Women’s Empowerment and Wellbeing: Evidence from Africa

We use household survey data from Senegal to model the effects of empowerment within the home on married women’s wellbeing. The estimated effects of empowerment are at least as large as more conventional development indicators, such as household income. The size of the empowerment effect is robust to alternative estimation techniques, including an Instrumental Variables estimator.     

Neighbourhood Ethnic Diversity,Child Health Outcomes and Women’s Empowerment

Much of the existing literature suggests that ethnic diversity undermines economic development. However, there are also ways in which local ethnic diversity might be beneficial, and we show that in the case of Ethiopian child health, the benefits of diversity can outweigh the costs. We find that children in relatively diverse communities are better nourished and more likely to receive a full set of vaccinations. There is some evidence that one explanation for this effect is that women in relatively diverse communities are better informed about health issues and more empowered in making healthcare decisions.     

Health scrutiny,democracy and integration: Part of the same jigsaw?

Set against the major restructuring of decision-making processes within local government and the wider modernisation agenda for public services, this paper suggests that the scrutiny process (specifically in relation to local authority health scrutiny) can be described in two analytically different, but not necessarily contradictory, ways. It could be seen as a process to increase the levels of local democracy or as a form of integration across different organisations/sectors. The article is informed from the first half of a three-year evaluation that includes interview and observational data from in-depth case study research in five local authorities and their associated Primary Care Trusts (PCTs). The research highlights examples of health scrutiny in terms of both democratic input and integration/joined-up working by organisations from different public sectors, to facilitate scrutiny reviews and resulting changes. It is suggested that further evaluation of the continued development of health scrutiny will be required to examine the potential longer-term impacts on local governance issues, partnership working and the health of the local population.     

Does Health Insurance Reduce Child Labour and Education Gaps? Evidence from Rwanda

A common practice of poor households to informally deal with risk is to allocate children’s time away from school towards income-generating activities or household production. Focussing on Rwanda, this study investigates whether the provision of formal health insurance helps to prevent this undesired risk coping strategy. We find that children of households enrolled in health insurance work significantly less compared to those of not enrolled families, and also have better educational achievements. The results suggest that policy interventions which reduce household risk exposure may have additional benefits in terms of lower child labour supply and higher schooling levels.     

Health and human security: a wrinkle in time or a new paradigm?

Since it was first advanced in the 1994 Human development report of the United Nations Development Programme [United Nations Development Project. (1994). Human development report. New York: UN], the concept of ‘human security’ has evolved as a holistic development-oriented acuity [Nef, J. (1999). Human security and mutual vulnerability: The global political economy of development and underdevelopment (2nd ed.). Ottawa: International Development Research Centre]. The human security concept reinforces the right to health, drawing on both the role of states and the global community's commitment to human rights. Yet, health and human security, long the purview of state power and responsibility, increasingly include alliances of state and non-state actors. This paper proceeds in three parts. The first looks at health and human security linkages, charting the trajectory of the health and human security relationship. The second deals with policy and operational implications. It explores the health–human security link, paying particular attention to the allocation of responsibility and accountability, including through private–public partnerships and rising powers such as China. The third provides a theoretical and technical analysis of the status of health and human security since 1994, taking into account its evolution vis-à-vis human rights’ development and development more broadly, also asking whether it represents but a wrinkle in time or a new sustainable development paradigm.     

Non-State Health Care Provision in Kazakhstan and Uzbekistan: Is Politicisation a Model?

Drawing on comparisons with cooperative and competitive non-state health care provision around the world, this article analyses non-state provision of health services in post-Soviet Uzbekistan and Kazakhstan. It explores the conditions in which non-state provisions remain cooperative or become politicised and contrasts the relations between NGOs and the state in Uzbekistan and Kazakhstan and the way they became politicised in the Middle East. In contrast to Western conceptions of NGOs, Central Asia's health NGOs cooperate with state agencies to serve their constituencies. In contrast to the perceptions of Central Asian governments, health-oriented NGOs do not aim to politicise health care. Donor support to Central Asia's health NGOs has created civically oriented actors that fill gaps in the state's capacity and enable governments to better serve their populations.     

Pensions and the Health of Older People in South Africa: Is there an Effect?

Abstract

This paper critically reviews evidence from low and middle income countries that pensions are associated with better health outcomes for older people. It draws on new, nationally representative survey data from South Africa to provide a systematic analysis of pension effects on health and quality of life. It reports significant associations with the frequency of health service utilisation, as well as with awareness and treatment of hypertension. There is, however, no association with actual control of hypertension, self-reported health or quality of life. The paper calls for a more balanced and integrated approach to social protection for older people.     

Health care reform in britain and the united- states: Public or market-led? a review

The organization of health care in the US and Britain is based on different historical, ideological and political assumptions. This paper draws on those assumptions to describe the current health care crisis and proposed reforms. Central to the discussion is an analysis of the forms of public and market-led provision of health care in operation, particularly in relation to the role of the state and their implications for access, cost, and quality.     

Which Institutions are Good for Your Health? The Deep Determinants of Comparative Cross-country Health Status

We extend the literature on the deep determinants of economic development by focusing on life expectancy, instead of income per capita, as an indicator of economic development, and by examining the role of informal, as well as formal, institutions. Our empirical results suggest that formal and informal institutions are substitutes. Improving informal institutions has positive effects on life expectancy that are statistically significant for most countries and stronger than the effects of improving formal institutions. The gains from improving informal institutions are greatest for countries in which institutions are weakest. Geographical factors also help explain cross-country variation in life expectancy.     

