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Sex-disaggregating Tax Administrative Data: Experience from Colombia’s Tax and Customs Authority
(Washington, DC: World Bank, 2024-12-06) Gamboa, Luis Fernando; Reyes, Luis Carlos; Tribin, Ana Maria; Komatsu, Hitomi
This Knowledge Note aims to document National Tax and Customs Authority's (DIAN’s) experience in sex-disaggregating income taxpayer data and provide examples of the use of disaggregated data for policy analysis. It offers lessons for other revenue authorities and government agencies planning to sex-disaggregate and analyze administrative tax data. It summarizes the institutional strategies, methodologies used, and challenges encountered in this process based on interviews with experts and government officials. We use the term “sex” to mean biological sex at birth unless explicitly stated otherwise.
Research for Innovation in Health Systems - Improving the Management of Health Care Services for Patients with Multiple Chronic Conditions in Three Latin American Countries: Brazil, Colombia and Uruguay - Key Messages
(Washington, DC: World Bank, 2024-06-24) World Bank
The accelerated aging of the Brazilian population, alongside the gradual increase in the concomitant occurrence of multiple chronic diseases in the same individual, brings important challenges to the Brazilian National Health System (SUS). n Colombia, during 2012 - 2016, multimorbidity had a prevalence of 19.5 percent for all ages, according to data from the study carried out by the World Bank and the Ministry of Health and Social Protection. The investigation also showed an increase in the use and cost of health services associated with older age and the complexity of multimorbidity, in an aging population that shifts its epidemiological profile towards chronic diseases. The expenditure with patients with multimorbidity in Uruguay is high. Persons with five or more of diseases (Cardiovascular Disease, High Blood Pressure, Diabetes, Chronic Obstructive Pulmonary Disease and Degenerative Neurological Disease) represent 8.44 percent of the total patient population, but their care accounts for 42.07 percent of the total expenditure, and 50.48 percent of the expenditure on medications.
Proposal to Optimize the Care Model for People with Chronic Diseases and Multimorbidity in Uruguay
(Washington, DC: World Bank, 2024-06-20) World Bank
The importance of Chronic Disease (CD) in Uruguay has been widely analyzed for many years and in multiple studies and reports 1, 2, 3. Its impact on mortality and its high cost of care was decisive in creating various health promotion and primary and secondary prevention strategies, whose impact has begun to be perceived in the change in trends in some specific areas, such as cardiovascular diseases. However, beyond measures to include specific programs and benefits for CD care and general organization guidelines for health services to satisfy the spontaneous demand generated by CD, there have not been many review initiatives of the care models for CD, especially about the multimorbidity problem, except for the development by the Ministry of Public Health (MPH) of the “Guide to Frailty in Older Adults: Practical Criteria and Research Instruments in The First Level of Care”, an aspect of great clinical relevance about both CD and multimorbidity for human resources and providers of the National Integrated Health System (NIHS). This document presents the work carried out in Uruguay, which culminates with the proposal of the Comprehensive Model of Care for Multimorbidity and includes the study’s results. As such, the authors present the general and specific objectives, the methodology for each of the proposed phases, the results and main contributions to the country and the region, and finally, future projections or possibilities.
The Nerds, the Cool and the Central: Peer Education and Teen Pregnancy in Brazil
(Washington, DC: World Bank, 2024-06-11) World Bank
Teenage pregnancy rates in Brazil are among the highest in Latin America. The current rate of 68.4 per 1,000 adolescents lies well above the world average of 46 per 1,000 and is higher than the Latin American average of 65.5 per 1,000
Towards a More Competitive, Inclusive, and Resilient Agrifood Sector in Argentina
(Washington, DC: World Bank, 2024-04-05) World Bank
Argentina’s agrifood sector drives both prosperity and crisis. While agrifood generates essential foreign currency earnings, tax revenue and employment, the sector’s vulnerability to external shocks can wreak havoc on the larger economy. This agriculture sector review addresses the economic, social, and environmental dimensions of Argentina’s agrifood sector. The economic dimension is vital, due to the influence of agrifood productivity and its growth on Argentina’s macroeconomy. The social, or inclusion, dimension highlights the potential to improve the livelihoods of the rural poor as well as access to affordable food for the urban poor. Finally, the environmental dimension examines the urgent need to increase the resilience of agricultural production systems and support their adaptation to climate change, as well as the agrifood sector’s potential to mitigate climate change and other externalities. This summary report is based on a series of more detailed sectoral background papers and is aimed at public sector policymakers and other key stakeholders, with the goal of identifying potential reforms in public policies and programs and contributing to the development of a new shared vision for the Argentine agrifood sector.
Challenges and Opportunities of the Economic Integration of the Venezuelan Population in the Peruvian Labor Market
(Washington, DC: World Bank, 2024-03-08) World Bank
This study demonstrates that although Venezuelans are more educated relative to Peruvians and most of them have successfully entered the Peruvian labor market, they are mostly employed in low-quality jobs and with a degree of skills mismatch. Most of them are overqualified and have transitioned to more elementary occupations. Furthermore, four out of five Venezuelan workers are employed informally and their returns to higher education are lower than those perceived by Peruvians despite working more hours per week. In addition, we find that they have a significant participation in the digital economy, mainly in delivery platforms, and that two-thirds of Venezuelan workers send remittances abroad. Finally, the report concludes that whether refugees and migrants have the right to work at the level of his or her qualifications and capabilities depends on: (i) the regulatory process to validate their educational degrees, (ii) the migration policy and status, and (iii) the local attitudes towards Venezuelan migration.
