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Adam Wagstaff's blog

Reconciling the two “sciences of delivery”

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Last week on Let’s Talk Development, I asked what the term “science of delivery” (SOD) means. I suggested that SOD is about moving from thinking about “what to deliver” to “how to deliver”.  We know, for example, the interventions that cut child mortality (bednets, vaccinations, breastfeeding, etc.) but these interventions reach too few children, and the trick is to get them delivered to more. Much of the Bank’s analytic work, policy dialogue and lending work has focused precisely on how to reform policies and programs to ensure the interventions that are needed to improve development outcomes actually reach people. Much of this work merits the term “science” – it makes use of an explicit “theory of change” in the form of a results framework that reflects the latest social science, and builds on rigorous empirical evidence that compares actual outcomes with an explicit and plausible counterfactual.

So what exactly is the “science of delivery”?

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The World Bank’s president, Jim Kim, has now made two major speeches outlining his vision for the institution – one at the Annual Meetings the other at Georgetown University on April 2 ahead of the upcoming Spring Meetings.

Several themes are emerging. Two are easy to grasp and likely to resonate strongly with Bank staff and stakeholders: “ending poverty” and “boosting shared prosperity”. For years the Bank has seen fighting poverty as its mission. It has made major contributions in the areas of measuring and monitoring poverty – Bank staff have authored many of the world’s most-cited publications with poverty in the title. The Bank’s work at the country level has always had a strong anti-poverty focus. “Ending” poverty – rather than merely “fighting” it – is a natural next step. The idea of “boosting shared prosperity” also resonates. While economic growth is still seen as the principal driver of poverty-reduction, the goal has always been pro-poor growth – a concept that links naturally to the idea of “shared prosperity”.

Should inequality be reflected in the new international development goals?

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The last few months have been a busy time for inequality. And over the last few days the poor thing got busier still. Inequality is now dancing on two stages. It must be really quite dizzy.

We need an inequality goal. No we don’t. Yes we do

One of the two stages is the post-2015 development goals. At some point, someone seems to have decided that reducing inequality needs to be an explicit commitment in the post-2105 goals. The UN System Task Team on the Post-2015 UN Development Agenda wrote a report on inequality and argued that “addressing inequalities is in everyone’s best interest.” Another report by Claire Melamed of Britain’s Overseas Development Institute argued that “equity, or inequality, needs to be somehow integrated into any new framework.” Last week a group of 90 academics wrote an open letter to the High Level Panel on the Post 2015 Development Agenda demanding that inequality be put at the heart of any new framework.

Using an iPad to increase your productivity: a roundup

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It's a while since I blogged about the iPad. I thought it might be useful to pull all my tips on this handy little gadget (including some new ones) together in one post. I'm going to focus for the most part on using it to improve productivity, but there will be some thoughts at the end on using the iPad to have a little fun.  

Get yourself a keyboard and stylus

There's a lot you can do without these add-ons, but they'll dramatically increase your productivity.

There are lots of keyboards on the market — here's a nice review. I waited until the Brydge came out. The Brydge team had functionality in mind, but what sold me was the design — it makes your iPad looks (almost) as cool as the MacBook Air but gives you the advantages of the iPad. 

Universal Health Coverage and the post-2015 development goal agenda. And Mrs Gauri

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In a recent blogpost I asked whether Universal Health Coverage (UHC) is old wine in a new bottle, and if so whether that’s so bad.

I argued that UHC is ultimately about making sure that “everyone – whether rich or poor – gets the care they need without suffering undue financial hardship as a result.” I suggested UHC embraces three important concepts:

• equity: linking care to need, not to ability pay;
• financial protection: making sure that people's use of needed care doesn't leave their family in poverty; and
• quality of care: making sure providers make the right diagnosis, and prescribe a treatment that's appropriate and affordable.

A Sketch of a Ministerial Meeting on Universal Health Coverage

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I had been warned—I found it hard to believe—that WHO ministerial meetings can be rather dull affairs of little consequence. Ministers typically take it in turn to read their prepared speeches; their fellow ministers appear to be listening attentively through their headsets but some, it seems, have been known to zap through the simultaneous translation channels in search of lighter entertainment. Speeches aren’t played over the loudspeakers for fear of waking jetlagged ministers from their afternoon naps. WHO is a very considerate organization: it likes to make sure that while on its premises visitors reach “a state of complete physical, mental and social well-being.”

Well I’m happy to report that last week’s ministerial meeting on Universal Health Coverage (UHC)—held in Geneva on February 18-19, jointly organized by WHO and the World Bank, and attended by delegates from all over the world (see map)—didn’t fit the stereotype.

Universal health coverage: Old wine in a new bottle? If so, is that so bad?

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It's easy to see how the concept of universal health coverage (UHC) became so elusive.

At the start, the idea must have seemed straightforward enough. Lots of countries "covered" only part of their population, and several were making efforts to expand coverage to "uncovered" populations. China, for example, started out on this process in 2003, trying to expand coverage to the rural population that lost coverage when the old rural cooperative medical scheme collapsed following the de-collectivization of agriculture in 1978.

Human Development and Inequality of Opportunity: a rejoinder to Ferreira

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My colleague and (I hope still) friend, Chico Ferreira recently took the trouble to write a comment on my earlier LTD post on measuring inequality of opportunity in the context of human development. Early on in his comment, Chico also paid me the compliment of a being a “clever guy”, which was nice until I read on and found that while he agreed with some of what I said there was a lot he didn’t like. Now Chico is a really clever guy, and this is an area he knows a lot about. So I realize I’m treading on thin ice when I say I’m not completely convinced about his ripostes. But let me take the risk. Chico’s not just super-clever – he’s also very nice. So if the ice cracks and I fall in, I think there’s a good chance he’ll pull me out.

Some thoughts on human development, equal opportunity, and universal coverage

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I was asked recently to advise on some ongoing work on human development, equal opportunities, and universal coverage. The work was building on previous work undertaken by the World Bank in its Latin America and the Caribbean (LAC) region that had developed a new index known as the Human Opportunity Index (HOI).

The core idea underlying the HOI isn’t new. The argument is that inequalities are inequitable insofar as they’re the result of circumstances beyond the individual’s control (inequality in opportunity), but not if they reflect factors that are within the individual’s control. The object of the exercise is to separate empirically the two.

A guide to the top World Bank blogs and blog posts of 2012

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Last year I wrote a post listing the most read 100 World Bank blogposts of 2011. I also compared the Bank’s 26 English-language blogs with one another in terms of how many posts they got in the top-200. 2012 was an even more successful year for World Bank bloggers.

Fig 1 compares the Bank’s 29 blogs in terms of their shares of the top-200 posts for both 2011 and 2012. (I excluded pages that didn’t look like posts – blog home pages, blogger profiles, thematic pages, and so on. I may have inadvertently dropped some posts in which case my apologies to the blogger.) Africa Can End Poverty retains the number one slot, accounting for 20% of the top-200 in both years. Development Impact, which started mid-way through 2011, increased its share to 10% in 2012 with 20 posts in the top-200; it now occupies 2nd position. Last year’s runner-up (East Asia & the Pacific on the rise) slipped to 4th position this year, and last year’s #3 (Let’s Talk Development) slipped to 5th position. Open Data, new this year, came in strongly at #7. Voices - Perspectives on Development improved its position considerably, while Development in a Changing Climate slid the other way.

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