Income Risk, Coping Strategies, and Safety Nets

Poor rural and urban households in developing countries facesubstantial risks, which they handle with risk-management andrisk-coping strategies, including self-insurance through savingsand informal insurance mechanisms. Despite these mechanisms,however, vulnerability to poverty linked to risk remains high.This article reviews the literature on poor households' useof risk-management and risk-coping strategies. It identifiesthe constraints on their effectiveness and discusses policyoptions. It shows that risk and lumpiness limit the opportunitiesto use assets as insurance, that entry constraints limit theusefulness of income diversification, and that informal risk-sharingprovides only limited protection, leaving some of the poor exposedto very severe negative shocks. Public safety nets are likelyto be beneficial, but their impact is sometimes limited, andthey may have negative externalities on households that arenot covered. Collecting more information on households' vulnerabilityto poverty—through both quantitative and qualitative methods—couldhelp inform policy.      

ECONOMIC ANALYSIS FOR HEALTH PROJECTS

This paper applies to the health sector a method of projectanalysis advocated recently by Devarajan, Squire, and Suthiwart-Narueput.A health project evaluation should establish a firm justificationfor public involvement; establish the counterfactual—whatwould happen with and without the project; and determine thefiscal effect of the project and the appropriate levels of feesin conjunction with project evaluation. The evaluation shouldalso acknowledge the fungibility of project resources and examinethe incentives both for high-level public servants to shiftgovernment resources away from project-funded activities tothose that have not been evaluated and for lower-level contractorsand civil servants to provide good or bad service. Market failuresin health services and insurance markets should serve as a startingpoint for economic analysis, not as a reason to ignore economicsin health projects. Project outputs should be predicted aftertaking into account the reaction of consumers and providersin the private sector as well as market structures of supply,demand, and equilibrium for health services.      

HOUSEHOLD RESPONSES TO PUBLIC HEALTH SERVICES: COST AND QUALITY TRADEOFFS

The effectiveness of government investments in health care dependson the public's response to price and quality as well as onwhether these expenditures actually improve health outcomes.Consumers, even those in low-income households, are willingto pay fees for better health care if the fees translate intoimproved access and reliability. But when prices rise withouta concomitant improvement in services, malnutrition and childmortality rates increase. The availability of basic health carehas a relatively greater impact on households with low incomesor low education, or both, than does the provision of more specializedservices. This article describes the types of services for whichhouseholds indicate they are willing to pay increased fees.It also indicates the potential gains from improving these services,as well as the consequences of moving faster on cost recoverythan on providing improved or better-targeted services.      

Promoting Efficient Rural Financial Intermediation

Although governments have traditionally used subsidized creditprograms to promote agricultural growth, this approach has generallyfailed to improve incomes and alleviate poverty in rural areas.It has also led to the mistaken belief that rural credit programscannot be profitable. A new approach seeks to raise standardsof living in rural areas by casting the government in a veryd role—one of setting a favorable legal andpolicy environmentfor rural financial markets and addressing spec market failurescost effectively through well-designed and self-sustaining interventions.There is evidence that this approach can be highly successful.The Village Bank system of Bank Rakyat Indonesia has shown thatfinancial services can be extended to millions of low-incomerural clients without relying on subsidies. Indeed, the programhas generated enormous profits for the bank by using simple,innovative, and largely replicable techniques.      

Agricultural Extension: Good Intentions and Hard Realities

What considerations lead policymakers to invest in agriculturalextension as a key public responsibility, and what factors andagency incentives explain differences in extension system performance?To help answer these questions, this article provides a frameworkoutlining farmers' demand for information, the public goodscharacter of extension services, and the organizational andpolitical attributes affecting the performance of extensionsystems. This conceptual framework is used to analyze severalextension modalities and their likely and actual effectiveness.The analysis highlights the efficiency gains that can come fromlocally decentralized delivery systems with incentive structuresbased on largely private provision, although in most poorercountries extension services will remain publicly funded.      

