03. Journals
2,963 items available
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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
Using Individual-Level Randomized Treatment to Learn about Market Structure
(American Economic Association, 2022-10)Interference across competing firms in RCTs can be informative about market structure. An experiment that subsidizes a random subset of traders who buy cocoa from farmers in Sierra Leone illustrates this idea. Interpreting treatment-control differences in prices and quantities purchased from farmers through a model of Cournot competition reveals differentiation between traders is low. Combining this result with quasi-experimental variation in world prices shows that the number of traders competing is 50 percent higher than the number operating in a village. Own-price and cross-price supply elasticities are high. Farmers face a competitive market in this first stage of the value chain. -
Publication
Koranic Schools in Niger: How Much Can Be Learned from Existing Data?
(Taylor and Francis, 2022-01-28)The term Koranic school is often used to describe schools that are not part of the formal education system and typically place a strong emphasis on memorizing the Koran in Arabic, as well as on knowledge of Islamic religious education and practice. Using data from Niger as a case study, this paper provides data on trends in the share of individuals that have a Koranic education, a formal education, or no education at all, as well as a basic profile (univariate and multivariate) of children with Koranic education, formal education, or no education at all. In addition, the potential impacts of Koranic education in comparison to formal education or no education at all on outcomes such as literacy and numeracy, labor market earnings, household consumption, assets and perceptions of well-being, and infant mortality is analyzed. -
Publication
Factors Associated with Educational and Career Aspirations of Young Women and Girls in Sierra Leone
(Taylor and Francis, 2021-09-05)Empirical data on the aspirations of young women and girls in post-conflict settings are scarce. This article analyses the factors associated with the educational and career aspirations of 2,473 young women and girls in Sierra Leone. Findings indicated that over three-quarters of our sample aspired to continue their studies up to the university level, and two-thirds aspired to obtain a formal sector job requiring an education. These findings are important for discussions of aid which can accelerate economic advances and opportunities within advanced economies for both women and men. -
Publication
Looking into the performance-based financing black box: Evidence from an impact evaluation in the health sector in Cameroon
(Oxford University Press, 2021-07)Performance-based financing (PBF) is a complex health systems intervention aimed at improving the coverage and quality of care. Several studies have shown a positive impact of PBF on health service coverage, often coupled with improvements in quality, but relatively little is known about the mechanisms driving those results. This article presents results of a randomized impact evaluation in Cameroon designed to isolate the role of specific components of the PBF approach with four study groups: (i) PBF with explicit financial incentives linked to results, (ii) direct financing with additional resources available for health providers not linked to performance, (iii) enhanced supervision and monitoring without additional resources and (iv) a control group. Overall, results indicate that, when compared with the pure control group, PBF in Cameroon led to significant increases in utilization for several services (child and maternal vaccinations, use of modern family planning), but not for others like antenatal care visits and facility-based deliveries. In terms of quality, PBF increased the availability of inputs and equipment, qualified health workers, led to a reduction in formal and informal user fees but did not affect the content of care. However, for many positively impacted outcomes, the differences between the PBF group and the group receiving additional financing not linked to performance are not significant, suggesting that additional funding rather than the explicit incentives might be driving improvements. In contrast, the intervention group offering enhanced supervision, coaching and monitoring without additional funding did not experience significant impacts compared to the control group. -
Publication
Exploring Behavioral Competencies for Effective Medical Practice in Nigeria
(Sage Publications, 2020-12-01)Clinical performance varies due to academic, clinical, and behavioral factors. However, in many countries, selection of medical professionals tends to focus on exclusively academic ability and clinical acumen. Appropriate selection processes for medical professionals should consider behavioral factors, which may vary across contexts. This study was conducted to identify behavioral competencies considered relevant for effective medical practice in Nigeria, by medical students and doctors, and compared with other contexts. This study is one of the few to examine the perspectives of medical students and physicians on behavioral competencies for effective medical practice in an African country. We found differences in the perspectives of medical physicians and students, and in the prioritized competencies across countries. Our study illustrates the need for careful consideration in identifying subject matter experts and in generalizing competencies across contexts. Future research in this field in Nigeria should examine effective ways of testing for key behavioral competencies among medical students and for residency programs. Also, investigating the perspectives of medical faculty and administrators on important competencies, and exploring the generalizability of these competencies across cultures in Nigeria should be considered. -
Publication
Death Registration in Nigeria: A Systematic Literature Review of its Performance and Challenges
