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  • 1
    Online Resource
    Online Resource
    How Subjective Beliefs about HIV Infection Affect Life-Cycle Fertility : Evidence from Rural Malawi (2013)
    Washington, D.C : The World Bank
    Details
    Language: English
    Pages: Online-Ressource (53 p)
    Edition: 2013 World Bank eLibrary
    Parallel Title: Shapira, Gil How Subjective Beliefs about HIV Infection Affect Life-Cycle Fertility
    Abstract: This paper studies the effect of subjective beliefs about HIV infection on fertility decisions in a context of high HIV prevalence and simulates the impact of different policy interventions, such as HIV testing programs and prevention of mother-to-child transmission, on fertility and child mortality. It develops a model of women's life-cycle, in which women make sequential fertility decisions. Expectations about the life horizon and child survival depend on women's perceived exposure to HIV infection, which is allowed to differ from the actual exposure. In the model, women form beliefs about their HIV status and about their own and their children's survival in future periods. Women update their beliefs with survival to each additional period as well as when their HIV status is revealed by an HIV test. Model parameters are estimated by maximum likelihood with longitudinal data from the Malawi Diffusion and Ideational Change Project, which contain family rosters, information on HIV testing, and measures of subjective beliefs about own HIV status. The model successfully fits the fertility patterns in the data, as well as the distribution of reported beliefs about own HIV status. The analysis uses the model to assess the effect of HIV on fertility by simulating behavior in an environment without HIV. The results show that the presence of HIV reduces the average number of births a woman has during her life-cycle by 0.15. The paper also finds that HIV testing can reduce the fertility of infected women, leading to a reduction of child mortality and orphan-hood
    DOI: 10.1596/1813-9450-6343
    URL: Volltext  (Deutschlandweit zugänglich)
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    MPI Ethno. Forsch.
  • 2
    Online Resource
    Online Resource
    Effects of Performance Incentives for Community Health Worker Cooperatives in Rwanda (2017)
    Washington, D.C : The World Bank
    Details
    Language: English
    Pages: 1 Online-Ressource (34 p)
    Series Statement: World Bank E-Library Archive
    Parallel Title: Erscheint auch als Shapira, Gil Effects of Performance Incentives for Community Health Worker Cooperatives in Rwanda
    Abstract: This paper presents the results of a randomized controlled trial set to evaluate the effects of a pay-for-performance scheme that rewarded community health worker cooperatives for the utilization of five targeted maternal and child health services by their communities. The experiment took place in 19 districts in Rwanda between 2010 and 2014. The analysis finds no impact of the performance payments on coverage of the targeted services, attitudes and behaviors of community health workers, or outcomes at the cooperative level. No synergies are found between the scheme and a demand-side, in-kind transfer intervention that was independently effective in increasing coverage rates of targeted services
    DOI: 10.1596/1813-9450-8059
    URL: Volltext  (Deutschlandweit zugänglich)
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  • 3
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    Online Resource
    The Effects of In-Kind Demand-Side Conditional Transfers for Improving Uptake of Maternal and Child Health Services in Rwanda (2017)
    Washington, D.C : The World Bank
    Details
    Language: English
    Pages: 1 Online-Ressource (21 p)
    Series Statement: World Bank E-Library Archive
    Parallel Title: Erscheint auch als Shapira, Gil The Effects of In-Kind Demand-Side Conditional Transfers for Improving Uptake of Maternal and Child Health Services in Rwanda
    Abstract: To diagnose and treat preventable threats to maternal and neonatal health in Sub-Saharan Africa, a policy focus has been put on increasing coverage rates of targeted health services. Exploiting an experimental design, this study evaluates the impacts of an in-kind conditional transfer intervention in Rwanda that endowed women with gifts for receiving timely antenatal and postnatal care, as well as for delivering in health facilities. The analysis finds that although health centers experienced frequent stock outs of the gifts, the rate of women who initiated antenatal care within the first four months of their pregnancy increased by 7.7 percent, and that of women who received postnatal care in the 10 days following delivery increased by 8.6 percent. No impact was found on the rate of in-facility deliveries, which independently sharply increased during the years of the implementation of the program
    DOI: 10.1596/1813-9450-8060
    URL: Volltext  (Deutschlandweit zugänglich)
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    MPI Ethno. Forsch.
