03. Journals

2,963 items available

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http://hdl.handle.net/10986/2210

These are journal articles published in World Bank journals as well as externally by World Bank authors.

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Estimating the Welfare Costs of Reforming the Iraq Public Distribution System: A Mixed Demand Approach

(Taylor and Francis, 2019-12-06) Krishnan, Nandini ; Olivieri, Sergio ; Ramadan, Racha

Through three decades of conflict, food rations delivered through the public distribution system (PDS) have remained the largest safety net among Iraq’s population. Reforming the PDS continues to be politically challenging, notwithstanding the system’s import dependence, economic distortions, and unsustainable fiscal burden. The oil price decline of mid-2014 and recent efforts to rebuild and recover have put PDS reform back on the agenda. The government needs to find an effective way to deliver broad benefits from a narrow economic base reliant on oil. The study described here adopts a mixed demand approach to analyzing household consumption patterns for the purpose of assessing plausible reform scenarios and estimating the direction and scale of the associated welfare costs and transfers. It finds that household consumption of PDS items is relatively inelastic to changes in price, particularly among the poor. The results suggest that any one-shot reform will have sizeable adverse welfare impacts and will need to be preceded by a well-targeted compensation mechanism. To keep welfare constant, subsidy removal in urban areas, for example, would require the poorest and richest households to be compensated for, respectively, 74 per cent and nearly 40 per cent of their PDS expenditures.
Challenges and Opportunities in the Continuity of Care for Hypertension: A Mixed-Methods Study Embedded in a Primary Health Care Intervention in Tajikistan

(Springer Nature, 2019-12-03) Chukwuma, Adanna ; Gong, Estelle ; Latypova, Mutriba ; Fraser-Hurt, Nicole

Hypertension, a significant risk factor for ischemic heart disease and other chronic conditions, is the third-highest cause of death and disability in Tajikistan. Thus, ensuring the early detection and appropriate management of hypertension is a core element of strategies to improve population health in Tajikistan. For a strategy to be successful, it should be informed by the causes of gaps in service delivery and feasible solutions to these challenges. The objective of this study was to undertake a systematic assessment of hypertension case detection and retention in care within Tajikistan’s primary health care system, and to identify challenges and appropriate solutions. We review the results for the case detection stage of the cascade of care, which had the most significant gaps. Of the half a million people with hypertension in Khatlon and Sogd Oblasts (administrative regions), about 10% have been diagnosed in Khatlon and only 5% in Sogd. Barriers to case detection include misinformation about hypertension, ambiguous protocols, and limited delivery capacity. Solutions identified to these challenges were mobilizing faith-based organizations, scaling up screening through health caravans, task-shifting to increase provider supply, and introducing job aids for providers. Translating findings on discontinuities in care for hypertension and other chronic diseases to actionable policy insights can be facilitated by collaboration with local stakeholders, triangulation of data sources, and identifying the intersection between the feasible and the effective in defining solutions to service delivery challenges.
Quality of Care for Children with Severe Disease in the Democratic Republic of the Congo

(Springer Nature, 2019-12) Clarke-Deelder, Emma ; Shapira, Gil ; Samaha, Hadia ; Fritsche, Gyorgy Bela ; Fink, Gunther

Despite the almost universal adoption of Integrated Management of Childhood Illness (IMCI) guidelines for the diagnosis and treatment of sick children under the age of five in low- and middle-income countries, child mortality remains high in many settings. One possible explanation of the continued high mortality burden is lack of compliance with diagnostic and treatment protocols. We test this hypothesis in a sample of children with severe illness in the Democratic Republic of the Congo (DRC).
The Effects of Health Insurance within Families: Experimental Evidence from Nicaragua

(Published by Oxford University Press on behalf of the World Bank, 2019-10) Fitzpatrick, Anne ; Thornton, Rebecca