(Taylor and Francis, 2020-09-07)Death registration provides an opportunity for the legal documentation of death of persons. Documentation of deaths has several implications including its use in the recovery of inheritance and insurance benefits. It is also an important input for construction of life tables which are crucial for national planning. However, the registration of deaths is poor in several countries including Nigeria. This paper describes the performance of death registration in Nigeria and factors that may affect its performance. We conducted a systematic literature review of death registration completeness in Nigeria to identify, characterize issues as well as challenges associated with realizing completeness in death registration. Only 13.5% of deaths in Nigeria were registered in 2007 which regressed to 10% in 2017. There was no data reported for Nigeria in the World Health Organization database between 2008 and 2017. The country scored less than 0.1 (out of a maximum of 1) on the Vital Statistics Performance Index. There are multiple institutions with parallel constitutional and legal responsibilities for death registration in Nigeria including the National Population Commission, National Identity Management Commission and Local Government Authorities, which may be contributing to its overall poor performance. -
Publication
Quality of Clinical Assessment and Child Mortality: A Three-Country Cross-Sectional Study
(Oxford University Press, 2020-06)This analysis describes specific gaps in the quality of health care in Central Africa and assesses the association between quality of clinical care and mortality at age 2–59 months. Regionally representative facility and household surveys for the Democratic Republic of the Congo, Cameroon and Central African Republic were collected between 2012 and 2016. These data are novel in linking facilities with households in their catchment area. Compliance with diagnostic and danger sign protocols during sick-child visits was observed by trained assessors. We computed facility- and district-level compliance indicators for patients aged 2–59 months and used multivariate multi-level logistic regression models to estimate the association between clinical assessment quality and mortality at age 2–59 months in the catchment areas of the observed facilities. A total of 13 618 live births were analysed and 1818 sick-child visits were directly observed and used to rate 643 facilities. Eight percent of observed visits complied with 80% of basic diagnostic protocols, and 13% of visits fully adhered to select general danger sign protocols. A 10% greater compliance with diagnostic protocols was associated with a 14.1% (adjusted odds ratio (aOR) 95% CI: 0.025–0.244) reduction in the odds of mortality at age 2–59 months; a 10% greater compliance with select general danger sign protocols was associated with a 15.3% (aOR 95% CI: 0.058–0.237) reduction in the same odds. The results of this article suggest that compliance with recommended clinical protocols remains poor in many settings and improvements in mortality at age 2–59 months could be possible if compliance were improved. -
Publication
Games as Boundary Objects: Charting Trade-offs in Sustainable Livestock Transformation
(Taylor and Francis, 2020-03-27)Attempts to structurally transform segments of the agri-food system inevitably involve trade-offs between the priorities of actors with different incentives, perspectives and values. Trade-offs are context-specific, reflecting different socio-economic and political realities. We investigate the potential of structured boundary objects to facilitate exposing and reconciling these trade-offs within the context of multi-stakeholder social learning processes with pastoral and mixed crop-livestock communities in Burkina Faso, Ethiopia and Tanzania. Building on boundary objects as items flexible enough to be understood by all without having one common definition, structured boundary objects visualize actors’ input in a comparable format to facilitate knowledge sharing. Stakeholders in each country used a simulation tool and board game to explore the implications of changing livestock stocking and management practices for the environment and for actors’ future socio-economic priorities. Using structured boundary objects elicited trade-offs between household food and animal feed, and between livestock for income, labor, and/ or cultural functions, reflecting the context-specific and subjective evaluations actors make when attempting to plan livelihood changes. Our findings suggest to policy and decision-makers that sustainable transition plans can be developed when stakeholders in local agri-food systems employ approaches that allow shared understandings of trade-offs inherent to sustainable agriculture to emerge. -
Publication
Urbanization and Child Nutritional Outcomes
(Published by Oxford University Press on behalf of the World Bank, 2020-02)The implications of urbanization on child nutritional outcomes are investigated using satellite-based nighttime light intensity data as a marker of urbanization with data from two rounds of the Nigeria Demographic and Health Survey. Nighttime light introduces a gradient of urbanization permitting investigation of the implications of urbanization on child nutritional outcomes along an urbanization continuum. Nightlight is found to significantly predict child nutritional outcomes even after controlling for observable covariates known to influence child nutrition. In all specifications, improvements in child nutrition outcomes onset with relatively low levels of light emissions and continue rapidly as nightlight intensity increases before largely leveling off. These nonlinear relationships highlight the value of nightlight as a population agglomeration indicator relative to traditional binary rural-urban indicators. Consistent with other recent work, patterns of urbanization influence welfare outcomes. At least for Nigeria, a pattern that extends the benefits of urban agglomeration to larger shares of the population would speed improvements to child nutritional outcomes. -
Publication
Predicting Dynamic Patterns of Short-Term Movement
(Published by Oxford University Press on behalf of the World Bank, 2020-02)Short-term human mobility has important health consequences, but measuring short-term movement using survey data is difficult and costly, and use of mobile phone data to study short-term movement is only possible in locations that can access the data. Combining several accessible data sources, Senegal is used as a case study to predict short-term movement within the country. The focus is on two main drivers of movement—economic and social—which explain almost 70 percent of the variation in short-term movement. Comparing real and predicted short-term movement to measure the impact of population movement on the spread of malaria in Senegal, the predictions generated by the model provide estimates for the effect that are not significantly different from the estimates using the real data. Given that the data used in this paper are often accessible in other country settings, this paper demonstrates how predictive modeling can be used by policy makers to estimate short-term mobility.