"Once upon a time in the faraway Baltic region was a tiny nation of Estonia. Newly independent, with a population of 1.3 million, and with 50 percent of its land covered in forests, it was saddled with 50 years of under development. While it was operating with a 1938 telephone exchange, it’s once comparable neighbor across the gulf, Finland, had a 30 times higher GDP per capita and was waltzing its way into new technological advances. Estonia was faced with the challenge of catching-up with the rest of the world. It too embarked upon the technology bandwagon, but revolutionized it’s progression, by creating identity, secured digital Identity for its citizens. And finally, Estonia became a country teeming with cutting-edge technology. The end. “
Bureaucratic reform is a priority of donor organizations, including the World Bank, but is notoriously difficult to implement. In many countries, politicians have little interest in the basic financial and personnel management systems that are essential to political oversight of bureaucratic performance. A new paper by Cesi Cruz and Philip Keefer presents a new perspective on the political economy of bureaucracy. Politicians in some countries belong to parties that are organized to allow party members to act collectively to limit leader shirking. This is particularly the case with programmatic parties. Such politicians have stronger incentives to pursue public policies that require a well-functioning public administration. Novel evidence offers robust support for this argument. From a sample of 439 World Bank public sector reform loans in 109 countries, the paper finds that public sector reforms are more likely to succeed in countries with programmatic political parties. Read the entire paper here.
In the past decade, economists such as Daron Acemoglu, Abhijit Banerjee, Nathan Nunn, and James Robinson have empirically validated the primacy of ‘good’ institutions in driving beneficial political and economic outcomes. While this has been a great leap for academic economics, the applicability to policy is debatable. Specifically, as the empirical techniques employed generally exclude components of institutional variation that change over the short- to medium-run (see Rohini Pande and Christopher Udry), the respective findings potentially don't have much to say about what can be expected from deliberate attempts to generate 'good' institutions.
Serious empirical investigation of the effects of institutional reform remains scant, and for good reason. Rigorously identifying the effects of democratization – or any other specific reform – is extremely difficult, particularly at the national-level. When and where societies enact democratic reforms (such as in Eastern Europe in 1989), such reforms go part in parcel with sweeping changes in economic policy, institutional frameworks, and political actors (in the technical lexicon, such reforms are ‘endogenous’). This makes it almost impossible to isolate the effects of the reform itself from the effects of the multitude of other contemporaneous changes.
Hospitals in France deliver services for acute care. Except for surgery, the consumption of hospital care is predominantly public. The sector accounts for half of the national consumption of medical goods and services and is mostly funded through the Health Insurance system.
The public hospital sector has been facing recurrent deficits over the last three decades, associated with weak managerial print and uneven performance. Since the 80s, global budget was the norm, leading to rent seeking within and across public Hospitals in the absence of incentives for quality and efficiency. Thus, the French Government launched a massive reform initiative starting 2004 to strengthen hospital efficiency and quality of care in a resource-constrained environment.
In Sierra Leone's rainy season, the Sewa River, feared by many locals for its powerful currents, floods over its banks separating entire villages from basic services. Konta health clinic in Kenema district operates near the shores of the Sewa, and during the six-month rainy season, five of Konta’s 17 dependent villages cannot access the clinic. If women in those villages give birth during the rains, they entrust care to traditional birth attendants; if children fall ill, they turn to traditional medicine, stockpiled drugs, and, often, prayer. As one woman explained during a recent community meeting in Konta, these are the only options, even if the all-too-frequent consequence is death. Hearing her account, it’s difficult not to feel a strong sense of injustice, even in an incredibly resource-constrained country like Sierra Leone. But is there a role for the law in remedying this situation?
There is one simple answer to the “what-will-it-take-to-end-poverty” question: it will take courageous politicians who actually implement the policies we already know are needed. Politicians, even the well-intentioned ones, are too often unable to implement good policies, because bad policies are needed for their political survival. For example, vote-buying, the direct exchange of “gifts” or money for political support during elections is widespread in many developing countries. For the first time, new research provides direct empirical evidence that where vote-buying practices are more prevalent, governments invest less in pro-poor services.
Which comes first in the wake of revolution, bread or freedom?
A Reuters reporter asked about this during the embargoed press briefing last Friday to launch the World Development Report 2011: Conflict, Security and Development. What she wondered about was the tough choices of what to deal with most urgently in the throes of revolutions like we are seeing in the Middle East and North Africa.
In other words, should policymakers pay urgent attention to, say, food, jobs and the flow of cash or do justice and political change take precedence?
Rising food prices have once again grabbed everyone’s attention. Prices for some basic foods are nearing the 2008 food crisis levels. In the post ‘Soaring Food Crisis’, Paul Krugman analyzes the data from USDA World supply and demand estimates, and blames the current price spikes on global harvest failures. However, the main question still remains unanswered – is another food crisis afoot? Answers to this and some other concerns are addressed in the latest World Bank Flash and also in the World Food Program’s ‘Rising Food Prices: 10 Questions Answered’ piece.
Should 16 year old Africans vote? Why not… Africa has the youngest and fastest growing population in the world…where more than 20% are between the ages of 15- 24, argues Calestous Juma in an insightful post on the Guardian’s Poverty Matters blog. Speaking of Africa, in an interesting post, ‘Do informed citizens hold governments accountable? It depends…’ (Governance for Development blog), Stuti Khemani from the World Bank’s Research Group examines the impact of radio access on government accountability in Benin.