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1. Modicare Post-Election: Recommendations to Enhance the Impact of Public Health Insurance on UHC Goals in India

Author:
Kalipso Chalkidou, Nishant Jain, Françoise Cluzeau, and Amanda Glassman
Publication Date:
05-2019
Content Type:
Working Paper
Institution:
Center for Global Development
Abstract:
Hailed as one of the largest publicly funded health insurance programs in the world, India’s “Modicare” has, since its launch a little more than six months ago, made universal healthcare coverage an election theme for the first time in the country’s history.[1] In this note, we describe the program, with an emphasis on its better-known secondary and tertiary care component, and offer policy recommendations to strengthen the scheme post-election to enhance its contribution to India’s vision for universal health coverage (UHC). In a country of almost 1.4 billion people that is home to one-third of global maternal deaths, where public spending for health accounts for roughly 1 percent of GDP and where 60 million people fall into poverty every year because of healthcare bills, fixing healthcare is a daunting task that will determine the world’s performance against the Sustainable Development Goals over the coming decade.
Topic:
Health, Health Care Policy, Public Health, and Health Insurance
Political Geography:
India and Asia

2. Aligning to 2020: How the FP2020 Core Partners Can Work Better, Together

Author:
Rachel Silverman and Amanda Glassman
Publication Date:
11-2016
Content Type:
Special Report
Institution:
Center for Global Development
Abstract:
In July 2012, world leaders gathered in London to support the right of women and girls to make informed and autonomous choices about whether, when, and how many children they want to have. There, low income-country governments and donors committed to a new partnership—Family Planning 2020 (FP2020). FP2020 set an aspirational goal—120 million additional users of voluntary, high-quality family planning services by 2020—and received commitments totaling $4.6 billion in additional funding. Since then, the focus countries involved in the FP2020 partnership have made significant progress. Yet as FP2020 reaches its halfway point, and new, even more ambitious goals are set as part of the Sustainable Development Goals, gains fall short of aspirations. The midpoint of the FP2020 initiative is thus an important inflection point, offering an opportunity for family planning funders and the FP2020 partnership more broadly to take stock of progress, to reflect on the lessons of the past four years, to refine funding and accountability mechanisms, and to reallocate existing resources for greater impact. Of course, the primary responsibility for expanding contraceptive access falls squarely on country governments. Nonetheless, donor contributions play an important role. With the goal of reaching as many women and girls as possible by 2020 and an eye toward the 2030 Sustainable Development Goals, the Center for Global Development (CGD) convened a working group on donor alignment in family planning in fall 2015 to see how scarce donor resources could go farther to accelerate family planning gains. As the final product of the working group, the report analyzes the successes and limitations of family planning alignment to date, with a focus on procurement, cross-country and in-country resource allocation, incentives, and accountability mechanisms, and makes recommendations for next steps.
Topic:
International Trade and Finance, Population, and International Development
Political Geography:
Global Focus

3. The Impact of Gavi on Vaccination Rates: Regression Discontinuity Evidence

Author:
Amanda Glassman, Charles Kenny, Justin Sandefur, and Sarah Dykstra
Publication Date:
02-2015
Content Type:
Working Paper
Institution:
Center for Global Development
Abstract:
Since 2001, an aid consortium known as Gavi has accounted for over half of vaccination expenditure in the 75 eligible countries with an initial per capita GNI below $1,000. Regression discontinuity (RD) estimates show aid significantly displaced other immunization efforts and failed to increase vaccination rates for diseases covered by cheap, existing vaccines. For some newer and more expensive vaccines, i.e., Hib and rotavirus, we found large effects on vaccination and limited fungibility, though statistical significance is not robust. These RD estimates apply to middle-income countries near Gavi's eligibility threshold, and cannot rule out differential effects for the poorest countries.

4. Refocusing Gavi for Greater Impact

Author:
Amanda Glassman, Charles Kenny, Justin Sandefur, and Sarah Dykstra
Publication Date:
02-2015
Content Type:
Policy Brief
Institution:
Center for Global Development
Abstract:
Gavi, the Vaccine Alliance, pools donor funds to increase immunization rates in developing countries. Vaccines have saved millions of lives. Results from new research at the Center for Global Development suggest Gavi could save more lives by shifting support away from lower-cost vaccines provided to middle-income countries toward more underused vaccines and support to the poorest countries.

