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The Impoverishing Effect of Adverse Health Events: Evidence from the Western Balkans
Abstract: This paper investigates the extent to which the health systems of the Western Balkans (Albania, Bosnia and Herzegovina, Montenegro, Serbia, and Kosovo) have succeeded in providing financial protection against adverse health events. The authors examine disparities in health status, healthcare utilization, and out-of-pocket payments for healthcare (including informal payments), and explore the impact of healthcare expenditures on household economic status and poverty. Methodologies include (i) generating a descriptive assessment of health and healthcare disparities across socioeconomic groups, (ii) measuring the incidence and intensity of catastrophic healthcare payments, (iii) exami...
As Time Goes By in Argentina
The process of demographic transition through which Argentina is passing is a window of both opportunities and challenges in economic and social terms. Argentina is still a young country in which the working-age population represents the largest proportion of its total population. Currently, the country just began a 30-year period with the most advantageous age structure of its population, which could favor greater economic growth. This situation, known as the 'demographic window of opportunity,' will last until the beginning of the 2040s. The dynamics of the fertility and mortality rates signify a gradual ageing of the population, with implications for various dimensions of the economy, the...
Growing Old in an Older Brazil
Brazil is in the middle of a profound socioeconomic transformation driven by demographic change. Because of profound changes in mortality and, especially, fertility over the past four decades the population at older ages then begun to increase, a trend that will become more and more rapid as time progresses. While it took more than a century for France's population, aged 65 and above, to increase from 7 to 14 percent of the total population, the same demographic change will occur in the next two decades in Brazil (between 2011 and 2031). The elderly population will more than triple within the next four decades, from less than 20 million in 2010 to approximately 65 million in 2050. On the one...
Short But Not Sweet
India spends 6 percent of its GDP on health-three times the amount spent by Indonesia and twice that of China-and spending on non-chronic morbidities is three times that of chronic illnesses. It is normally assumed that the high spending on non-chronic illnesses reflects the prevalence of morbidities with high case-fatality or case-disability ratios. But there is little data that can be used to separate out spending by type of illness. The authors address this issue with a unique dataset where 1,621 individuals in Delhi were observed for 16 weeks through detailed weekly interviews on morbidity and health-seeking behavior. The authors' findings are surprising and contrary to the normal view o...
The Social Impact of Social Funds in Jamaica
Rao and Ibáñez develop an evaluation method that combines qualitative evidence with quantitative survey data analyzed with propensity score methods on matched samples to study the impact of a participatory community-driven social fund on preference targeting, collective action, and community decisionmaking. The data come from a case study of five pairs of communities in Jamaica where one community in the pair has received funds from the Jamaica social investment fund (JSIF) while the other has not--but has been picked to match the funded community in its social and economic characteristics. The qualitative data reveal that the social fund process is elite-driven and decisionmaking tends to...
Policy Options for Meeting the Millenium Development Goals in Brazil
Ferreira and Leite investigate whether micro-simulation techniques can shed light on the types of policies that should be adopted by countries wishing to meet their Millennium Development Goals. They compare two families of micro-simulations. The first family of micro-simulations decomposes required poverty changes into a change in the mean and a reduction in inequality. Although it highlights the importance of inequality reduction, it appears to be too general to be of much use for policymaking. The second family of micro-simulations is based on a richer model of behavior in the labor markets. It points to the importance of combining different policy options, such as educational expansion and targeted conditional redistribution schemes, to ensure that the poorest people in society are successfully reached. But the absence of market equilibria in these statistical models, as well as the strong stability assumptions which are implicit in their use, argue for extreme caution in their interpretation. This paper--a product of the Poverty Team, Development Research Group--is part of a larger effort in the group to understand pro-poor policies.
Intellectual Property Rights, Licencing, and Innovation
There is considerable debate in economics literature on whether a decision by developing countries to strengthen their protection of intellectual property rights (IPRs) will increase or reduce their access to modern technologies invented by industrial countries. This access can be achieved through technology transfer of various kinds, including foreign direct investment and licensing. Licensing is the focus of this paper. To the extent that inventing firms choose to act more monopolistically and offer fewer technologies on the market, stronger IPRs could reduce international technology flows. However, to the extent that IPRs raise the returns to innovation and licensing, these flows would ex...
Fostering Community-driven Development
States can do much to tap community-level energies, and resources for development, if they seek to interact more synergistically with local communities. The broader spin-off is creating a developmental society, and polity. Using case studies from Asia and Latin America, the authors show how: 1) State efforts to bring about land reform, tenancy reform, and expanding non-crop sources of income, can broaden the distribution of power in rural communities, laying the basis for more effective community-driven collective action; and 2) Higher levels of government can form alliances with communities, putting pressure on local authorities from above, and below to improve development outcomes at the l...
