Additional file 2. Results of the model comparison using the Akaike Information Criterion (AIC), ... more Additional file 2. Results of the model comparison using the Akaike Information Criterion (AIC), the Bayesian Information Criterion (BIC) and the Vuong's closeness test, and the stratified analysis on the rural and urban sample. Table S1. The AIC, BIC and results of Vuong test of different regression models for each outcome variable Table S2. Regression analysis of factors associated with self-reported emergent illness using NB model: rural vs urban. Table S3. Regression analysis of factors associated with the total times of conducting self-treatment using NB model: rural vs urban. Table S4. Regression analysis of factors associated with outpatient service use using NB model: urban vs. rural. Table S5. Regression analysis of factors associated with inpatient service use using logit model: urban vs. rural. Table S6. Regression analysis of factors associated with OOP health expenditure using a two-part model combining logit regression and GLM: urban vs. rural. Table S7. Logit regr...
Background In response to the high financial burden of health services facing tuberculosis (TB) p... more Background In response to the high financial burden of health services facing tuberculosis (TB) patients in China, the China-Gates TB project, Phase II, has implemented a new financing and payment model as an important component of the overall project in three cities in eastern, central and western China. The model focuses on increasing the reimbursement rate for TB patients and reforming provider payment methods by replacing fee-for-service with a case-based payment approach. This study investigated changes in out-of-pocket (OOP) health expenditure and the financial burden on TB patients before and after the interventions, with a focus on potential differential impacts on patients from different income groups. Methods Three sample counties in each of the three prefectures: Zhenjiang, Yichang and Hanzhong were chosen as study sites. TB patients who started and completed treatment before, and during the intervention period, were randomly sampled and surveyed at the baseline in 2013 a...
wish to thank Jishnu Das, Elisabeth Sadoulet and Alain de Janvry for valuable input, and Françoi... more wish to thank Jishnu Das, Elisabeth Sadoulet and Alain de Janvry for valuable input, and François Bourguignon and Martin Ravallion for stimulating our interest in the questions pursued here. Finally, the paper has benefited from the comments of two anonymous referees.
Madagascar, we simulate the impact on poverty of transferring an exogenously given budget to geog... more Madagascar, we simulate the impact on poverty of transferring an exogenously given budget to geographically defined sub-groups of the population according to their relative poverty status. We find large gains from targeting smaller administrative units, such as districts or villages. However, these gains are still far from the poverty reduction that would be possible had the planners had access to information on household level income or consumption. Our results suggest that a useful way forward might be to combine fine geographic targeting using a poverty map with within-community targeting mechanisms.
Assessing the scope for insurance in rural communities usually requires a structural model of hou... more Assessing the scope for insurance in rural communities usually requires a structural model of household behavior under risk. One of the few empirical applications of such models is the study by Rosenzweig and Wolpin (1993) who conclude that Indian farmers in the ICRISAT villages would not benefit from the introduction of formal weather insurance. In this paper we investigate how models such as theirs can be estimated from panel data on production and assets. We show that if assets can take only a limited number of values the coefficients of the model cannot be estimated with reasonable precision. We also show that this can affect the conclusion that insurance would not be welfare improving. 2 1
this paper are our own and should not be taken to reflect those of the World Bank or any of its a... more this paper are our own and should not be taken to reflect those of the World Bank or any of its affiliates. All errors are our own
Increasingly both donor agencies and recipient governments want to assess the effectiveness of ai... more Increasingly both donor agencies and recipient governments want to assess the effectiveness of aid. Unfortunately, existing methods for impact evaluation are designed for the evaluation of homogeneous interventions (‘projects’) where those with and without ‘treatment ’ can be compared. However, when assessing the effectiveness of sector aid or general budget support one is concerned about the impact of numerous heterogeneous interventions; there is then no obvious control group. The lack of a credible methodology for such high level evaluations is a serious constraint in the debate on aid effectiveness. We propose a method of statistical impact evaluation in situations with heterogeneous interventions, an extension of the double differencing method often used in project evaluations. We illustrate its feasibility with an example for the education sector in Zambia. 2
10BUZ281478|E Support to water supply and sanitary facilities has been a priority for Netherlands... more 10BUZ281478|E Support to water supply and sanitary facilities has been a priority for Netherlands development cooperation for many years. The purpose of support goes beyond sustainable access to improved facilities: it is intended to reduce the burden of water collection, improve health, raise school enrolment; improve livelihoods and ultimately reduce poverty. IOB is undertaking a series of impact studies in five countries to measure the effects of supported programmes, using a combination of quantitative and qualitative methods and techniques. Dutch support provided to the drinkwater supply and sanitation programme in Fayoum Governorate, Arab Republic of Egypt started in 1990. The impact evaluation report is the third report published in the series. Preface Support to water supply and sanitary facilities has been a priority for the Netherlands' development cooperation for many years. Current policy on development cooperation is guided by the Millennium Development Goals. The M...
