World Bank Studies

Bangladesh is committed to achieving universal health coverage (UHC) by 2032; to this end, the government of Bangladesh is exploring policy options to increase fiscal space for health and expand coverage while improving service quality and availability. Despite Bangladesh's impressive strides in improving its economic and social development outcomes, the government still confronts health financing and service delivery challenges. In its review of the health system, this study highlights the limited fiscal space for implementing UHC in Bangladesh, particularly given low public spending for health and high out-of-pocket expenditure. The crisis in the country's human resources for health (HRH) compounds public health service delivery inefficiencies. As the government explores options to finance its UHC plan, it must recognize that reform of its service delivery system with particular focus on HRH has to be the centerpiece of any policy initiative.

Unlocking East Africa's Economic Potential Through Strategic Infrastructure PartnershipsBuilding Integrated Markets within the East African Community offers a roadmap for policymakers, investors, and developers seeking to transform East Africa's infrastructure landscape. This study, commissioned by the East African Community Secretariat, dives deep into the opportunities and challenges of public-private partnerships (PPPs) in the region. Discover how the EAC is working to harmonize legal frameworks, attract private sector investment, and foster regional collaboration. Learn from detailed case studies, explore innovative financing mechanisms, and gain insights into overcoming key obstacles. This report provides actionable recommendations for building a more interconnected and prosperous East Africa. For anyone committed to driving sustainable growth and development in the region, this is an essential resource. - Understand the current state of PPPs in the EAC - Identify key areas for policy reform - Explore options for regional resource centers and financing instruments

This World Bank Study provides a basic diagnostic of access to safe water and sanitation in Uganda and their relationship with poverty. The analysis relies on a series of nationally representative household surveys for the period 2002–13, as well as on qualitative data collection. The study first relies on household surveys to analyze trends in access to safe water and some of the constraints faced by households for access. The issue of the cost of water for households without a connection to the piped water network is discussed. This includes a discussion of public stand pipes. Next, qualitative data are presented on the obstacles faced by households in accessing safe water. The next two chapters are devoted to sanitation. The focus is again first on analyzing household survey data about sanitation, including with respect to toilets, bathrooms, waste disposal, and hand washing, and next on an analysis of qualitative data from focus groups and key informants. Finally, the study reviews some of the policies and programs that have been implemented in order to improve access to safe water and sanitation for the poor as well as options going forward.

Adapting Azerbaijan's Agriculture to a Changing ClimateIs Azerbaijan's agricultural sector prepared for the challenges of climate change? This study provides a comprehensive analysis of the vulnerabilities facing Azerbaijan's agricultural systems and offers practical adaptation options to ensure food security and sustainable rural development. Reducing the Vulnerability of Azerbaijan's Agricultural Systems to Climate Change identifies key priorities for policymakers, researchers, and practitioners. Discover strategies for: - Improving irrigation and water management - Promoting climate-resilient crop varieties - Enhancing livestock production practices - Strengthening institutional capacity This insightful resource is essential for anyone working to build climate resilience in agriculture and support rural communities in Azerbaijan and similar regions.

A roadmap for Romania's economic future through enhanced competition. This World Bank study offers a comprehensive analysis of Romania's competition framework and provides actionable recommendations for policymakers, economists, and legal professionals. Building Landmarks, Smoothing Out Markets examines Romania's progress in aligning its competition policies with European Union standards. It identifies key challenges and opportunities for improving market efficiency, attracting investment, and promoting economic growth. The study covers a wide range of topics, including competition law, state aid, antitrust, and regulatory frameworks. Discover how Romania can: - Strengthen its regulatory framework to foster a more competitive environment - Reduce administrative burdens and attract foreign investment - Enhance its enforcement of competition law and promote compliance This insightful resource is essential for anyone seeking to understand and contribute to Romania's economic development.

