Person:
Das, Jishnu
Author Name Variants
Fields of Specialization
Health economics,
Education,
Gender,
Health,
Microeconomics,
Cultural economics,
India,
Pakistan,
Kenya,
Zambia,
Macroeconomic and Structural Policies
Degrees
ORCID
External Links
Departments
Development Research Group
Externally Hosted Work
Contact Information
Last updated
January 31, 2023
Biography
Jishnu Das is a Lead Economist in the Development Research Group (Human Development Team) at the World Bank and a Visiting Fellow at the Center for Policy Research, New Delhi. Jishnu’s work focuses on the delivery of basic services, particularly health and education. He has worked on the quality of health care, mental health, information in health and education markets, child learning and test-scores and the determinants of trust. His work has been published in leading economics, health and education journals and widely covered in the media and policy forums. In 2011 he was part of the core team on the World Development Report on Gender and Development. He received the George Bereday Award from the Comparative and International Education Society and the Stockholm Challenge Award for the best ICT project in the public administration category in 2006, and the Research Academy award from the World Bank in 2013. He is currently working on long-term projects on health and education markets in India and Pakistan.
Publication Search Results
1 - 10 of 22
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Publication
Equity in Educational Expenditures: Can Government Subsidies Help?
(World Bank, Washington, D.C., 2004-03)When there are externalities across households, governments can improve economic outcomes by equitably subsidizing education. But this chain of causality works only if (1) allocated resources reach the final recipients, and (2) equity in public subsidies translates directly into equity in total educational expenditures, including private spending at the household level. Using a unique data set from Zambia, the author shows that whether these conditions are met depends on the specific schemes used to allocate resources as well as the exact form of the subsidies. First, subsidies allocated through clear guidelines and legislated rules reached the final recipients, but those allocated at the discretion of province and educational offices did not. Second, even those components of subsidies that were progressive (in that the share of total subsidies for the poor was greater than the share for the non-poor) had no effect on inequality in total educational expenditures due to the crowding-out of household spending. -
Publication
Which Doctor? Combining Vignettes and Item Response to Measure Doctor Quality
(World Bank, Washington, D.C., 2004-05)The authors develop a method in which vignettes-a battery of questions for hypothetical cases-are evaluated with item response theory to create a metric for doctor quality. The method allows a simultaneous estimation of quality and validation of the test instrument that can be used for further refinements. The authors apply the method to a sample of medical practitioners in Delhi, India. The method gives plausible results, rationalizes different perceptions of quality in the public and private sectors, and pinpoints several serious problems with health care delivery in urban India. The findings confirm, for instance, that the quality of private providers located in poorer areas of the city is significantly lower than those in richer neighborhoods. Surprisingly, similar results hold for providers in the public sector, with important implications for inequities in the availability of health care. -
Publication
Conditional Cash Transfers and the Equity-Efficiency Debate
(World Bank, Washington, D.C., 2004-04)During the past decade, the use of conditional cash transfers to increase investment in human capital has generated considerable excitement in both research and policy forums. Such schemes are being increasingly adopted in a number of contexts and countries to improve outcomes in health, education, and child labor as they aim to balance the goals of current and future poverty reduction. In this paper, the authors define any scheme requiring a specified course of action in order to receive a benefit as a conditional cash transfer. This definition includes cash transfers based on human capital investments, but is sufficiently broad to encompass other schemes such as work-fare programs or consumption transfers. The authors examine the rationales behind, the problems with, and the tradeoffs inherent to conditional cash transfer programs. They discuss two main concerns: low participation and fungibility. Low participation refers to the problem of program uptake. If individuals do not participate in the program, whether it was designed to increase human capital investment or to target resources, the program will not be successful. The problem of fungibility, however, depends on the rationale for the particular conditional cash transfer program. When used to increase efficiency, even when program uptake is high, program effects may be less than envisioned due to behavioral responses of households that lead to changes in the consumption of close substitutes. While researchers have typically addressed these issues separately, the authors emphasize the need for policymakers to incorporate a number of different factors in a comprehensive framework to design optimal conditional cash transfer schemes. -
Publication
Strained Mercy: The Quality of Medical Care in Delhi
(World Bank, Washington, D.C., 2004-03)The quality of medical care is a potentially important determinant of health outcomes. Nevertheless, it remains an understudied area. The limited research that exists defines quality either on the basis of drug availability or facility characteristics, but little is known about how provider quality affects the provision of health care. The authors address this gap through a survey in Delhi with two related components. They evaluate "competence" (what providers know) through vignettes and practice (what providers do) through direct clinical observation. Overall quality as measured by the competence necessary to recognize and handle common and dangerous conditions is quite low, albeit with tremendous variation. While there is some correlation with simple observed characteristics, there is still an enormous amount of variation within such categories. Further, even when providers know what to do they often do not do it in practice. This appears to be true in both the public and private sectors though for very different, and systematic, reasons. In the public sector providers are more likely to commit errors of omission-they are less likely to exert effort compared with their private counterparts. In the private sector, providers are prone to errors of commission-they are more likely to behave according to the patient's expectations, resulting in the inappropriate use of medications, the overuse of antibiotics, and increased expenditures. This has important policy implications for our understanding of how market failures and failures of regulation in the health sector affect the poor. -
Publication
When Can School Inputs Improve Test Scores?
