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Working in health : financing and managing the public sector health workforce
'Working in Health' addresses two key questions related to health workforce policy in developing countries: • What is the impact of government wage bill policies on the size of the health wage bill and on health workforce staffing levels in the public sector? • Do current human resources management policies and practices lead to effective use of wage bill resources in the public sector? Health workers play a key role in increasing access to health services for poor people in developing countries. Global and country level estimates show that staffing levels in many developing countries—particularly in sub-Saharan Africa—are far below what is needed to deliver essential health services to the population. One factor that potentially limits scaling up the health workforce in developing countries is the government overall wage bill policy which sometimes creates restrictions. Through a review of literature, analysis of data, and country case studies in Kenya, Zambia, Rwanda, and the Dominican Republic, this book examines the process that determines the health wage bill budget in the public sector, how this is linked to overall wage bill policies, how this affects staffing levels in the health sector, and the relevant policy options. But staff numbers are not everything and more money for the health wage bill alone will not solve the health workforce problems of developing countries. 'Working in Health' looks at how effectively governments use the available wage bill resources in the health sector and policy options. Policies and practices in recruitment, deployment, promotion, transfer, sanctioning, and remuneration for health workers are reviewed to identify their influence on budget execution rates, geographic distribution, and productivity of health workers.
eBook
An assessment of the investment climate in Nigeria
Nigeria's Vision 2020 has expressed a bold desire for the country to be among the world's top 20 economies by the year 2020. The economy has posted impressive growth figures since 2003, driven by higher oil revenues and a series of home-grown economic reforms. The country is now firmly on the road to middle-income status. But what else do government and the private sector need to do to create the jobs and growth that will underpin the national development strategy? What are the challenges that Nigeria's businesses face today? 'An Assessment of the Investment Climate in Nigeria' provides answers to these questions. Based on a survey of 2,300 companies, it provides evidence-based recommendations designed to support Vision 2020 and the president's seven-point agenda. The authors find that government must move quickly to create jobs and reduce poverty. Key challenges include a desperate shortage of energy and a poor transportation network, as well as low levels of education and continuing unrest in the Niger delta. In addition, Nigeria's workers need to become more productive in order to compete in a globalized economy. As a matter of fact, they are less productive than workers in more dynamic countries, such as Brazil, China, and Kenya. Improving productivity will require simultaneous efforts to foster competition, improve specific aspects of the business environment, and facilitate better management and training within individual firms. In addition to the issues of productivity, Nigeria's best firms have not been able to expand their market share. Consequently, policy makers need to address and elimate obstacles to competition, including barriers to entry, convoluted taxation, property registration, and licensing.
eBook
Reducing poverty and investing in people
The World Bank Africa Social Protection Strategy for 2012-22 highlights the need for a strong evidence base to inform the design and implementation of social protection programs in Africa. Since 2009 the World Bank has conducted comprehensive social safety net assessments in 22 countries in Sub-Saharan Africa. The countries reviewed are Benin, Botswana, Burkina Faso, Cameroon, Ethiopia, Ghana, Kenya, Lesotho, Liberia, Madagascar, Malawi, Mali, Mauritania, Mauritius, Mozambique, Niger, Rwanda, Sierra Leone, Swaziland, Tanzania, Togo and Zambia. The findings of these assessments and other studies of safety net programs were recently synthesized into a regional review. This review provides an assessment of the current status of safety net programs in Africa and presents lessons on how they can be strengthened to better tackle poverty and vulnerability. The review finds that social safety nets are on the rise in Africa, and beginning to evolve from scattered stand-alone programs into safety net systems. Until recently, many African countries approached social protection on a largely ad hoc basis. Then the global economic crisis threatened recent progress in poverty reduction. Now social protection programming has started to develop from emergency food aid programs to one-off safety net interventions, and then to targeted cash transfers and cash-for-work programs. Some countries now seek to consolidate programs into national systems. There is progress towards articulating national social protection strategies, but there is still a long way to go.
eBook
The Investment Climate in Brazil, India, and South Africa : A Comparison of Approaches for Sustaining Economic Growth in Emerging Economies
This book seeks to contribute to the sharing of knowledge between Brazil, India, and South Africa, three of the largest emerging economies today. By assessing and comparing the investment climate in each, the authors seek to profile concrete steps that countries can take to improve the business environment. The authors focus particularly on identifying the commonalities and differences both within and among the three countries and attempt to highlight examples where policy makers will be able to drawn on the lessons from their own reform experiences and those of their counterparts in other core emerging markets. The book is organized as follows: (1) Provides a brief overview of the investment climate in each of the three countries, highlighting the key constraints identified by the national business communities, and explains the underlying concepts of the investment climate assessments and doing business indicators. (2) Examines the macroeconomic performance of Brazil, India, and South Africa and shows how the three countries perform with regard to taxation and foreign trade and exchange. (3) Reviews key microeconomic regulations, such as rules regarding the entry and exit of firms and labor regulations, and assesses the enforcement of contracts and regulations. (4) Studies the set of services, factors, and conditions that firms require when establishing operations and engaging in production and exchange, including access to finance, physical infrastructure, cost and availability of labor, and security. (5) Offers guidance on how to manage investment climate reforms by showcasing best-practice examples from recent reforms in Brazil, India, and South Africa.