This paper measures the causal effects of parent enrollment into voluntary health insurance on healthcare utilization among insured and uninsured children in Nicaragua. The study utilizes a randomized trial and age-eligibility cutoff in which insurance subsidies were randomly allocated to parents that covered their dependent children under 12; children age 12 and older were not eligible for coverage. Among eligible children, the insurance increased utilization at covered providers by 0.56 visits and increased overall utilization by 1.3 visits. Ineligible children with insured parents experienced 1.7 fewer healthcare visits driven by parent, not sibling, enrollment. The results suggest complementarities across healthcare provider type and provide evidence that households reallocate resources across all members in response to changes in healthcare prices for some.
Personality Traits, Technology Adoption, and Technical Efficiency: Evidence from Smallholder Rice Farms in Ghana

(Taylor and Francis, 2019-09) Ali, Daniel Ayalew ; Brown, Derick ; Deininger, Klaus

Although a large literature highlights the impact of personality traits on key labor market outcomes, evidence of their impact on agricultural production decisions remains limited. Data from 1,200 Ghanaian rice farmers suggest that noncognitive skills (polychronicity, work centrality, and optimism) significantly affect simple adoption decisions, returns from adoption, and technical efficiency in rice production, and that the size of the estimated impacts exceeds that of traditional human capital measures. Greater focus on personality traits relative to cognitive skills may help accelerate innovation diffusion in the short term, and help farmers to respond flexibly to new opportunities and risks in the longer term.
The More Stringent, the Better? Rationing Car Use in Bogotá with Moderate and Drastic Restrictions

(Published by Oxford University Press on behalf of the World Bank, 2019-06) Bonilla, Jorge A.

Rationing car use based on license plate number has become a popular policy in several cities around the world to address traffic congestion and air pollution. This paper studies the effects of the moderate and drastic driving restrictions imposed as part of the Pico y Placa program on car use and air pollution in Bogotá. Using data on ambient carbon monoxide, gasoline consumption, and vehicle sales and registrations, no evidence of an improvement in air quality or a reduction in car use is found in either phase of the program. On the contrary, there is some indication that, relative to the moderate phase, gasoline consumption, vehicle ownership, and carbon monoxide in the morning peak tended to increase slightly when drastic restrictions were implemented.
Cash Transfers and Health: Evidence from Tanzania

(Published by Oxford University Press on behalf of the World Bank, 2019-06) Evans, David K. ; Holtemeyer, Brian ; Kosec, Katrina

How do cash transfers conditioned on health clinic visits and school attendance impact health-related outcomes? Examining the 2010 randomized introduction of a program in Tanzania, this paper finds nuanced impacts. An initial surge in clinic visits after 1.5 years—due to more visits by those already complying with program health conditions and by non-compliers—disappeared after 2.5 years, largely due to compliers reducing above-minimal visits. The study finds significant increases in take-up of health insurance and the likelihood of seeking treatment when ill. Health improvements were concentrated among children ages 0–5 years rather than the elderly, and took time to materialize; the study finds no improvements after 1.5 years, but 0.76 fewer sick days per month after 2.5 years, suggesting the importance of looking beyond short-term impacts. Reductions in sick days were largest in villages with more baseline health workers per capita, consistent with improvements being sensitive to capacity constraints. These results are robust to adjustments for multiple hypothesis testing.
The Impact of Monetary Incentives on Referrals by Traditional Birth Attendants for Postnatal Care in Nigeria

(World Bank, Washington, DC, 2019-05-20) Chukwuma, Adanna ; Mbachu, Chinyere ; McConnell, Margaret ; Bossert, Thomas J. ; Cohen, Jessica

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.
Entertainment, Education, and Attitudes Toward Domestic Violence

(American Economic Association, 2019-05) Banerjee, Abhijit ; La Ferrara, Eliana ; Orozco, Victor

We study attitudes towards domestic violence in a sample of young women and men exposed to the edutainment TV series MTV Shuga 3, which features a sub-plot on this theme, and in a sample that was not. We measure viewers' memory of the characters and identification with them. Eight months after the show, male viewers of Shuga report improved attitudes and are 21 percent less likely to justify violence than men in the control group. Attitudes improve among women and men who remember the characters associated with the violence plot, though not among those who identify with the characters.
Health Service Delivery and Political Trust in Nigeria

(Elsevier, 2019-04) Chukwuma, Adanna ; Bossert, Thomas J. ; Croke, Kevin

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.