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
Pathways to Better Nutrition in South Asia: Evidence on the Effects of Food and Agricultural Interventions
(Elsevier, 2021-03)In South Asia, nearly half a billion people are malnourished. This paper examines the links of food and agriculture with nutrition in South Asia, with the goal of informing policy to reduce hunger and malnutrition in the region. We investigate pathways including public food transfer programs, agricultural diversification, and different methods of food fortification. We find that public food transfer programs, used to make food available and affordable to poor households, are often unable to significantly protect or promote nutrition. But several supply-side food and agricultural interventions show promise in improving nutrition, although their effects have yet to be well identified. These include the cultivation of home gardens, animal agriculture, and use of biofortification and post-harvest fortification. All these efforts to reduce hunger and malnutrition will be futile, however, without parallel efforts to mitigate rising challenges in the region, including those posed by climate change, urbanization, food loss and food waste, and food safety hazards. -
Publication
Curse of the Mummy-ji: The Influence of Mothers-in-Law on Women in India
(John Wiley and Sons, 2020-08-23)Restrictive social norms and strategic constraints imposed by family members can limit women's access to and benefits from social networks, especially in patrilocal societies. We characterize young married women's social networks in rural India and analyze how inter-generational power dynamics within the household affect their network formation. Using primary data from Uttar Pradesh, we show that co-residence with the mother-in-law is negatively correlated with her daughter-in-law's mobility and ability to form social connections outside the household, especially those related to health, fertility, and family planning. Our findings suggest that the mother-in-law's restrictive behavior is potentially driven by the misalignment of fertility preferences between the mother-in-law and the daughter-in-law. The lack of peers outside the household lowers the daughter-in-law's likelihood of visiting a family planning clinic and of using modern contraception. We find suggestive evidence that this is because outside peers (a) positively influence daughter-in-law's beliefs about the social acceptability of family planning and (b) enable the daughter-in-law to overcome mobility constraints by accompanying her to health clinics. Wiley Terms and Conditions, https://authorservices.wiley.com/author-resources/Journal-Authors/licensing/self-archiving.html -
Publication
Six Sigma to Reduce Claims Processing Errors in a Healthcare Payer Firm
(Taylor and Francis, 2020-06)As a continuous improvement practice, Six Sigma has been accepted globally across the service industry. In the past one decade, the application and success of Six Sigma in healthcare services has been remarkable. Despite the fact that several papers on Six Sigma have appeared in the erstwhile literature related to healthcare operations, there is a dearth of field studies highlighting the application of Six Sigma in healthcare outsourced firms, in specific to healthcare payers that engage in a non-clinical setup. The aim of this paper is to explore the role of Six Sigma within the healthcare payer outsourced firms, where error-free delivery becomes critical. The article contributes to the literature of Six Sigma in healthcare outsourcing highlighting how “Six Sigma as a methodology” could help reduce claims adjudication errors in a healthcare payer firm. The Six Sigma DMAIC project case study presented as part of the paper delivered a saving of USD 0.53 million and is a classic example of how Six Sigma can bring bottom-line impact to healthcare outsourced organizations. Managerial implications and lessons learned are discussed alongside the concluding notes. -
Publication
Flies without Borders: Lessons from Chennai on Improving India's Municipal Public Health Services
(Taylor and Francis, 2020-05)India’s cities face key challenges to improving public health outcomes. First, unequally distributed public resources create insanitary conditions, especially in slums – threatening everyone’s health, as suggested by poor child growth even among the wealthiest. Second, devolving services to elected bodies works poorly for highly technical services like public health. Third, services are highly fragmented. This paper examines the differences in the organisation and management of municipal services in Chennai and Delhi, two cities with sharply contrasting health indicators. Chennai mitigates these challenges by retaining professional management of service delivery and actively serving vulnerable populations − while services in Delhi are quite constrained. Management and institutional issues have received inadequate attention in the public health literature on developing countries, and the policy lessons from Chennai have wide relevance. -
Publication
Is Consanguinity an Impediment to Child Development?
