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Publication
Poverty and Distributional Impact of Fiscal Policy in Dominican Republic
(Washington, DC, 2023-11-28)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. -
Publication
Abordando las brechas de derechos humanos de las personas migrantes y refugiadas venezolanas considerando aspectos de género en el Perú
(Washington, DC: World Bank, 2023-11-03)Las Ollas Comunes son espacios autogestionados, conformados principalmente por mujeres, que han surgido históricamente en países de América Latina para responder a crisis multidimensionales y a las necesidades alimentarias de las personas más vulnerables. Este estudio tiene como objetivo identificar oportunidades de integración social entre mujeres peruanas y mujeres migrantes y refugiadas venezolanas mediante su intervención en las Ollas Comunes de Lima. A través de métodos cualitativos y participativos con enfoque etnográfico, se describe la participación de las mujeres en estos espacios comunitarios, se analizan sus dinámicas y se identifican las brechas de derechos humanos basadas en aspectos de género existentes. Los hallazgos del estudio muestran el potencial que poseen las Ollas Comunes como espacios de integración social; por ejemplo, mediante su contribución en la creación de redes de apoyo. En esa línea, el estudio incluye recomendaciones para incrementar el impacto positivo de las Ollas Comunes en la integración social de mujeres venezolanas refugiadas y migrantes a las comunidades de acogida. -
Publication
Expansion of the Coverage of the Single Digital Health Record (EDUS) in the PHC System in Costa Rica
(World Bank, Washington, DC, 2023-10-24)Costa Rica was one of the first countries in the Latin America and Caribbean region to choose the World Bank Program for Results (PforR) financing instrument to support the implementation of the Strategic Agenda for Strengthening Health Insurance by the Costa Rican Social Security Fund (CCSS), for its name in Spanish, Caja Costarricense de Seguro Social). The PforR’s unique features include using a country’s own institutions and processes and linking disbursement of funds directly to the achievement of specific program results, which helps building capacity within the country, enhances effectiveness and efficiency and leads to achievement of tangible, sustainable program results. The CCSS is the primary provider of health care in the country. The PforR “Strengthening Universal Health Insurance in Costa Rica" was approved by the World Bank's Board of Executive Directors in 2016, with the aim of improving the availability and quality of the universal health insurance system while boosting the institutional efficiency of the CCSS. Through the PforR, the CCSS successfully undertook strategic and complex health sector reforms that have had significant impact on quality of care, equity, and efficiency in Costa Rica’s health sector. This series of knowledge reports, developed by the World Bank in collaboration with the CCSS, aims to document the drivers of success, how challenges were faced, and crucial lessons learned during the design and implementation of the PforR and its associated transformative reforms. The overarching objective is to provide a practical guide for other countries interested in implementing similar programs. -
Publication
Lessons Learned through the Health Program for Results in Costa Rica
(World Bank, Washington, DC, 2023-10-24)Costa Rica was one of the first countries in the Latin America and Caribbean region to choose the World Bank Program for Results (PforR) financing instrument to support the implementation of the Strategic Agenda for Strengthening Health Insurance by the Costa Rican Social Security Fund (CCSS), for its name in Spanish, Caja Costarricense de Seguro Social). The PforR’s unique features include using a country’s own institutions and processes and linking disbursement of funds directly to the achievement of specific program results, which helps building capacity within the country, enhances effectiveness and efficiency and leads to achievement of tangible, sustainable program results. The CCSS is the primary provider of health care in the country. The PforR “Strengthening Universal Health Insurance in Costa Rica" was approved by the World Bank's Board of Executive Directors in 2016, with the aim of improving the availability and quality of the universal health insurance system while boosting the institutional efficiency of the CCSS. Through the PforR, the CCSS successfully undertook strategic and complex health sector reforms that have had significant impact on quality of care, equity, and efficiency in Costa Rica’s health sector. This series of knowledge reports, developed by the World Bank in collaboration with the CCSS, aims to document the drivers of success, how challenges were faced, and crucial lessons learned during the design and implementation of the PforR and its associated transformative reforms. The overarching objective is to provide a practical guide for other countries interested in implementing similar programs. -
Publication
