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
Improving Services for Chronic Non-communicable Diseases in Samoa: An Implementation Research Study Using the Care Cascade Framework
(John Wiley and Sons, Inc., 2021-07-26)Samoa needs to intensify the response to the growing non-communicable disease burden. This study aimed to assess bottlenecks in the care continuum and identify possible solutions. The mixed-methods study used the cascade framework as an analysis tool and hypertension as a tracer condition for chronic non-communicable diseases. Household survey data were integrated with medical record data of hypertension patients and results from focus group discussions with patients and healthcare providers. Hypertension prevalence was 38.1% but only 4.7% of hypertensive individuals had controlled blood pressure. There were large gaps in the care continuum especially at screening and referral due to multiple socio-cultural, economic and service delivery constraints. In Samoa, care for chronic non-communicable diseases is not effectively addressing patient needs. This calls for better health communication, demand creation, treatment support, nutritional interventions and health service redesign, with a focus on primary healthcare and effective patient and community engagement. -
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What Drives Utilization of Primary Care Facilities? Evidence from a National Facility Survey
(Taylor and Francis, 2021)This analysis aims to assess the association between commune health station (CHS) service availability/readiness and health service utilization. Data from the 2015 Vietnam District and Commune Health Facility Survey was used to build a series of multivariate negative binomial regressions to measure the association between domains of service availability/readiness and CHS's average number of visits per capita. Three domains of service availability/readiness are significantly associated with higher utilization rates: health infrastructure, basic equipment availability, and capacity to deliver services for non-communicable diseases. If all three modifiable CHS characteristics were to be improved from their current level, the predicted utilization rate of the CHS would be 3.3–3.7 times as high as current levels. Investments in improving facility infrastructure, making available essential equipment items, and enabling the CHS to provide hypertension and diabetes services would all likely increase health service utilization at CHS level. -
Publication
'Sex in Marriage Is a Divine Gift'? Evidence on the Quantity-Quality Trade-off from the Manila Contraceptive Ban
(Published by Oxford University Press on behalf of the World Bank, 2019-02)We analyze the trade-off between child quantity and child quality in developing countries by estimating the effect of family size on child’s education in urban Philippines. To isolate exogenous changes in family size, we exploit a policy shock: in the late 1990s, the mayor of Manila enacted a municipal ban on modern contraceptives. Since other comparable cities in the Manila metropolitan area were not affected by the ban, this allows us to implement a difference-in-difference estimation of the effect on family size. We also exploit the fact that older mothers were less likely to become pregnant during the ban. Our results indicate that the contraceptive ban led to a significant increase in family size. They also provide evidence of a quality-quantity trade-off: increased family size led to a sizable decrease in educational attainment. -
Publication
Gender Patterns of Eldercare in China
(Taylor and Francis, 2018-03)Using the baseline wave of the China Health and Retirement Longitudinal Study (CHARLS), collected from 2011 to 2012, this study finds that among those age 60 and above, women are 7.6 percent more likely than men to have care needs and 29.3 percent more likely than men to have unmet needs; and that most of the gender gap in unmet needs is explained by the existence and health status of a spouse. Further analysis reveals a sharp gender division in patterns of family care in China. While men are more likely to receive care from their wives, women are primarily cared for by their children. Marital status and spouse health also affect provision of care, with infirm women who have healthy husbands less likely to receive care than infirm men with healthy wives. The findings have important implications for designing gender-sensitive policies in eldercare. -
Publication
The Long-term Impacts of International Migration: Evidence from a Lottery
(Published by Oxford University Press on behalf of the World Bank, 2018-02-01)We examine the long-term impacts of international migration by comparing immigrants who had successful ballot entries in a migration lottery program, and first moved almost a decade ago, with people who had unsuccessful entries into those same ballots. The long-term gain in income is found to be similar in magnitude to the gain in the first year despite migrants upgrading their education and changing their locations and occupations. This results in large sustained benefits to their immediate family who have substantially higher consumption, durable asset ownership, savings, and dietary diversity. In contrast we find no measurable impact on extended family. -