Since the 2011 uprising that toppled the former regime, Libya has been mired in deep political strife. An economy in which agriculture once flourished was converted wholesale to an oil-based rentier state of the most extreme kind. Following the immediate post-revolution oil-consumption boom, in 2014 Libya's economy is in recession. Security is the greatest challenge to stability (World Bank 2014). Today, limited opportunities exist for reintegrating youth and ex-combatants into the labor market. This policy note provides an initial assessment of Libya's labor market and discusses policy options for promoting employability as part of a broader jobs strategy. It is intended as a contribution to evidence on Libya's labor market for the benefit of policy makers, civil society and the broader international community. The report finds that the overall unemployment rate in Libya increased from 13.5 percent in 2010 prior to the uprising to 19 percent as of 2012, having changed little since then. Youth unemployment stands at approximately 48 percent and female unemployment 25 percent. The vast majority (85 percent) of Libya's active labor force is employed in the public sector, a high rate even by regional standards. The rate for women is even higher (93 percent). Employment in industry (largely the oil sector) and agriculture accounts for only 10 percent of the labor force. While nearly all public sector workers are covered by some form of social insurance, only 46 percent of private sector workers are enrolled - a striking difference. The report further discusses the implications of Libyan jobseeker profiles. Thirty percent of firms have reported difficulty in recruiting qualified Libyan nationals. Only 15-30 percent of Libya's labor force is relatively skilled and likely could be hired readily if given access to basic job training and job search assistance. For the remainder of the unemployed work force, targeted interventions would need to be designed for advanced skills development, vocational training, reconversion, and apprenticeship and entrepreneurship programs. The report discusses options for shifting Libya from a rentier state to a diversified, productive economy through economic and technical partnerships to help accelerate creating economic opportunities and jobs.

Unlocking STEM Potential in Sub-Saharan Africa: A Decade of DevelopmentHow can Sub-Saharan Africa leverage science, technology, engineering, and mathematics (STEM) to drive economic growth and improve prosperity? This study analyzes the region's progress in STEM research over a decade, offering insights for policymakers, researchers, and development practitioners. Sub-Saharan African Science, Technology, Engineering, and Mathematics Research: A Decade of Development examines research output, citation impact, and international collaboration. Discover key trends, challenges, and policy recommendations to enhance STEM education, foster innovation, and build human capital. This book is for those seeking to understand and contribute to Africa's STEM revolution.

The importance of good land governance to strengthen women's land rights, facilitate land-related investment, transfer land to better uses, use it as collateral, and allow effective decentralization through collection of property taxes has long been recognized. The challenges posed by recent global developments, especially urbanization, increased and more volatile food prices, and climate change have raised the profile of land and the need for countries to have appropriate land policies. However, efforts to improve country-level land governance are often frustrated by technical complexities, institutional fragmentation, vested interests, and lack of a shared vision on how to move towards good land governance and measure progress in concrete settings. Recent initiatives have recognized the important challenges this raises and the need for partners to act in a collaborative and coordinated fashion to address them. The breadth and depth of the papers included in this volume, all of which were presented at the World Bank's Annual Conference on Land Policy and Administration, illustrate the benefits from such collaboration. They are indicative not only of the diversity of issues related to land governance but, more importantly, highlight that, even though the topic is complex and politically challenging, there is a wealth of promising new approaches to improving land governance through innovative technologies, country-wide policy dialogue, and legal and administrative reforms. The publication is based on an on-going partnership between the World Bank, the International Federation of Surveyors, the Global Land Tool Network and the United Nations Food and Agriculture Organization provide tools that can help to address land governance in practice and at scale. It is our hope that this volume will be of use to increase awareness of and support to the successful implementation of innovative approaches that can help to not only improve land governance, but also thereby contribute to the well-being of the poorest and the achievement of the Millennium Development Goals.

The Government of the Republic of Belarus (GoB) plans to increase district heating tariffs to cost-recovery levels and gradually phase out subsidies, replacing them with social assistance programs. Residential DH tariffs in Belarus are currently at roughly 10–21 percent of cost-recovery levels. DH subsidies are highly regressive, add costs to business, and create significant fiscal risks and macroeconomic vulnerabilities. The study analyzes the social, sectoral, and fiscal impacts of the proposed tariff reform, and identifies and recommends measures to mitigate adverse impacts of district heating tariff increases on the households. The analysis shows that a negative social impact is manageable if a tariff increase is accompanied by countervailing measures to compensate for the loss of purchasing power, in particular of the poor, through targeted social assistance and energy efficiency programs. The reform is more likely to be successful if communication campaigns to address consumer concerns are carried out before significant price increases, and consumer engagement and monitoring systems are established. When tariff reform and mitigation measures are properly sequenced and coordinated, the reform will become more socially acceptable, consumers will benefit from better quality of services, the government will achieve positive fiscal savings, and the DH sector will become sustainable in the long term. The study analyzes the social, sectoral, and fiscal impacts of the proposed district heating tariff reform in Belarus, and identifies and recommends measures to mitigate adverse impacts of district heating tariff increases on the households.

