03. Journals
2,932 items available
Permanent URI for this collection
These are journal articles published in World Bank journals as well as externally by World Bank authors.
Sub-collections of this Collection
Items in this collection
1 - 10 of 23
-
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)The 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
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
Quality of Care for Children with Severe Disease in the Democratic Republic of the Congo
(Springer Nature, 2019-12)Despite the almost universal adoption of Integrated Management of Childhood Illness (IMCI) guidelines for the diagnosis and treatment of sick children under the age of five in low- and middle-income countries, child mortality remains high in many settings. One possible explanation of the continued high mortality burden is lack of compliance with diagnostic and treatment protocols. We test this hypothesis in a sample of children with severe illness in the Democratic Republic of the Congo (DRC). -
Publication
The Effects of Health Insurance within Families: Experimental Evidence from Nicaragua
(Published by Oxford University Press on behalf of the World Bank, 2019-10)This paper measures the causal effects of parent enrollment into voluntary health insurance on healthcare utilization among insured and uninsured children in Nicaragua. The study utilizes a randomized trial and age-eligibility cutoff in which insurance subsidies were randomly allocated to parents that covered their dependent children under 12; children age 12 and older were not eligible for coverage. Among eligible children, the insurance increased utilization at covered providers by 0.56 visits and increased overall utilization by 1.3 visits. Ineligible children with insured parents experienced 1.7 fewer healthcare visits driven by parent, not sibling, enrollment. The results suggest complementarities across healthcare provider type and provide evidence that households reallocate resources across all members in response to changes in healthcare prices for some. -
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
Introducing the World Bank’s 2018 Health Equity and Financial Protection Indicators Database
(Elsevier, 2018-10-22)Among the many shifts of emphasis that have been evident in global health over the past twenty-five years or so, two stand out: a concern over the poor lagging behind the better off in progress towards global goals; and a concern to look beyond whether people get the services they need to the affordability of the out-of-pocket expenditures associated with these services. The World Bank's 2018 Health equity and financial protection indicators (HEFPI) database is a new global resource for tracking progress on both fronts. It is, in effect, the fourth in the series of such databases. The 2018 database includes eighteen indicators of service use (twelve preventative, six curative) and twenty-eight health outcome indicators. The data are calculated from household surveys, identified mostly through searches of data catalogues and websites of multicountry survey initiatives. The 2018 HEFPI dataset is freely downloadable, and a data visualisation tool is also available. To ensure the data are reproducible, and in line with the guidelines for accurate and transparent health estimates reporting, the authors document their methods thoroughly in a working paper and highlight the differences between their definitions and others; They also provide the essential computer code used to produce the estimates. -
Publication
The Child Health Effects of Terrorism: Evidence from the Boko Haram Insurgency in Nigeria
(Taylor and Francis, 2018-08-25)This study examines the effect of terrorism on height-for-age z-scores, weight-for-age z-scores, weight-for-height z-scores, stunting, and wasting. Using the Boko Haram Insurgency, it compares outcomes in Boko Haram high-active and low-active areas. A difference-in-difference and regression model identifies the extensive and intensive margin effects respectively. The study uses data from the Nigeria Demographic and Health Survey and the Global Terrorism Database. The results suggest that the Boko Haram Insurgency reduces weight-for-age and weight-for-height z-scores and increases the probability of wasting. The evidence suggests that policies targeting healthcare services may mitigate the long-term impacts of the Boko Haram Insurgency on human capital production. -
Publication
Integrating Social Protection and Early Childhood Development: Open Trial of a Family Home-Visiting Intervention, Sugira Muryango
(Taylor and Francis, 2018-04-24)A pre-post design with 6–13-month follow-up assessed the feasibility and acceptability of a home-visiting intervention to promote early childhood development, improve parenting and shared decision-making, and reduce violence in impoverished Rwandan households. Twenty vulnerable families with a child 36-months or younger enrolled in Sugira Muryango. Measures of parenting, home environment, family-violence, decision-making, and health-status were administered at pre/post and follow-up. Families reported high satisfaction post-intervention. OMCI scores improved for 4.8% of mother-child dyads at post-intervention and 19.0% at follow-up, while 9.5% of dyads showed declines at both times. HOME Inventory scores improved for 9.5% and 14.3% of dyads at post-intervention and follow-up respectively and declined for 4.8% and 0.0%. Indicators for equal decision-making and child dietary-diversity improved at post-intervention and follow-up. Fewer mothers believed physical punishment was necessary at follow-up. Sugira Muryango shows promise for improving parenting, beliefs about harsh punishment, child nutritional status, and shared decision-making among vulnerable families. -
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
Pathways to High and Low Performance: Factors Differentiating Primary Care Facilities under Performance-Based Financing in Nigeria
(Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine, 2018-01)The determinants of primary health facility performance in developing countries have not been well studied. One of the most under-researched areas is health facility management. This study investigated health facilities under the pilot performance-based financing (PBF) scheme in Nigeria, and aimed to understand which factors differentiated primary health care centers (PHCCs) which had performed well, vs those which had not, with a focus on health facility management practices. We used a multiple case study where we compared two high-performing PHCCs and two low-performing PHCCs for each of the two PBF target states. Two teams of two trained local researchers spent 1 week at each PHCC and collected semi-structured interview, observation and documentary data. Data from interviews were transcribed, translated and coded using a framework approach. The data for each PHCC were synthesized to understand dynamic interactions of different elements in each case. We then compared the characteristics of high and low performers. The areas in which critical differences between high and low-performers emerged were: community engagement and support; and performance and staff management. We also found that (i) contextual and health system factors particularly staffing, access and competition with other providers; (ii) health center management including community engagement, performance management and staff management; and (iii) community leader support interacted and drove performance improvement among the PHCCs. Among them, we found that good health center management can overcome some contextual and health system barriers and enhance community leader support. This study findings suggest a strong need to select capable and motivated health center managers, provide long-term coaching in managerial skills, and motivate them to improve their practices. The study also highlights the need to position engagement with community leaders as a key management practice and a central element of interventions to improve PHCC performance.