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11. The Face of African Infrastructure: Service Availability and Citizens' Demands

Author:
Vijaya Ramachandran, Benjamin Leo, and Robert Morello
Publication Date:
02-2015
Content Type:
Working Paper
Institution:
Center for Global Development
Abstract:
The need for infrastructure improvements is a top-tier economic, political, and social issue in nearly every African country. Although the academic and policy literature is extensive in terms of estimating the impact of infrastructure deficits on economic and social indicators, very few studies have examined citizen demands for infrastructure. In this paper, we draw upon survey data to move beyond topline estimates of national infrastructure access rates towards a more nuanced understanding of service availability and citizen demands at the regional, national, and sub-national level. We find a predictable pattern of infrastructure services across income levels—lower income countries have fewer services. The survey data also allows us to observe the sequencing of infrastructure services. On the demand side, survey respondents are most concerned with jobs and income-related issues, as well as with the availability of infrastructure: specifically transportation and sanitation. These priorities transcend demographic factors, including gender and location (urban/rural).
Topic:
Health
Political Geography:
Africa

12. The Health Financing Transition: A Conceptual Framework and Empirical Evidence

Author:
William Savedoff and Victoria Fan
Publication Date:
03-2014
Content Type:
Working Paper
Institution:
Center for Global Development
Abstract:
Almost every country exhibits two important health financing trends: health spending per person rises and the share of out-of-pocket spending on health services declines. We describe these trends as a "health financing transition" to provide a conceptual framework for understanding health markets and public policy. Using data over 1995-2009 from 126 countries, we examine the various explanations for changes in health spending and its composition with regressions in levels and first differences. We estimate that the income elasticity of health spending is about 0.7, consistent with recent comparable studies. Our analysis also shows a significant trend in health spending - rising about 1 percent annually - which is associated with a combination of changing technology and medical practices, cost pressures and institutions that finance and manage healthcare. The out-of-pocket share of total health spending is not related to income, but is influenced by a country's capacity to raise general revenues. These results support the existence of a health financing transition and characterize how public policy influences these trends.
Topic:
Development, Economics, Health, and Governance
Political Geography:
United States

13. To Charge or Not to Charge: Evidence from a Health Products Experiment in Uganda

Author:
Dean Karlan, Pia Raffler, Greg Fischer, and Margaret McConnell
Publication Date:
11-2014
Content Type:
Working Paper
Institution:
Center for Global Development
Abstract:
In a field experiment in Uganda, we find that demand after a free distribution of three health products is lower than after a sale distribution. This contrasts with work on insecticide-treated bed nets, highlighting the importance of product characteristics in determining pricing policy. We put forward a model to illustrate the potential tension between two important factors, learning and anchoring, and then test this model with three products selected specifically for their variation in the scope for learning. We find the rank order of shifts in demand matches with the theoretical prediction, although the differences are not statistically significant.
Topic:
Development and Health
Political Geography:
Uganda and Africa

14. 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

15. 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

16. Commitment to Development Index 2013

Author:
Owen Barder and Petra Krylová
Publication Date:
11-2013
Content Type:
Policy Brief
Institution:
Center for Global Development
Abstract:
The Commitment to Development Index ranks 27 of the world's richest countries on policies that affect the more than five billion people living in poorer nations. The CDI goes beyond measures of foreign aid to quantify performance in seven areas: Quantity and quality of foreign aid Openness to trade policies that encourage investment and financial transparency Openness to migration Environmental policies Promotion of international security Support for technology creation and transfer Why does the CDI matter? Because in an integrated world, the behavior of rich countries and powerful institutions can profoundly affect the lives of people in poor countries and because poverty and weak institutions in developing countries can breed public health crises, security threats, and economic crises that know no borders. Committing to policies that promote development and well-being is a global imperative: no human being should be denied the chance to live free of poverty and oppression and to enjoy a basic standard of education and health. The CDI countries all promote respect for human life and dignity; the Index looks at whether the policies of rich countries match these aspirations.
Topic:
Security, Development, Education, Health, Poverty, and Fragile/Failed State

17. 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

18. 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

19. Quantifying the Quality of Health Aid: Health QuODA

Author:
Amanda Glassman and Denizhan Duran
Publication Date:
05-2012
Content Type:
Policy Brief
Institution:
Center for Global Development
Abstract:
Health is one of the largest and most complex sectors of foreign aid: in recent years, about 15 cents of every aid dollar went to global health. While health is often cited as one of the few undisputed aid success stories, there is little quantitative analysis of the quality of health aid, and some studies suggest that health aid does not necessarily improve health outcomes.
Topic:
Development, Globalization, Health, Foreign Aid, and Health Care Policy

20. CARMA Revisited: An Updated Database of Carbon Dioxide Emissions from Power Plants Worldwide

Author:
Kevin Ummel
Publication Date:
08-2012
Content Type:
Working Paper
Institution:
Center for Global Development
Abstract:
The Carbon Monitoring for Action (CARMA) database provides information about the carbon dioxide emissions, electricity production, corporate ownership, and location of more than 60,000 power plants in over 200 countries. Originally launched in 2007, CARMA is provided freely to the public at www.carma. org and remains the only comprehensive data source of its kind. This paper documents the methodology underpinning CARMA v3.0, released in July, 2012. Comparison of CARMA model output with reported data highlights the general difficulty of precisely predicting annual electricity generation for a given plant and year. Estimating the rate at which a plant emits CO2 (per unit of electricity generated) generally faces fewer obstacles. Ultimately, greater disclosure of plant-specific data is needed to overcome these limitations, particularly in major emitting countries like China, Russia, and Japan. For any given plant in CARMA v3.0, it is estimated that the reported value is within 20 percent of the actual value in 85 percent of cases for CO2 intensity, 75 percent for annual CO2 emissions, and 45 percent for annual electricity generation. CARMA's prediction models are shown to offer significantly better estimates than more naïve approaches to estimating plant-specific performance.
Topic:
Climate Change, Environment, Health, and Industrial Policy
Political Geography:
Russia, Japan, and China