The extractive industries (EI) sector occupies an outsize space in the economies of many developing countries. Policy makers, economists, and public finance professionals working in such countries are frequently confronted with issues that require an in-depth understanding of the sector, its economics, governance, and policy challenges, as well as the implications of natural resource wealth for fiscal and public financial management. The objective of the two-volume Essentials for Economists, Public Finance Professionals, and Policy Makers, published in the World Bank Studies series, is to provide a concise overview of the EI-related topics these professionals are likely to encounter. This second volume, Fiscal Management in Resource-Rich Countries, addresses critical fiscal challenges typically associated with large revenue flows from the EI sector. The volume discusses fiscal policy across four related dimensions: short-run stabilization, the management of fiscal risks and vulnerabilities, the promotion of long-term sustainability, and the importance of good public financial management and public investment management systems. The volume subsequently examines several institutional mechanisms used to aid fiscal management, including medium-term expenditure frameworks, resource funds, fiscal rules, and fiscal councils. The volume also discusses the earmarking of revenue, resource revenue projections as applied to the government budget, and fiscal transparency, and outlines several fiscal indicators used to assess the fiscal stance of resource-rich countries. The authors hope that economists, public finance professionals, and policy makers working in resource-rich countries-including decision makers in ministries of finance, international organizations, and other relevant entities-will find the volume useful to their understanding and analysis of fiscal management in resource-rich countries.

Optimize health professional education for universal health coverage. This World Bank study explores the economic forces shaping health workforce development, offering insights for policymakers and administrators. The Economics of Health Professional Education and Careers examines the influence of market dynamics on training, career choices, and workforce imbalances. It addresses critical questions: - What are the global trends in health professions? - How do these trends affect career decisions? - What is the value of different types of health professional education? For healthcare policymakers, health economists, and researchers, this study provides recommendations to align market forces with universal health coverage goals. Authors Barbara McPake, Allison Squires, Agya Mahat, and Edson C. Araujo offer a comprehensive literature review to support evidence-based policy design.

India's landmark Right of Children to Free and Compulsory Education Act (2009) guarantees education to all children aged 6-14 years. The Act mandates specific student-teacher ratios and emphasizes teacher quality. Writing this into legislation took seven years, but the seven years since has proven that ensuring effective teachers are recruited and placed in all schools in a time-bound manner is considerably more challenging. This report takes a detailed look at the complexity of the teacher management landscape in elementary and secondary schools in nine Indian states. On a daily basis, the administrative machinery of these states has to manage between 19,000 to nearly a million teachers in different types of schools and employment contracts, and cope with recruiting thousands more and distributing them equitably across schools. This report examines the following issues: official requirements for becoming a schoolteacher in India; policies and processes for teacher recruitment, deployment and transfers; salaries and benefits of teachers; professional growth of teachers; and grievance redressal mechanisms for teachers. For the first time in India, this report compares and contrasts stated policy with actual practice in teacher management in the country, using a combination of primary and secondary data. In so doing, the report reveals the hidden challenges and the nature of problems faced by administrators in attempting to build an effective teacher workforce which serves the needs of all of India's 200 million school children. The report examines states with varying characteristics, thus generating knowledge and evidence likely to be of interest to policy makers and practitioners in a wide range of contexts.