The Integrated Family Record System (SIFF), a Key Tool for Monitoring the Social Determinants of Health in Costa Rica
(World Bank, Washington, DC, 2023-10-24)Costa Rica was one of the first countries in the Latin America and Caribbean region to choose the World Bank Program for Results (PforR) financing instrument to support the implementation of the Strategic Agenda for Strengthening Health Insurance by the Costa Rican Social Security Fund (CCSS), for its name in Spanish, Caja Costarricense de Seguro Social). The PforR’s unique features include using a country’s own institutions and processes and linking disbursement of funds directly to the achievement of specific program results, which helps building capacity within the country, enhances effectiveness and efficiency and leads to achievement of tangible, sustainable program results. The CCSS is the primary provider of health care in the country. The PforR “Strengthening Universal Health Insurance in Costa Rica" was approved by the World Bank's Board of Executive Directors in 2016, with the aim of improving the availability and quality of the universal health insurance system while boosting the institutional efficiency of the CCSS. Through the PforR, the CCSS successfully undertook strategic and complex health sector reforms that have had significant impact on quality of care, equity, and efficiency in Costa Rica’s health sector. This series of knowledge reports, developed by the World Bank in collaboration with the CCSS, aims to document the drivers of success, how challenges were faced, and crucial lessons learned during the design and implementation of the PforR and its associated transformative reforms. The overarching objective is to provide a practical guide for other countries interested in implementing similar programs. -
Publication
Increasing the Number of Major Outpatient Surgeries to Reduce the Waiting List in Costa Rica
(World Bank, Washington, DC, 2023-10-23)Costa Rica was one of the first countries in the Latin America and Caribbean region to choose the World Bank Program for Results (PforR) financing instrument to support the implementation of the Strategic Agenda for Strengthening Health Insurance by the Costa Rican Social Security Fund (CCSS), for its name in Spanish, Caja Costarricense de Seguro Social). The PforR’s unique features include using a country’s own institutions and processes and linking disbursement of funds directly to the achievement of specific program results, which helps building capacity within the country, enhances effectiveness and efficiency and leads to achievement of tangible, sustainable program results. The CCSS is the primary provider of health care in the country. The PforR “Strengthening Universal Health Insurance in Costa Rica" was approved by the World Bank's Board of Executive Directors in 2016, with the aim of improving the availability and quality of the universal health insurance system while boosting the institutional efficiency of the CCSS. Through the PforR, the CCSS successfully undertook strategic and complex health sector reforms that have had significant impact on quality of care, equity, and efficiency in Costa Rica’s health sector. This series of knowledge reports, developed by the World Bank in collaboration with the CCSS, aims to document the drivers of success, how challenges were faced, and crucial lessons learned during the design and implementation of the PforR and its associated transformative reforms. The overarching objective is to provide a practical guide for other countries interested in implementing similar programs. -
Publication
The Use of Satisfaction Surveys to Improve the Delivery of Health Services to the Population in Costa Rica
(World Bank, Washington DC, 2023-10-23)Costa Rica was one of the first countries in the Latin America and Caribbean region to choose the World Bank Program for Results (PforR) financing instrument to support the implementation of the Strategic Agenda for Strengthening Health Insurance by the Costa Rican Social Security Fund (CCSS), for its name in Spanish, Caja Costarricense de Seguro Social). The PforR’s unique features include using a country’s own institutions and processes and linking disbursement of funds directly to the achievement of specific program results, which helps building capacity within the country, enhances effectiveness and efficiency and leads to achievement of tangible, sustainable program results. The CCSS is the primary provider of health care in the country. The PforR “Strengthening Universal Health Insurance in Costa Rica" was approved by the World Bank's Board of Executive Directors in 2016, with the aim of improving the availability and quality of the universal health insurance system while boosting the institutional efficiency of the CCSS. Through the PforR, the CCSS successfully undertook strategic and complex health sector reforms that have had significant impact on quality of care, equity, and efficiency in Costa Rica’s health sector. This series of knowledge reports, developed by the World Bank in collaboration with the CCSS, aims to document the drivers of success, how challenges were faced, and crucial lessons learned during the design and implementation of the PforR and its associated transformative reforms. The overarching objective is to provide a practical guide for other countries interested in implementing similar programs. -
