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141. State Health Insurance and Out-of-Pocket Health Expenditures in Andhra Pradesh, India

Author:
Victoria Fan, Anup Karan, and Ajay Mahal
Publication Date:
06-2012
Content Type:
Working Paper
Institution:
Center for Global Development
Abstract:
In 2007, the state of Andhra Pradesh in southern India began rolling out the Aarogyasri health insurance to reduce catastrophic health expenditures in households “below the poverty line.” We exploit variation in program roll-out over time and districts to evaluate the impacts of the scheme using difference-in-differences. Our results suggest that, within the first year of implementation, Phase I of Aarogyasri significantly reduced out-of-pocket inpatient expenditures and, to a lesser extent, outpatient expenditures. These results are robust to checks using quantile regression and matching methods. No clear effects on catastrophic health expenditures or medical impoverishment are seen. Aarogyasri is not benefiting scheduled caste and scheduled tribe households as much as the rest of the population.
Topic:
Health, Poverty, and Health Care Policy
Political Geography:
India, Asia, and Andhra Pradesh

142. Saving Mothers, Giving Life: Attainable or Aspirational?

Author:
Janet Fleischman
Publication Date:
06-2012
Content Type:
Working Paper
Institution:
Center for Strategic and International Studies
Abstract:
Each day, nearly 800 women die around the world from complications in pregnancy or childbirth. That's one woman losing her life, every 100 seconds, every day. And while, from 1990 to 2010, global maternal mortality rates declined by roughly 47%, from about 546,000 to 287,000, the regional disparities are enormous: 85% of all maternal deaths occur in sub-Saharan Africa and South Asia—and more than half of these occur in sub-Saharan Africa. These deaths are largely preventable with interventions and training to address complications such as hemorrhage, infection, and obstructed labor, and more broadly with increased access to reproductive health services.
Topic:
Foreign Policy, Health, International Affairs, Foreign Aid, and Health Care Policy
Political Geography:
Africa, United States, and South Asia

143. South Africa's AIDS Diplomacy

Author:
Pieter Fourie
Publication Date:
06-2012
Content Type:
Working Paper
Institution:
Center for Strategic and International Studies
Abstract:
When the Group of Eight (G-8) industrialized countries decided at their 2001 meeting in Genoa to establish the Global Fund to Fight AIDS, Tuberculosis, and Malaria to increase international funding for interventions against the three diseases, the United States was a leading supporter. The fund was a public-private partnership set up in 2002 with formal status as a foundation under Swiss law. In the fund's first two years, the United States accounted for nearly half the total amount pledged and challenged other donors to increase their contributions. By 2008 the Global Fund had committed $15.6 billion to AIDS activities in 140 country.
Topic:
Foreign Policy, Government, Health, and Health Care Policy
Political Geography:
United States and South Africa

144. A Commitment to Vaccination Index: Measuring Government Progress toward Global Immunization

Author:
Amanda Glassman, Denizhan Duran, and Juan Ignacio Zoloa
Publication Date:
08-2012
Content Type:
Working Paper
Institution:
Center for Global Development
Abstract:
Vaccination is among the most cost-effective health interventions and has attracted ever greater levels of investment from public and private funders. However, some countries, mainly populous lower-middle-income countries, are lagging behind in vaccination financing and performance.
Topic:
Development, Foreign Aid, and Health Care Policy

145. Understanding the Links Between Sexual and Reproductive Health Status and Poverty Reduction

Author:
Nata Duvvury and Philip Oxhorn
Publication Date:
01-2012
Content Type:
Policy Brief
Institution:
Institute for the Study of International Development, McGill University
Abstract:
The interrelationship between poverty and sexual and reproductive health status (SRHS) is widely noted in academic, policy and programmatic discourses, though none establishes causality. The primary emphasis in these discourses is that poor SRHS is an outcome of poverty, and thus can be addressed through poverty reduction programmes. The purpose of this brief is to understand what factors contribute to the interrelationship between SRHS and poverty, with a specific focus on understanding how SRHS impacts household poverty. Future studies may then focus specifically on these factors in order to address issues of causality. This brief is based on desk research involving two sources of data: 1) a review of global literature and 2) three country case studies. The global literature review examined literature documenting the nature, extent and strength of the interrelationship between poverty and SRHS. The literature search was conducted using keywords from different disciplinary perspectives demography, economics, development, women’s studies, sociology, human rights and public health. Key databases such as JSTOR, PubMed, MEDLINE and Elsevier Science Direct were consulted, as well as the specific library databases at National University of Ireland, Galway and McGill University. Researchers at McGill compiled an annotated bibliography of literature on India. The three country case studies were undertaken in Brazil, Ghana and Lebanon. Consultants in each country undertook an extensive search of academic, policy and programmatic literature including journal publications, research reports, policy briefs, and non-governmental organization (NGO) reports. The literature search in each country followed the same method as the global literature review, including identifying keywords from different disciplines and exploring different databases. In addition, the consultants searched grey literature through contacting various NGOs and research institutions. They also obtained statistical information from governmental and institutional databases. All country case studies explored three key questions: 1) Is there literature that demonstrates the impact of poor SRHS on poverty? 2) What factors have been highlighted in the literature as influencing the relationship between SRHS and poverty? 3) Are there trade-offs involved for women between education, fertility, status and work participation? and 4) Do programmes by civil society organizations, such as micro-credit or income-generating programmes, promote sexual and reproductive health?
Topic:
Development, Education, Poverty, Health Care Policy, and Reproductive Health
Political Geography:
Africa, Middle East, Brazil, South America, Lebanon, and Ghana