Kenya, over the years, has attempted to introduce measures to improve access to health care servi... more Kenya, over the years, has attempted to introduce measures to improve access to health care services especially by the poor and vulnerable including women and children and therefore cushion them from the unintended consequences of having to pay for health care as point of consumption. In 2007, for instance, the government of Kenya reduced user fees at the lower level facilities - health centres and dispensaries – to a maximum of Kenya Shillings (KES) 10 and KES 20 respectively to cover for registration. Under this policy – commonly referred to as the 10/20 policy – children aged below five years and specific health conditions such as Malaria and Tuberculosis were exempted from payment. All fees for deliveries in public health facilities were also abolished in July 2007 to further increase access to maternal health care services. Even though user fees were low, there was widespread evidence to show that such fees encouraged self-treatment and in some cases acted as barrier to timely ...
How exposure to risk affects economic growth is a key issue in development. This article quantifi... more How exposure to risk affects economic growth is a key issue in development. This article quantifies both the ex ante and ex post effects of risk using long-running panel data for rural households in Zimbabwe. It proposes a simulation-based econometric methodology to estimate the structural form of a micro model of household investment decisions under risk. The key finding is that risk substantially reduces growth in this particular setting: the mean capital stock in the sample is (in expectation) 46 percent lower than in the absence of risk. About two-thirds of the impact of risk is due to the ex ante effect (that is, the behavioral response to risk), which is usually not taken into account in policy design. These results suggest that policy interventions that reduce exposure to shocks or that help households manage risk could be much more effective than is commonly thought.
International Journal of Environmental Research and Public Health
Many European countries have implemented pension reforms to increase the statutory retirement age... more Many European countries have implemented pension reforms to increase the statutory retirement age with the aim of increasing labor supply. However, not all older workers may be able or want to work to a very high age. Using a nation-wide register data of labor market transitions, we investigated in this natural experiment the effect of an unexpected change in the Dutch pension system on labor market behaviors of older workers. Specifically, we analyzed transitions in labor market positions over a 5-year period in two nation-wide Dutch cohorts of employees aged 60 years until they reached the retirement age (n = 23,703). We compared transitions between the group that was still entitled to receive early retirement benefits to a group that was no longer entitled to receive early retirement benefits. Results showed that the pension reform was effective in prolonging work participation until the statutory retirement age (82% vs. 61% at age 64), but also to a larger proportion of unemploy...
Background: Although public medical insurance covers over 95% of the population in China, dispari... more Background: Although public medical insurance covers over 95% of the population in China, disparities in health service use and out-of-pocket (OOP) health expenditure across income groups are still widely observed. This study aims to investigate the socio-economic disparities in perceived health care needs, informal care, formal care and payment for health care and explore their equity implication. Methods: We assessed healthcare needs, service use and payment in 400 households in rural and urban areas in Jiangsu, China, and included only the adult sample (N=925). One baseline survey and 10 follow-up surveys were conducted during the 7-month monitoring period, and the Affordability Ladder Program (ALP) framework was adopted for data analysis. Negative binomial/zero-inflated negative binomial and logit regression models were used to explore factors associated with perceived care needs and with the use of three types of health service (self-treatment, outpatient and inpatient care). T...