Improving the returns to labor for low-paid workers is a key policy challenge, especially in low-income countries (LICs) where earnings increases are the single most important source of poverty reduction and an important engine of shared prosperity. Yet, the understanding of individual earnings dynamics remains limited. The small-but growing-body of empirical literature on the factors leading to larger and faster pay increases points to strong persistence in earnings over time. However, it remains unclear to what extent this is due to differences in individual endowments rather than to the fact that being in low-paying jobs itself undermines future earnings prospects, and to what extent determinants of earnings vary across types of activities and sectors. The knowledge gap is particularly large for LICs due to the limited availability of reliable panel data. This study uses unusually rich longitudinal data from Ghana and Tanzania to identify engines of, and barriers to, earnings and earnings mobility. It examines the relative role of individual endowments-such as gender, age, and skills-and characteristics of the job, but also focuses on the role of job switches-for example, moves into and out of self-employment. The analysis also zooms in on the drivers of transitions between low-paying and high-paying jobs and addresses questions such as whether being low paid is a transitory or permanent phenomenon, and whether it has a scarring effect on an individual's employment prospects. The extent to which earnings dynamics differ for women and young adults is also discussed in detail. Tanzania and Ghana provide a particularly relevant context in which to examine these issues and the cross-country comparison helps shed light on the institutional factors that promote labor market mobility and entrepreneurship. The audience for this report is broad: it is an important read for policy makers, academics, and development practitioners interested in reducing poverty and promoting shared prosperity in Ghana and Tanzania. However, its relevance spans well beyond the two countries analyzed to include all developing countries where self-employment in small-scale activities accounts for a very large proportion of all employment.

This publication briefly describes the processes and methodologies for building and sustaining multistakeholder coalition to drive reforms in the health sector. It is based on the experiences of three East African countries -- Uganda, Tanzania and Kenya. It outlines, by chapter, each country's experience in identifying, mobilizing, and coalescing key stakeholders to address governance bottlenecks in pharmaceutical procurement and supply chain management. It highlights challenges, successes as well as lessons learned to guide other countries.

Drylands account for three-quarters of Sub-Saharan Africa's cropland, two-thirds of cereal production, and four-fifths of livestock holdings. Today frequent and severe shocks, especially droughts, limit the livelihood opportunities available to millions of households and undermine efforts to eradicate poverty in the drylands. Prospects for sustainable development of drylands are assessed in this book through the lens of resilience, understood here to mean the ability of people to withstand and respond to droughts and other shocks. An original model was developed expressly to consistently and coherently evaluate different type of interventions on the ground, which provided a common framework to anticipate the scale of the challenges likely to arise in drylands, as well as to generate insights into opportunities for addressing those challenges. Such modeling framework consisted in a) estimating the baseline vulnerability profiles of people living in drylands (2010), b) estimate the evolution of vulnerability by 2030 under a range of assumptions, c) calculated the number of people affectedby drought in the different administrative units of each country, and d) evaluate different types of interventions in agriculture and livestock for mitigating drought impact by calculating the potential for reducing the number of people affected for each scenario and conducting a simplified · benefit/cost (B/C) analysis for each type of intervention. For livestock, simulation models were used to estimate the impacts of feed balances, livestock production, and household income resilience interventions under different climate scenarios). For agriculture, the DSSAT (Decision Support System for·Agrotechnology Transfer) framework was used to assess the potential impact on yields likely to result from adoption of five crop farming technologies: (1) drought-tolerant varieties, (2) heat-tolerant varieties, (3) additional fertilizer, (4) agroforestry practices, (S) irrigation (6) water-harvesting techniques and selected combinations thereof.

The report first summarizes the key findings from the following three studies in three provinces (Guizhou, Jilin, Shandong): (a) a demand survey to assess rural ICT access and attitudes; (b) a library study including scoping the status of ICT use in rural libraries; and (c) a limited impact evaluation to examine how ICT interventions have affected rural uers. Then the report addresses the challenges and policy recommendations of ICT use in the Chinese Countryside.