Publication
Latin America and the Caribbean Economic Review, October 2023 - Wired: Digital Connectivity for Inclusion and Growth
(Washington, DC: World Bank, 2023-10-04)Latin America and the Caribbean continues to face adverse global headwinds: high interest rates, modest G-7 growth, soft commodity prices and uncertain prospects in China will all depress growth. Well-grounded policy responses have led to largely recovering employment and income losses from the pandemic and falling rates of inflation. However, the region faces the mutually reinforcing triple challenges of low growth, limited fiscal space, and citizen dissatisfaction. Expanding digital connectivity offers a possibility to make progress on all three fronts. To maximize the social benefits of connectivity as well as to ensure that it does not exacerbate spatial, educational, gender or racial inequalities, three challenges are important to address: first, expanding coverage to the remaining unconnected areas as well as improving the quality of service; second, increasing the productive use of existing infrastructure, and; third, as with any other infrastructure "hardware," investments in "software" - such as digital and traditional skills, managerial capabilities, supportive regulatory frameworks, and deeper financial markets are critical. -
Publication
New Approaches to Closing the Fiscal Gap
(Washington, DC : World Bank, 2022-10-04)As the COVID‐19 crisis recedes, Latin America and the Caribbean (LAC) is back to work and looking forward. Reported deaths related to the pandemic are low and have plausibly converged to global levels. Yet low vaccination rates in some countries leave them vulnerable to new variants. In most countries, gross domestic product (GDP) and employment have fully recovered their 2019 levels, although forecasted growth rates might be said to be “resiliently mediocre”: banking systems appear sound, and rising debt burdens are manageable so far, but growth is not expected to exceed the low levels of the 2010 decade. Poverty in terms of income (monetary poverty) has largely receded with the economic recovery, but the longer‐term scars of the pandemic in terms of education and health have planted deep seeds of future inequality. Redressing these problems and undertaking the structural reforms needed to reach higher levels of growth and reduce poverty remain central on the policy agenda. The new and unwelcome entrant in the policy space is inflation. While comparable to advanced country levels and well managed by regional monetary authorities, inflation nonetheless is being propelled by forces that may give it more staying power than originally hoped. Finally, public deficits induced by the pandemic and the need to finance critical government programs and directions have opened a fiscal gap and led to constrained fiscal space. The need to close the fiscal gap, put debt on a sustainable footing, and generate fiscal space to finance necessary physical and social investments has led to a search for new revenues and in particular to pressure to increase income taxes. In looking at any tax hike, concerns center on the possible depressive effects on growth, overall progressivity, and possible incentives for informality. This report presents new evidence on these effects for value added taxes (VAT) and income taxes. It also advocates for steps to cut wasteful government spending and increase government efficiency - both to generate substantial resources and as an entry point to a broader agenda of state modernization and generating public trust. -
Publication
Opportunities for Reducing Poverty and Inequality in Costa Rica: World Bank Poverty and Inequality Assessment
(Washington, DC: World Bank, 2022-09-01)The purpose of this poverty assessment is to shine a new light on poverty, inequality, and its drivers in Costa Rica. The report provides a descriptive overview of poverty trends in the country and examines why the poorest do not reap the benefits of economic growth. It provides high-level policy directions, i.e., areas that merit a high level of attention according to the results of the analysis and broad implications of the findings for policy makers. The report should be interpreted as a contribution to the debate within Costa Rica on how to improve the country’s model of growth for the benefit of all. It is important to mention at the outset that the analysis presented in this report was completed at the time the conflict in Ukraine started. The conflict is expected to have substantial repercussions in Costa Rica and the rest of the Latin America region. The conflict is expected to hit the poorest hardest, as food and fuel – the prices of which are expected to increase due to the conflict – make up a large part of their consumption. However, these possible implications of the conflict are not reflected in the report.