Adam Wagstaff's blog

Today's launch of the World Bank's Open Knowledge Repository (OKR) and Open Access Policy might not seem a big deal. But it is.

The knowledge bank’s assets are huge, but until today were hard to access

The Bank is a huge producer of knowledge on development. This knowledge surfaces in formal publications of the Bank – the institution publishes books and flagship reports like the World Development Report. It also surfaces in publications of external publishers, including journal articles – up to now, these external publications haven't been seen by the Bank as part of its knowledge output despite the fact they dwarf the Bank's own publications in volume and in citations. The Bank's knowledge also surfaces in reports, and in informal "knowledge products" like briefing notes and other web content.

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.

Not everyone thinks that’s a good thing.

In July I wrote a post on this blog about coping with information overload using an iPad. Rather to my surprise, a few people actually read it. Four months on I thought I'd share with you some new apps and new uses of old apps. It turns out that four months is a long time in the iPad world right now.

World Bank apps, and apps for World Bankers

Three sets of iPad apps allow you to track what the World Bank is up to. InfoFinder gives you a nice way to search among 120,000 or so documents in the Bank's documents and reports database. DataFinder gets you into the Bank's data vaults and allows you to produce some very pretty charts. There are specialized versions of DataFinder on Africa, Climate Change, and Education.  Finally, WB Finances shows you what the Bank is doing in its operational work. You can search for projects via a Google map or via a country listing. This beautifully designed app tells you what each project is about, how much is being lent, and how much has been disbursed. These apps reflect not just the Bank's new openness but also its tech savviness.

According to its first-ever Knowledge Report, published earlier this year, the World Bank spends over $600 million a year on “core knowledge services” – research, economic and sector work, technical assistance, “knowledge management”, training, and the like. Yet as the authors of report concede, precious little is known about the impact of this spending.

In a post on this blog last year, I reported on some work that Martin Ravallion and I did on a subset of the Bank’s knowledge portfolio – formal publications. We found the publications portfolio is larger than typically thought: the Bank’s Documents and Reports (D&R) database excludes the vast majority of journal articles authored by Bank staff, and there are as many of these as there are books and other formal publications published by the Bank. We also tried to look at the impact of the Bank’s publications on development thinking, which we measured using citations in Google Scholar. We found that, despite a view by some that the Bank is more a proselytizer than a producer of new knowledge, a lot of Bank publications do get cited a lot, suggesting that these publications contain new knowledge that’s considered useful by others.

Quantity inequalities may be dwarfed by quality inequalities

In my last post on UC I argued that UC is best thought of as a means to achieving lower inequalities and improved financial protection in the health sector, but that in practice UC is unlikely to be sufficient – and may not even be necessary – for us to achieve these goals.

In this post, I argue that our focus on narrowing inequalities in the quantity of care is leading us to ignore another and potentially more important type of inequality in the health sector: inequality in the quality of care.