MENA Chief Economist Office
Author Name Variants
Fields of Specialization
LABOR ECONOMICS, POLITICAL ECONOMY, SOCIAL INCLUSION, ECONOMIC GROWTH
MENA Chief Economist Office
Externally Hosted Work
Last updated May 17, 2023
Roberta Gatti is the World Bank’s chief economist of the Middle East and North Africa region and former chief economist of the Human Development Practice Group, where she led the SDI and the Human Capital Index initiatives. She joined the World Bank in 1998 as a Young Professional in the Development Research Group. Her research includes theoretical and empirical contributions to labor and household economics, political economy, growth, and social inclusion. She has authored multiple World Bank flagship reports, including Jobs for Shared Prosperity and Being Fair, Faring Better. She has taught at Georgetown University and Johns Hopkins University.
Publication Search Results
Now showing 1 - 8 of 8
Publication(World Bank, Washington, DC, 2019-01) Gatti, Roberta ; Mohpal, AakashThis paper compiles project-level data from the World Bank's lending history to describe patterns and the composition of its portfolio. The paper focuses particularly on the effect of countries' transition from International Development Association to International Bank for Reconstruction and Development status, which marks the point when countries start borrowing at near market rates, on lending for human development sectors (education, health and social protection). Using country and year fixed effects, which account for unobservable country characteristics (for example, national priorities) and time effects (for example, market interest rates), the paper finds that human development lending decreases when countries graduate from the International Development Association. The average difference in the binary indicator of lending for any sector is 27 percent while it is 60 percent for human development sectors. The share of human development lending (lending by human development Global Practices over total lending) is also 6.9 percentage points (30 percent) lower. This decline in human development lending in International Bank for Reconstruction and Development countries is accompanied by a greater use of budget support. The results are robust to controlling for non-World Bank aid, as well as various alternative specifications and estimation samples.
Publication(World Bank, Washington, DC, 2019-10) Andrews, Kathryn ; Avitabile, Ciro ; Gatti, RobertaUsing a new data set comprised of publicly available information, this paper provides cross-country evidence on domestic government spending for human capital in recent years. Creating a measure of social spending that covers the three sectors of health, education, and social protection has proven to be a challenging task. Only for health spending is there high data coverage over time and across countries. Education and, especially, social protection display large gaps. Increases in social sector spending have generally been slow and unsteady. Although education spending in low-income countries has seen a stable and steady increase, spending on health has been remarkably flat. Human capital outcomes are only weakly correlated with spending in the three sectors. Finally, this paper discusses future research required to provide guidance on how much and what type of investment is needed to achieve high levels of human capital.
The Quality of Health and Education Systems Across Africa: Evidence from a Decade of Service Delivery Indicators Surveys(Washington, DC: World Bank, 2021-11-18) Gatti, Roberta ; Andrews, Kathryn ; Avitabile, Ciro ; Conner, Ruben ; Sharma, Jigyasa ; Yi Chang, AndresHave teachers mastered the subject matter they are teaching? Can doctors accurately diagnose and treat critical health conditions? Are schools and health facilities sufficiently stocked with needed equipment and supplies? Are they sufficiently supported and staffed to optimize learning and health care outcomes? For the past decade, the World Bank’s Service Delivery Indicators (SDI) surveys have collected nationally representative data in countries across Africa to answer these questions. The surveys aim to measure the quality of services where they meet citizens: in schools and health facilities. The Quality of Health and Education Systems Across Africa: Evidence from a Decade of Service Delivery Indicators Surveys identifies areas of achievement and constraint in service delivery, shedding light on how service delivery may foster or stunt human capital accumulation. SDI surveys show that schools and health clinics across Africa are still falling short in some critical areas. The delivery of primary care services is very heterogenous between and within countries. Many health facilities lack the basic necessities to provide proper care, such as essential medicines, basic diagnostic equipment, and adequate water and sanitation. Moreover, health care providers’ ability to diagnose and treat common health conditions correctly is low and distributed unevenly. Health personnel’s absence from health facilities remains a concern across the surveyed countries. Learning is low, and, not unlike health care, levels of student learning vary significantly across countries: less than half of grade 4 students can recite a simple sentence or perform basic mathematical operations. This deficient learning is correlated with teachers’ low levels of content knowledge and sub-par pedagogy skills. Some schools are also missing crucial inputs, such as blackboards or private and gendered toilets, and struggle with high pupil-teacher ratios. Despite these challenges, success stories in both sectors illustrate the quality of service delivery that could be achieved and showcase the dedication of teachers and medical staff across Africa. By studying data from thousands of facilities, considering the local context, and drawing insights from the literature, this book offers important insights for how countries can strengthen health and education systems and build back better in the wake of the massive disruptions brought about by the COVID-19 pandemic.
Five Ways that COVID-19 Diagnostics Can Save Lives: Prioritizing Uses of Tests to Maximize Cost-Effectiveness(World Bank, Washington, DC, 2021-02-23) Reed, Tristan ; Waites, William ; Manheim, David ; de Walque, Damien ; Vallini, Chiara ; Gatti, Roberta ; Hallett, Timothy B.Supplies of diagnostic tests for SARS-CoV-2, the virus that causes COVID-19 (coronavirus), are still limited in many countries, and there is uncertainty about how to allocate the scarce supply across alternative types of testing (use cases). This Research & Policy Brief quantifies the cost-effectiveness of five alternative diagnostic use cases in terms of tests required per death averted. Across use cases, a single death can be averted by administering 940 to 8,838 tests, implying a large and positive return on investment in all use cases-even assuming a very low value for loss of life. That is, all five use cases pay for themselves many times over. When prevalence of SARS-CoV-2 is high, the most cost-effective uses of SARS-CoV-2 diagnostics seem to be clinical triage of patients, at-risk worker screening, and population surveillance. Test-trace-isolate programs and border screening are alsoworthwhile, although they are more resource intensive per death averted if done comprehensively. These latter two interventions become relativelymore cost effective when prevalence is low, and can stop the virus from entering a community completely. While governments should seekwidespread deployment of tests in all five use cases, prioritizing them in this way is likely to maximize the cost-effectiveness of their use. As morecontagious strains emerge, each use case will become more valuable than ever.