5. The Political Economy of Bad Data: Evidence from African Survey Administrative Statistics

Author:
Amanda Glassman and Justin Sandefur
Publication Date:
07-2014
Content Type:
Working Paper
Institution:
Center for Global Development
Abstract:
Across multiple African countries, discrepancies between administrative data and independent household surveys suggest official statistics systematically exaggerate development progress. We provide evidence for two distinct explanations of these discrepancies. First, governments misreport to foreign donors, as in the case of a results-based aid program rewarding reported vaccination rates. Second, national governments are themselves misled by frontline service providers, as in the case of primary education, where official enrollment numbers diverged from survey estimates after funding shifted from user fees to per pupil government grants. Both syndromes highlight the need for incentive compatibility between data systems and funding rules.
Topic:
Development, Foreign Aid, Foreign Direct Investment, Governance, and Developing World
Political Geography:
Africa

6. Delivering on a Data Revolution in Sub-Saharan Africa

Author:
Amanda Glassman and Alex Ezeh
Publication Date:
07-2014
Content Type:
Policy Brief
Institution:
Center for Global Development
Abstract:
Despite improvements in censuses and household surveys, the building blocks of national statistical systems in sub-Saharan Africa remain weak. Measurement of fundamentals such as births and deaths, growth and poverty, taxes and trade, land and the environment, and sickness, schooling, and safety is shaky at best. The challenges are fourfold: (1) national statistics offices have limited independence and unstable budgets, (2) misaligned incentives encourage the production of inaccurate data, (3) donor priorities dominate national priorities, and (4) access to and usability of data are limited. The Data for African Development Working Group's recommendations for reaping the benefits of a data revolution in Africa fall into three categories: (1) fund more and fund differently, (2) build institutions that can produce accurate, unbiased data, and (3) prioritize the core attributes of data building blocks.
Topic:
Development
Political Geography:
Africa

7. How Much Will Health Coverage Cost? Future Health Spending Scenarios in Brazil, Chile, and Mexico

Author:
Amanda Glassman and Juan Ignacio Zoloa
Publication Date:
10-2014
Content Type:
Working Paper
Institution:
Center for Global Development
Abstract:
As Latin American countries seek to expand the coverage and benefits provided by their health systems under a global drive for universal health coverage (UHC), decisions taken today–whether by government or individuals-will have an impact tomorrow on public spending requirements. To understand the implications of these decisions and define needed policy reforms, this paper calculates long-term projections for public spending on health in three countries, analyzing different scenarios related to population, risk factors, labor market participation, and technological growth. In addition, the paper simulates the effects of different policy options and their potential knock-on effects on health expenditure.
Topic:
Health, Governance, and Reform
Political Geography:
Brazil, Latin America, Mexico, and Chile

8. HIV/AIDS Intervention Packages in Five Countries: A Review of Budget Data

Author:
Amanda Glassman, Denizhan Duran, Rachel Silverman, and Victoria Fan
Publication Date:
10-2013
Content Type:
Working Paper
Institution:
Center for Global Development
Abstract:
More than ever, global health funding agencies must get better value for money from their investment portfolios; to do so, each agency must know the interventions it supports and the sub-populations targeted by those interventions in each country.
Topic:
Foreign Policy, Development, Economics, Health, Humanitarian Aid, and Health Care Policy
Political Geography:
India, Philippines, Ethiopia, and Nigeria

9. Getting Better Value for Money in Malaria Control

Author:
Amanda Glassman and Paul Wilson
Publication Date:
07-2012
Content Type:
Policy Brief
Institution:
Center for Global Development
Abstract:
Malaria kills hundreds of thousands of people every year and is among the leading causes of death for children under five. While funding for malaria control increased dramatically in recent years, gains are fragile and budgets are now stagnating. In that fiscal reality, getting better value for money is more important than ever. In this brief, we present a framework for increasing the efficiency of malaria-control initiatives that addresses where to intervene, what interventions are best, and how to deliver them most effectively. Much of what is spent on malaria control is already spent well, but health policymakers and practitioners could get better value and save more lives by implementing the following recommendations: Improve procurement procedures for bednets. Reduce overlap of insecticide-spraying and bednet programs. Expand the use of rapid diagnostics. Scale up intermittent presumptive treatment for pregnant women and infants.
Topic:
Health and Infectious Diseases

10. Priority-Setting in Health: Building Institutions for Smarter Public Spending

Author:
Amanda Glassman and Kalipso Chalkidou
Publication Date:
06-2012
Content Type:
Policy Brief
Institution:
Center for Global Development
Abstract:
Health donors, policymakers, and practitioners continuously make life-and-death decisions about which type of patients receive what interventions, when, and at what cost. These decisions—as consequential as they are—often result from ad hoc, nontransparent processes driven more by inertia and interest groups than by science, ethics, and the public interest. The result is perverse priorities, wasted money, and needless death and illness. Examples abound: In India, only 44 percent of children 1 to 2 years old are fully vaccinated, yet open-heart surgery is subsidized in national public hospitals. In Colombia, 58 percent of children are fully vaccinated, but public monies subsidize treating breast cancer with Avastin, a brand-name medicine considered ineffective and unsafe for this purpose in the United States.
Topic:
Development, Health, and Foreign Aid
Political Geography:
United States, India, and Colombia