Urbanization in Developing Countries

The rapid urbanization in many developing countries over thepast half century seems to have been accompanied by excessivelyhigh levels of concentration of the urban population in verylarge cities. Some degree of urban concentration may be desirableinitially to reduce inter- and intraregional infrastructureexpenditures. But in a mature system of cities, economic activityis more spread out. Standardized manufacturing production tendsto be deconcentrated into smaller and medium-size metropolitanareas, whereas production in large metropolitan areas focuseson services, research and development, and nonstandardized manufacturing.The costs of excessive concentration (traffic accidents, healthcosts from exposure to high levels of air and water pollution,and time lost to long commutes) stem from the large size ofmegacities and underdeveloped institutions and human resourcesfor urban planning and management. Alleviating excessively highurban concentration requires investments in interregional transportand telecommunications to facilitate deconcentration of industry.It also requires fiscal deconcentration, so that interior citiescan raise the fiscal resources and provide the services neededto compete with primate cities for industry and population.      

What Works in Fighting Diarrheal Diseases in Developing Countries? A Critical Review

The Millennium Development Goals call for reducing by half theproportion of people without sustainable access to safe drinkingwater. This goal was adopted in large part because clean waterwas seen as critical to fighting diarrheal disease, which kills2 million children annually. There is compelling evidence thatprovision of piped water and sanitation can substantially reducechild mortality. However, in dispersed rural settlements, providingcomplete piped water and sanitation infrastructure to householdsis expensive. Many poor countries have therefore focused insteadon providing community-level water infrastructure, such as wells.Various traditional child health interventions have been shownto be effective in fighting diarrhea. Among environmental interventions,handwashing and point-of-use water treatment both reduce diarrhea,although more needs to be learned about ways to encourage householdsto take up these behavior changes. In contrast, there is littleevidence that providing community-level rural water infrastructuresubstantially reduces diarrheal disease or that this infrastructurecan be effectively maintained. Investments in communal waterinfrastructure short of piped water may serve other needs, andmay reduce diarrhea in particular circumstances, but the casefor prioritizing communal infrastructure provision needs tobe made rather than assumed. JEL codes: Q56, Q52, O22     

农村社会养老服务需求现状及对策的实证研究

当前我国农村社会养老服务体系建立健全问题已经成为政府和理论界普遍关注的热点问题。对河南省六个地市的抽样调查显示,在农村社会养老服务需求层次中,经济保障是农村老年人最为迫切的需求,其次是生活照料需求,医疗卫生服务需求位居第三,最后是精神服务需求。在此情况下,要建立健全的农村社会养老服务体系,就必须大力发展农村老年经济保障、加快发展农村社区居家养老、充分发挥农村基层医疗卫生机构的功能、完善农村社区卫生服务体系、加快农村社区文体活动基础设施建设。     

提高海南省农村居民消费水平的路径选择

近年来,我国经济实现快速增长,但是居民消费特别是农村居民消费增长缓慢,一定程度上约束我国经济内生性增长.本文以近几年海南省农村居民消费为调查对象,实证分析农村居民低消费现状与影响因素,提出改善欠发达地区农村居民低消费的路径.     

Weak Links in the Chain: A Diagnosis of Health Policy in Poor Countries

Recent empirical and theoretical literature sheds light on thedisappointing experience with implementation of primary healthcare programs in developing countries. This article focuseson the evidence showing two weak links in the chain betweengovernment spending for services to improve health and actualimprovements in health status. First, institutional capacityis a vital ingredient in providing effective services. Whenthis capacity is inadequate, health spending, even on the rightservices, may lead to little actual provision of services. Second,the net effect of government health services depends on theseverity of market failures—the more severe the marketfailures, the greater the potential for government servicesto have an impact. Evidence suggests that market failures arethe least severe for relatively inexpensive curative services,which often absorb the bulk of primary health care budgets.A companion paper, available from the authors (seep. 219), offersa perspective on how government funds can best be used to improvehealth and well-being in developing countries. It gives an alternativeview of appropriate public health policy, one that focuses onmitigating the characteristic market failures of the sectorand tailoring public health activities to the government's abilityto deliver various services.      