Additional file 2. Results of the model comparison using the Akaike Information Criterion (AIC), ... more Additional file 2. Results of the model comparison using the Akaike Information Criterion (AIC), the Bayesian Information Criterion (BIC) and the Vuong's closeness test, and the stratified analysis on the rural and urban sample. Table S1. The AIC, BIC and results of Vuong test of different regression models for each outcome variable Table S2. Regression analysis of factors associated with self-reported emergent illness using NB model: rural vs urban. Table S3. Regression analysis of factors associated with the total times of conducting self-treatment using NB model: rural vs urban. Table S4. Regression analysis of factors associated with outpatient service use using NB model: urban vs. rural. Table S5. Regression analysis of factors associated with inpatient service use using logit model: urban vs. rural. Table S6. Regression analysis of factors associated with OOP health expenditure using a two-part model combining logit regression and GLM: urban vs. rural. Table S7. Logit regr...
Background In response to the high financial burden of health services facing tuberculosis (TB) p... more Background In response to the high financial burden of health services facing tuberculosis (TB) patients in China, the China-Gates TB project, Phase II, has implemented a new financing and payment model as an important component of the overall project in three cities in eastern, central and western China. The model focuses on increasing the reimbursement rate for TB patients and reforming provider payment methods by replacing fee-for-service with a case-based payment approach. This study investigated changes in out-of-pocket (OOP) health expenditure and the financial burden on TB patients before and after the interventions, with a focus on potential differential impacts on patients from different income groups. Methods Three sample counties in each of the three prefectures: Zhenjiang, Yichang and Hanzhong were chosen as study sites. TB patients who started and completed treatment before, and during the intervention period, were randomly sampled and surveyed at the baseline in 2013 a...
wish to thank Jishnu Das, Elisabeth Sadoulet and Alain de Janvry for valuable input, and Françoi... more wish to thank Jishnu Das, Elisabeth Sadoulet and Alain de Janvry for valuable input, and François Bourguignon and Martin Ravallion for stimulating our interest in the questions pursued here. Finally, the paper has benefited from the comments of two anonymous referees.
Madagascar, we simulate the impact on poverty of transferring an exogenously given budget to geog... more Madagascar, we simulate the impact on poverty of transferring an exogenously given budget to geographically defined sub-groups of the population according to their relative poverty status. We find large gains from targeting smaller administrative units, such as districts or villages. However, these gains are still far from the poverty reduction that would be possible had the planners had access to information on household level income or consumption. Our results suggest that a useful way forward might be to combine fine geographic targeting using a poverty map with within-community targeting mechanisms.
Assessing the scope for insurance in rural communities usually requires a structural model of hou... more Assessing the scope for insurance in rural communities usually requires a structural model of household behavior under risk. One of the few empirical applications of such models is the study by Rosenzweig and Wolpin (1993) who conclude that Indian farmers in the ICRISAT villages would not benefit from the introduction of formal weather insurance. In this paper we investigate how models such as theirs can be estimated from panel data on production and assets. We show that if assets can take only a limited number of values the coefficients of the model cannot be estimated with reasonable precision. We also show that this can affect the conclusion that insurance would not be welfare improving. 2 1
this paper are our own and should not be taken to reflect those of the World Bank or any of its a... more this paper are our own and should not be taken to reflect those of the World Bank or any of its affiliates. All errors are our own
Increasingly both donor agencies and recipient governments want to assess the effectiveness of ai... more Increasingly both donor agencies and recipient governments want to assess the effectiveness of aid. Unfortunately, existing methods for impact evaluation are designed for the evaluation of homogeneous interventions (‘projects’) where those with and without ‘treatment ’ can be compared. However, when assessing the effectiveness of sector aid or general budget support one is concerned about the impact of numerous heterogeneous interventions; there is then no obvious control group. The lack of a credible methodology for such high level evaluations is a serious constraint in the debate on aid effectiveness. We propose a method of statistical impact evaluation in situations with heterogeneous interventions, an extension of the double differencing method often used in project evaluations. We illustrate its feasibility with an example for the education sector in Zambia. 2
10BUZ281478|E Support to water supply and sanitary facilities has been a priority for Netherlands... more 10BUZ281478|E Support to water supply and sanitary facilities has been a priority for Netherlands development cooperation for many years. The purpose of support goes beyond sustainable access to improved facilities: it is intended to reduce the burden of water collection, improve health, raise school enrolment; improve livelihoods and ultimately reduce poverty. IOB is undertaking a series of impact studies in five countries to measure the effects of supported programmes, using a combination of quantitative and qualitative methods and techniques. Dutch support provided to the drinkwater supply and sanitation programme in Fayoum Governorate, Arab Republic of Egypt started in 1990. The impact evaluation report is the third report published in the series. Preface Support to water supply and sanitary facilities has been a priority for the Netherlands' development cooperation for many years. Current policy on development cooperation is guided by the Millennium Development Goals. The M...