(Taylor and Francis, 2020-01-14)Marriages between blood relatives—also known as consanguineous unions—are widespread in North Africa, Central and West Asia, and South Asia. Researchers have suggested that consanguinity has adverse effects on child development, but assessing its impact is not straightforward, as the decision to marry a relative might be endogenous to other socio-economic factors. Using a unique data set collected in rural Pakistan, this paper assesses the extent to which consanguinity is linked to children’s cognitive and physical development. It exploits grandfathers’ land ownership (current and past) and maternal grandparent mortality to identify the effect of endogenous consanguinity on child development. Children born into consanguineous unions have lower cognitive scores, lower height-for-age, and a higher likelihood of being severely stunted. More importantly, adverse effects are greater after accounting for the endogeneity of consanguinity, suggesting that impacts on child development are substantial, and likely to be larger than suggested in previous studies. -
Publication
Cities, Slums, and Child Nutrition in Bangladesh
(Wiley, 2018-11-09)This study uses novel household survey data that are representative of Bangladesh's large cities, and of slum and non-slum areas within the cities, to investigate the effects of demographic and socioeconomic factors on child nutrition status in 2013. The study also decomposes the difference in mean child nutrition status between slum and non-slum areas in 2013, and the increase in mean child nutrition status in slum and non-slum areas from 2006 to 2013. Mother's education attainment and household wealth largely explain the cross‐sectional difference and intertemporal change in mean child nutrition status. Although positive in some cases, the effects of maternal and child health services, and potential health‐protective household amenities, on child nutrition status differ by the type of health facility, household amenity, and urban area (slum or non-slum). Focusing on nutrition‐sensitive programs for slum residents and the urban poor is consistent with the results. 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
Variations in the Quality of Tuberculosis Care in Urban India: A Cross-Sectional, Standardized Patient Study in Two Cities
(PLoS, 2018-09-25)India has the highest burden of tuberculosis (TB). Although most patients with TB in India seek care from the private sector, there is limited evidence on quality of TB care or its correlates. Following our validation study on the standardized patient (SP) method for TB, we utilized SPs to examine quality of adult TB care among health providers with different qualifications in 2 Indian cities. -
Publication
Fecal Indicator Bacteria along Multiple Environmental Transmission Pathways (Water, Hands, Food, Soil, Flies) and Subsequent Child Diarrhea in Rural Bangladesh
(American Chemical Society, 2018-06-14)Enteric pathogens can be transmitted through multiple environmental pathways, yet little is known about the relative contribution of each pathway to diarrhea risk among children. We aimed to identify fecal transmission pathways in the household environment associated with prospectively measured child diarrhea in rural Bangladesh. We measured the presence and levels of Escherichia coli in tube wells, stored drinking water, pond water, child hand rinses, courtyard soil, flies, and food in 1843 households. Gastrointestinal symptoms among children ages 0–60 months were recorded concurrently at the time of environmental sample collection and again a median of 6 days later. Incident diarrhea (3 or more loose stools in a 24-h period) was positively associated with the concentration of E. coli on child hands measured on the first visit (incidence rate ratio [IRR] = 1.23, 95% CI 1.06, 1.43 for a log10 increase), while other pathways were not associated. In cross-sectional analysis, there were no associations between concurrently measured environmental contamination and diarrhea. Our findings suggest higher levels of E. coli on child hands are strongly associated with subsequent diarrheal illness rates among children in rural Bangladesh. -
Publication
Optima Nutrition: An Allocative Efficiency Tool to Reduce Childhood Stunting by Better Targeting of Nutrition-Related Interventions
(Springer, 2018-03-20)Child stunting due to chronic malnutrition is a major problem in low- and middle-income countries due, in part, to inadequate nutrition-related practices and insufficient access to services. Limited budgets for nutritional interventions mean that available resources must be targeted in the most cost-effective manner to have the greatest impact. Quantitative tools can help guide budget allocation decisions. -
Publication
Quality of Tuberculosis Care by Indian Pharmacies: Mystery Clients Offer New Insights
(Elsevier, 2018-01)For many patients in India, pharmacies are their first point of contact, where most drugs, including antibiotics, can be purchased over-the-counter (OTC). Recent standardized (simulated) patient studies, covering four Indian cities, provide new insights on how Indian pharmacies manage patients with suspected or known tuberculosis. Correct management of the simulated patients ranged from 13% to 62%, increasing with the certainty of the TB diagnosis. Antibiotics were frequently dispensed OTC to patients, with 16% to 37% receiving such drugs across the cases. On a positive note, these studies showed that no pharmacy dispensed first-line anti-TB drugs. Engagement of pharmacies is important to not only improve TB detection and care, but also limit the abuse of antibiotics.