146. Bankrupt: Entitlements and the Federal Budget

Author:
Michael Tanner
Publication Date:
03-2011
Content Type:
Working Paper
Institution:
The Cato Institute
Abstract:
The U.S. government is about to exceed its statutory debt limit of $14.3 trillion. But that actually underestimates the size of the fiscal time bomb that this country is facing. If one considers the unfunded liabilities of programs such as Medicare and Social Security, the true national debt could run as high as $119.5 trillion.
Topic:
Debt, Economics, Human Welfare, Financial Crisis, Governance, and Health Care Policy
Political Geography:
United States

147. Travelling for health: The potential for medical tourism

Author:
Ana Nicholls
Publication Date:
10-2011
Content Type:
Working Paper
Abstract:
Market size: Medical tourism is not new, but it is growing. Global shift: The flow of travel from developed to developing world. Marketing: How developing countries are targeting the industry. EIU ranking: Why some countries are better placed to benefit than others. US, Europe and Asia trends: The effect of healthcare reforms, budget cuts, and growing wealth. The barriers: The need to harmonise standards and regulations.
Topic:
Globalization, Health, and Health Care Policy
Political Geography:
Europe and Asia

148. Progressive Taxation: Towards fair tax policies

Author:
Deborah Itriago
Publication Date:
09-2011
Content Type:
Working Paper
Institution:
Oxfam Publishing
Abstract:
This report focuses on tax policy in developing countries: who pays tax, what taxes are paid, and how. Tax policy can have a huge impact on inequality and poverty reduction, either positively or negatively, depending on what tax policies a country decides to implement. Taxation is also often at the heart of the social contract between citizens and their government, and progressive taxation is central to creating strong, democratic, and effective states.
Topic:
Development, Economics, Education, Poverty, Social Stratification, and Health Care Policy

149. Pakistan 2020: A Vision for Building a Better Future

Author:
Hassan Abbas
Publication Date:
05-2011
Content Type:
Working Paper
Institution:
Asia Society
Abstract:
In recent years, Pakistan has stumbled from one crisis to another. A number of political and socioeconomic challenges threaten to further destabilize a country that already is reeling from insurgencies along its northwestern border. Pakistan's newest democratic government is struggling to maintain control over parts of its territory where militant religious groups are intent on challenging its authority and legitimacy. The country's conflict with India over Kashmir, now in its seventh decade, appears as intractable as ever, and the war in neighboring Afghanistan has deepened instability throughout Pakistan. The transition from a near-decade-long rule under a military dictatorship is slow and complicated, as rampant corruption and politicization of the bureaucracy present huge obstacles to the state-building process.
Topic:
Conflict Resolution, Foreign Policy, Democratization, Development, Economics, Education, and Health Care Policy
Political Geography:
Pakistan, Afghanistan, and South Asia

150. Antiretroviral Therapy Awareness and Risky Sexual Behaviors: Evidence from Mozambique

Author:
Mead Over, Damien de Walque, and Harounan Kazianga
Publication Date:
01-2011
Content Type:
Working Paper
Institution:
Center for Global Development
Abstract:
This paper studies the effect of increased access to antiretroviral therapy on risky sexual behavior, using data collected in Mozambique in 2007 and 2008. The survey sampled both households of randomly selected HIV-positive individuals and households from the general population. Controlling for unobserved individual characteristics, the findings support the hypothesis of disinhibition behaviors, whereby risky sexual behaviors increase in response to the perceived changes in risk associated with increased access to antiretroviral therapy. Furthermore, men and women respond differently to the perceived changes in risk. In particular, risky behaviors increase for men who believe, wrongly, that AIDS can be cured, while risky behaviors increase for women who believe, correctly, that antiretroviral therapy can treat AIDS but cannot cure it. The findings suggest that scaling up access to antiretroviral therapy without prevention programs may not be optimal if the objective is to contain the disease, since people would adjust their sexual behavior in response to the perceived changes in risk. Therefore, prevention programs need to include educational messages about antiretroviral therapy and address the changing beliefs about HIV in the era of increasing antiretroviral therapy availability.
Topic:
Education and Health Care Policy
Political Geography:
Africa