Kenya, over the years, has attempted to introduce measures to improve access to health care servi... more Kenya, over the years, has attempted to introduce measures to improve access to health care services especially by the poor and vulnerable including women and children and therefore cushion them from the unintended consequences of having to pay for health care as point of consumption. In 2007, for instance, the government of Kenya reduced user fees at the lower level facilities - health centres and dispensaries – to a maximum of Kenya Shillings (KES) 10 and KES 20 respectively to cover for registration. Under this policy – commonly referred to as the 10/20 policy – children aged below five years and specific health conditions such as Malaria and Tuberculosis were exempted from payment. All fees for deliveries in public health facilities were also abolished in July 2007 to further increase access to maternal health care services. Even though user fees were low, there was widespread evidence to show that such fees encouraged self-treatment and in some cases acted as barrier to timely ...
How exposure to risk affects economic growth is a key issue in development. This article quantifi... more How exposure to risk affects economic growth is a key issue in development. This article quantifies both the ex ante and ex post effects of risk using long-running panel data for rural households in Zimbabwe. It proposes a simulation-based econometric methodology to estimate the structural form of a micro model of household investment decisions under risk. The key finding is that risk substantially reduces growth in this particular setting: the mean capital stock in the sample is (in expectation) 46 percent lower than in the absence of risk. About two-thirds of the impact of risk is due to the ex ante effect (that is, the behavioral response to risk), which is usually not taken into account in policy design. These results suggest that policy interventions that reduce exposure to shocks or that help households manage risk could be much more effective than is commonly thought.
International Journal of Environmental Research and Public Health
Many European countries have implemented pension reforms to increase the statutory retirement age... more Many European countries have implemented pension reforms to increase the statutory retirement age with the aim of increasing labor supply. However, not all older workers may be able or want to work to a very high age. Using a nation-wide register data of labor market transitions, we investigated in this natural experiment the effect of an unexpected change in the Dutch pension system on labor market behaviors of older workers. Specifically, we analyzed transitions in labor market positions over a 5-year period in two nation-wide Dutch cohorts of employees aged 60 years until they reached the retirement age (n = 23,703). We compared transitions between the group that was still entitled to receive early retirement benefits to a group that was no longer entitled to receive early retirement benefits. Results showed that the pension reform was effective in prolonging work participation until the statutory retirement age (82% vs. 61% at age 64), but also to a larger proportion of unemploy...
Background: Although public medical insurance covers over 95% of the population in China, dispari... more Background: Although public medical insurance covers over 95% of the population in China, disparities in health service use and out-of-pocket (OOP) health expenditure across income groups are still widely observed. This study aims to investigate the socio-economic disparities in perceived health care needs, informal care, formal care and payment for health care and explore their equity implication. Methods: We assessed healthcare needs, service use and payment in 400 households in rural and urban areas in Jiangsu, China, and included only the adult sample (N=925). One baseline survey and 10 follow-up surveys were conducted during the 7-month monitoring period, and the Affordability Ladder Program (ALP) framework was adopted for data analysis. Negative binomial/zero-inflated negative binomial and logit regression models were used to explore factors associated with perceived care needs and with the use of three types of health service (self-treatment, outpatient and inpatient care). T...
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