Publication
Ordinary Families, Extraordinary Lives: Assets and Poverty Reduction in Guayaquil, 1978-2004
Fifty years after Oscar Lewis's famous depiction of five Mexican families caught in a \"culture of poverty,\" Caroline Moser tells a very different story of five neighborhood women and their families strategically accumulating assets to escape poverty in the Ecuadoran city of Guayaquil. InOrdinary Families, Extraordinary Lives, Moser shows how a more sophisticated understanding of the complexities of asset accumulation as well as poverty itself can help counter inaccurate stereotypes about global poverty. It provides invaluable insight into strategies that may help people in developing countries improve their wellbeing.
The similar socioeconomic characteristics and economic circumstances of the Guayaquil families in 1978, when Moser began her research, set the stage for a natural experiment. By 2004, these circumstances varied widely. Moser captures the causes and consequences of these developments through economic data, anthropological narrative, and personal photos. She then places this compelling story within the broader context of political, economic, and spatial changes in Guayaquil and Ecuador.
Moser describes how households in a Third World urban slum relentlessly and systematically fought to accumulate human, social, and financial capital assets. Her longitudinal account of their odyssey captures long-term trends and changes in perception that are missed in snapshot assessments. Chapters in this holistic story cover diverse issues such as housing and infrastructure, community mobilization and political negotiation, employment, family dynamics, violence, and emigration.
eBook
Does the Classic Microfinance Model Discourage Entrepreneurship Among the Poor? Experimental Evidence from India
Do the repayment requirements of the classic microfinance contract inhibit investment in high-return but illiquid business opportunities among the poor? Using a field experiment, we compare the classic contract which requires that repayment begin immediately after loan disbursement to a contract that includes a two-month grace period. The provision of a grace period increased short-run business investment and long-run profits but also default rates. The results, thus, indicate that debt contracts that require early repayment discourage illiquid risky investment and thereby limit the potential impact of microfinance on microenterprise growth and household poverty.
Journal Article
It's not like I'm poor : how working families make ends meet in a post-welfare world
The world of welfare has changed radically. As the poor trade welfare checks for low-wage jobs, their low earnings qualify them for a hefty check come tax time—a combination of the earned income tax credit and other refunds. For many working parents this one check is like hitting the lottery, offering several months' wages as well as the hope of investing in a better future. Drawing on interviews with 115 families, the authors look at how parents plan to use this annual cash windfall to build up savings, go back to school, and send their kids to college. However, these dreams of upward mobility are often dashed by the difficulty of trying to get by on meager wages. In accessible and engaging prose, It's Not Like I'm Poor examines the costs and benefits of the new work-based safety net, suggesting ways to augment its strengths so that more of the working poor can realize the promise of a middle-class life.
eBook
Why Don't the Poor Save More? Evidence from Health Savings Experiments
Using data from a field experiment in Kenya, we document that providing individuals with simple informal savings technologies can substantially increase investment in preventative health and reduce vulnerability to health shocks. Simply providing a safe place to keep money was sufficient to increase health savings by 66 percent. Adding an earmarking feature was only helpful when funds were put toward emergencies, or for individuals that are frequently taxed by friends and relatives. Group-based savings and credit schemes had very large effects.
Journal Article
Effect of Financial Inclusion on Poverty and Vulnerability to Poverty: Evidence Using a Multidimensional Measure of Financial Inclusion
This study examines the effect of financial inclusion on poverty and vulnerability to poverty of Ghanaian households. Using data extracted from the seventh round of the Ghana Living Standards Survey in 2016/17, a multiple correspondence analysis is employed to generate a financial inclusion index, and three-stage feasible least squares is used to estimate households’ vulnerability to poverty. Endogeneity associated with financial inclusion is resolved using distance to the nearest bank as an instrument in an instrumental variables probit technique. Results showed that while 23.4% of Ghanaians are considered poor, about 51% are vulnerable to poverty. We found that an increase in financial inclusion has two effects on household poverty. First, it is associated with a decline in a household’s likelihood of being poor by 27%. Second, it prevents a household’s exposure to future poverty by 28%. Female-headed households have a greater chance of experiencing a larger reduction in poverty and vulnerability to poverty through enhanced financial inclusion than do male-headed households. Furthermore, financial inclusion reduces poverty and vulnerability to poverty more in rural than in urban areas. Governments are encouraged to design or enhance policies that provide an enabling environment for the private sector to innovate and expand financial services to more distant places. Government investment in, and regulation of, the mobile money industry will be a necessary step to enhancing financial inclusion in developing countries.
Journal Article