Directions in Development – Human Development

Over the past decade, Indonesia has implemented significant health sector reforms that include decentralizing responsibilities for service delivery, designing incentives for health providers, increasing the supply of midwives in remote areas, and analyzing demographic and epidemiological transitions causing changes in the patterns of disease prevalence. Financial protection against catastrophic expenditures has improved substantially, and legislation has been enacted to improve the quality of physician training and patient care. Despite the progress, substantial challenges remain and include comparatively low resources for the health sector, limitations in the supply of providers at the primary and hospital levels, inefficient payment systems, shortcomings in the quality of maternal and child and adult care, lack of oversight and effective licensing in an expanding private health sector, and ineffective planning for and recruitment and retention of health workers. Given the slow pace in improving health outcomes and limited evidence linking health performance and the health workforce, the need to make more information available about past experiences to inform future policy changes is pressing. Few studies have been undertaken to measure the actual impact of the reforms and the remaining challenges. 'New Insights into the Provision of Health Services in Indonesia: A Health Workforce Study' begins the process, providing real time evidence-based inputs to facilitate the Government of Indonesia's comprehensive health sector review. The authors' analysis of panel data from households and health providers will assist the government's assessment of the impact of past health work force policies and its consideration of policy changes.

Behavioral Insights for Development: Cases from Central America brings together a set of experiences that applied behavioral insights to different areas of public policy-in some cases through randomized control trials, and in others using surveys or behavioral games. These experiences collectively show the promise of public policies that are informed by a better understanding of what drives individual behavior. In Costa Rica, for example, informing households of how much water they consume relative to their neighbors reduced water consumption (chapter 1). In Guatemala, altering the way government communicates with taxpayers increased revenue collection (chapter 2). In Nicaragua, an analysis of a cash transfer program found that children in households receiving benefits exhibited significantly higher cognitive development-a result influenced by parental behavior changes during the program (chapter 3). In El Salvador, we explore how different biases explain the apparent puzzle of a gas subsidy reform that benefited most of the population yet proved to be widely unpopular (chapter 4). Chapter 5 also uses behavioral insights to analyze subsidy reforms in El Salvador, this time using a different methodology: a set of economic behavioral games designed to evaluate the willingness of individuals to accept subsidy reforms that would affect them directly. Finally, chapter 6 reflects on the progress made in applying behavioral insights in a development context. These cases illustrate, in practice, some of the findings of the World Development Report 2015: Mind, Society, and Behavior. In particular, they demonstrate the possibility of using nontraditional tools, complementary to regulation, in contexts where time and resources are limited. The World Bank has since established a Mind, Behavior, and Development (eMBeD) Unit within the Poverty and Equity Global Practice to mainstream and scale up behavioral science in public policies and programs. We hope these experiences will help to inform other practitioners about the potential of applying behavioral insights in a development context and will encourage them to consider such approaches as a complement to traditional policy measures.

The health workforce must be able to cope with shifts in the pattern of causes of death and disease that are being seen worldwide-particularly with the rise in noncommunicable diseases (NCDs). This requires health personnel to have a set of skills and competencies that can adapt to meet the population's growing and changing health needs. This report examines the status of the nurse workforce in the Eastern Caribbean, assessing how best to strengthen its capacity to respond to the growing burden of NCDs. The report is based on four Eastern Caribbean case studies conducted in Dominica, Grenada, St. Lucia, and St. Vincent and the Grenadines. The case studies showed that, although overall nurse staffing levels seem to be sufficient across the four countries in terms of numbers, there are nurse shortages at hospitals and health clinics, as well as in the availability of specialists. Better management of the nurse workforce is needed to ensure adequate coverage at the hospitals and clinics is maintained. In terms of specialists, while the quality of education is generally reported to be good, there are barriers to accessing specialized training which include the high-cost of seeking specialized training due to non-existing or very limited local options and the lack of built-in incentives for completing additional education. To help address the capacity constraints faced by the nurse workforce in the Eastern Caribbean to respond to NCDs, the report generated knowledge in support of two critical areas: (i) provide an understanding of the educational and training opportunities available to nurses to strengthen their capacity to meet the NCD challenges, and (ii) assess whether there is a supportive policy environment in place for nurses to play a role in addressing NCDs. As part of the study, a toolkit was developed, which can be used to strengthen the capacity for HRH planning and management with respect to NCDs.

