The 2019 Annual Meetings of the African Development Bank Group will be held from 11-14 June 2019, in Malabo, Republic of Equatorial Guinea. Find out more

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Working Paper 312 - Quality Homes for Sustainable Malaria Prevention in Africa
22/02/2019 16:20
Working Paper 312 - Quality Homes for Sustainable Malaria Prevention in Africa

Categories: Health

Money & Mosquitoes - The economics of malaria in an age of declining aid
29/08/2018 09:05
Money & Mosquitoes - The economics of malaria in an age of declining aid

Categories: Health

Working Paper 276 - A Tax on Children? Food Price Inflation and Health
01/08/2017 09:18
Working Paper 276 - A Tax on Children? Food Price Inflation and Health
MDGs to Agenda 2063/SDGs - Transition Report 2016
26/09/2016 09:22
MDGs to Agenda 2063/SDGs - Transition Report 2016
Working Paper 239 - Concept and measure of inclusive health across countries
26/08/2016 16:22
Working Paper 239 - Concept and measure of inclusive health across countries

Categories: Health

Working Paper 234 - The Unintended Consequences of Agricultural Input Intensification: Human Health Implications of Agro-chemical use in Sub-Saharan Africa
21/04/2016 17:23
Working Paper 234 - The Unintended Consequences of Agricultural Input Intensification: Human Health Implications of Agro-chemical use in Sub-Saharan Africa
Millennium Development Goals (MDGs) Report 2014
01/11/2014 15:31
Millennium Development Goals (MDGs) Report 2014
Economic Brief - What policies should be implemented to address inequalities in health care in Tunisia ?
12/05/2014 13:10
Economic Brief - What policies should be implemented to address inequalities in health care in Tunisia ?
Compendium of Statistics on AfDB Group Operations 2014
06/05/2014 13:16
Compendium of Statistics on AfDB Group Operations 2014
Working Paper 120 - Community Based Health Insurance Schemes in Africa: The Case of Rwanda
15/01/2014 18:52
Working Paper 120 - Community Based Health Insurance Schemes in Africa: The Case of Rwanda
Every year, around 100 million people are driven into poverty due to burden of health expenditure. Most of these newly poor reside in resource poor countries such as Sub Saharan Africa (SSA) where health care systems significantly lag behind developed country counterparts and are characterized by either dysfunctional or non-existent health insurance schemes. The result has been a high disease burden propagating a sickly, unproductive labor force. In Sub-Saharan Africa, formal and well functioning health insurance schemes generally exist for the very few who are employed in the formal sector. Households in poorer countries generally tend to spend as much as those living in relatively richer countries. This paper evaluates the impact of the Community-based health insurance schemes (Mutuelles) in Rwanda on demand for modern health care, mitigation of out-of-pocket catastrophic health expenditure and social inclusiveness based on a nationally representative household survey using traditional regression approach and matching estimator popular in the evaluation literature. The data used in this study was collected in 2005/06 covering around 6,900 households with about 35,000 individual histories. The data is a typical living standard survey where information on household demographics, educational attainment, health, consumption, income sources, migration, agriculture, labor market condition, household assets, living conditions and other variables were collected. The preferred method of estimation is the matching estimator that uses data organized along the dichotomy: “treated” vs. “control” conditional on observed covariates. Such a dichotomy allows estimation of three statistics relevant for evaluation. The Average Treatment Effect (ATE) compares outcomes between “treated” vs. “control” group by taking randomly selected individuals from both samples so that impact of a program is evaluated directly. The results based on simple probit model suggest that membership into CBHISs had a potential of increasing health care utilization by about 15% following an illness episode. The effect is slightly higher for poor households than the non-poor. With regard to catastrophic expenditure, there is significant effect returned by the probit model where insured households had a much lower probability of experiencing catastrophic expenditure compared to the uninsured and more so among the poor than the non-poor. Similarly, the results from the matching estimator indicate that households that were members of the CBHISs had a 15 percentage point higher utilization of health care facilities than uninsured ones following an illness episode. According to our preferred method, higher utilization of health care services was found among the insured non-poor than insured poor households, with comparable effect in reducing health-related expenditure shocks. Utilization of modern health care services among the insured did not have statistically significant effect on health utilization, particularly among the poor. The non-poor did show 21 percentage point increase in the use of health services. The CBHISs succeeded however in reducing significantly health related consumption shocks in all households, more among the poor than the non-poor. This result is very encouraging since health related shocks have the potential of persisting for a long time in typical poor households. The study also shows that if the insurance scheme was extended to non-members, heath utilization would increase by 18 percentage points. This figure is close to 30 percentage points for non-poor households and about 10 percentage points among poor households. With respect to income protection, the potential of CBHIs is still very high. It could reduce catastrophic expenditure by 17 percentage points and much more significantly among the poor than the non-poor households. Overall the matching estimator indicates stronger evidence of better utilization of health care facilities and income protection due to CBHISs in Rwanda.Read more
Global health 2035: a world converging within a generation
03/12/2013 13:18
Global health 2035: a world converging within a generation