  • 4
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    Online Resource
    Financial Incentives, Fertility, and Son Preference in Armenia (2021)
    Washington, D.C : The World Bank
    Details
    Language: English
    Pages: 1 Online-Ressource (39 pages)
    Parallel Title: Erscheint auch als Print Version: Pinto, Maria Florencia Financial Incentives, Fertility, and Son Preference in Armenia
    Abstract: Armenia experienced dramatic demographic changes in the past three decades: the share of adults age 65 and over nearly doubled, the total fertility rate reduced by more than 30 percent, and the male-to-female sex ratio at birth increased to one of the world's highest. Like other middle-income countries concerned with the implications of an aging population for long-term growth and fiscal sustainability, Armenia introduced financial incentives to promote fertility. This paper estimates the effect of the 2009 reform of the universal Childbirth Benefit Program, which increased the amounts of lump sum transfers conditional on birth. The analysis relies on a quasi-experimental strategy exploiting the timing of the policy change and eligibility rule-women get a larger transfer for third and higher-order births. The findings show that the annual probability of an additional birth among women with at least two other children increased between 1.4 and 1.6 percentage points in the five years following the policy change. These effects are equivalent to 58 and 64 percent of the pre-reform birth probability for women who had at least two children. Given the previously demonstrated relationship between fertility level and sex ratio in societies with strong son preference, the reform may potentially alleviate the sex imbalance without directly targeting it. Parents who already have at least one son and are less likely to engage in sex selection and more likely to have additional births; however, the findings do not indicate a significant increase in the likelihood of having daughters
    DOI: 10.1596/1813-9450-9705
    URL: Deutschlandweit zugänglich
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  • 5
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    Online Resource
    Improving Effective Coverage in Health : do financial incentives work? (2022)
    Washington, D.C : The World Bank
    Details
    ISBN: 9781464818257
    Language: English
    Pages: 1 Online-Ressource (pages cm)
    Series Statement: Policy research report
    Parallel Title: Erscheint auch als
    Abstract: In many low- and middle-income countries, health coverage has improved dramatically in the past two decades, but health outcomes have not. As such, effective coverage-a measure of service delivery that meets a minimum standard of quality-remains unacceptably low. Improving Effective Coverage in Health examines one specific policy approach to improving effective coverage: financial incentives in the form of performance-based financing (PBF), a package reform that typically includes performance pay to frontline health workers as well as facility autonomy, transparency, and community engagement. This Policy Research Report draws on a rich set of rigorous studies and new analysis. When compared with business-as-usual, in low-income settings with centralized health systems PBF can result in substantial gains in effective coverage. However, the relative benefits of PBF-the performance pay component in particular-are less clear when it is compared with two alternative approaches, direct facility financing, which provides operating budgets to frontline health services with facility autonomy on allocation, but not performance pay, and demand-side financial support for health services (that is, conditional cash transfers and vouchers). Although PBF often results in improvements on the margins, closing the substantial gaps in effective health coverage is not yet within reach for many countries. Nonetheless, important lessons and experiences from the rollout of PBF over the past decade can guide health financing into the future. In particular, to be successful, health financing reform may need to pivot from performance pay while retaining the elements of direct facility financing, autonomy, transparency, and community engagement--
    URL: lizenzpflichtig
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  • 6
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    Online Resource
    HIV Testing, Behavior Change, and the Transition to Adulthood in Malawi (2014)
    Washington, D.C : The World Bank
    Details
    Language: English
    Pages: Online-Ressource (33 p)
    Edition: 2014 World Bank eLibrary
    Parallel Title: Beegle, Kathleen HIV Testing, Behavior Change, and the Transition to Adulthood in Malawi
    Abstract: For young adults living in countries with AIDS epidemics, getting an HIV test may influence near-term decisions, such as when to leave school, when to marry, and when to have a first child. These behaviors, which define the transition from adolescence to adulthood, have long-term implications on well-being and directly affect a person's risk of contracting HIV. Using an experimental design embedded in a panel survey from Malawi, this study assesses the impact of voluntary counseling and testing of young adults for HIV on these decisions. The results show negligible intent-to-treat effect of HIV testing on behaviors. There is some suggestive evidence on differential response by wealth and by prior beliefs about one's status
    DOI: 10.1596/1813-9450-6825
    URL: Volltext  (Deutschlandweit zugänglich)
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  • 7
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    Online Resource
    The Intergenerational Mortality Tradeoff of COVID-19 Lockdown Policies (2021)
    Washington, D.C : The World Bank
    Details
    Language: English
    Pages: 1 Online-Ressource (55 pages)