Ghana was, until very recently, a success story in Africa, achieving high and sustained growth and impressive poverty reduction. However, Ghana is now facing major challenges in diversifying its economy, sustaining growth, and making it more inclusive. Most of the new jobs that have been created in the past decade have been in low-earning, low-productivity trade services. Macroeconomic instability, limited diversification and growing inequities in Ghana's labor markets make it harder for the economy to create more jobs, and particularly, better jobs. Employment needs to expand in both urban areas, which will continue to grow rapidly, and rural areas, where poverty is still concentrated. The current fiscal and economic crisis is heightening the need for urgent reforms but limiting the room for maneuver and increasing pressure for a careful prioritization of policy actions. Going forward, Ghana will need to consider an integrated jobs strategy that addresses barriers to the business climate, deficiencies in skills, lack of competitiveness of job-creating sectors, problems with labor mobility, and the need for comprehensive labor market regulation. Ghana needs to diversify its economy through gains in productivity in sectors like agribusiness, transport, construction, energy, and information and communications technology (ICT) services. Productivity needs to be increased also in agriculture, in order to increase the earnings potential for the many poor who still work there. In particular, Ghana's youth and women need help in connecting to these jobs, through relevant skills development and services that target gaps in information about job opportunities. Even with significant effort, most of Ghana's population will continue to work in jobs characterized by low and fluctuating earnings for the foreseeable future, however, and they will need social safety nets that help them manage vulnerability to income shortfalls. More productive and inclusive jobs will help Ghana move to a second phase of structural transformation and develop into a modern middle-income economy.

Strong science, technology, and innovation links between universities and industry are of critical importance to Sri Lanka as it strives to become an upper-middle-income country. This report presents an overview of current U-I collaboration in Sri Lanka by analyzing responses to a survey of companies and university departments in 2015. Data from the 2015 survey are compared with data from a similar survey in 2007 to identify trends over time. The study examines current policies to promote U-I collaboration in Sri Lanka, highlights some good practices in other countries, and suggests possible ways that Sri Lanka may be able to strengthen U-I collaboration. The report is intended primarily for policy makers in the fields of higher education, research, and innovation, as well as for researchers in companies, universities, and research institutes who are already collaborating in public-private partnerships or are planning to do so. The responses show that the majority of existing links between Sri Lankan universities and companies are short-term, informal interactions with low direct transfer of knowledge and innovation. However, the survey findings also show a growing emphasis on deeper and more demanding types of collaboration, such as joint Research and Development activities, prototype testing, and spin-offs, even though these remain relatively uncommon. Key recommendations to strengthen U-I collaboration are: •As part of the national Science, Technology, and Innovation Policy 2016–2020, develop and implement a national plan to upgrade the country's research infrastructure, in line with national research and innovation priorities. •Strengthen Research and Development funding schemes for joint projects between universities/research institutes and companies, based on national and international experiences. •Define and implement clear intellectual property rights rules for publicly funded research to encourage the use of research results and ensure effective and timely legal protection of intellectual property. •Establish open innovation spaces and business incubators at universities and make available seed money for faculty and students to develop start-ups. •Strengthen the U-I interaction cells at universities with professional expertise in technology transfer and business model development. •Establish opportunities for master's and PhD students to pursue targeted research projects in companies as part of their study.

Unlock insights into health workforce challenges and solutions in low- and middle-income countries. This book provides an economic framework for analyzing health labor markets, offering practical guidance for policymakers, researchers, and practitioners. Are you grappling with health workforce shortages, inequitable distribution, or performance issues? This book equips you with the tools to understand the complex interplay of labor supply and demand, wage determination, and policy interventions. Discover how to: - Apply economic principles to analyze health labor markets - Identify and address market failures - Design effective policy interventions - Improve health outcomes and achieve universal health coverage Analyzing Markets for Health Workers offers actionable insights to strengthen health systems and achieve equitable, sustainable improvements in population health. This book is for policymakers, researchers, and practitioners in health economics and human resources for health seeking to improve health workforce planning and management in resource-constrained settings.

This study reviews the role and workings, with their strengths and weaknesses of last-resort income support (LRIS) programs in Eastern Europe and Central Asia. It draws on a combination of household survey and administrative data for a large group of countries and detailed case studies for a smaller number of countries that span the spectrum of the income range in the region. It thus combines the value of wide, comparable multi-country work with that of in-depth, country-specific probing on key themes. The experiences of LRIS programs in Eastern Europe and Central Asia have demonstrated the technical feasibility of highly efficient poverty-targeted programs in the region. The detailed case studies suggest how programs can improve their coverage, control error and fraud and be implemented effectively in decentralized settings. This experience is pertinent to other regions as well, adding to the know-how for poverty targeting programs in middle and low income countries. Perhaps especially importantly, the book shows that means testing can be accomplished in settings with sizeable informal sectors and at reasonable administrative costs. The study also suggests that currently the role of last resort income support programs within the overall social protection systems of the region is often too small and that their eligibility thresholds should be revised and indexed, so that the programs continue to serve a meaningful swath of the low income households in each country. Moreover the programs can be used as the nexus to weave together a variety of income supports and services for low income households.

