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 10
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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
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
Teacher Shocks and Student Learning : Evidence from Zambia.
(World Bank, Washington, DC, 2005-04)A large literature examines the link between shocks to households and the educational attainment of children. The authors use new data to estimate the impact of shocks to teachers on student learning in mathematics and English. Using absenteeism in the 30 days preceding the survey as a measure of these shocks they find large impacts: A 5 percent increase in the teacher's absence rate reduces learning by 4 to 8 percent of average gains over the year. This reduction in learning achievement likely reflects both the direct effect of increased absenteeism and the indirect effects of less lesson preparation and lower teaching quality when in class. The authors document that health problems-primarily teachers' own illness and the illnesses of their family members-account for more than 60 percent of teacher absences; not surprising in a country struggling with an HIV/AIDS epidemic. The relationship between shocks to teachers and student learning suggests that households are unable to substitute adequately for teaching inputs. Excess teaching capacity that allows for the greater use of substitute teachers could lead to larger gains in student learning. -
Publication
Quality and Accountability in Healthcare Delivery: Audit Evidence from Primary Care Providers in India
(World Bank, Washington, DC, 2015-06)This paper presents direct evidence on the quality of health care in low-income settings using a unique and original set of audit studies, where standardized patients were presented to a nearly representative sample of rural public and private primary care providers in the Indian state of Madhya Pradesh. Three main findings are reported. First, private providers are mostly unqualified, but they spent more time with patients and completed more items on a checklist of essential history and examination items than public providers, while being no different in their diagnostic and treatment accuracy. Second, the private practices of qualified public sector doctors were identified and the same doctors exerted higher effort and were more likely to provide correct treatment in their private practices. Third, there is a strong positive correlation between provider effort and prices charged in the private sector, whereas there is no correlation between effort and wages in the public sector. The results suggest that market-based accountability in the unregulated private sector may be providing better incentives for provider effort than administrative accountability in the public sector in this setting. While the overall quality of care is low both sectors, the differences in provider effort may partly explain the dominant market share of fee-charging private providers even in the presence of a system of free public healthcare. -
Publication
Women in the Pipeline: A Dynamic Decomposition of Firm Pay Gaps
(World Bank, Washington, DC, 2020-06)This paper proposes a new decomposition method to understand how gender pay gaps arise within firms. The method accounts for pipeline effects, nonstationary environments, and dynamic interactions between pay gap components. This paper assembles a new data set covering all employees at the World Bank Group between 1987 and 2015 and shows that historical differences in the positions for which men and women were hired account for 77 percent of today's average salary difference, dwarfing the roles of entry salaries, salary growth, or retention. Forward simulations show that 20 percent of the total gap can be assigned to pipeline effects that would resolve mechanically with time. -
Publication
The Impact of Recall Periods on Reported Morbidity and Health Seeking Behavior
( 2011-08-01)Between 2000 and 2002, the authors followed 1621 individuals in Delhi, India using a combination of weekly and monthly-recall health questionnaires. In 2008, they augmented these data with another 8 weeks of surveys during which households were experimentally allocated to surveys with different recall periods in the second half of the survey. This paper shows that the length of the recall period had a large impact on reported morbidity, doctor visits, time spent sick, whether at least one day of work/school was lost due to sickness, and the reported use of self-medication. The effects are more pronounced among the poor than the rich. In one example, differential recall effects across income groups reverse the sign of the gradient between doctor visits and per-capita expenditures such that the poor use health care providers more than the rich in the weekly recall surveys but less in monthly recall surveys. The authors hypothesize that illnesses -- especially among the poor -- are no longer perceived as "extraordinary events" but have become part of "normal" life. They discuss the implications of these results for health survey methodology, and the economic interpretation of sickness in poor populations. -
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Mental Health Patterns and Consequences : Results from Survey Data in Five Developing Countries
(World Bank, Washington, DC, 2008-01)The social and economic consequences of poor mental health in the developing world are presumed to be significant, yet are largely under-researched. The authors argue that mental health modules can be meaningfully added to multi-purpose household surveys in developing countries, and used to investigate this relationship. Data from nationally representative surveys in Bosnia and Herzegovina, Indonesia, and Mexico, along with special surveys from India and Tonga, show similar patterns of association between mental health and socioeconomic characteristics across countries. Individuals who are older, female, widowed, and report poor physical health are more likely to report worse mental health outcomes. Individuals living with others with poor mental health are also significantly more likely to report worse mental health themselves. In contrast, there is little observed relationship between mental health and poverty or education, common measures of socio-economic status. The results instead suggest that economic and multi-dimensional shocks such as illness or crisis can have a greater impact on mental health than overall levels of poverty. This may have important implications for social protection policy. The authors also find significant associations between poor mental health and lowered labor force participation (especially for women) and higher frequency visits to health centers, suggesting that poor mental health can have significant economic consequences for households and the health system. Finally, the paper discusses how measures of mental health are distinct from general subjective welfare measures such as happiness and indicate useful directions of future research. -
Publication
The Quality of Medical Advice in Low-Income Countries
(World Bank, Washington, DC, 2008-01)This paper provides an overview of recent work on quality measurement of medical care and its correlates in four low and middle-income countries-India, Indonesia, Tanzania, and Paraguay. The authors describe two methods-testing doctors and watching doctors-that are relatively easy to implement and yield important insights about the nature of medical care in these countries. The paper discusses the properties of these measures, their correlates, and how they may be used to evaluate policy changes. Finally, the authors outline an agenda for further research and measurement. -
Publication
Compensation, Diversity and Inclusion at the World Bank Group
(World Bank, Washington, DC, 2017-05)This paper examines salary gaps by gender and nationality at the World Bank Group between 1987 and 2015 using a unique panel of all employees over this period. The paper develops and implements a dynamic simulation approach that models existing gaps as arising from differences in job composition at entry, entry salaries, salary growth and attrition. There are three main findings. First, 76 percent of the $27,400 salary gap across the average male and female staff at the World Bank Group can be attributed to composition effects, whereby men entered the World Bank Group at higher paid positions, particularly in the earlier half of the sample. Second, salary gaps 15 years after joining the World Bank Group can favor either men or women depending on their entry position. Third, for the most common entry-level professional position (known as Grade GF at the World Bank Group) there is a gender gap of 3.5 percent in favor of males 15 years after entry. The majority of this gap (84 percent) is due to differences in salary growth rather than differences in entry salaries or attrition. The pattern of these gaps is similar for staff from different nationalities. The dynamic decomposition method developed here thus identifies specific areas of concern and can be widely applied to the analysis of salary gaps within firms.