Person:
Vermeersch, Christel M. J.

Global Practice on Health, Nutrition, and Population, The World Bank

Fields of Specialization

Impact evaluation, Health, Education

ORCID

0000-0001-9652-5546

External Links

ResearchGate

Departments

Global Practice on Health, Nutrition, and Population, The World Bank

Last updated January 31, 2023

Biography

Christel M. J. Vermeersch is a Senior Economist in the Health, Nutrition and Population Global Practice at the World Bank. She currently works on issues related to health sector financing, results-based financing, monitoring and evaluation and impact evaluation. She previously worked in the education, early childhood development and skills areas. Among other research, she has co-authored impact evaluation results for results-based financing programs in Rwanda and Argentina, as well as the book “Impact Evaluation in Practice.” Prior to joining the World Bank, she was a Prize Postdoctoral Research Fellow at Oxford University, U.K. She holds a Ph.D. in Economics from Harvard University.

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Publication Search Results

Now showing 1 - 10 of 12

Using Provider Performance Incentives to Increase HIV Testing and Counseling Services in Rwanda

(World Bank, Washington, DC, 2013-02) de Walque, Damien ; Gertler, Paul J. ; Bautista-Arredondo, Sergio ; Kwan, Ada ; Vermeersch, Christel ; de Dieu Bizimana, Jean ; Binagwaho, Agnès ; Condo, Jeanine

Paying for performance provides financial rewards to medical care providers for improvements in performance measured by specific utilization and quality of care indicators. In 2006, Rwanda began a paying for performance scheme to improve health services delivery, including HIV/AIDS services. This study examines the scheme's impact on individual and couples HIV testing and counseling and using data from a prospective quasi-experimental design. The study finds a positive impact of paying for performance with an increase of 6.1 percentage points in the probability of individuals having ever been tested. This positive impact is stronger for married individuals: 10.2 percentage points. The results also indicate larger impacts of paying for performance on the likelihood that the respondent reports both partners have ever been tested, especially among discordant couples (14.7 percentage point increase) in which only one of the partners is HIV positive.
Labor Market Returns to Early Childhood Stimulation : A 20-year Followup to an Experimental Intervention in Jamaica

(World Bank, Washington, DC, 2013-07) Gertler, Paul ; Heckman, James ; Pinto, Rodrigo ; Zanolini, Arianna ; Vermeersch, Christel ; Walker, Susan ; Chang-Lopez, Susan ; Grantham-McGregor, Sally

This paper finds large effects on the earnings of participants from a randomized intervention that gave psychosocial stimulation to stunted Jamaican toddlers living in poverty. The intervention consisted of one-hour weekly visits from community Jamaican health workers over a 2-year period that taught parenting skills and encouraged mothers to interact and play with their children in ways that would develop their children's cognitive and personality skills. The authors re-interviewed the study participants 20 years after the intervention. Stimulation increased the average earnings of participants by 42 percent. Treatment group earnings caught up to the earnings of a matched non-stunted comparison group. These findings show that psychosocial stimulation early in childhood in disadvantaged settings can have substantial effects on labor market outcomes and reduce later life inequality.
More Time is Better : An Evaluation of the Full-time School Program in Uruguay

(World Bank, Washington, DC, 2007-03) Cerdan-Infantes, Pedro ; Vermeersch, Christel

This paper estimates the impact of the full-time school program in Uruguay on standardized test scores of 6th grade students. The program lengthened the school day from a half day to a full day, and provided additional inputs to schools to make this possible, such as additional teachers and construction of classrooms. The program was not randomly placed, but targeted poor urban schools. Using propensity score matching, the authors construct a comparable group of schools, and show that students in very disadvantaged schools improved in their test scores by 0.07 of a standard deviation per year of participation in the full-time program in mathematics, and 0.04 in language. While the program is expensive, it may, if well targeted, help address inequalities in education in Uruguay, at an increase in cost per student not larger than the current deficit in spending between Uruguay and the rest of the region.
School Meals, Educational Achievement and School Competition : Evidence from a Randomized Evaluation

(World Bank, Washington, DC, 2005-02) Vermeersch, Christel ; Kremer, Michael

This paper examines the effects of subsidized school meals on school participation, educational achievement, and school finance in a developing country setting. The paper uses data from a program that was implemented in 25 randomly chosen preschools in a pool of 50. Children's school participation was 30 percent higher in the treatment group than in the comparison group. The meals program led to higher curriculum test scores, but only in schools where the teacher was relatively experienced prior to the program. The school meals displaced teaching time and led to larger class sizes. Despite improved incentives, teacher absenteeism remained at a high level of 30 percent. Treatment schools raised their fees, and comparison schools close to treatment schools decreased their fees. Some of the price effects are due to a combination of capacity constraints and pupil transfers that would not happen if the school meals were offered in all schools. The intention-to-treat estimator of the effect of the randomized program incorporates those price effects, and therefore it should be considered a lower bound on the effect of generalized school meals. This insight on price effects generalizes to other randomized program evaluations.
Using Performance Incentives to Improve Health Outcomes