Publication
Tuberculosis Detection and the Challenges of Integrated Care in Rural China: A Cross-Sectional Standardized Patient Study
(PLoS, 2017-10-17)Despite recent reductions in prevalence, China still faces a substantial tuberculosis (TB) burden, with future progress dependent on the ability of rural providers to appropriately detect and refer TB patients for further care. This study (a) provides a baseline assessment of the ability of rural providers to correctly manage presumptive TB cases; (b) measures the gap between provider knowledge and practice and; (c) evaluates how ongoing reforms of China’s health system—characterized by a movement toward “integrated care” and promotion of initial contact with grassroots providers—will affect the care of TB patients. -
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
Prices, Engel Curves, and Time-Space Deflation: Impacts on Poverty and Inequality in Vietnam
(Published by Oxford University Press on behalf of the World Bank, 2017-06-01)Many developing countries lack spatially disaggregated price data. Some analysts use “no-price” methods by using a food Engel curve to derive the deflator as that needed for nominally similar households to have equal food shares in all regions and time periods. This method cannot be tested in countries where it is used as a spatial deflator since they lack suitable price data. In this paper, data from Vietnam are used to test this method against benchmarks provided by multilateral price indexes calculated from repeated spatial price surveys. Deflators from a food Engel curve appear to be a poor proxy for deflators obtained from multilateral price indexes. To the extent that such price indexes reliably compare real living standards over time and space, these results suggest that estimates of the level, location, and change in poverty and inequality would be distorted if the Engel method deflator was used in their stead. -
Publication
Unconditional Cash Transfers in China: Who Benefits from the Rural Minimum Living Standard Guarantee (Dibao) Program?
(Elsevier, 2017-05)This paper analyzes China’s rural minimum living standard guarantee (dibao) program, one of the largest minimum income cash transfer schemes in the world, and examines possible changes to the program design. Despite its size and central position in China’s current poverty reduction strategy, little is known about the rural dibao program’s performance and targeting effectiveness. Our analysis uses annual household survey data from the China Household Income Project matched with published administrative data for the years 2007–09. We find that the program provides sufficient income to poor beneficiaries but does not substantially reduce the overall level of poverty. Conventional targeting analysis reveals large inclusionary and exclusionary targeting errors; propensity score targeting analysis yields smaller but still large targeting errors. Simulations of possible changes to the program design reveal that expanding coverage can potentially yield greater poverty reduction than increasing transfer amounts. Replacing locally diverse dibao lines and transfer amounts with a nationally uniform dibao threshold and transfer could in theory reduce poverty further, but the potential gains are modest without improvements in targeting. This paper makes several contributions. To our knowledge this is the first household-level empirical analysis of China’s dibao program in rural areas, so the findings provide new, policy-relevant information. Moreover, the literature has not settled the question of whether such programs should be centralized or decentralized. We show that in practice the potential gains of centralizing the eligibility rule and transfer amount are conditional on the efficiency of targeting. By varying the program’s key design parameters our analysis also yields insights into alternative policy recommendations to improve the program performance. -
Publication
Relapse to Opioid Use in Opioid-Dependent Individuals Released from Compulsory Drug Detention Centres Compared with Those from Voluntary Methadone Treatment Centres in Malaysia: A Two-Arm, Prospective Observational Study
(Elsevier, 2017-02)Detention of people who use drugs into compulsory drug detention centres (CDDCs) is common throughout East and Southeast Asia. Evidence-based pharmacological therapies for treating substance use disorders, such as opioid agonist treatments with methadone, are generally unavailable in these settings. We used a unique opportunity where CDDCs coexisted with voluntary drug treatment centres (VTCs) providing methadone in Malaysia to compare the timing and occurrence of opioid relapse (measured using urine drug testing) in individuals transitioning from CDDCs versus methadone maintenance in VTCs. Opioid-dependent individuals in CDDCs are significantly more likely to relapse to opioid use after release, and sooner, than those treated with evidence-based treatments such as methadone, suggesting that CDDCs have no role in the treatment of opioid-use disorders.