03. Journals
2,963 items available
Permanent URI for this collection
These are journal articles published in World Bank journals as well as externally by World Bank authors.
Sub-collections of this Collection
Items in this collection
1 - 10 of 138
-
Publication
Effectiveness of Fertiliser Policy Reforms to Enhance Food Security in Kenya: A Macro-Microsimulation Analysis
(Taylor and Francis, 2022-02)Food security represents a key challenge in most Sub-Saharan African countries and in Kenya in particular where still a relevant share of the population lives below a minimum dietary energy consumption. Kenya addresses this concern with a noteworthy policy mix, aiming at giving to the agricultural sector a leading task in improving food security. This paper evaluates the impacts on food security of expanding fertilizer capacities in Kenya, combined with a set of additional policy changes targeting fertilizer use. In a top-down analysis, a specific Computable General Equilibrium (CGE) model is linked with a microsimulation approach. Scenarios present overall positive effects on key food security aggregates. The same is true for welfare. Nevertheless, the heterogeneity of households across and within regions suggests that improving input productivity through better market access and service extension are critical to reducing possible discrepancies across farmers, households and regions. The paper concludes on the need for a sound policy mix since increasing fertilizer production alone is not enough to enhance food security evenly. Among accompanying measures, intensifying extension services are essential especially for smallholders in their acquisition of better knowledge on the use of agricultural inputs. -
Publication
How Do Shocks Affect Enrollment in Faith-Based Schools?: Evidence from West Africa
(Taylor and Francis, 2022-01-28)The COVID-19 pandemic has renewed concerns about how shocks may affect religious and other private schools in low-income countries, especially when they do not benefit from state support. By reducing parental incomes, shocks – not only epidemics but also natural disasters and conflicts, reduce overall enrollment in school. But they may also lead to a shift from private to public schools with potentially differentiated effects by type of private school depending on context. In addition, household responses to shocks such as migration may lead to a change in the socio-cultural context in which households live, and these changes may also affect school choice. This paper explores the effects of shocks and migration on school choice in West Africa. Results suggest that shocks and migration lead to a shift from private to public schools, but with differentiated effects by type of private schools. -
Publication
Cereal Prices and Child Undernutrition in Ethiopia
(Taylor and Francis, 2021-07-06)This paper looks at how changing cereal prices affect child undernutrition in Ethiopia. It derives height for age (stunting) and weight for height (wasting) as indicators of child undernutrition from the two most recent years of the Livings Standards Measurement Survey and utilizes market prices for key cereals, teff, wheat, and maize at the enumeration area across all regions of the country. Using a panel data fixed effects model, the analysis finds that, contrary to previous studies, rising cereal prices are positively associated with improved child stunting rates for children between ages 6 months and 5 years. There is no evidence to suggest that cereal prices have a significantly greater impact on height for age for children that come from households who are net sellers of these crops. Cereal prices do not appear to be associated with wasting, which is a shorter-term negative health outcome. -
Publication
Looking into the performance-based financing black box: Evidence from an impact evaluation in the health sector in Cameroon
(Oxford University Press, 2021-07)Performance-based financing (PBF) is a complex health systems intervention aimed at improving the coverage and quality of care. Several studies have shown a positive impact of PBF on health service coverage, often coupled with improvements in quality, but relatively little is known about the mechanisms driving those results. This article presents results of a randomized impact evaluation in Cameroon designed to isolate the role of specific components of the PBF approach with four study groups: (i) PBF with explicit financial incentives linked to results, (ii) direct financing with additional resources available for health providers not linked to performance, (iii) enhanced supervision and monitoring without additional resources and (iv) a control group. Overall, results indicate that, when compared with the pure control group, PBF in Cameroon led to significant increases in utilization for several services (child and maternal vaccinations, use of modern family planning), but not for others like antenatal care visits and facility-based deliveries. In terms of quality, PBF increased the availability of inputs and equipment, qualified health workers, led to a reduction in formal and informal user fees but did not affect the content of care. However, for many positively impacted outcomes, the differences between the PBF group and the group receiving additional financing not linked to performance are not significant, suggesting that additional funding rather than the explicit incentives might be driving improvements. In contrast, the intervention group offering enhanced supervision, coaching and monitoring without additional funding did not experience significant impacts compared to the control group. -