Categories: Health

Shale Gas and its Implications for Africa and the African Development Bank
17/10/2013 12:21
Shale Gas and its Implications for Africa and the African Development Bank
Sénégal - 2013 - Profil pays - Un aperçu des interventions du Groupe de la BAD
18/09/2013 13:37
Sénégal - 2013 - Profil pays - Un aperçu des interventions du Groupe de la BAD
Millennium Development Goals (MDGs) Report 2013 - Full Report
25/06/2013 10:28
Millennium Development Goals (MDGs) Report 2013 - Full Report
Economic Brief - Health in Africa Over the Next 50 Years
06/05/2013 09:13
Economic Brief - Health in Africa Over the Next 50 Years
Compendium of Statistics on Bank Group Operations 2013
03/05/2013 09:42
Compendium of Statistics on Bank Group Operations 2013
Economic Brief - The Growth of International Trade in Health Services Export Prospects in North Africa
26/03/2013 15:27
Economic Brief - The Growth of International Trade in Health Services Export Prospects in North Africa
Economic Brief - The Political Economy of Food Security in North Africa
19/11/2012 14:18
Economic Brief - The Political Economy of Food Security in North Africa
Working Paper 148 - Role of Fiscal Policy in Tackling the HIV/AIDS Epidemic in Southern Africa
14/05/2012 14:19
Working Paper 148 - Role of Fiscal Policy in Tackling the HIV/AIDS Epidemic in Southern Africa
This paper investigates the impact of  fiscal policy on reducing the HIV/AIDS  incidence rates in  Southern Africa. In particular, it studies the welfare impact of different taxation and debt paths in these countries in reducing the HIV/AIDS prevalence rates. Our results show that, acting  optimally has not  only positive societal welfare effect but also positive fiscal effects. There is evidence from that region that antiretroviral therapy (ART) dramatically slows down the progression of HIV infection and AIDS by sharply depressing viral load, improving the cluster of differentiation (CD4) cell counts, and delaying clinical progression to AIDS and fatal complications. However, financing these ART programs is very challenging. The question then is: if these countries use public revenues to fund the intervention against HIV/AIDS, will there not be increase in their debt burden or some negative externalities on other public funded programs? We use a calibrated model, an extension of Robalino et al (2002), in order to capture the fiscal implications of government interventions against HIV/AIDS epidemics. Capital stock level as well as labor force are assumed to be optimally chosen by a unique representative firm. HIV/AIDS affects the economy through the labor force and labor productivity. The government raises taxes to finance its intervention against the HIV/AIDS epidemics and chooses the optimal reduction in the prevalence rate that maximizes the inter-temporal societal welfare. Data on demographic, epidemiologic and macroeconomic indicators used in this study are from the World Bank’s 2011 World Development Indicators (WDI). The main contribution of this paper is that it demonstrates the cost-effectiveness of the fiscal tool in the fight against HIV/AIDS if optimally used during the next decade. By acting optimally, Lesotho, Botswana and Swaziland could respectively alleviate their debt burden by around 1%, 5% and 13% of GDP, respectively, while maximizing simultaneously the inter-temporal societal welfare. This suggests that their governments should not be reluctant in using the fiscal tool to fight HIV/AIDS due to fear of an increase in public debt. One of the most important implications of our results therefore is that African countries can make much better use of their own resources to fund development projects, by increasing tax revenues. This doesn’t necessarily mean increasing tax rates, but making the tax collection system more efficient, improving general tax administration and extending the tax base. Second, optimal intervention leads to early sharp reductions in the prevalence rate, stressing the urgency of increasing expenditures on the expensive but cost-effective ART programs. Traditional fight against AIDS includes mother to child transmission prevention, condom distribution, information campaigns and counseling. But implementing these “cheap” interventions without the ART interventions is fiscally worse than the no-intervention and less macro-economically efficient than the full ART intervention case. Again, the global health agenda in the coming decade will also be about sustainable delivery of the high-impact interventions that were previously supported by development partners. It is worth noting that we have been pessimistic about intervention costs and that our approach to measuring societal welfare omits some important negative consequences of HIV/AIDS for Southern Africa such as increases in the number of orphans and human suffering of the infected. Thus estimates of welfare gains from HIV/AIDS reductions in our paper are likely to be underestimated, underscoring further the importance of immediate and optimal government interventions.Read more
Working Paper 91 - Health Expenditures and Health Outcomes in Africa
17/12/2007 00:00
Working Paper 91 - Health Expenditures and Health Outcomes in Africa
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