03. Journals
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These are journal articles published in World Bank journals as well as externally by World Bank authors.
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Publication
Six Sigma to Reduce Claims Processing Errors in a Healthcare Payer Firm
(Taylor and Francis, 2020-06)As a continuous improvement practice, Six Sigma has been accepted globally across the service industry. In the past one decade, the application and success of Six Sigma in healthcare services has been remarkable. Despite the fact that several papers on Six Sigma have appeared in the erstwhile literature related to healthcare operations, there is a dearth of field studies highlighting the application of Six Sigma in healthcare outsourced firms, in specific to healthcare payers that engage in a non-clinical setup. The aim of this paper is to explore the role of Six Sigma within the healthcare payer outsourced firms, where error-free delivery becomes critical. The article contributes to the literature of Six Sigma in healthcare outsourcing highlighting how “Six Sigma as a methodology” could help reduce claims adjudication errors in a healthcare payer firm. The Six Sigma DMAIC project case study presented as part of the paper delivered a saving of USD 0.53 million and is a classic example of how Six Sigma can bring bottom-line impact to healthcare outsourced organizations. Managerial implications and lessons learned are discussed alongside the concluding notes. -
Publication
Flies without Borders: Lessons from Chennai on Improving India's Municipal Public Health Services
(Taylor and Francis, 2020-05)India’s cities face key challenges to improving public health outcomes. First, unequally distributed public resources create insanitary conditions, especially in slums – threatening everyone’s health, as suggested by poor child growth even among the wealthiest. Second, devolving services to elected bodies works poorly for highly technical services like public health. Third, services are highly fragmented. This paper examines the differences in the organisation and management of municipal services in Chennai and Delhi, two cities with sharply contrasting health indicators. Chennai mitigates these challenges by retaining professional management of service delivery and actively serving vulnerable populations − while services in Delhi are quite constrained. Management and institutional issues have received inadequate attention in the public health literature on developing countries, and the policy lessons from Chennai have wide relevance. -
Publication
Variations in the Quality of Tuberculosis Care in Urban India: A Cross-Sectional, Standardized Patient Study in Two Cities
(PLoS, 2018-09-25)India has the highest burden of tuberculosis (TB). Although most patients with TB in India seek care from the private sector, there is limited evidence on quality of TB care or its correlates. Following our validation study on the standardized patient (SP) method for TB, we utilized SPs to examine quality of adult TB care among health providers with different qualifications in 2 Indian cities. -
Publication
Quality of Tuberculosis Care by Indian Pharmacies: Mystery Clients Offer New Insights
(Elsevier, 2018-01)For many patients in India, pharmacies are their first point of contact, where most drugs, including antibiotics, can be purchased over-the-counter (OTC). Recent standardized (simulated) patient studies, covering four Indian cities, provide new insights on how Indian pharmacies manage patients with suspected or known tuberculosis. Correct management of the simulated patients ranged from 13% to 62%, increasing with the certainty of the TB diagnosis. Antibiotics were frequently dispensed OTC to patients, with 16% to 37% receiving such drugs across the cases. On a positive note, these studies showed that no pharmacy dispensed first-line anti-TB drugs. Engagement of pharmacies is important to not only improve TB detection and care, but also limit the abuse of antibiotics. -
Publication
Designing for Sustainable Outcomes: Espousing Behavioural Change into Co-production Programs
(Taylor and Francis, 2017-10-12)This paper uses a policy design perspective with which to examine the formulation of programs that are based on the concept of co-production. In doing so, the paper reviews essential literature on policy design and co-production to identify that a limited focus on outcomes and specifically how behavioral change can make these outcomes sustainable represents a major gap in the current discussion of co-production. We firstly argue that in designing programs involving co-production, outcomes need to be considered at the initial design stages where broad policy objectives are being defined. Secondly, we argue that for these outcomes to be sustainable, behavioral change on the part of policy targets needs to be an important objective of a co-production program. To illustrate our point, we use the example of rural sanitation programs from three developing countries to specifically demonstrate how the absence or inclusion of behavioral change considerations in the early phases of policy design can elicit different levels of success in achieving desired policy outcomes. -