(World Bank, Washington, D.C., 2004-02)The relationship between school inputs and educational outcomes is critical for educational policy. The authors recognize that households will respond optimally to changes in school inputs and study how such responses affect the link between school inputs and cognitive achievement. To incorporate the forward-looking behavior of households, the authors present a household optimization model relating household resources and cognitive achievement to school inputs. In this framework, if household and school inputs are technical substitutes in the production function for cognitive achievement, the impact of unanticipated inputs is larger than that of anticipated inputs. The authors test the predictions of the model for nonsalary cash grants to schools using a unique data set from Zambia. They find that household educational expenditures and school cash grants are substitutes with a coefficient of elasticity between -0.35 and -0.52. Consistent with the optimization model, anticipated funds have no impact on cognitive achievement, but unanticipated funds lead to significant improvements in learning. This methodology has important implications for educational research and policy. -
Publication
Reassessing Conditional Cash Transfer Programs
(Oxford University Press on behalf of the World Bank, 2005-03-01)During the past decade, the use of conditional cash transfer programs to increase investment in human capital has generated considerable excitement in both research and policy forums. This article surveys the existing literature, which suggests that most conditional cash transfer programs are used for essentially one of two purposes: restoring efficiency when externalities exist or improving equity by targeting resources to poor households. The programs often meet their stated objectives, but in some instances there is tension between the efficiency and equity objectives. The overall impact of a program depends on the gains and losses associated with each objective. -
Publication
Short but not Sweet : New Evidence on Short Duration Morbidities from India
(World Bank, Washington, DC, 2003-02)India spends 6 percent of its GDP on health-three times the amount spent by Indonesia and twice that of China-and spending on non-chronic morbidities is three times that of chronic illnesses. It is normally assumed that the high spending on non-chronic illnesses reflects the prevalence of morbidities with high case-fatality or case-disability ratios. But there is little data that can be used to separate out spending by type of illness. The authors address this issue with a unique dataset where 1,621 individuals in Delhi were observed for 16 weeks through detailed weekly interviews on morbidity and health-seeking behavior. The authors' findings are surprising and contrary to the normal view of health spending. They define a new class of illnesses as "short duration morbidities" if they are classified as non-chronic in the international classification of disease and are medically expected to last less than two weeks. The authors show that short duration morbidities are important in terms of prevalence, practitioner visits, and household health expenditure: Individuals report a short duration morbidity in one out of every five weeks. Moreover, one out of every three weeks reported with a short duration morbidity results in a doctor visit, and each week sick with such a morbidity increases health expenditure by 25 percent. Further, the absolute spending on short duration morbidities is similar across poor and rich income households. The authors discuss the implications of these findings in understanding household health behavior in an urban context, with special emphasis on the role of information in health-seeking behavior. -
Publication
India Shining and Bharat Drowning : Comparing Two Indian States to the Worldwide Distribution in Mathematics Achievement
(World Bank, Washington, DC, 2008-06)This paper uses student answers to publicly released questions from an international testing agency together with statistical methods from Item Response Theory to place secondary students from two Indian states -Orissa and Rajasthan -on a worldwide distribution of mathematics achievement. These two states fall below 43 of the 51 countries for which data exist. The bottom 5 percent of children rank higher than the bottom 5 percent in only three countries-South Africa, Ghana and Saudi Arabia. But not all students test poorly. Inequality in the test-score distribution for both states is next only to South Africa in the worldwide ranking exercise. Consequently, and to the extent that these two states can represent India, the two statements "for every ten top performers in the United States there are four in India" and "for every ten low performers in the United States there are two hundred in India" are both consistent with the data. The combination of India's size and large variance in achievement give both the perceptions that India is shining even as Bharat, the vernacular for India, is drowning. Comparable estimates of inequalities in learning are the building blocks for substantive research on the correlates of earnings inequality in India and other low-income countries; the methods proposed here allow for independent testing exercises to build up such data by linking scores to internationally comparable tests. -
Publication
Patient Satisfaction, Doctor Effort and Interview Location: Evidence from Paraguay
(World Bank, Washington, DC, 2006-12)To examine the relationship between patient satisfaction and doctor performance, the authors observed 2,271 interactions between 292 doctors and their patients in 98 clinics and hospitals in Paraguay and conducted an exit-survey with the same patients as they left the clinic. For a subsample of 64 facilities they also interviewed patients who visited the facility within the last week. There are three patterns in the data: (1) Patient satisfaction is positively correlated with doctor effort, measured as a combination of time spent, questions asked, and examinations performed after controlling for observed doctor and patient characteristics; (2) However, accounting for unobserved doctor characteristics dramatically reduces the level of significance and size of correlation between effort and satisfaction, showing that much of the positive relationship is driven by these unobserved doctor-specific factors; and (3) Reported satisfaction is significantly lower for patients interviewed at home compared with those interviewed at the clinic. This leads the authors to conclude that even if patient satisfaction reflects some aspects of the doctor's performance, unobserved heterogeneity combined with survey biases limit the widespread applicability of patient satisfaction as an indicator of doctor performance. -
Publication
A Dime a Day : The Possibilities and Limits of Private Schooling in Pakistan
(Washington, DC : World Bank, 2006-11)This paper looks at the private schooling sector in Pakistan, a country that is seriously behind schedule in achieving the Millennium Development Goals. Using new data, the authors document the phenomenal rise of the private sector in Pakistan and show that an increasing segment of children enrolled in private schools are from rural areas and from middle-class and poorer families. The key element in their rise is their low fees-the average fee of a rural private school in Pakistan is less than a dime a day (Rs.6). They hire predominantly local, female, and moderately educated teachers who have limited alternative opportunities outside the village. Hiring these teachers at low cost allows the savings to be passed on to parents through low fees. This mechanism-the need to hire teachers with a certain demographic profile so that salary costs are minimized-defines the possibility of private schools: where they arise, fees are low. It also defines their limits. Private schools are horizontally constrained in that they arise in villages where there is a pool of secondary educated women. They are also vertically constrained in that they are unlikely to cater to the secondary levels in rural areas, at least until there is an increase in the supply of potential teachers with the required skills and educational levels.