Participation in Micro-Finance Programmes and Women’s Mental Health in South Asia: A Modified Systematic Review

Micro-finance provides financial services to poor women from developing countries where cultural and social constraints limit their opportunities for economic advancement. Using Forbes’s process of conducting systematic review, 12 quantitative studies from South Asia reporting on the impact of micro-finance on women’s mental health outcomes were analysed. Overall, studies revealed that the duration and depth of involvement in micro-finance activities would make a difference in women’s mental health and not just receiving loans; however, rigorous programme evaluation is needed. Collaborative actions by micro-finance and health care practitioners to recognise women’s mental health needs and to strengthen measures to optimise the beneficial effects of micro-finance must be considered.     

The Effect of Sibling Size on Children’s Health and Education: Is there a Quantity-Quality Trade-off?

The quantity-quality trade-off is one important motivation for the family planning policies in many developing countries. In this paper, we examine the effect of number of siblings on children’s health and education in China. We find evidence of quantity-quality trade-off in children’s health but not in children’s education. Our study has three contributions. First, we focus not only on children’s education but also on children’s health, which has received rather little attention in the literature. Secondly, we use a new source of exogenous variation in fertility – variations of the strictness of the One-Child policy across localities in China – to construct instrumental variable's (IV's). Finally, we empirically explore the underlying mechanism of the quantity-quality trade-off, and find supporting evidence for the resource dilution hypothesis.     

Does Education Improve Health? Evidence from Indonesia

I examine the effects of education on health in Indonesia using an exogenous variation in education induced by an extension of Indonesia’s school term length in 1978–1979, a natural experiment that fits a regression discontinuity design. I find the longer school year increases educational attainment and wages, but I do not find evidence that education improves health. I explore some mechanisms through which education may affect health, but education does not seem to promote healthy lifestyles, increase the use of modern healthcare services, or improve access to health insurance; if anything, education improves only cognitive capacity.     

Do School Board Governance Best Practices Improve District Performance? Testing the Key Work of School Boards in Wisconsin

The most prominent set of school board governance best practices used in the United States is the National School Boards Association’s (NSBA’s) Key Work of School Boards. In this article, we operationalize adherence to the Key Work of School Boards with multiple survey items answered by Wisconsin school board members. Using multivariate regression models, we find that adherence to the best practices results in improved achievement in districts represented by board members who have served for five or more years. The findings support the idea that school board governance behaviors are linked to district-level academic outcomes.     

Households’ Willingness to Pay for Health Microinsurance and its Impact on Actual Take-up: Results from a Field Experiment in Senegal

Abstract

Community-based health insurance schemes (CBHIS) have been present in the region of Theis, Senegal, for many years. Yet, despite the benefits they offer, take-up rates remain low. This article measures the willingness to pay (WTP) for CBHIS premiums in such a context; our results highlight the role of income, wealth and risk preferences as determinants of WTP. We also provide an analysis of the predictive power of WTP on the actual take-up of insurance following our offering of membership to a sample of 360 households. Results show that WTP has a positive and significant impact on actual CBHIS take-up.     

Can Foreign Health Assistance Reduce the Medical Brain Drain?

In this article, we analyse the impact of foreign health aid on the emigration rates of physicians. The analysis is based on a dataset of physician emigration rates from 50 source countries between 1998 and 2004. First, we investigate the direct impact of health assistance using the generalised method of moments estimation, and we highlight the significant negative effect of foreign health assistance on the medical brain drain. Second, we show that this effect results more from technical assistance than from financial assistance. Finally, the robustness of our analysis is verified to confirm the validity of the results.     

Including Older Adults in Development Goals: Is Subjective Wellbeing the Answer? A Case Study of Older South Africans

Measures of subjective wellbeing are gaining importance as indicators of overall societal progress, yet the majority of studies come from higher income countries. This paper explores the relationship between human development indicators and measures of subjective wellbeing among persons aged 50-plus in South Africa. Using the first nationally representative population-based study of older South Africans, WHO Study on global AGEing and adult health (WHO SAGE), this paper adds to a small but growing literature on subjective wellbeing in lower-income countries. Results indicate that education, socio-economic status and health are, in fact, correlated with measures of subjective wellbeing, but the relationships and strength of the relationships differ depending on the measure used to assess wellbeing.     

The Learning Orientation of Primary Health Care Teams in the English National Health Service: Is This a Myth That Should Be Perpetuated?

A qualitative study of primary health care teams in the UK provides insight into their co-ordination or learning-orientation and how this affects member commitment, conceptions of ‘core’ and periphery, group identification and willingness to integrate roles. Even if the ideal of a learning-oriented primary health care team is viewed as a myth, it can still perform useful functions despite an apparent withdrawal of its official authorization by the Cameron-led government. The perpetuation of this myth maintains a tension between reality and potentiality in the hopes that inspire its pursuit as an ideal of team formation.     

Investing or Squandering Social Capital? Community-Based Organizations for Indigent Health Care

Abstract

Externally funded collaboratives are compared in a US–Mexico border location, focusing on the local commitments that are made in financial and social capital for long-term sustainability. The border offers special challenges to sustainable health care programs, given the substantial crossing that occurs among health care users in both North-to-South and South-to-North directions. Funding organizations that decentralize programs to community collaboratives, demanding considerable local leverage and in-kind contributions, create a pernicious tax on poor communities in the name of building community capacity. Despite good intentions, precious community social capital is squandered.