Wagstaff A.,The World Bank
Health Economics | Year: 2010
Vietnam's health care fund for the poor (HCFP) uses government revenues to finance health care for the poor, ethnic minorities living in selected mountainous provinces, and all households living in communes officially designated as highly disadvantaged. As of 2006, the program, which started in 2003, covered around 60% of those eligible. Those who were covered (about 20% of the population) were disproportionately poor, and around 80% of those covered were eligible. Estimates of the program's impact were obtained using a method that takes into account unobserved heterogeneity - including unobserved idiosyncratic returns - but requires minimal assumptions. The downside is that it provides an estimate only of the program's impact on those covered by it; it cannot therefore answer the question of how those currently uncovered will fare when they are eventually covered. The results suggest that HCFP has had no impact on use of services, but has substantially reduced out-ofpocket spending. Copyright © 2009 John Wiley & Sons, Ltd.
Wagstaff A.,The World Bank
Health Economics | Year: 2012
Authors of benefit-incidence analyses (BIA) have to impute subsidies using assumptions about the relationship between unobserved subsidies 'captured' by the household and what can be observed at the household and aggregate levels. This paper shows that one of the two assumptions used in BIA studies to date will necessarily produce a more pro-rich (or less pro-poor) picture of government health spending than the other, depending on whether utilization is more pro-rich or pro-poor than fees paid to public providers. Both assumptions have their disadvantages, and the paper suggests a couple of alternatives that explicitly link fees paid to the costliness of care. It shows that in the most likely case where fees are distributed in a more pro-rich fashion than utilization, the two traditional assumptions will produce less pro-rich distributions of subsidies than the two new alternatives. Also considered are three complications that arise in BIA studies, including factoring in social health insurance. The paper's theoretical results are illustrated with an empirical BIA for Vietnam. © 2011 John Wiley & Sons, Ltd.
Alderman H.,The World Bank
Journal of Nutrition | Year: 2010
Models of climate change predict increased variability of weather as well as changes in agro-ecology. The increased variability will pose special challenges for nutrition. This study reviews evidence on climate shocks and nutrition and estimates the economic consequences in terms of reduced schooling and economic productivity stemming from nutritional insults in childhood. Panel data covering up to 20 y indicate that that short-term climate shocks have long-term impacts on children that persist, often into their adult lives. Other studies document the potential for relief programs to offset these shocks providing that the programs can be implemented with flexible financing, rapid identification of those affected by the shock, and timely scale-up. The last of these presumes that programs are already in place with contingency plans drawn up. Arguably, direct food distribution, including that of ready-to-use therapeutic food, may be part of the overall strategy. Even if such programs are too expensive for sustainable widespread use in the prevention of malnutrition, scalable food distribution programs may be cost effective to address the heightened risk of malnutrition following weather-related shocks. © 2010 American Society for Nutrition.
Kessides I.N.,The World Bank
Energy Policy | Year: 2013
Pakistan is facing a severe electricity crisis due to a persistent and widening gap between demand and available system generating capacity. The worsening of power shortages has become a major political issue, reflecting the hardships for individuals and businesses. It threatens to undermine the credibility and legitimacy of government and to further stress the social fabric of the country. The power crisis did not emerge suddenly. It is the direct result of imprudent and reckless energy policies over the last three decades. These policies have impeded the development of cheap and abundant domestic energy sources. They have also resulted in very inefficient fuel-mix choices, compromising energy and economic security. Pakistan's energy bankruptcy is ultimately due to massive institutional and governance failure. This paper analyzes the problems confronting Pakistan's electricity sector and identifies the key elements of a potential policy response to address the country's severe power crisis. © 2012 Elsevier Ltd.
Ahlroth S.,The World Bank
Resources, Conservation and Recycling | Year: 2014
In environmental impact assessment of policies and product design results need to be presented in a comprehensible way to make alternatives easily comparable. One way of doing this is to aggregate results to a manageable set by using weighting methods. Valuing the environmental impacts can be a challenging task that can also be quite time-consuming. To the aid of practitioners, several weighting sets with readily available weights have been developed over the last decade. The scope and coverage of these sets vary, and it is important to be aware of the implications of using different valuation methods and weighting sets. The aim of this paper is to map valuation and weighting techniques and indicate the methods that are suitable to use, depending on the purpose of the analysis. Furthermore, we give an overview over sets of generic values or weights and their properties, and give an illustration of how different sets may influence the results. It is very useful to use several weighting sets, and discuss the results thoroughly. It is often a very interesting and fruitful exercise to see if and how the results differ, why they differ, and which one seems to be the best alternative to base any recommendation on. The example provided in this article demonstrates that looking at aggregate results is not enough. Since many weighting sets are not sufficiently transparent as to how they are constructed and what their impact categories actually include, a general recommendation is to provide weighting sets with a declaration of content, providing a clear picture of what is included and what is not, and a recommendation of suitable uses of the weighting set. © 2013 Elsevier B.V.