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
Joint Roles of Parenting and Nutritional Status for Child Development: Evidence from Rural Cambodia
(Wiley, 2019-05-31)Substantial work has demonstrated that early nutrition and home environments, including the degree to which children receive cognitive stimulation and emotional support from parents, play a profound role in influencing early childhood development. Yet, less work has documented the joint influences of parenting and nutritional status on child development among children in the preschool years living in low‐income countries. Using panel data from 2016 to 2017 on the parenting, nutritional status, and early developmental outcomes (executive function, language, early numeracy, and socioemotional problems) of 6,508 Cambodian children ages 3–5 years, our findings demonstrate that inequities in early development associated with family wealth are evident at age 3 and increase among children ages 4 and 5 years. Using hierarchical regression analysis, a significant share of these inequalities is explained by differences in parenting and early nutritional status, measured by stunting. Better‐educated parents engage in more stimulating and supportive parenting practices. However, the positive association between parenting and language and early numeracy outcomes is 35–54% stronger for non‐stunted children, and parental activities explain only about 8–14% of the cognitive gap between the lowest and highest wealth quintiles. The results highlight the need for additional research outlining interactions between environmental factors that link family wealth and child development. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions. https://authorservices.wiley.com/author-resources/Journal-Authors/licensing/self-archiving.html -
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
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
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. -
Publication
Understanding Health Workers' Job Preferences to Improve Rural Retention in Timor-Leste: Findings from a Discrete Choice Experiment
(PLoS, 2016-11-15)Timor-Leste built its health workforce up from extremely low levels after its war of independence, with the assistance of Cuban training, but faces challenges as the first cohorts of doctors will shortly be freed from their contracts with government. Retaining doctors, nurses and midwives in remote areas requires a good understanding of health worker preferences. The article reports on a discrete choice experiment (DCE) carried out amongst 441 health workers, including 173 doctors, 150 nurses and 118 midwives. Qualitative methods were conducted during the design phase. The attributes which emerged were wages, skills upgrading/specialisation, location, working conditions, transportation and housing. -
Publication
Decentralization of Health and Education in Developing Countries: A Quality-Adjusted Review of the Empirical Literature
(Published by Oxford University Press on behalf of the World Bank, 2016-08)We review empirical evidence on the ability of decentralization to enhance preference matching and technical efficiency in the provision of health and education in developing countries. Many influential surveys have found that the empirical evidence of decentralization's effects on service delivery is weak, incomplete, and often contradictory. Our own unweighted reading of the literature concurs. However, when we organize quantitative evidence first by substantive theme, and then—crucially—by empirical quality and the credibility of its identification strategy, clear patterns emerge. Higher-quality evidence indicates that decentralization increases technical efficiency across a variety of public services, from student test scores to infant mortality rates. Decentralization also improves preference matching in education, and can do so in health under certain conditions, although there is less evidence for both. We discuss individual studies in some detail. Weighting by quality is especially important when quantitative evidence informs policy-making. Firmer conclusions will require an increased focus on research design, and a deeper examination into the prerequisites and mechanisms of successful reforms. -
Publication
The Decision to Invest in Child Quality over Quantity: Household Size and Household Investment in Education in Vietnam
(Published by Oxford University Press on behalf of the World Bank, 2016-01)During Vietnam’s two decades of rapid economic growth, its fertility rate has fallen sharply at the same time that its educational attainment has risen rapidly—macro trends that are consistent with the hypothesis of a quantity-quality tradeoff in child-rearing. We investigate whether the micro-level evidence supports the hypothesis that Vietnamese parents are in fact making a tradeoff between quantity and “quality” of children. We present private tutoring—a widespread education phenomenon in Vietnam—as a new measure of household investment in children’s quality, combining it with traditional measures of household education investments. To assess the quantity-quality tradeoff, we instrument for family size using the commune distance to the nearest family planning center. Our IV estimation results based on data from the Vietnam Household Living Standards Surveys (VHLSSs) and other sources show that rural families do indeed invest less in the education of school-age children who have larger numbers of siblings. This effect holds for several different indicators of educational investment and is robust to different definitions of family size, identification strategies, and model specifications that control for community characteristics as well as the distance to the city center. Finally, our estimation results suggest that private tutoring may be a better measure of quality-oriented household investments in education than traditional measures like enrollment, which are arguably less nuanced and less household-driven.