Person:
Gragnolati, Michele

Health, Nutrition and Population
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Fields of Specialization
Demography, Health economics, Population studies, Aging, Development economics
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ORCID
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Health, Nutrition and Population
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Last updated: January 31, 2023
Biography
Michele Gragnolati currently serves as the Manager for Strategy, Operations and Global Engagement in the Health, Nutrition and Population Global Practice. He joined the World Bank as a Young Professional in 1998 and since 2000, he served first as an economist with the health sector in Latin America and South Asia, and later as program leader for Human Development for the Western Balkans, Brazil, and Argentina, Paraguay and Uruguay. His last position was as Global Lead for Population and Development and he worked mostly on issues related to high fertility and rapid population growth in Sub-Saharan Africa. Before coming back to HQ in Washington, DC, Michele was based in Sarajevo, Brasilia and Buenos Aires. Michele has published on different topics, including methodological and statistical demography, poverty during the East Asia financial crisis, malnutrition in Central America and India, the impact of health expenditures on poverty in former Yugoslavia, the economics of demographic change in Africa and the socioeconomic implications of population aging in Argentina, Brazil and Uruguay. Economist graduated from Luigi Bocconi Commercial University (Italy), Gragnolati has also a Master’s Degree in Population and Development from the London School of Economics (Great Britain) and a Ph.D. in Demography from the University of Princeton (USA). Michele speaks Italian, English, Spanish, French and Portuguese.
Citations 72 Scopus

Publication Search Results

Now showing 1 - 3 of 3
  • Publication
    Catastrophic and Impoverishing Effects of Health Expenditure : New Evidence from the Western Balkans
    (2011) Bredenkamp, C.; Gragnolati, M.
    This paper investigates the effect of health-related expenditure on household welfare in Albania, Bosnia and Herzegovina, Montenegro, Serbia and Kosovo, all of which have undertaken major health sector reform. Two methodologies are used: (i) the incidence and intensity of 'catastrophic' health care expenditure, and (ii) the effect of out-of-pocket payments on poverty headcount and poverty gap measures. Data are drawn from the most recent Living Standards and Measurement Surveys, 2000-05. While our analyses are not without their limitations, and the lack of comparability across instruments precludes a direct comparison across countries, there is no doubt that health expenditure contributes substantially to the impoverishment of households-increasing the incidence of poverty and pushing poor households into deeper poverty-in each country. Both the catastrophic and the impoverishing effects of health expenditures are particularly severe in Albania and Kosovo. Transportation expenditure accounts for a large share of total health expenditures, especially in Albania and Serbia. Informal payments are substantial in all countries, and are particularly high in Albania. As countries in the sub-region continue the process of health system reform, an important policy question should be how to protect vulnerable groups from the catastrophic and impoverishing effects of health care expenditure.
  • Publication
    The Impoverishing Effect of Adverse Health Events : Evidence from the Western Balkans
    (World Bank, Washington, DC, 2007-12) Mendola, Mariapia; Bredenkamp, Caryn; Gragnolati, Michele
    This paper investigates the extent to which the health systems of the Western Balkans (Albania, Bosnia and Herzegovina, Montenegro, Serbia, and Kosovo) have succeeded in providing financial protection against adverse health events. The authors examine disparities in health status, healthcare utilization, and out-of-pocket payments for healthcare (including informal payments), and explore the impact of healthcare expenditures on household economic status and poverty. Methodologies include (i) generating a descriptive assessment of health and healthcare disparities across socioeconomic groups, (ii) measuring the incidence and intensity of catastrophic healthcare payments, (iii) examining the effect of out-of-pocket payments on poverty headcount and poverty gap measures, and (iv) running sets of country-specific probit regressions to model the relationship between health status, healthcare utilization, and poverty. On balance, the findings show that the impact of health expenditures on household economic wellbeing and poverty is most severe in Albania and Kosovo, while Montenegro is striking for the financial protection that the health system seems to provide. Data are drawn from Living Standards and Measurement Surveys.
  • Publication
    Sustainability of Healthcare Financing in the Western Balkans : An Overview of Progress and Challenges
    (World Bank, Washington, DC, 2007-10) Bredenkamp, Caryn; Gragnolati, Michele
    This paper explores the major challenges to the sustainability of health sector financing in the countries of the Western Balkans - Albania, Bosnia and Herzegovina, the Former Yugoslav Republic of Macedonia, Montenegro, Serbia and the province of Kosovo. It focuses on how the incentives created by the different elements of the healthcare financing system affect the behavior of healthcare providers and individuals, and the resulting inefficiencies in revenue collection and expenditure containment. The paper analyzes patterns of healthcare expenditure, finding that there is some evidence of cost containment, but that current expenditure levels - while similar to that in EU countries as a share of GDP - are low in per capita terms and the fiscal space to increase expenditures is extremely limited. It also examines the key drivers of current healthcare expenditure and the most significant barriers to revenue generation, identifying some key health reforms that countries in the sub-region could consider in order to enhance the efficiency and sustainability of their health systems. Data are drawn from international databases, country institutions, and household surveys.