    Parallel Title: Erscheint auch als Print Version: Ma, Lin The Intergenerational Mortality Tradeoff of COVID-19 Lockdown Policies
    Abstract: In lower-income countries, the economic contractions that accompany lockdowns to contain the spread of COVID-19 can increase child mortality, counteracting the mortality reductions achieved by the lockdown. To formalize and quantify this effect, this paper builds a macro-susceptible-infected-recovered model that features heterogeneous agents and a country-group-specific relationship between economic downturns and child mortality. The model is calibrated to data for 85 countries across all income levels. The findings show that in low-income countries, a lockdown can potentially lead to 1.76 children's lives lost due to the economic contraction per COVID-19 fatality averted. The figure stands at 0.59 and 0.06 in lower-middle-income and upper-middle-income countries, respectively. As a result, in some countries, lockdowns can produce net increases in mortality. The optimal lockdowns are shorter and milder in poorer countries than in rich ones and never produce a net mortality increase
    DOI: 10.1596/1813-9450-9677
    URL: Deutschlandweit zugänglich
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  • 8
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    Online Resource
    Incentivizing quantity and quality of care : evidence from an impact evaluation of performance-based financing in the health sector in Tajikistan (2019)
    Washington, DC, USA : World Bank Group, Development Economics, Development Research Group & Health, Nutrition and Population Global Practice
    Details
    Language: English
    Pages: 1 Online-Ressource (circa 47 Seiten) , Illustrationen
    Series Statement: Policy research working paper 8951
    Series Statement: World Bank E-Library Archive
    Series Statement: Policy research working paper
    Parallel Title: Erscheint auch als Ahmed, Tashrik Incentivizing Quantity and Quality of Care: Evidence from an Impact Evaluation of Performance-Based Financing in the Health Sector in Tajikistan
    Keywords: Graue Literatur
    Abstract: This paper presents the results of an impact evaluation of a performance-based financing pilot in rural areas of two regions of Tajikistan. Primary care facilities were given financial incentives conditional on general quality and the quantity provided of selected services related to reproductive, maternal and child health, and hypertension-related services. The study relies on a difference-in-difference design and large-scale household and facility-based surveys conducted before the launch of the pilot in 2015 and after three years of implementation. The performance-based financing pilot had positive impacts on quality of care. Significant impacts are measured on facility infrastructure, infection prevention and control standards, availability of equipment and medical supplies, provider competency, provider satisfaction, and even some elements of the content of care, measured through direct observations of provider-patient interactions. While the communities in the performance-based financing districts reported higher satisfaction with the local primary care facilities, and despite the improvements in quality, the findings suggest moderate effects on utilization: among the incentivized utilization indicators, only timely postnatal care and blood pressure measurements for adults were significantly impacted
    DOI: 10.1596/1813-9450-8951
    URL: lizenzpflichtig
    URL: Deutschlandweit zugänglich
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  • 9
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    Online Resource
    Inequality in the quality of health services : wealth, content of care, and price of antenatal consultations in the Democratic Republic of Congo (2019)
    Washington, DC, USA : World Bank Group, Development Economics, Development Research Group
    Details
    Language: English
    Pages: 1 Online-Ressource (circa 38 Seiten) , Illustrationen
    Series Statement: Policy research working paper 8818
    Series Statement: World Bank E-Library Archive
    Series Statement: Policy research working paper
    Parallel Title: Erscheint auch als Fink, Gunther Inequality in the Quality of Health Services: Wealth, Content of Care, and Price of Antenatal Consultations in the Democratic Republic of Congo
    Keywords: Graue Literatur
    Abstract: Using unique direct observations of patient-provider interactions linked to patient exit interviews and detailed household surveys, this paper assesses the relationship between patient wealth and the quality and price of antenatal care in the Democratic Republic of Congo. Overall, the analysis finds a significant wealth-quality gradient, with a standard deviation increase in wealth being associated with an increase of 4 percentage points in protocol compliance. This increase in compliance represents 8 percent of the average quality of care received by women in the lowest wealth quintile. Over half of the wealth-quality gradient is driven by lower facility quality in poorer areas. However, the analysis also finds statistically significant within-village and even within-facility wealth-quality relationships. Within villages, wealth-quality gradients are primarily driven by wealthier women seeking care at higher-quality even if more distant facilities. Within the same facilities, poorer women tend to receive worse care, but on average they also pay less for the same quality of care compared with wealthier women. The price gap increases in the local ratio of wealthy to poor households, suggesting that providers do not charge different prices only for redistributive reasons
    DOI: 10.1596/1813-9450-8818
    URL: Volltext  (lizenzpflichtig)
    URL: Deutschlandweit zugänglich
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    MPI Ethno. Forsch.
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