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
How much does reducing inequality matter for global poverty?
(Springer Nature, 2022-03-02)The goals of ending extreme poverty by 2030 and working towards a more equal distribution of incomes are part of the United Nations’ Sustainable Development Goals. Using data from 166 countries comprising 97.5 percent of the world’s population, we simulate scenarios for global poverty from 2019 to 2030 under various assumptions about growth and inequality. We use different assumptions about growth incidence curves to model changes in inequality and rely on a machine-learning algorithm called model-based recursive partitioning to model how growth in GDP is passed through to growth as observed in household surveys. When holding within-country inequality unchanged and letting GDP per capita grow according to World Bank forecasts and historically observed growth rates, our simulations suggest that the number of extreme poor (living on less than 1.90 dollars/day) will remain above 600 million in 2030, resulting in a global extreme poverty rate of 7.4 percent. If the Gini index in each country decreases by 1 percent per year, the global poverty rate could reduce to around 6.3 percent in 2030, equivalent to 89 million fewer people living in extreme poverty. Reducing each country’s Gini index by 1 percent per year has a larger impact on global poverty than increasing each country’s annual growth 1 percentage point above forecasts. We also study the impact of COVID-19 on poverty and find that the pandemic may have driven around 60 million people into extreme poverty in 2020. If the pandemic increased the Gini index by 2 percent in all countries, then more than 90 million may have been driven into extreme poverty in 2020. -
Publication
Inequality in the Quality of Health Services: Wealth, Content of Care, and the Price of Antenatal Consultations in the Democratic Republic of Congo
(The University of Chicago Press, 2022-02-14)We use unique data on direct observations of patient-provider interactions linked to detailed patient exit interviews and household surveys to study the relationship between patients’ socioeconomic status and the quality of antenatal care in the Democratic Republic of Congo. We find a significant wealth-quality gradient: a 1 standard deviation in household wealth is associated with a 1.6–3.2 percentage point increase in protocol compliance, depending on the data source and the definition of the compliance index. A large part of the overall wealth-quality gradient is driven by generally lower facility quality in poorer areas. However, we also find a statistically significant within-village wealth-quality relationship that is primarily driven by wealthier women seeking care at higher-quality facilities even if they are more distant. Finally, we find some evidence that even within the same facilities, poorer women tend to receive worse care but, on average, also pay less for care of a given quality. -
Publication
An Individual-Based Index of Multidimensional Poverty for Low- and Middle-Income Countries
(Taylor and Francis, 2021-08-27)This paper proposes a new index of multidimensional poverty, called the Global Correlation Sensitive Poverty Index (G-CSPI), which has three interesting features. First, it encompasses three dimensions: decent work, education and access to drinking water and sanitation, which largely overlap with the list of ideal dimensions obtained by expanding the Constitutional Approach, although it does not include direct health measures. Second, it uses a distribution-sensitive measure that can also be decomposed into the three poverty components: incidence, intensity and inequality. Finally, the G-CSPI is an individual-based, rather than household-based index, although restricted to individuals 15–65 years of age. It is thus able to detect intra-household differences in poverty among members within that age-range. To have a full picture of multidimensional poverty at the country level, it should then be complemented by specific poverty measures for children and the elderly. Being centered on individuals and sensitive to inequality, the G-CSPI is coherent with the overarching principle of the 2030 Agenda “leaving no one behind”. Using recent estimates of the G-CSPI for 104 countries, the empirical analysis reveals that the index is highly robust to different specifications, and that, as expected, fragile countries experience the largest levels of poverty. -
Publication
We Forgot the Middle Class! Inequality Underestimation in a Changing Sub-Saharan Africa
(Springer Nature, 2020-01-11)The creation of national middle classes and the changes in consumption patterns in many Sub-Saharan African (SSA) countries suggest reconsidering the way welfare and consequently inequality is typically measured. Using only consumption to measure welfare can lead to an important loss of information regarding the real welfare of the top 10–20% of the welfare distribution that is generally referred as “middle class” in these countries. This paper proposes a method capable of correcting the middle-class part of the consumption distribution using information coming from the income distribution of the same surveys. Results from 6 SSA countries indicate an increase of about 20% in the Gini index. -
Publication
Myriad of Health Care Financing Reforms in Zambia: Have the Poor Benefited?