The goals of universal health coverage (UHC) are to ensure that all people can access quality health services, to safeguard all people from public health risks, and to protect all people from impoverishment due to illness, whether from out-of-pocket payments for health care or loss of income when a household member falls sick. Countries as diverse as Brazil, France, Japan, Thailand, and Turkey have shown how UHC can serve as a vital mechanism for improving the health and welfare of their citizens and lay the foundation for economic growth and competitiveness grounded in the principles of equity and sustainability. Ensuring universal access to affordable, quality health services will be an important contribution to ending extreme poverty by 2030 and boosting shared prosperity in low-income and middle-income countries, where most of the world's poor live. Universal Health Coverage for Inclusive and Sustainable Development synthesizes the experiences from 11 countries-Bangladesh, Brazil, Ethiopia, France, Ghana, Indonesia, Japan, Peru, Thailand, Turkey, and Vietnam-in implementing policies and strategies to achieve and sustain UHC. These countries represent diverse geographic and economic conditions, but all have committed to UHC as a key national aspiration and are approaching it in different ways. The book examines the UHC policies for each country around three common themes: (1) the political economy and policy process for adopting, achieving, and sustaining UHC; (2) health financing policies to enhance health coverage; and (3) human resources for health policies for achieving UHC. The findings from these country studies are intended to provide lessons that can be used by countries aspiring to adopt, achieve, and sustain UHC. Although the path to UHC is specific to each country, countries can benefit from the experiences of others in learning about different approaches and avoiding potential risks.

Adapting Georgian Agriculture to a Changing Climate This study assesses the vulnerability of Georgia's agricultural systems to climate change and proposes adaptation options to enhance resilience and sustainability. It's for policymakers, researchers, and practitioners seeking to understand and address climate risks in agriculture. - Understand the impacts of climate change on Georgian agriculture. - Discover effective adaptation strategies for different agricultural regions. - Learn how to improve food security and economic growth in a changing climate. This report provides a menu of options for climate change adaptation in the agricultural and water resources sectors, along with specific recommended actions that are tailored to distinct agricultural regions within Georgia. By implementing these strategies, Georgia can build a more resilient and sustainable agricultural sector, ensuring food security and economic prosperity for its rural communities. This book identifies key priorities for policies, programs and investments to reduce the vulnerability of Georgia's agricultural systems to climate change.

Skills development in Ghana encompasses foundational skills, transferable/soft-skills, and technical and vocational skills. This report focuses on one segment of this skills development system: formal and informal technical and vocational education and training (TVET) at the pre-tertiary level. TVET represents a major intersection between education, youth and the labor market. The government has long promised to the population that increasing technical and vocational skills training opportunities will help solve youth unemployment. However, market distortions and inefficiencies have led to an adverse cycle of high costs, inadequate quality of supply and low demand, leading to further pressures on the effectiveness and efficiency of TVET services. This adverse cycle means that the political and policy promise of skills development helping to ease the unemployment problem is at risk of remaining unfulfilled. The report focuses on social and economic demand for (pre-tertiary) technical and vocational skills and maps out the supply of these skills from formal and informal, private and public sectors. The dual purpose has been to both carry out an institutional and policy analysis and also to establish a platform for monitoring sector performance and assisting policy and Development Partner harmonization. The report analyzes the economic and social demand for technical and vocational skills and the suitability of the current supply as well as the effectiveness of policy, coordination and financing of technical and vocational skills development. The report annex provides the summary of economic demand analyses from the key sectors reviewed and provides a full mapping of all technical and vocational programs in Ghana. The study offers a comprehensive set of policy recommendations for improving Ghana's pre-tertiary technical and vocational skills development sector, which will be of interest to policy makers and development partners in Ghana.

La infraestructura escolar de Paraguay parece estar relativamente en mal estado y menos desarrollada que la de otros países de América Latina. Entonces, ¿Cuál es el estado de la infraestructura escolar para la educación primaria y secundaria en Paraguay? ¿Cuánto invierte el gobierno con el fin de mejorar la infraestructura escolar y cómo han evolucionado estas inversiones a través del tiempo? ¿Cuál es el marco legal para este tipo de inversiones y es este marco adecuado? Dadas las limitaciones presupuestarias, ¿qué tipos de inversiones son posiblemente las más necesarias para ayudar a mejorar el aprendizaje de los estudiantes? Por último, ¿cuán bien dirigidas a las escuelas más necesitadas están las inversiones en infraestructura que se realizan hoy en día? Con el propósito de ayudar a informar la toma de decisiones por parte del Ministerio de Educación en este ámbito, el objetivo de este estudio es proporcionar respuestas tentativas a estas preguntas sobre la base de los datos presupuestarios administrativos, así como los datos a nivel de la escuela recolectados a través de un censo de infraestructura escolar en 2008.