health professional. The negative effects of the BHI on maternal health care access extended beyond the Northeastern region, that is the current focus of humanitarian programs. Systematic efforts to identify and address the mechanisms underlying reductions in maternal health care use due to the BHI, and to target the affected populations, are essential to improving maternal health in Nigeria. -
Publication
Vulnerability to Stunting in the West African Sahel
(Elsevier, 2019-02)This paper presents a simple simulation framework for understanding and analyzing vulnerability to stunting. We utilize Demographic and Health Surveys merged with satellite data on climatic shocks. Children aged 0–5 years are grouped into three categories: consistently stunted, vulnerable, and non-vulnerable. The first group constitutes those who are stunted and will also be stunted in any hypothetical period. Non-vulnerable are those whose likelihood to be stunted is zero. The vulnerable face a probability between 0 and 1 of being stunted. The probability is calculated as the share of years in which the child would be stunted, given the village level distribution of weather shocks over the period 2000–2013. We provide estimates of vulnerability to stunting in Burkina Faso, Northern Ghana, Mali, Northern Nigeria, and Senegal by aggregating over villages, districts and countries. -
Publication
The Child Health Effects of Terrorism: Evidence from the Boko Haram Insurgency in Nigeria
(Taylor and Francis, 2018-08-25)This study examines the effect of terrorism on height-for-age z-scores, weight-for-age z-scores, weight-for-height z-scores, stunting, and wasting. Using the Boko Haram Insurgency, it compares outcomes in Boko Haram high-active and low-active areas. A difference-in-difference and regression model identifies the extensive and intensive margin effects respectively. The study uses data from the Nigeria Demographic and Health Survey and the Global Terrorism Database. The results suggest that the Boko Haram Insurgency reduces weight-for-age and weight-for-height z-scores and increases the probability of wasting. The evidence suggests that policies targeting healthcare services may mitigate the long-term impacts of the Boko Haram Insurgency on human capital production. -
Publication
Antenatal Care Satisfaction in a Developing Country: A Cross-Sectional Study from Nigeria
(Springer, 2018-03-20)Utilization of Antenatal Care (ANC) is very low in Nigeria. Self-reported patient satisfaction may be useful to identify provider- and facility-specific factors that can be improved to increase ANC satisfaction and utilization. Exit interview data collected from ANC users and facility assessment survey data from 534 systematically selected facilities in four northern Nigerian states were used. Associations between patient satisfaction (satisfied, not-satisfied) and patient ratings of the provider’s interactions, care processes, out-of-pocket costs, and quality of facility infrastructure were studied.