(Taylor and Francis, 2018-11-05)Zambia has implemented a number of financing and organizational reforms since the 1990s aimed at increasing efficiency, enhancing equity, and improving health outcomes. This study reviews the distributional impact of these health reforms on enhancing equity at the regional level and for different socioeconomic groups. Data from three nationally representative household surveys were collected, and a benefit incidence analysis was conducted to determine the distributional impact over the period 2010–2015. The results show that distribution of subsidies and utilization of outpatient services at public health facilities in Zambia has consistently been in favor of urban provinces. Further, distribution of health subsidies across the ten provinces in Zambia does not correspond to reported illnesses in each province. The study also shows that utilization of outpatient services at public (hospitals and health centers) and private health facilities is generally in favor of the rich, and utilization of both inpatient and outpatient services at public and private health facilities benefits the rich more than the poor. And although the results show a pro-poor redistribution of benefits across income groups in 2015 compared to 2010 whereby the poorest two income groups received more than a 20% share of benefits in each quintile, the benefits were still lower than their health needs. This is contrary to the richest two income groups whose share of benefits was higher than their health needs in both 2010 and 2015. The study concludes that Zambia has not yet fully attained its long-term health reform vision of “equity of access to quality health care” despite years of successive health reforms. The study calls for the Zambian government to complement strategies on financial risk protection with deliberate supply- and demand-side actions in order to enhance equity. Improvements in long- and short-term planning and regular monitoring and evaluation are critical. -
Publication
Progressive Pathway to Universal Health Coverage in Tanzania: A Call for Preferential Resource Allocation Targeting the Poor
(Taylor and Francis, 2018-10-31)Universal health coverage (UHC) can be a vehicle for improving equity, health outcomes, and financial well-being. After publication of the World Health Organization’s report in 2010, many countries declared their goal of achieving UHC. A key lesson from research evidence and country experience in implementation of pro-poor UHC is that public budget plays a crucial role in financing the poor. It has long been recognized that if a country wants to reduce the gap between the poor and non-poor, deprived groups should receive preferential allocation of health care resources to achieve more rapid improvements in their health. Based on a technical analysis of public funds allocation mechanisms in Tanzania, we argue that these mechanisms should prioritize the poor more explicitly and give them preferential treatment to close the gap with the non-poor in service utilization and health outcomes. -
Publication
Local Poverty and Inequality in Albania
(Taylor and Francis, 2018-03-20)This article presents the results of the latest poverty and inequality mapping update using the 2012 Living Standards Measurement Study (LSMS) survey and the 2011 census. This mapping builds on the methodology outlined by Chris Elbers and colleagues and further innovates by including new methodological developments. The results presented here allow better understanding of the regional inequalities in welfare across Albania, and thus can help policy makers address them. This is particularly needed because internal migration over the past decade led to large-scale urbanization in some areas and severe depopulation in others. Internal migration is multifaceted, but mostly flows toward Tirana. -
Publication
All that Glitters is not Gold: Polarization Amid Poverty Reduction in Ghana
(Elsevier, 2018-02)Ghana is an exceptional case in the Sub-Saharan Africa (SSA) landscape. Together with a handful of other countries, Ghana offers the opportunity to analyze the distributional changes in the past two decades, since four comparable household surveys are available. In addition, unlike many other countries in SSA, Ghana’s rapid growth translated into fast poverty reduction. A closer look at the distributional changes that occurred in the same period, however, suggests less optimism. The present paper develops an innovative methodology to analyze the distributional changes that occurred and their drivers, with a high degree of accuracy and granularity. Looking at the results from 1991 to 2012, the paper documents how the distributional changes over time hollowed out the middle of the Ghanaian household consumption distribution and increased the concentration of households around the highest and lowest deciles; there was a clear surge in polarization indeed. When looking at the drivers of polarization, household characteristics, educational attainment, and access to basic infrastructure all tended to increase over time the size of the upper and lower tails of the consumption distribution and, as a consequence, the degree of polarization. -
Publication
When the Centre Cannot Hold: Patterns of Polarization in Nigeria
(Wiley, 2017-12)This paper advances the hypothesis that Nigeria is going through a process of economic polarization. The notion of polarization is concerned with the disappearance or non-consolidation of the middle class, which occurs when there is a tendency to concentrate in the tails, rather than the middle, of the income/consumption distribution. This paper uses newly available data and the relative distribution methodology (Handcock and Morris, 1998, 1999) to present new results on polarization. The findings confirm the sharp increase of polarization. Compared to 2003, the distribution of consumption has become more concentrated in upper and lower deciles in 2013, while the middle deciles have thinned. A between-group analysis shows the emergence of a macro-regional gap: while the South-South and South-West regions contribute mainly to polarization in the upper tail, households in the North East and North West zones—the conflict-stricken areas—are more likely to fall in the lower national deciles. -
Publication
The Impact of Positive and Negative Income Changes on the Height and Weight of Young Children
(Published by Oxford University Press on behalf of the World Bank, 2017-10-01)We estimate the impact of changes in unearned income on the height and weight of young children in a developing country. As a source of income variation we use a change in the eligibility criteria for receipt of an unconditional cash transfer in Ecuador. Two years after families lost the transfer, which they had received for seven years, their young children weigh less and are shorter and more likely to be stunted than young children in families that kept the cash transfer. We find no statistically significant effect on young children's height and weight two years after gaining the cash transfer. Information on household expenditures suggests that a reduction of food expenditures by households that lost the transfer is the main mechanism behind this finding.