农户购买小额保险意愿影响因素研究——来自广东两个县的证据

本文利用两个县597户农户样本数据,采用Logistic模型分析了影响农户购买小额保险意愿的主要因素。研究结果表明,农户购买小额意外伤害保险和小额健康保险的意愿总体上非常强烈,购买小额财产保险的意愿不够强烈,农户的受教育程度、收入水平和储蓄状况对于所有小额保险的购买意愿具有显著的影响,而年龄、就业状态、风险和保险知识认知因素等只对部分小额保险,甚至是部分农户群体才具有显著的影响。     

Cofinanced Public Extension in Nicaragua

How effective is agricultural extension? Is it worth the vastsums governments spend to provide it, mostly as a free service,to farmers worldwide? Relatively few studies exist that measureand compare the benefits of extension activities against theircosts. In the absence of such data, this pilot activity concentratedinstead on demand. Would demand for extension services be highif they were no longer free? The existence of solid demand wouldpresuppose some benefits from the service. Further, might chargingfor the service actually improve its quality and sustainability? The pilot program in Nicaragua described here set out to testwhether a truly demand—driven extension system aimed atfarmers with small-and medium-size holdings could be developed.The principal mechanism was a contribution by the farmer paidas a bonus to the extensionist: the aim was to introduce incentivesfor providers to improve the service through rewards linkedto the quality of their work and to establish direct accountabilityof extensionist to client. The outcomes showed that the cofinancingconcept can be successful. The article describes the design,implementation, and results in the expectation that the lessonslearned may be of interest elsewhere.      

REACHING THE RURAL POOR THROUGH PUBLIC EMPLOYMENT: Arguments, Evidence, and Lessons from South Asia

With the limited set of policy instruments typically avaiablein the rural sectors of developing countries, imperfect coverageof the poor and leakage ot the nonpoor must be expected fromeven the most well-intentioned poverty alleviation scheme. Oneway to reach the poor more effectively is to build incentivesfor self-selection into the scheme. Labor-intensive rural publicworks projects have the potential to reach and protect the poor,as well as to create and maintain rural infrastructure. Thelimited evidence for South Asia suggests that few nonpoor personswant to participate, and that both direct and indirect transferever, be rapidly dissipated by a badly concevided and executedproject; the details of how project are selected, designed,and financed are crucial to success in both the short and thelong run.      

Privatization and Regulation of Transport Infrastructure in the 1990s

Although the link between improved infrastructure services andeconomic growth is uncertain, it is clear that reforms aimedat creating competition and regulating natural monopolies establishan environment conducive to private sector participation, incentivesfor companies to strive for efficiency savings that can ultimatelybe passed on to consumers, and greater provision of services(such as faster roll-out of infrastructure or innovative solutionsto service delivery for customers not connected to an existingnetwork). In determining the form that infrastructure restructuringmight undertake or the design of a regulatory agency, policymakerscan generally benefit from a review of the experiences of othercountries. A key element of any decisionmaking process shouldbe a review of how the various types of reform will affect theefficiency of the sector and whether they will increase privatefinancing of its significant investment needs.      

HOW MUCH DOES TRADE WITH THE SOUTH AFFECT WORKERS IN THE NORTH?

Does trade with developing countries have a small and benigneffect on workers in industrial countries, as most economistshave maintained, or a large and adverse effect, as the generalpublic and advocates of protection believe? A review of theevidence suggests that neither of these positions is tenable.The methods that economists have conventionally used to measurethe effect of North-South trade are biased downward. The truesize of this effect remains uncertain, but some recent studiessuggest that it is much larger than previously estimated. Tradewith the South has probably significantly altered the sectoralcomposition of employment in the North, shifting workers outof manufacturing and into nontraded services. More important,it has probably significantly worsened the relative economicposition of unskilled workers in industrial countries, and mayalso have aggravated the problem of reconciling low inflationwith low unemployment. Even so, the adverse side effects oftrade with the South are much smaller than is popularly supposed.And the popular remedy—protection—is clearly wrong.What is needed instead is more action by governments to offsetthe reduction in the relative demand for unskilled labor throughtraining and education, job creation, and income redistribution.      