Publication
Seeing Indian, Being Indian: Diaspora, Identity, and Ethnic Media
(Taylor and Francis, 2017-06-19)Grounded in the uses and gratifications theoretical framework, cultural proximity and social identity theories, researchers uncovered specific themes emerging from viewers of Indian television programming. The immigrant viewers actively chose ethnic programming, specifically Indian television available via the satellite dish, to feel a sense of gratification. That gratification came in the form of reinforcing their ethnic identity. One hundred Asian Indian immigrants from five major metropolitan U.S. cities (New York, Washington, DC, San Francisco, Chicago, and Houston) were interviewed. These participants had an average age of 68 and an average family income of $150,000. In spite of the fact that they have resided in the United States for 40–50 years, they still felt attracted to Indian programming, as it allowed them to stay informed about India and feel connected to their cultural roots. -
Publication
Does Child Sponsorship Pay off in Adulthood?: An International Study of Impacts on Income and Wealth
(Published by Oxford University Press on behalf of the World Bank, 2017-06-01)We estimate the impact of international child sponsorship on adult income and wealth of formerly sponsored children using data on 10,144 individuals in six countries. To identify causal effects, we utilize an age-eligibility rule followed from 1980 to 1992 that limited sponsorship to children twelve years old or younger when the program was introduced in a village, allowing comparisons of sponsored children with older siblings who were slightly too old to be sponsored. Estimations indicate that international child sponsorship increased monthly income by $13–17 over an untreated baseline of $75, principally from inducing higher future labor market participation. We find evidence for positive impacts on dwelling quality in adulthood and modest evidence of impacts on ownership of consumer durables in adulthood, limited to increased ownership of mobile phones. Finally, our results also show modest effects of child sponsorship on childbearing in adulthood. -
Publication
Long-term Gains from Electrification in Rural India
(Published by Oxford University Press on behalf of the World Bank, 2017-06-01)We know surprisingly little about the long-run impacts of household electrification. This paper studies the impacts on consumption in rural India over a 17-year period, allowing for both internal and external (village-level) effects. Under our identifying assumptions, electrification brought significant consumption gains for households who acquired electricity for their own use. We also find evidence of a dynamic effect of village connectivity for households without electricity themselves. This is suggestive of an external effect, which also comes with a shift in consumption spending suggestive of status concerns among those still without electricity. Labor earnings were an important channel of impact. This was mainly through extra work by men. There was no effect on average wage rates. -
Publication
The Effect of Metro Expansions on Air Pollution in Delhi
(Published by Oxford University Press on behalf of the World Bank, 2017-02)The Delhi Metro (DM) is a mass rapid transit system serving the National Capital Region of India. It is also the world's first rail project to earn carbon credits under the Clean Development Mechanism of the United Nations for reductions in CO2 emissions. We analyze whether the DM led to localized reduction in three transportation source pollutants. Looking at the period 2004–2006, one of the larger rail extensions of the DM led to a 34 percent reduction in localized CO at a major traffic intersection in the city. Results for NO2 are also suggestive of a decline, while those for PM2.5 are inconclusive due to missing data. These impacts of pollutant reductions are for the short run. A complete accounting of all long run costs and benefits should be done before building capital intensive metro rail projects. -
Publication
Use of Standardised Patients to Assess Antibiotic Dispensing for Tuberculosis by Pharmacies in Urban India: A Cross-Sectional Study
(Elsevier, 2016-11)India's total antibiotic use is the highest of any country. Patients often receive prescription-only drugs directly from pharmacies. Here we aimed to assess the medical advice and drug dispensing practices of pharmacies for standardized patients with presumed and confirmed tuberculosis in India. In this cross-sectional study in the three Indian cities Delhi, Mumbai, and Patna, we developed two standardized patient cases: first, a patient presenting with 2–3 weeks of pulmonary tuberculosis symptoms (Case 1); and second, a patient with microbiologically confirmed pulmonary tuberculosis (Case 2).