Rajkumar and Swaroop examine the role of governance, public spending on primary education governance-measured by level of corruption and quality becomes effective in increasing primary education of bureaucracy-and ask how it affects the relationship attainment. These findings have important implications between public spending and outcomes. Their main for enhancing the development effectiveness of public innovation is to see if differences in efficacy of public spending. The lessons are particularly relevant for spending can be explained by quality of governance. The developing countries, where public spending on authors find that public health spending lowers child and education and health is relatively low, and the state of infant mortality rates in countries with good governance.governance is often poor. The results also indicate that as countries improve their This paper-a product of Public Services, Development Research Group-is part of a larger effort in the group to better understand issues relating to effective service delivery. We thank Laura Schechter for useful comments and excellent research assistance. We received helpful comments from Roberta Gatti, Steve Knack, Lant Pritchett and seminar participants the World Bank.
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We examine the impact of local politics and voter preferences on the allocation of publicly subsidized the Unified and Decentralized Health Care System (SUS) health services across 4,338 counties in Brazil. SUS clinics, doctors, and nurses (per capita) are higher in counties with a higher share of uninsured in the population and with higher per capita incomes, as is consistent with a probabilistic voting model. Political participation (i.e., the fraction of the poor who vote) and the political power of the mayor (his vote share in the last election) are associated with more visible health inputs, namely, clinics and consultation rooms, but not with more doctors and nurses.
The national deployment of polyvalent community health workers (CHWs) is a constitutive part of the strategy initiated by the Ministry of Health to accelerate efforts towards universal health coverage in Haiti. Its implementation requires the planning of future recruitment and deployment activities for which mathematical modelling tools can provide useful support by exploring optimised placement scenarios based on access to care and population distribution. We combined existing gridded estimates of population and travel times with optimisation methods to derive theoretical CHW geographical placement scenarios including constraints on walking time and the number of people served per CHW. Four national-scale scenarios that align with total numbers of existing CHWs and that ensure that the walking time for each CHW does not exceed a predefined threshold are compared. The first scenario accounts for population distribution in rural and urban areas only, while the other three also incorporate in different ways the proximity of existing health centres. Comparing these scenarios to the current distribution, insufficient number of CHWs is systematically identified in several departments and gaps in access to health care are identified within all departments. These results highlight current suboptimal distribution of CHWs and emphasize the need to consider an optimal (re-)allocation.
Rajkumar and Swaroop examine the role of governance, public spending on primary education governance-measured by level of corruption and quality becomes effective in increasing primary education of bureaucracy-and ask how it affects the relationship attainment. These findings have important implications between public spending and outcomes. Their main for enhancing the development effectiveness of public innovation is to see if differences in efficacy of public spending. The lessons are particularly relevant for spending can be explained by quality of governance. The developing countries, where public spending on authors find that public health spending lowers child and education and health is relatively low, and the state of infant mortality rates in countries with good governance.governance is often poor. The results also indicate that as countries improve their This paper-a product of Public Services, Development Research Group-is part of a larger effort in the group to better understand issues relating to effective service delivery. Copies of the paper are available free from the World Bank,
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