03. Journals

2,963 items available

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http://hdl.handle.net/10986/2210

These are journal articles published in World Bank journals as well as externally by World Bank authors.

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Now showing 1 - 10 of 31

Migration and Urbanization in Post-Apartheid South Africa

(Published by Oxford University Press on behalf of the World Bank, 2020-06) Bakker, Jan David ; Parsons, Christopher ; Rauch, Ferdinand

Although Africa has experienced rapid urbanization in recent decades, little is known about the process of urbanization across the continent. This paper exploits a natural experiment, the abolition of South African pass laws, to explore how exogenous population shocks affect the spatial distribution of economic activity. Under apartheid, black South Africans were severely restricted in their choice of location, and many were forced to live in homelands. Following the abolition of apartheid they were free to migrate. Given a migration cost in distance, a town nearer to the homelands will receive a larger inflow of people than a more distant town following the removal of mobility restrictions. Drawing upon this exogenous variation, this study examines the effect of migration on urbanization in South Africa. While it is found that on average there is no endogenous adjustment of population location to a positive population shock, there is heterogeneity in the results. Cities that start off larger do grow endogenously in the wake of a migration shock, while rural areas that start off small do not respond in the same way. This heterogeneity indicates that population shocks lead to an increase in urban relative to rural populations. Overall, the evidence suggests that exogenous migration shocks can foster urbanization in the medium run.
Predicting Dynamic Patterns of Short-Term Movement

(Published by Oxford University Press on behalf of the World Bank, 2020-02) Milusheva, Sveta

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.
Cash Transfers and Health: Evidence from Tanzania

(Published by Oxford University Press on behalf of the World Bank, 2019-06) Evans, David K. ; Holtemeyer, Brian ; Kosec, Katrina

How do cash transfers conditioned on health clinic visits and school attendance impact health-related outcomes? Examining the 2010 randomized introduction of a program in Tanzania, this paper finds nuanced impacts. An initial surge in clinic visits after 1.5 years—due to more visits by those already complying with program health conditions and by non-compliers—disappeared after 2.5 years, largely due to compliers reducing above-minimal visits. The study finds significant increases in take-up of health insurance and the likelihood of seeking treatment when ill. Health improvements were concentrated among children ages 0–5 years rather than the elderly, and took time to materialize; the study finds no improvements after 1.5 years, but 0.76 fewer sick days per month after 2.5 years, suggesting the importance of looking beyond short-term impacts. Reductions in sick days were largest in villages with more baseline health workers per capita, consistent with improvements being sensitive to capacity constraints. These results are robust to adjustments for multiple hypothesis testing.
Vulnerability to Stunting in the West African Sahel

(Elsevier, 2019-02) Alfani, Federica ; Dabalen, Andrew ; Fisker, Peter ; Molini, Vasco

This paper presents a simple simulation framework for understanding and analyzing vulnerability to stunting. We utilize Demographic and Health Surveys merged with satellite data on climatic shocks. Children aged 0–5 years are grouped into three categories: consistently stunted, vulnerable, and non-vulnerable. The first group constitutes those who are stunted and will also be stunted in any hypothetical period. Non-vulnerable are those whose likelihood to be stunted is zero. The vulnerable face a probability between 0 and 1 of being stunted. The probability is calculated as the share of years in which the child would be stunted, given the village level distribution of weather shocks over the period 2000–2013. We provide estimates of vulnerability to stunting in Burkina Faso, Northern Ghana, Mali, Northern Nigeria, and Senegal by aggregating over villages, districts and countries.
Utilization of Health Care and Burden of Out-of-Pocket Health Expenditure in Zimbabwe: Results from a National Household Survey

(Taylor and Francis, 2018-11-06) Zeng, Wu ; Lannes, Laurence ; Mutasa, Ronald

In the last decade, Zimbabwe has undertaken substantial changes and implemented new initiatives to improve health system performance and services delivery, including results-based financing in rural health facilities. This study aims to examine the utilization of health services and level of financial risk protection of Zimbabwe’s health system. Using a multistage sampling approach, 7,135 households with a total of 32,294 individuals were surveyed in early 2016 on utilization of health services, out-of-pocket (OOP) health expenditure, and household consumption (as a measure of living standards) in 2015. The study found that the outpatient visits were favorable to the poor but the poorest had less access to inpatient care. In 2015, household OOP expenditure accounted for about one quarter of total health expenditure in Zimbabwe and 7.6% of households incurred catastrophic health expenditure (CHE). The incidence of CHE was 13.4% in the poorest quintile in comparison with 2.8% in the richest. Additionally, 1.29% of households fell into poverty due to health care–related expenditures. The study suggests that there are inequalities in utilization of health services among different population groups. The poor seeking inpatient care are the most vulnerable to CHE.
Kenya National Hospital Insurance Fund Reforms: Implications and Lessons for Universal Health Coverage

(Taylor and Francis, 2018-11-06) Barasa, Edwine ; Rogo, Khama ; Mwaura, Njeri ; Chuma, Jane

