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February 2012

Humanizing health systems

Adam Wagstaff's picture

In 1960, I wouldn’t have been writing this blog post. For a start I was just a baby at the time. Second, we were several decades away from 1994 when Justin Hall – then a student at Swarthmore – would sit down and tap out the world’s first blog. Most importantly of all, though, according to Google’s ngram viewer, people didn’t write about health systems much in 1960 (see chart). Usage of the term in books took off only in the mid 1960s, waned in the 1980s, and then started rising again in the 1990s. This doesn’t look like a statistical artifact. Usage of the term “Nobel prize” has stayed relatively constant over the period, and while the term “health economics” has also trended upwards, the growth has been much slower. So “health systems” is a fairly new term – and it’s on the rise.

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Not everyone thinks that’s a good thing.

Do Informed Citizens Receive More, or Pay More?

Philip Keefer's picture

One widely-accepted political economy research finding is that informed citizens receive greater benefits from government transfer programs. The evidence for the impact of information comes from particular contexts—disaster relief in India and welfare payments in the USA during the Great Depression.  Do other contexts yield similar results?  New research on the distribution of anti-malaria bed nets in Benin suggests:  “No.”  Instead, local health officials charged more informed households for bed nets that they could have given them for free.

The Benin context differs in three ways.  First, the policy is not the distribution of cash, but of health benefits.  Households’ access to information then influences not only their knowledge of government programs to distribute such benefits, but also the value they place on them. 

Second, the political context also differs.  In younger democracies, like Benin’s, citizens are more likely to confront additional obstacles, besides a lack of information, in their efforts to extract promised benefits from government.

BRIC Spillovers helped Low Income Countries Withstand Crisis

Justin Yifu Lin's picture

A clear pattern of 'two speed recovery' emerged from the global economic crisis: although the East Asian economies saw a drop of nearly 4 percentage points in their GDP growth to 8.5 percent in 2008 and a further decline to 7.5 percent in 2009, they rebounded quickly to 9.7 percent in 2010. At the same time, however, growth in high income countries fell by 6.6 percentage points during 2008-09, from 2.7 percent in 2007 to -3.9 in 2009. Moreover, these economies are not yet out of the woods given the sovereign debt crises in the Euro Area.  This is one of the many fascinating patterns revealed in the newly updated online version of the World Development Indicators.

What is more striking is that low income countries (LICs) have been resilient during the crises, more so than in the past.  The annual GDP growth rate for low income countries declined less than 1 percentage point in 2008, standing at 4.7 percent in 2009 and quickly recovered to 5.9 percent in 2010.  In particular, Ethiopia, Mozambique, Tanzania, and Zambia have shown robust growth of 6 to 11 percent throughout this period. Similar conclusions were presented in Didier, Hevia and Schmukler April 2011.

Is 2012 Africa’s Year of the Dragon?

John Wilson's picture

At the 2012 World Economic Forum’s Annual Meeting in Davos last week, a record 2,600 global leaders discussed a frenetic mix of economic and social issues facing the global community. A number of panels (some of which were overlooked with all the talk of the unfolding Eurocrisis) focused on the important transition Africa is making from an underdeveloped continent to one characterized by sustained growth -- backed by strong trade and investment flows. 

Leaders discussed the need for greater market integration to increase intra-African trade and better cooperation on infrastructure to facilitate investment and trade. Alpha Condé, President of Guinea, called for the establishment of Pan-African ministries to drive greater integration and coordination on the continent. “At the next African union meeting, we must consider establishing three of four ministers for all of Africa,” he said. “These new posts should at least cover energy, infrastructure, and trade in Africa.”

Europe: Fiscal Stimulus versus Structural Reform, or More?

Zia Qureshi's picture

The current policy debate on spurring growth is sometimes couched as a choice between fiscal stimulus and structural reform. In the context of the euro zone, this gives an incomplete picture. Two other issues are important: financial policies to avert a credit crunch; and collective actions to rebuild confidence. Adding these complicates the picture but helps point the way to a fuller policy response and clearer priorities to address the current mutually reinforcing combination of a growing sovereign debt-banking problem on the one hand and risks of a recession on the other.