Person:
Gragnolati, Michele
Author Name Variants
Fields of Specialization
Demography,
Health economics,
Population studies,
Aging,
Development economics
Degrees
Departments
Health, Nutrition and Population
Externally Hosted Work
Contact Information
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.
Publication Search Results
1 - 4 of 4
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Publication
As Time Goes By in Argentina: Economic Opportunities and Challenges of the Demographic Transition
(Washington, DC: World Bank, 2015-04-23)The process of demographic transition through which Argentina is passing is a window of both opportunities and challenges in economic and social terms. Argentina is still a young country in which the working-age population represents the largest proportion of its total population. Currently, the country just began a 30-year period with the most advantageous age structure of its population, which could favor greater economic growth. This situation, known as the 'demographic window of opportunity,' will last until the beginning of the 2040s. The dynamics of the fertility and mortality rates signify a gradual ageing of the population, with implications for various dimensions of the economy, the social protection system, public policies, and society in general. This book studies the opportunities and challenges that the demographic transition poses for the Argentine economy, its most important social sectors like the healthcare, education, and social protection systems, and the potential fiscal trade-offs that must be dealt with. The study shows that even though Argentina is moving through its demographic transition, it just recently began to enjoy the window of opportunity and this constitutes a great opportunity to achieve an accumulation of capital and future economic growth. Once the window of opportunity has passed, population ageing will have a significant impact on the level of expenditure, especially spending in the social protection system. This signifies a challenge from a fiscal policy point of view, because if long-term reforms are not undertaken to mediate these effects, the demographic transition will put pressure on the reallocation of fiscal resources among social sectors. Finally, population ageing poses concerns related to sustaining the rate of economic growth with a smaller working-age population. Taking advantage of the current window of opportunities, increasing savings that will finance the accumulation of capital, and increasing future labor force productivity in this way is a challenge for the Argentine economy. -
Publication
Growing Old in an Older Brazil : Implications of Population Ageing on Growth, Poverty, Public Finance, and Service Delivery
(World Bank, 2011-09-07)This chapter introduces the main issues associated with population aging, many of which will be investigated in detail throughout the volume. The next section describes the demographic transformation that Brazil has been experiencing and highlights its specific features, including a very rapid population aging process in the next few decades. Then the main economic framework behind this work, the life cycle theory according to which individuals' economic behavior varies according to their age, is discussed. The section after that introduces the first and second demographic dividends associated with the changing population age structure that accompanies the demographic transition of any country. Next covered is how poverty is linked to the life cycle in Brazil and the role of public transfers in reducing poverty among different age groups, followed by an investigation of how public expenditures vary across age groups and generations and what makes Brazil distinct from comparable OECD (Organization for Economic Co-operation and Development) and Latin American countries. Concluding the chapter are the main findings of the report. -
Publication
Twenty Years of Health System Reform in Brazil : An Assessment of the Sistema Único de Saúde
(Washington, DC: World Bank, 2013-06-13)It has been more than 20 years since Brazil's 1988 Constitution formally established the Unified Health System (Sistema Unico de Saude, SUS). Building on reforms that started in the 1980s, the SUS represented a significant break with the past, establishing health care as a fundamental right and duty of the state and initiating a process of fundamentally transforming Brazil's health system to achieve this goal. This report aims to answer two main questions. First is have the SUS reforms transformed the health system as envisaged 20 years ago? Second, have the reforms led to improvements with regard to access to services, financial protection, and health outcomes? In addressing these questions, the report revisits ground covered in previous assessments, but also brings to bear additional or more recent data and places Brazil's health system in an international context. The report shows that the health system reforms can be credited with significant achievements. The report points to some promising directions for health system reforms that will allow Brazil to continue building on the achievements made to date. Although it is possible to reach some broad conclusions, there are many gaps and caveats in the story. A secondary aim of the report is to consider how some of these gaps can be filled through improved monitoring of health system performance and future research. The introduction presents a short review of the history of the SUS, describes the core principles that underpinned the reform, and offers a brief description of the evaluation framework used in the report. Chapter two presents findings on the extent to which the SUS reforms have transformed the health system, focusing on delivery, financing, and governance. Chapter three asks whether the reforms have resulted in improved outcomes with regard to access to services, financial protection, quality, health outcomes, and efficiency. The concluding chapter presents the main findings of the study, discusses some policy directions for addressing the current shortcomings, and identifies areas for further research. -
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Catastrophic and Impoverishing Effects of Health Expenditure : New Evidence from the Western Balkans
( 2011)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.