Publication(World Bank, Washington, DC, 2020-07) Sharma, Jigyasa ; Andrews, Kathryn ; Conner, Ruben ; Gatti, RobertaTo aid national and international efforts to support countries in enhancing their pandemic preparedness in the face of COVID-19, this paper draws from the World Bank's Service Delivery Indicator surveys to highlight key aspects of health service preparedness in Kenya, Sierra Leone, and Tanzania. The results of this analysis paint a highly variable picture. At least 10 percent of lower-level facilities in all three countries have inpatient care capacity, suggesting that these lower-level facilities could help absorb surges in patient flow. Less than half of the facilities in the three countries have a fixed or mobile phone and less than a third have internet access, suggesting a likely challenge in communication and timely sharing of essential information. Concerningly, less than half of the facilities have appropriate handwashing facilities for patients, with even lower rates in rural areas. Between 80 and 95 percent of the facilities have a thermometer to diagnose fever, but availability of a thermometer, stethoscope, and blood pressure cuff together is variable (ranging from almost 90 percent of the facilities in Tanzania to less than 65 percent in Sierra Leone). The paper concludes by highlighting key innovations for future surveys to improve measurement of pandemic preparedness.
Publication(World Bank, Washington, DC, 2019-09) D'Souza, Ritika ; Gatti, Roberta ; Kraay, AartThis paper documents inequality in health and education outcomes by constructing an index of human capital disaggregated by quintiles of socioeconomic status (SES) for a sample 51 mostly low- and middle-income countries. The index measures the expected future human capital of children born today, following the methodology of the World Bank Human Capital Index that was launched in October 2018. Within-country disparities in human capital outcomes across SES quintiles are large, accounting for roughly one-third of the total variation. On average, human capital outcomes increase with income at roughly the same rate across socio-economic groups within countries as they do across countries.
The Realities of Primary Care: Variation in Quality of Care Across Nine Countries in Sub-Saharan Africa(World Bank, Washington, DC, 2021-04) Andrews, Kathryn ; Conner, Ruben ; Gatti, Roberta ; Sharma, JigyasaThe COVID-19 pandemic has highlighted the centrality of primary care in protecting people’s health and well-being during and beyond crises. It has also provided an opportunity to strengthen and redesign primary care so that it will better serve its purpose. However, to-date there is limited evidence on the quality of service delivery in primary care. Service Delivery Indicators surveys have attempted to fill this gap. Using Service Delivery Indicators surveys of 7,810 health facilities and 66,151 health care providers in nine Sub-Saharan African countries, this paper investigates the quality of care across five domains to understand a citizen’s experience of primary care in his/her country. The results indicate substantial heterogeneity in the quality of primary care service delivery between and within countries. The availability of basic equipment, infrastructure, and essential medicines varies—public facilities, facilities in rural areas, and non-hospitals are more lacking compared with private facilities, urban facilities, and hospitals. In terms of patient care, health care providers’ ability to correctly diagnose and treat common health conditions is low and variably distributed. COVID-19 has catalyzed a long overdue health system redesign effort, and the Service Delivery Indicators surveys offer an opportunity to examine carefully the quality of service delivery, with an eye toward health system reform.
Publication(World Bank, Washington, DC, 2020-04-08) de Walque, Damien ; Friedman, Jed ; Gatti, Roberta ; Mattoo, Aaditya ; Mattoo, AadityaFaced with COVID-19 (Coronavirus), countries are taking drastic action based on little information. Two tests can help governments shorten and soften economically costly suppression measures while still containing the novel coronavirus (COVID-19) pandemic. The first—a PCR assay—identifies people currently infected by testing for the presence of live virus in the subject. The second—an antibody test—identifies those rendered immune after being infected by searching for COVID-19-specific antibodies. The first test can help contain the disease because it facilitates the identification of infected persons, the tracing of their contacts, and isolation in the very early stages of an epidemic—or after a period of suppression, in case of a resurgent epidemic. The second can help us assess the extent of immunity in the general population or subgroups, to finetune social isolation and to manage health care resources. Wide application of the two tests could transform the battle against COVID-19 (Coronavirus), but implementing either on a large scale in developing countries presents challenges. The first test is generally available, but needs to be processed in adequately equipped laboratories with trained staff. The second test is easy to perform and can be processed quickly on the spot, but at this stage it is produced and available only on a limited basis in a few countries. This policy brief reviews the use of both tests, suggests strategies to target their use, and discusses the benefits and costs of such strategies. If PCR assay testing, together with tracing and isolation, helps reduce the duration of suppression measures by two weeks, and antibody testing allows one-fifth of the immune return to work early, the gain could be about 2 percent of national income, or about $8 billion for a country like the Philippines. Because the estimated economic benefits of the tests are likely to far outweigh the cost, the international community must help countries develop the capacity to process the first test and procure the second.