Formal Water Markets: Why, When, and How to Introduce Tradable Water Rights

In most countries the state owns the water resources and thehydraulic infrastructure, and public officials decide who getsthe water, how it is to be used, and how much will be chargedfor it. But costly inefficiencies in the supply and use of watersupport a shift from government provision to a market-basedapproach that is more effective and less wasteful. Markets can allow rapid changes in allocation in response tochanging demands for water and can stimulate investment andemployment as investors are assured of access to secure suppliesof water. Because of water's unique characteristics, such marketsdo not work everywhere; nor do they resolve all water-relatedissues. By designing appropriate water laws and regulationsand by strengthening private and public institutions to administerthem, formal water markets can effectively address rising demandsfor groundwater and for water found in rivers, lakes, and canals.Lessons from Chile's experience demonstrate that formal watermarkets can improve the economic efficiency of water use andstimulate investment.      

Rural Poverty: Old Challenges in New Contexts

Poverty is still a predominantly rural phenomenon. However,the context of rural poverty has been changing across the world,with high growth in some economies and stagnation in others.Furthermore, increased openness in many economies has affectedthe specific role of agricultural growth for rural poverty reduction.This paper revisits an ‘old’ question: how doesgrowth and poverty reduction come about if most of the poorlive in rural areas and are dependent on agriculture? What isthe role of agricultural and rural development in this respect?Focusing on Sub-Saharan Africa, and using economic theory andthe available evidence, the author comes to the conclusion thatchanging contexts has meant that agricultural growth is onlycrucial as an engine for growth in particular settings, morespecifically in landlocked, resource-poor countries, which areoften also characterized by relatively low potential for agriculture.However, extensive market failures in key factor markets andlikely spatial effects give a remaining crucial role for ruraldevelopment policies, including focusing on agriculture, toassist the inclusion of the rural poor in growth and development.How to overcome these market failures remains a key issue forfurther research. JEL codes: O41, Q10, O55     

差异性农村金融服务:基于农民收入视角的分析——以吉林省四平市为例

"十一五"期间,我国农村居民人均收入有了显著提高,在促进农民持续增收的诸多因素中,金融发挥着不可替代的作用。但其农村金融在发展过程中,也存在着许多新情况、新问题。本文拟从农民收入变化的视角审视差异性农村金融需求与服务,进而研究探索出转变金融投资方式、完善金融服务体系,促进农民增收的思路和对策。     

ANIMAL HEALTH SERVICES: FINDING THE BALANCE BETWEEN PUBLIC AND PRIVATE DELIVERY

Growing fiscal deficits and greater awareness of the huge economiccost of often-inefficient government activities have renewedinterest in transferring the delivery of important servicesfrom the public to the private sector in developing countries.This article, drawn from a longer study, offers a frameworkfor determining the appropriate roles of the public and privatesectors in delivering animal health services, such as veterinarysurveillance, disease vector control, vaccination, clinicaltreatment of sick animals, inspection of livestock products,and veterinary research and extension. The profitability and therefore the supply of private veterinaryservices is governed by several factors arising from economiesof scale, such as the size of the livestock enterprises in thelocality, the nature of potential or actual diseases, and thetypes of animals raised in the production systems. Thus, inareas where private veterinary work is unprofitable or whereother types of market failure occur, economic or social concernsmay make some type of public intervention necessary. The transferof animal health services from the public to the private sectormust be done selectively, and government support may be neededto ensure the success of such transfers.      

MACROECONOMIC ADJUSTMENT AND POVERTY IN AFRICA: AN EMERGING PICTURE

The view that macroeconomic adjustment disproportionately hurtsthe poor in Africa has become commonplace. The popular mediaand the nongovernmental aid community frequently express thisview in critiques of Bankfunded economic reform programs. Yetthe evidence on which the claim has been based is flimsy andanecdotal. The emergence of more convincing data, from detailedhousehold surveys in Africa, provides an opportunity to setthe record straight. The evidence from six African countries reviewed in this articledemonstrates that poverty was more likely to decline in thosethat improved their macroeconomic balances than in those thatdid not. The critical factor is economic growth: the economygrew more rapidly and poverty declined faster in countries thatimproved macroeconomic balances, depreciating the real effectiveexchange rate. Changes in the real exchange rate also immediatelyand favorably affected rural incomes, benefiting the poor bothdirectly and indirectly. But the findings also highlighted threecauses for policy concern. First, many African governments haveyet to display a real commitment to macroeconomic reform; second,the poorest of the poor have not benefited from recent growthin some countries; and, third, the prospects for the poor arenot rosy unless there is more investment in human capital andbetter targeting of social spending.