Unlocking Yunnan's Potential: Skills for Economic Growth and Social Harmony. This report examines how to develop a skilled workforce in Yunnan Province, China, to support its economic transformation and promote social harmony. It addresses critical questions: - What skills are needed for workers to achieve Yunnan's economic and social transformation? - Is Yunnan's current education and training system capable of supplying sufficient and relevant skills? This study offers insights and policy recommendations for strengthening technical and vocational education, improving access to education, encouraging work-based and rural training, and investing in general education. It is a valuable resource for policymakers, researchers, and development workers interested in skills development in China.

Ukraine's economic progress since its independence in the early 1990s has been uneven, in part due to the slow pace of reforms, unfavorable demographic factors, and low productivity. One of the key factors limiting success is the inadequacy of the skills of Ukraine's workforce with the needs of a modern economy. While the country demonstrates a strong record of educational attainment and acquisition of foundational skills, the post-secondary education and training system fails to equip workers with the right advanced skills for labor market success. This study provides new evidence on the nature of skills valued in the labor market, reviews the institutional constraints hindering the development and use of workforce's skills, and proposes a set of policy options. This study argues that, to improve skills formation and use, Ukraine needs to renew its public policies on post-secondary education, labor-market intermediation and information, and labor regulations. Drawing on household and firm surveys, the study finds that workers need a mix of advanced cognitive skills (like problem solving and communication), socio-emotional skills (like self-management and teamwork), and technical skills (like computer programing or sale skills) to be successful in the labor market and meet employers' demand. These skills are not necessarily explicitly taught in traditional learning settings. Policy makers should therefore rethink the content of post-secondary education and training to focus on the development of skills for the labor market rather than only attendance. To do so, establishing steady links between education institutions and enterprises, by setting up occupation standards and adapting curricula to firm demand, is crucial. An essential instrument to identify the demand for skills and facilitate fruitful investments in skills formation is a labor market information system-which provides reliable information on labor market prospects across post-secondary education fields and institutions and job requirements and characteristics to students, their families, and jobseekers. Nonetheless, a better formation of skills would only be beneficial if most of the workforce can put them at use in jobs, promoted by better labor regulations.

An Investment Framework for Nutrition: Reaching the Global Targets for Stunting, Anemia, Breastfeeding, and Wasting estimates the costs, impacts, and financing scenarios to achieve the World Health Assembly global nutrition targets for stunting, anemia in women, exclusive breastfeeding and the scaling up of the treatment of severe wasting among young children. To reach these four targets, the world needs US$70 billion over 10 years to invest in high-impact nutrition-specific interventions. This investment would have enormous benefits: 65 million cases of stunting and 265 million cases of anemia in women would be prevented in 2025 as compared with the 2015 baseline. In addition, at least 91 million more children would be treated for severe wasting and 105 million additional babies would be exclusively breastfed during the first six months of life over 10 years. Altogether, achieving these targets would avert at least 3.7 million child deaths. Every dollar invested in this package of interventions would yield between US$4 and US$35 in economic returns, making investing in early nutrition one of the best value-for-money development actions. Although some of the targets-especially those for reducing stunting in children and anemia in women-are ambitious and will require concerted efforts in financing, scale-up, and sustained commitment, recent experience from several countries suggests that meeting these targets is feasible. These investments in the critical 1000-day window of early childhood are inalienable and portable and will pay lifelong dividends-not only for children directly affected but also for us all in the form of more robust societies-that will drive future economies.

The Filipino economy has experienced overall growth over the last 20 years, but the growth of the manufacturing sector has been sluggish, and the country has lost innovation capacity. Regaining momentum will depend on many factors, but skills have a key role to play in supporting the growing service sector, improving the competitiveness of the manufacturing sector, and enhancing the long-term ability of the country to innovate and adapt and assimilate new technologies. 'Skills for the Labor Market in the Philippines' analyzes the functional skills with which workers need to be equipped to be employable and support firms' competitiveness and productivity, and evaluates the role of the education and training system in providing these skills. Based on an innovative survey of employers, this book is the most comprehensive attempt thus far to review the skills that matter for the labor market. The book reveals that a dramatic increase in educational attainment occurred in just under two decades in the Philippines. However, in light of the growing demand for skills, the authors also make it clear that there are indications of emerging skills gaps, suggesting that skills are becoming a constraining factor for economic growth. The authors flesh out several policy implications, which should provide a valuable contribution to improving the country's education and training system. The book is primarily intended for the policy makers and researchers who shape the delivery of education and training in the Philippines and other middle-income countries.

