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 Do School Feeding Programmes Reduce Child Labour? Evidence from Liberia(Taylor and Francis, 2022-05-16) Dadie, Dago; Yogo, ThierryThough there is comprehensive literature on the effectiveness of school feeding in increasing school enrollment and school attendance, little is known about its potential effect on child labor. This paper takes advantage of the 2007 Core Welfare Questionnaire Indicator survey conducted between August and September 2007 in Liberia to assess the causal impact of the School Feeding Programme (SFP) on child labour. Using the propensity score-matching technique, we find that the SFP leads to a statistically significant decrease in child labour estimated at between 14 and 17%. This result is robust to the use of different matching techniques and the choice of covariates used in the estimation of the propensity score. In addition, the analysis reveals that the SFP is mainly effective in reducing child labour for male children, children living in war-displaced households, and children living in households in which the head is literate. Overall, the study shows that the detrimental effect of conflict on child labor can be mitigated by school feeding interventions.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) de Walque, Damien; Saidou, Hamadou; Sorgho, Gaston; Steenland, MariaPerformance-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 Disruptions in Maternal and Child Health Service Utilization during COVID-19: Analysis from Eight Sub-Saharan African Countries(Oxford University Press, 2021-06-19) Shapira, Gil; Drouard, Salome Henriette Paulette; Fernandez, Pablo Amor; Kandpal, Eeshani; Sanford Wesseh, Chea; Mohamud, Nur Ali; Smart, Francis; Mwansambo, Charles; Baye, Martina L; Diabate, Mamatou; Yuma, Sylvain; Ogunlayi, Munirat; De Dieu Rusatira, Rwema Jean; Hashemi, Tawab; Vergeer, Petra; Friedman, JedThe coronavirus-19 pandemic and its secondary effects threaten the continuity of essential health services delivery, which may lead to worsened population health and a protracted public health crisis. We quantify such disruptions, focusing on maternal and child health, in eight sub-Saharan countries. Service volumes are extracted from administrative systems for 63 954 facilities in eight countries: Cameroon, Democratic Republic of Congo, Liberia, Malawi, Mali, Nigeria, Sierra Leone and Somalia. Using an interrupted time series design and an ordinary least squares regression model with facility-level fixed effects, we analyze data from January 2018 to February 2020 to predict what service utilization levels would have been in March–July 2020 in the absence of the pandemic, accounting for both secular trends and seasonality. Estimates of disruption are derived by comparing the predicted and observed service utilization levels during the pandemic period. All countries experienced service disruptions for at least 1 month, but the magnitude and duration of the disruptions vary. Outpatient consultations and child vaccinations were the most commonly affected services and fell by the largest margins. We estimate a cumulative shortfall of 5 149 491 outpatient consultations and 328 961 third-dose pentavalent vaccinations during the 5 months in these eight countries. Decreases in maternal health service utilization are less generalized, although significant declines in institutional deliveries, antenatal care and postnatal care were detected in some countries. There is a need to better understand the factors determining the magnitude and duration of such disruptions in order to design interventions that would respond to the shortfall in care. Service delivery modifications need to be both highly contextualized and integrated as a core component of future epidemic response and planning.Publication Exploring Behavioral Competencies for Effective Medical Practice in Nigeria(Sage Publications, 2020-12-01) Obi, Uche; Chukwuma, Adanna; Agu, Ifunanya; Mbachu, ChinyereClinical 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) Makinde, Olusesan Ayodeji; Odimegwu, Clifford Obby; Udoh, Mojisola O.; Adedini, Sunday A.; Akinyemi, Joshua O.; Atobatele, Akinyemi; Fadeyibi, Opeyemi; Abdulaziz-Sule, Fatima; Babalola, Stella; Orobaton, NosakhareDeath 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) Perales, Nicole A.; Wei, Dorothy; Khadka, Aayush; Leslie, Hannah H.; Hamadou, Saidou; Chamberlin Yama, Gervais; Robyn, Paul Jacob; Shapira, Gil; Kruk, Margaret E.; Fink, GuntherThis 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 Urbanization and Child Nutritional Outcomes(Published by Oxford University Press on behalf of the World Bank, 2020-02) Amare, Mulubrhan; Arndt, Channing; Abay, Kibrom A.; Benson, ToddThe 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.