The Evolving Geography of Productivity and Employment: Ideas for Inclusive Growth through a Territorial Lens in Latin America and the Caribbean
(Washington, DC: World Bank, 2024-01-25) Ianchovichina, Elena
The Evolving Geography of Productivity and Employment: Ideas for Inclusive Growth through a Territorial Lens in Latin America and the Caribbean employs a territorial lens to understand the persistently low economic growth rates in Latin America and the Caribbean (LAC). Using new data and methods, it shows that deindustrialization, distance, and divisions offer intertwined explanations for an urban productivity paradox in the LAC region: its highly dense cities should be among the world’s most productive, yet they are not. LAC cities have been held back by lack of dynamism, poor connectivity, and divisions into disconnected poor and affluent neighborhoods. Deindustrialization has shifted urban employment, especially in the largest LAC cities, away from manufacturing and toward less dynamic, low-productivity nontradable activities, such as retail trade and personal and other services, that profit less from agglomeration, especially in highly congested cities. Although employment in urban tradable services has risen, the increase has not been strong enough to offset the decline in manufacturing employment. Meanwhile, intercity connectivity issues have undermined the performance of the region’s network of cities by restricting market access and firms’ ability to benefit from specialization in smaller cities. Within cities, poor connectivity and residential labor market segregation have limited the gains from agglomeration to neighborhoods in central business districts where formal firms operate. Informality has persisted in low-income neighborhoods, where residents face multiple deprivations. By contrast, many agricultural and mining areas have benefited from the strong demand for commodities by China and other fast-growing economies, particularly during the Golden Decade (2003–13), leading to a decline in territorial inequality in most countries in the region. The report concludes that to encourage inclusive growth, countries must more efficiently transform natural wealth into human capital, infrastructure, and institutions and improve the competitiveness of the urban economy. It then sketches out the contours of such a development strategy, identifying policy priorities at the national, regional, and local levels.
Dominican Republic Gender Assessment
(Washington, DC, 2024-01-17) World Bank
Achieving inclusive growth and maximizing poverty reduction in the Dominican Republic requires closing existing gender gaps: from early childhood to working age, and further still into old age. Using a lifecycle approach, this gender Assessment attempts to uncover, better understand, and deliver some policy recommendations for the main challenges in this area, with a focus on the three main dimensions of endowments, economic opportunity, and agency.
Oncopediatric Health Service’s Network in Argentina: Background, Capabilities, and Challenges
(Washington, DC: World Bank, 2023-12-09) Maceira, Daniel; Suárez, Patricia; Díaz, María Laura
The development of integrated health service networks is one of the main priorities set by the National Health Ministry of the Argentine Republic (Ministerio de Salud, MINSAL), considering that these networks are an effective strategy to overcome the inefficiencies and inequities that affect the health system. As a result, MINSAL requested the World Bank’s financial support to design and implement a National Fund for High Complexity Diseases (NFHCD) by means of a new loan provided under a Program for Results scheme (PforR). As a first step toward the design of a National Fund for High Complexity Diseases, this paper, based on the study of childhood cancer in Argentina, seeks to investigate the key aspects that should be considered when planning an effective service network for such diseases. The selection of case studies was based on the characteristics of a high-complexity and low-incidence specialty, with a marked specificity in approach strategies. In addition, it is a high-cost network, taking into account the price of treatments, which may involve days, months, or years of hospitalization—and the cost of the drugs required to treat such cases. The evidence collected has allowed us to shed light on the critical pathways patients navigate in the current oncopediatric care structure. First, the family is the one that identifies the child's first symptoms and therefore approaches the health care system. Second, there is a poor understanding that both health care service providers and users have the health network organized by levels of resolution. Another structural challenge is the fragmentation between subsystems, public, social security, and private health insurance companies—resulting in different approaches and qualities of care beyond the health need identified. A strong interplay between national public referral hospitals with patients with different health care coverage schemes could contribute to reducing access gaps.
Poverty and Distributional Impact of Fiscal Policy in Dominican Republic
(Washington, DC, 2023-11-28) World Bank
This report assesses the impact of fiscal policy, both revenue and expenditure, on inequality and poverty in the Dominican Republic. On the revenue side, the analysis focuses on the personal income tax, the value added tax (tax on the transfer of industrialized goods and services, known as ITBIS in the Dominican Republic for its initials in Spanish) and excise taxes on alcoholic beverages, cigarettes, fuel products and telecommunication services. These taxes combined accounted for 7.8 percent of GDP in 2018, equivalent to 60 percent of total tax revenues. On the expenditure side, the analysis focuses on social protection benefits like direct cash and near-cash transfers (e.g., the school food-program and the school uniforms and supplies program), indirect subsidies (energy, water, and public transport), and in-kind benefits on education and health, which together account for 39.2 percent of total government expenditures and 85.9 percent of social expenditures. The remainder of this report is organized as follows: Section II describes the Dominican Republic’s tax systems and government spending in 2018 and compares them with those of selected Latin American countries. Section III includes a description of the data, methodology and assumptions made in carrying out the analysis in this report. The main results are provided in Section IV, starting with fiscal policy’s net impact on inequality, followed by its impact on poverty incidence. A comparison with other countries is then provided. Section IV also includes a detailed analysis of the distributional impact of taxes, social spending, and subsidies, to demonstrate their impact on the welfare of the poor. The report’s main conclusions are presented in Section V.