The training and development of human capital in Sub-Saharan Africa (SSA) will help countries in the region diversify their economies, carry out economic transformation, and support sustainable growth. Higher education plays a key role in training qualified individuals who will be able to implement new technologies and use innovative methods to establish cost-efficient and effective enterprises and institutions. However, in order for SSA to reap the benefits of this investment in human capital, higher education institutions must secure financing to provide quality training and sound professional prospects to their students. Currently, tertiary education development is unsustainable-resources per student are declining and the quality of education is affected. These issues are particularly pressing in times of financial global crisis, when available resources for tertiary education tend to diminish. The impact of the crisis that started in 2008 provides a clear illustration of the need to explore innovative ways to diversify and secure financing for higher education in SSA. 'Financing Higher Education in Africa' provides a comprehensive overview of higher education financing in SSA. The book begins with an explanation of the fundamental problems faced by higher education institutions and students in SSA, namely the combined pressure of a rapid growth in demand and a growing scarcity of public resources, and it presents the dramatic consequences of these trends on quality. The book then turns to analyzing and comparing the current funding policies in SSA countries and it provides recommendations for improvement. Finally, the book examines the alternatives to the status quo and the policy tools needed to both diversify resources and allocate them based on performance. It will be of great interest to governments, universities, research institutions, and international organizations throughout the region.

A practical guide to investing in early childhood development for policymakers and practitioners. This guide offers advice and support for navigating policy discussions and implementing effective ECD programs in low- and middle-income countries. It addresses key questions about investing in ECD, assessing needs, measuring outcomes, and establishing policy frameworks. Discover strategic entry points for ECD investments, including center-based programs, home-based interventions, and communication campaigns. Learn how to cost and finance ECD programs, considering financial opportunities and constraints. This resource helps maximize investments in human capital and improve the lives of young children. - Understand the economic arguments for investing in ECD. - Learn how to assess the needs of young children and measure outcomes. - Explore strategic entry points for ECD investments. - Discover costing and financing strategies for ECD programs. This guide is for policy makers, project managers, and development practitioners seeking to create a brighter future for young children.

Is Latin America ready for its aging population? This book examines the socioeconomic challenges and opportunities presented by population aging in Latin America and the Caribbean, a process that will occur rapidly in the region. The book explores the support of the aging and poverty in the life cycle, the health transition, and the fiscal pressures that accompany population aging. It disentangles the role of demography from policy, offering insights into work and retirement, income and wealth, and living arrangements. Readers will discover: - How demographic changes impact health status and health care demand - The economic implications of aging on health demand - The fiscal impact of demographic change on public expenditures This volume is essential for policymakers, economists, and researchers seeking to understand and address the challenges of population aging in the developing world. Edited by Daniel Cotlear and published by The World Bank.

Public debate in Nigeria on the country's progress since its return to democracy in 1999 has been dominated by two seemingly opposite themes. The first theme is the strong growth performance of the non-oil economy. This success has been marked by sharp increases in agriculture, trade, and construction and by the emergence of new industries in the financial, telecommunications, and entertainment sectors, supported by sound macroeconomic policies and structural reforms. The second, opposing theme is the seeming failure of Nigeria's much improved economic performance to reduce unemployment, especially among the young. Rising levels of unemployment have increased militancy among the young and impacted negatively on public order. 'Putting Nigeria to Work: A Strategy for Employment and Growth' looks at the ways in which Nigeria's improved economic performance has impacted the labor market. A number of relevant factors are carefully examined and analyzed, including industrial policy and the investment environment, the effects of restrictive trade policies on growth, and the ability of the technical and vocational education system to address the country's skills gap. The book proposes a strategy that will allow Nigeria to increase the availability of quality jobs, reduce rising youth unemployment, and sustain and further accelerate the country's economic performance and growth. At the core of this strategy are targeted interventions aimed at removing binding constraints to growth in sectors of the economy that are already growing fast, but have the potential to grow faster and have significant employment-creating potential.

A comprehensive analysis of poverty and inequality in Guangdong Province, China, with strategies for achieving shared and sustainable growth. Despite rapid economic growth, Guangdong Province faces challenges in tackling poverty and inequality. This report assesses the situation and proposes policy options for a new phase of reforms. Discover strategies to: - Eliminate absolute poverty through social assistance - Enhance income opportunities for the rural poor - Ensure equitable access to quality social services This book is for policymakers, researchers, and anyone interested in economic and social development in China and developing countries. Learn how Guangdong's experience can inform efforts to promote shared growth and reduce inequality worldwide.