This article identifies and describes the reforms undertaken by the National Hospital Insurance Fund (NHIF) and examines their implications for Kenya’s quest to achieve universal health coverage (UHC). We undertook a review of published and grey literature to identify key reforms that had been implemented by the NHIF since 2010. We examined the reforms undertaken by the NHIF using a health financing evaluation framework that considers the feasibility, equity, efficiency, and sustainability of health financing mechanisms. We found the following NHIF reforms: (1) the introduction of the Civil Servants Scheme (CSS), (2) the introduction of a stepwise quality improvement system, (3) the health insurance subsidy for the poor (HISP), (4) revision of monthly contribution rates and expansion of the benefit package, and (5) the upward revision of provider reimbursement rates. Though there are improvements in several areas, these reforms raise equity, efficiency, feasibility, and sustainability concerns. The article concludes that though NHIF reforms in Kenya are well intentioned and there has been improvement in several areas, design attributes could compromise the extent to which they achieve their intended goal of providing universal financing risk protection to the Kenyan population.
Myriad of Health Care Financing Reforms in Zambia: Have the Poor Benefited?

(Taylor and Francis, 2018-11-05) Chitah, Bona Mukosha ; Chansa, Collins ; Kaonga, Oliver ; Workie, Netsanet Walelign

Zambia has implemented a number of financing and organizational reforms since the 1990s aimed at increasing efficiency, enhancing equity, and improving health outcomes. This study reviews the distributional impact of these health reforms on enhancing equity at the regional level and for different socioeconomic groups. Data from three nationally representative household surveys were collected, and a benefit incidence analysis was conducted to determine the distributional impact over the period 2010–2015. The results show that distribution of subsidies and utilization of outpatient services at public health facilities in Zambia has consistently been in favor of urban provinces. Further, distribution of health subsidies across the ten provinces in Zambia does not correspond to reported illnesses in each province. The study also shows that utilization of outpatient services at public (hospitals and health centers) and private health facilities is generally in favor of the rich, and utilization of both inpatient and outpatient services at public and private health facilities benefits the rich more than the poor. And although the results show a pro-poor redistribution of benefits across income groups in 2015 compared to 2010 whereby the poorest two income groups received more than a 20% share of benefits in each quintile, the benefits were still lower than their health needs. This is contrary to the richest two income groups whose share of benefits was higher than their health needs in both 2010 and 2015. The study concludes that Zambia has not yet fully attained its long-term health reform vision of “equity of access to quality health care” despite years of successive health reforms. The study calls for the Zambian government to complement strategies on financial risk protection with deliberate supply- and demand-side actions in order to enhance equity. Improvements in long- and short-term planning and regular monitoring and evaluation are critical.
Progressive Pathway to Universal Health Coverage in Tanzania: A Call for Preferential Resource Allocation Targeting the Poor

(Taylor and Francis, 2018-10-31) Wang, Huihui ; Juma, Mariam Ally ; Rosemberg, Nicolas ; Ulisubisya, Mpoki M.

Universal health coverage (UHC) can be a vehicle for improving equity, health outcomes, and financial well-being. After publication of the World Health Organization’s report in 2010, many countries declared their goal of achieving UHC. A key lesson from research evidence and country experience in implementation of pro-poor UHC is that public budget plays a crucial role in financing the poor. It has long been recognized that if a country wants to reduce the gap between the poor and non-poor, deprived groups should receive preferential allocation of health care resources to achieve more rapid improvements in their health. Based on a technical analysis of public funds allocation mechanisms in Tanzania, we argue that these mechanisms should prioritize the poor more explicitly and give them preferential treatment to close the gap with the non-poor in service utilization and health outcomes.
What Are Governments Spending on Health in East and Southern Africa?

(Taylor and Francis, 2018-10-30) Piatti-Funfkirchen, Moritz ; Lindelow, Magnus ; Yoo, Katelyn

Progress toward universal health care (UHC) in Africa will require sustained increases in public spending on health and reduced reliance on out-of-pocket financing. This article reviews trends and patterns of government spending in the East and Southern Africa regions and points out methodological challenges with interpreting data from the World Health Organization’s (WHO) Global Health Expenditure Database (GHED) and other sources.
Introduction to Special Issue on Health Financing in East and Southern Africa

(Taylor and Francis, 2018-09-24) Schneider, Pia ; Yazbeck, Abdo S. ; Lindelow, Magnus

This special issue on health financing in East and Sothern Africa comes at an opportune time. Economic growth in the region is contributing to a changing lifestyle and an increasing burden of noncommunicable diseases, such as diabetes, which are costlier to treat. Coupled with the unfinished health agenda of communicable diseases and maternal and child health, demand for health care is increasing rapidly and putting financial pressure on governments. A risky response in a resource-constrained setting is governments reallocating funds away from the poor to more expensive specialist and tertiary care. Another risky response relates to ways of raising additional revenues, especially in countries where health facilities already charge user fees in the absence of prepayment. Relatively poor patients who pay fees when seeking care may have to sell assets and incur debts, which may push them into poverty or deeper into poverty. Protecting households against falling into poverty and ensuring access to essential health services are thus top priorities for governments committed to universal health coverage (UHC) in the region. Achieving this objective requires solving several pertinent problems.