Publication
Assessing Bias in Smartphone Mobility Estimates in Low Income Countries
(Association for Computing Machinery, 2021-06-28)It has become common for governments and practitioners to measure mobility using data from smartphones, especially during the COVID-19 pandemic. Yet in countries where few people have smartphones, or use mobile internet, the movement of smartphones may not be a good indicator of the movement of the population. This paper develops a framework for approaching potential bias that can arise when measuring mobility with smartphones. Using mobile phone operator records in Uganda, we compare the mobility of smartphones and the basic and feature phones that are more common. Smartphones have different travel patterns, and decrease mobility substantially more in response to a COVID-19 lockdown. This suggests caution when interpreting smartphone mobility estimates in contexts with low adoption. -
Publication
Disruptions in Maternal and Child Health Service Utilization during COVID-19: Analysis from Eight Sub-Saharan African Countries
(Oxford University Press, 2021-06-19)The coronavirus-19 pandemic and its secondary effects threaten the continuity of essential health services delivery, which may lead to worsened population health and a protracted public health crisis. We quantify such disruptions, focusing on maternal and child health, in eight sub-Saharan countries. Service volumes are extracted from administrative systems for 63 954 facilities in eight countries: Cameroon, Democratic Republic of Congo, Liberia, Malawi, Mali, Nigeria, Sierra Leone and Somalia. Using an interrupted time series design and an ordinary least squares regression model with facility-level fixed effects, we analyze data from January 2018 to February 2020 to predict what service utilization levels would have been in March–July 2020 in the absence of the pandemic, accounting for both secular trends and seasonality. Estimates of disruption are derived by comparing the predicted and observed service utilization levels during the pandemic period. All countries experienced service disruptions for at least 1 month, but the magnitude and duration of the disruptions vary. Outpatient consultations and child vaccinations were the most commonly affected services and fell by the largest margins. We estimate a cumulative shortfall of 5 149 491 outpatient consultations and 328 961 third-dose pentavalent vaccinations during the 5 months in these eight countries. Decreases in maternal health service utilization are less generalized, although significant declines in institutional deliveries, antenatal care and postnatal care were detected in some countries. There is a need to better understand the factors determining the magnitude and duration of such disruptions in order to design interventions that would respond to the shortfall in care. Service delivery modifications need to be both highly contextualized and integrated as a core component of future epidemic response and planning. -
Publication
Disrupted Service Delivery? The Impact of Conflict on Antenatal Care Quality in Kenya
(Frontiers Media, 2021-02-28)African countries facing conflict have higher levels of maternal mortality. Understanding the gaps in the utilization of high-quality maternal health care is essential to improving maternal survival in these states. Few studies have estimated the impact of conflict on the quality of health care. In this study, we estimated the impact of conflict on the quality of health care in Kenya, a country with multiple overlapping conflicts and significant disparities in maternal survival. Our study demonstrates the importance of designing maternal health policy based on the context-specific evidence on the mechanisms through which conflict affects health care. In Kenya, deterioration of equipment and infrastructure does not appear to be the main mechanism through which conflict has affected ANC quality. Further research should focus on better understanding the determinants of the gaps in process quality in conflict-affected settings, including provider motivation, competence, and incentives. -
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
Opportunities for Improved HIV Prevention and Treatment through Budget Optimization in Eswatini
(PLoS, 2020-07-23)Eswatini achieved a 44% decrease in new HIV infections from 2014 to 2019 through substantial scale-up of testing and treatment. However, it still has one of the highest rates of HIV incidence in the world, with 14 infections per 1,000 adults 15–49 years estimated for 2017. The Government of Eswatini has called for an 85% reduction in new infections by 2023 over 2017 levels. To make further progress towards this target and to achieve maximum health gains, this study aims to model optimized investments of available HIV resources.