(World Bank, Washington, DC, 2012-06) Gertler, Paul ; Vermeersch, Christel

This study examines the effect of performance incentives for health care providers to provide more and higher quality care in Rwanda on child health outcomes. The authors find that the incentives had a large and significant effect on the weight-for-age of children 0-11 months and on the height-for-age of children 24-49 months. They attribute this improvement to increases in the use and quality of prenatal and postnatal care. Consistent with theory, They find larger effects of incentives on services where monetary rewards and the marginal return to effort are higher. The also find that incentives reduced the gap between provider knowledge and practice of appropriate clinical procedures by 20 percent, implying a large gain in efficiency. Finally, they find evidence of a strong complementarity between performance incentives and provider skill.
Universal Health Coverage for Inclusive and Sustainable Development : Country Summary Report for Peru

(World Bank Group, Washington, DC, 2014-09) Vermeersch, Christel ; Medici, Andre C. ; Narvaez, Rory

Peru is an upper middle-income country that has experienced fast economic growth (average of 6.9 percent per year from 2004 to 2013, according World Developing Indicators, WDI) combined with a reduction in poverty and inequality over the past decade. Economic growth was led by exports and domestic demand, generating an increase in private investment, attracting foreign capital, and strengthening public finances. The population living in poverty and extreme poverty fell from 58.7 percent and 16.4 percent in 2004 to 25.8 percent and 6 percent in 2012, respectively (INEI 2014a). Inequality has also decreased, with the Gini index declining from 0.503 in 2004 to 0.48.1 in 2010 (WDI).
Long-Run Effects of Temporary Incentives on Medical Care Productivity

(World Bank, Washington, DC, 2015-06) Celhay, Pablo ; Gertler, Paul ; Giovagnoli, Paula ; Vermeersch, Christel

The adoption of new clinical practice patterns by medical care providers is often challenging, even when the patterns are believed to be efficacious and profitable. This paper uses a randomized field experiment to examine the effects of temporary financial incentives paid to medical care clinics for the initiation of prenatal care in the first trimester of pregnancy. The rate of early initiation of prenatal care was 34 percent higher in the treatment group than in the control group while the incentives were being paid, and this effect persisted at least 15 months and likely 24 months or more after the incentives ended. These results are consistent with a model where the incentives enable providers to address the fixed costs of overcoming organizational inertia in innovation, and suggest that temporary incentives may be effective at motivating improvements in long-run provider performance at a substantially lower cost than permanent incentives.
Using Provider Performance Incentives to Increase HIV Testing and Counseling Services in Rwanda

(Elsevier, 2014-12-12) de Walque, Damien ; Gertler, Paul J. ; Bautista-Arredondo, Sergio ; Kwan, Ada ; Vermeersch, Christel ; de Dieu Bizimana, Jean ; Binagwaho, Agnès ; Condo, Jeanine

Paying for performance provides financial rewards to medical care providers for improvements in performance measured by utilization and quality of care indicators. In 2006, Rwanda began a pay for performance scheme to improve health services delivery, including HIV/AIDS services. Using a prospective quasi-experimental design, this study examines the scheme's impact on individual and couples HIV testing. We find a positive impact of pay for performance on HIV testing among married individuals (10.2 percentage points increase). Paying for performance also increased testing by both partners by 14.7 percentage point among discordant couples in which only one of the partners is an AIDS patient.
Analysis of the Health Care Labor Market in Peru

(World Bank, Washington, DC, 2015-01) Jimenez, Michelle ; Mantilla, Eduardo ; Huayanay, Carlos ; Mego, Michael ; Vermeersch, Christel

This report aims to provide an updated analysis of labor market trends for the health workforce in Peru, focusing on the basic health team, physician, nurse, and midwife, and other health professionals related to current priorities. Peru has been labeled as a country with a shortage of health professionals (that is, with less than 25 professionals per 10,000 inhabitants), and although the most recent numbers indicate that the situation has improved, the shortages are bound to become more acute as the country aims to achieve Universal Health Coverage. The authors found that the country trains both in public and private universities a large number of professionals, but that the majority of trained professionals do not then go on to work for the public sector. This dynamic had not been described before and challenges current assumptions of human resources needs and availability. There is very little reliable data on numbers, type and work conditions for human resources working outside the public sector, including the social security insurance health system (EsSalud), other health insurance providers, and the private sector, and as a result no detailed information can be obtained about the distribution of health professionals outside the public sector. For policy purposes, it is necessary to improve the quality and integration of HRH information across the sector.
Effect of the Jamaica Early Childhood Stimulation Intervention on Labor Market Outcomes at Age 31

(World Bank, Washington, DC, 2021-09) Gertler, Paul ; Heckman, James ; Pinto, Rodrigo ; Chang-Lopez, Susan M. ; Grantham-McGregor, Sally ; Vermeersch, Christel ; Walker, Susan ; Wright, Amika S.

This paper reports the labor market effects of the Jamaica Early Childhood Stimulation intervention at age 31. The study is a small-sample randomized early childhood education stimulation intervention targeting stunted children living in the poor neighborhoods of Kingston, Jamaica. Implemented in 1987–89, treatment consisted of a two-year, home-based intervention designed to improve nutrition and the quality of mother-child interactions to foster cognitive, language, and psycho-social skills. The original sample was 127 stunted children between ages 9 and 24 months. The study was able to track and interview 75 percent of the original sample 30 years after the intervention, both still living in Jamaica and migrated abroad. The findings reveal large and statistically significant effects on income and schooling; the treatment group had 43 percent higher hourly wages and 37 percent higher earnings than the control group. This is a substantial increase over the treatment effect estimated for age 22, when a 25 percent increase in earnings was observed.