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Improving Effective Coverage in Health
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 compa...
Améliorer la couverture effective en matière de santé
Dans de nombreux pays à faible revenu et à revenu intermédiaire, la couverture sanitaire s’est considérablement améliorée au cours des deux dernières décennies, mais pas les résultats en matière de santé. Ainsi, la couverture effective — une mesure de la prestation de services qui répond à une norme minimale de qualité — demeure à un niveau inacceptable. Le rapport Améliorer la couverture effective en matière de santé examine une approche particulière visant à améliorer la couverture effective : les incitations financières sous la forme d’un financement basé sur la performance (FBP), une réforme globale qui comprend généralement la rémunération liée à la...
Undernutrition in the Philippines
For nearly 30 years, the rates of both wasting and stunting in the Philippines have been nearly flat. For 2019, the rate of stunting among children under five years of age (28.8 percent) was only slightly lower than in 2008 (32 percent)—the prevalence of underweight in 2019 was 19 percent and that of wasting was 6 percent. Based on the World Health Organization’s classification of undernutrition rates, the stunting prevalence of children in the Philippines is of “very high†? public health significance. The Philippines’ 29 percent stunting rate places it fifth among countries in the East Asia and Pacific region, and among the top 10 countries globally. The Philippines’ high levels...
Shock Waves
Ending poverty and stabilizing climate change will be two unprecedented global achievements and two major steps toward sustainable development. But the two objectives cannot be considered in isolation: they need to be jointly tackled through an integrated strategy. This report brings together those two objectives and explores how they can more easily be achieved if considered together. It examines the potential impact of climate change and climate policies on poverty reduction. It also provides guidance on how to create a “win-win†? situation so that climate change policies contribute to poverty reduction and poverty-reduction policies contribute to climate change mitigation and resilience building. The key finding of the report is that climate change represents a significant obstacle to the sustained eradication of poverty, but future impacts on poverty are determined by policy choices: rapid, inclusive, and climate-informed development can prevent most short-term impacts whereas immediate pro-poor, emissions-reduction policies can drastically limit long-term ones.
Food for thought? Experimental evidence on the learning impacts of a large-scale school feeding program in Ghana
There is very limited experimental evidence of the impact of large-scale, government-led school meals programs on child educational achievements in Sub-Saharan Africa. We address this gap by reporting treatment effects from a nationwide randomized trial of the Government of Ghana’s school feeding program (GSFP) on children’s math and literacy, cognition (problem-solving ability and working memory), and composite scores of overall attainments. Based on the government’s plans to re-target and scale up the GSFP, food insecure schools and related communities across the country were randomly assigned to school feeding. After two years of implementation, program availability led to moderate ...
Poverty and Shared Prosperity 2022
The COVID-19 pandemic triggered a pronounced setback in the fight against global poverty—likely the largest setback since World War II. Many low- and middle-income countries have yet to see a full recovery. High indebtedness in many countries has hindered a swift recovery, while rising food and energy prices—fueled in part by conflict and climate shocks—have made a return to progress on poverty reduction more challenging than ever. These setbacks have altered the trajectory of poverty reduction in large and lasting ways. The world is significantly off course on the goal of ending extreme poverty by 2030.The year 2020 also marked a historic turning point as decades of global income conv...
Altered Destinies
Growth is forecasted to slow down for the Middle East and North Africa region. The war in Ukraine in 2022 exacerbated inflationary pressures as the world recovered from the COVID 19 pandemic-induced recession. The response by central banks to raise rates to curb inflation is slowing economic activity, while rising food prices are making it difficult for families to put meals on the table. Inflation, when it stems from food prices, hits the poor harder than the rich. Moreover, food insecurity in MENA has been rising over decades. The immediate effects of food insecurity can be a devastating loss of life, but even temporary increases in food prices can cause long-term irreversible damages, especially to children. The rise in food prices due to the war in Ukraine may have altered the destinies of thousands of children in the region, setting them on paths to limited prosperity. Food insecurity imposes challenges to a region where the state of child nutrition and health were inadequate before the shocks from the COVID-19 pandemic. The report discusses policy options and highlights the need for data to guide effective decision making.
Cash transfers and intimate partner violence (IPV) in low- and middle-income settings: A joint research agenda to inform policy and practice
Over the last five years, there has been increasing interest from global stakeholders in the relationship between cash transfers and gender-based violence, and in particular, intimate partner violence (IPV). Interest has grown both within the development and humanitarian spaces, although empirical research is mainly concentrated in the former. A mixed-method review paper published in 2018 found that, across 22 quantitative or qualitative studies in low- and middle-income countries (LMICs), the majority (73%) showed that cash decreased IPV; however, two studies showed mixed effects, and several others showed heterogenous impacts (Buller et al. 2018). A more recent meta-analysis of 14 experime...
Foreign Aid and Its Unintended Consequences
Foreign aid and international development frequently bring with it a range of unintended consequences, both negative and positive. This book delves into these consequences, providing a fresh and comprehensive guide to understanding and addressing them. The book starts by laying out a theoretical framework based on complexity thinking, before going on to explore the ten most prevalent kinds of unintended effects of foreign aid: backlash effects, conflict effects, migration and resettlement effects, price effects, marginalization effects, behavioural effects, negative spillover effects, governance effects, environmental effects, and ripple effects. Each chapter revolves around a set of concret...
Do ultra-poor graduation programs build resilience against droughts? Evidence from rural Ethiopia
We study the role of a multifaceted ultra-poor graduation program in protecting household wellbeing and women’s welfare from the effects of localized droughts in Ethiopia. We use data from a large experimental trial of an integrated livelihood and nutrition intervention that supplemented the consumption support provided by Ethiopia’s Productive Safety Net Program (PSNP), conducted within a sample in which all households were beneficiaries of the PSNP. We match three rounds of household survey data to detailed satellite weather data to identify community-level exposure to droughts. We then exploit random assignment to the graduation program to evaluate whether exposed households show hete...
