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Human Development and Public Services

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This research program spans the full gamut of human development — education, health, labor markets, and social protection. It examines the performance of the sectors in terms of levels and inequalities in utilization, quality and outcomes, as well as methods for improving performance, whether aimed at households, service providers, politicians and policymakers, or donors.    More »


Progress on Global Health Goals: are the Poor Being Left Behind?
Adam Wagstaff, Caryn Bredenkamp and Leander R. Buisman
World Bank Research Observer 29(2): 1-26.August 2014.

We examine differential progress on health Millennium Development Goals (MDGs) between the poor and the better off within countries. Our findings are based on an original analysis of 235 DHS and MICS surveys spanning 64 developing countries over the 1990–2011 period. We track five health status indicators and seven intervention indicators from all four health MDGs. In approximately three-quarters of countries, the poorest 40 percent have made faster progress than the richest 60 percent on MDG intervention indicators.

The Law’s Majestic Equality? The Distributive Impact of Judicializing Social and Economic Rights
Daniel M. Brinks and Varun Gauri
Perspectives on Politics 12(2):375-393. June 2014.

While many find cause for optimism about the use of law and rights for progressive ends, the academic literature has long been skeptical that courts favor the poor. We show that, with the move toward a robust “new constitutionalism” of social and economic rights, the assumptions underlying the skepticism do not always hold. Our theories must account for variation in the elite bias of law and litigation.

Intergenerational Mobility and Interpersonal Inequality in an African Economy
Sylvie Lambert, Martin Ravallion, Dominique van de Walle
Journal of Development Economics June 2014.

How much economic mobility is there across generations in a poor, primarily rural, economy? How much do intergenerational linkages contribute to current inequality? We address these questions using original survey data on Senegal that include a sub-household measure of consumption for cells within the household.

Changes in addressing inequalities in access to hospital care in Andhra Pradesh and Maharashtra states of India: a difference-in-differences study using repeated cross-sectional surveys
M. Rao, A. Katyal, P. V. Singh, A. Samarth, S. Bergkvist, M. Kancharla, A. Wagstaff, G. Netuveli and A. Renton
BMJ Open 4(6):1-15, June 2014.
Objectives To compare the effects of the Rajiv Aarogyasri Health Insurance Scheme of Andhra Pradesh (AP) with health financing innovations including the Rashtriya Swasthya Bima Yojana (RSBY) in Maharashtra (MH) over time on access to and out-of-pocket expenditure (OOPE) on hospital inpatient care.


We just learned a whole lot more about achieving Universal Health Coverage
Adam Wagstaff, August 2014
Subsidized health insurance is unlikely to lead to Universal Health Coverage (UHC); insurance coverage doesn’t always improve financial protection and when it does, doesn’t necessarily eliminate financial protection concerns; and tackling provider incentives may be just as – if not more – important in the UHC agenda as demand-side initiatives.

Inequality of opportunity: the new motherhood and apple pie?
Adam Wagstaff and Ravi Kanbur, August 2014
On the face of it, questioning the usefulness of “inequality of opportunity” seems about as wrongheaded as questioning the merits of family vacations, Thanksgiving or dessert trolleys. What’s not to like about it?

Were the poor left behind by the health MDGs?
Adam Wagstaff and Caryn Bredenkamp, July 2014
Thanks to Thomas Piketty, we’ve heard a lot this year about rising inequality. And with just over a year to go before the MDG ‘window’ closes, we’ve also heard a lot about the ‘post-2015 agenda’.

Transactional Sex as Risk-Coping Behavior
Damien de Walque, William H. Dow, and Erick Gong, Summer 2014
Transactional sex rises after shocks, suggesting that access to insuranceor savings may have public health implications.

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Youth Employment in SSAYouth Employment in Sub-Saharan Africa
January 2014 - The report examines obstacles faced by households and firms in meeting the youth employment challenge. It focuses primarily on productivity, in agriculture, in nonfarm household enterprises (HEs), and in the modern wage sector, because productivity is the key to higher earnings as well as to more stable, less vulnerable, livelihoods. To respond to the policy makers' dilemma, the report identifies specific areas where government intervention can reduce those obstacles to productivity for households and firms, leading to brighter employment prospects for youth, their parents, and their own children.
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Risking Your Health: Causes, Consequences, and Interventions to Prevent Risky Behaviors
November 2013 – Individuals all over the worlds engage in behaviors that are risky for their health: smoking, drugs, alcohol, unhealthy food, and risky sexual encounters. They increasingly affect the health of individual and their populations. This report examines the causes, consequences and interventions to prevent these growing threats.
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The Elderly and Old Age in Rural ChinaThe Elderly and Old Age Support in Rural China
March 2012 - This book examines projected demographic changes that will affect the economic well-being of China’s rural elderly over the next 20 years, taking into account both China’s sharp demographic transition and the continued migration of young adults to cities. The projected old age dependency ratio of 34 percent in China’s rural areas by 2030 suggests that support of the elderly is likely to be an increasing burden on China’s families.


Who Benefits from Government Health Spending and Why? A Global Assessment
Ravi Kanbu and Adam Wagstaff
This paper uses a common household survey instrument and a common set of imputation assumptions to estimate the pro-poorness of government health expenditure across 69 countries at all levels of income. On average, government health expenditure emerges as significantly pro-rich, but there is heterogeneity across countries: in the majority, government health expenditure is neither pro-rich nor pro-poor, while in a small minority it is pro-rich, and in an even smaller minority it is pro-poor.
Working Paper 7044, September 2014

How Useful is Inequality of Opportunity as a Policy Construct?
Ravi Kanbu and Adam Wagstaff
The academic literature on equality of opportunity has burgeoned. The concepts and measures have begun to be used by policy institutions, including in specific sectors such as health and education. It is argued that one advantage of focusing on equality of opportunity is that policy makers are more responsive to that discourse than to equality of outcomes per se. This paper presents a critique of equality of opportunity in the policy context.
Working Paper 6980, July 2014

Radio’s Impact on Preferences for Patronage Benefits
Philip Keefer and Stuti Khemani
Citizens in developing countries support politicians who provide patronage or clientelist benefits, such as government jobs and gifts at the time of elections. Can access to mass media that broadcasts public interest messages shift citizens' preferences for such benefits? This paper examines the impact of community radio on responses to novel survey vignettes that make an explicit trade-off between political promises of jobs for a few versus public services for all. The impact of community radio is identified through a natural experiment in the media market in northern Benin, which yields exogenous variation in access across villages.
Working Paper 6932, June 2014

World Bank Lending and the Quality of Economic Policy
Lodewijk Smets, Stephen Knack
Subsidized voluntary enrollment in government-run health insurance schemes is often proposed as a way of increasing coverage among informal sector workers and their families. This paper reports the results of a cluster randomized control trial in which 3,000 households in 20 communes in Vietnam were randomly assigned at baseline to a control group or one of three treatments: an information leaflet about Vietnam’s government-run scheme and the benefits of health insurance; a voucher entitling eligible household members to 25 percent off their annual premium; and both.
Working Paper 6924, June 2014


Publications (2008-2014)

Boogle map of the countries covered by selected research
The map shows research on human development by research department staff, 2008-2014.


Research Manager

Adam Wagstaff
Adam Wagstaff

Last updated: 2014-10-03