Working Papers
Shedding light on the shadows of informality: A meta-analysis of formalization interventions targeted at informal firms
[Submitted to Labour Economics]
with Andrea Floridi and Binyam A. Demena
Governments and policy-makers promote formalization through various interventions ranging from simplifying registration procedures to increasing enforcement of the law. But despite various efforts, not much is known about the effects of interventions aiming at formalizing informal firms. This meta-analysis examines the empirical literature on the impact of such formalization interventions. We systematically assessed the literature on the impact of formalization policies resulting in 568 observations from 18 studies conducted by 33 researchers and published until June 2018. We analyzed the meta-impact of (i) cost, (ii) benefit and (iii) enforcement policy interventions and assessed whether the resulting outcomes are influenced by the type of data, econometric approach, and specification as well as publication bias. The findings suggest that policies increasing the benefits after formalization are associated with the highest formalization rates. Yet, the overall impact of the studied policy interventions remains weak when we control for publication quality and method heterogeneity. Overall, we only find modest evidence for increased formalization associated with the so far implemented interventions suggesting that further piloting and experimenting is needed to achieve large-scale formalization of the informal economy.
Adaptation and biomedical transition of people living with HIV to antiretroviral treatment
[Submitted to BMC Public Health]
with Luis Artavia-Mora , Boundia Alexandre Thiombiano and Arjun Bedi
Background: This paper uses a nationally representative sample from Burkina Faso to assess adaptation and biomedical transition of people living with HIV (PLHIV) to antiretroviral treatment (ART). Subjective and objective measures of health (CD4 count) are compared for short-term (≤24 months) versus longer-term ART adherents (>24 months) to test for adaptation and biomedical transition in the health measures and their socio-economic correlates.
Methods: Two steps are employed: First, changes in subjective health and the socio-economic determinants of subjective health are assessed in a descriptive as well as a multivariate regression analysis. Second, the subjective health findings are contrasted with the dynamics in an objective indicator of health, namely a patient’s T-lymphocytes cells known as the CD4 count.
Results: Good health is reported by 92% of the sampled PLHIV compared to 79% in the general population; subjective health is high in short-term (90%) and longer-term (94%) patients. However, the objective measure of good health increases from 27% among short-term to 42% among longer-term patients. These dynamics show that the two measures capture different health dimensions. Related, the socio-economic health correlates were assessed. For short-term adherents, subjective health is associated with short-lived pleasures while for longer-term patients it is correlated with economic characteristics. Objective health is associated with factors that determine ART adherence such as membership in a self-help group.
Discussion: Subjective and objective measures of health capture different aspects of wellbeing. The subjective health measure provides an overly optimistic indication while the objective measure underestimates the actual beneficial effects of ART. Our results highlight the relevance of recognizing variations in emotions and health stages over time to account for the variability in living requirements and constraints. Since nutrition is the single parameter that consistently predicts higher levels of subjective and objective health across disease stages our research provides further evidence for integrating food support in ART programs.
Conclusions: The analysis yields insights to better understand and support PLHIV in the adaptation process. Recognizing the different stages of adaptation is important for resources allocation and the conceptualization of well-targeted policies.
The impact of the Ethiopian health extension program and health development army on maternal mortality: A synthetic control approach
[Revise & Resubmit from Social Science & Medicine]
with Matthias Rieger, Anagaw Mebratie, G. Alemu and Arjun Bedi
The Ethiopian government has implemented nationwide strategies to improve access to basic health services and enhance health outcomes. The Health Extension Program (HEP) launched in 2003, expanded basic health infrastructure and local human resources. In 2011, the government introduced the Health Development Army (HDA). HDA is a women-centered community movement inspired by military structures and discipline. Its special objective is to improve maternal health outcomes. The paper uses a synthetic control approach to assess the effects of HEP and HDA on maternal mortality ratios (MMR). The MMR data are from the Global Burden of Diseases (GBD) database. A pool of 42 Sub-Saharan African countries, covering the period 1990 to 2016, is used to construct a synthetic comparator which displays a mortality trajectory similar to Ethiopia prior to the interventions. On average, since 2004, maternal mortality in the control countries exhibits a moderate downward trend. In Ethiopia, the downward trend is considerably steeper as compared to its synthetic control. By 2016, maternal mortality in Ethiopia was lower by 171 (p-value 0.048) maternal deaths per 100,000 live births as compared to its synthetic control. Between 2003 and 2016, Ethiopia’s maternal mortality ratio declined from 728 to 357. About 46% of this decline may be attributed to HEP/HDA. The Ethiopian experience of enhancing nation-wide access to and use of maternal health services in a short time-span is remarkable. Whether such a model may be transplanted is an open question.
Improving the quality of policing in Uganda: Impact Assessment of the police accountability and reform project
[Revision submitted to Review of Development Economics]
with Wil Hout and Rose Namara
Uganda and in particular the Ugandan police are perceived as highly corrupt. To address the quality of policing, the Police Accountability and Reform Project (PARP) was implemented between 2010 and early 2013 in selected police districts. This paper studies the impact of PARP for a sample of 600 police officers that were interviewed about the quality of policing by means of twelve hypothetical vignette cases depicting undesirable behaviour of varying degrees of severity. The assessments of the cases by the police officers are analysed using propensity score matching and in-depth interviews. We show that self-selection of police officers into the program is unlikely to drive the results. The results suggest that officers participating in PARP activities (i) judge the presented cases of misconduct more severely, (ii) are more inclined to report misconduct and (iii) also expect their colleagues to judge misbehaviour at the level of the police more critically although the latter coefficient estimates are halved in size. This suggests that PARP activities have affected the perception of police officers but only encouraged them slightly to take action against bad practices.
A study of Egyptian and Palestine trans-formal firms – a neglected category operating in the borderland between formality and informality
with Andrea Floridi and John Cameron
This article outlines a new approach to firm behaviour different from both ‘dichotomist’ and ‘continuum’ formal/informal models. The approach adopts a new heuristic based on the notion of a borderland as space of interaction between dimensions of formality, and creates an umbrella category of trans-formal firms, which are neither purely formal nor informal. Three formality dimensions are adopted: (i) registration of the firm, (ii) existence of a bank account in the name of the firm, and the (iii) presence of an official balance sheet. After elucidating the new approach theoretically, the paper assesses the analytical capacity of the approach with quantitative and qualitative information representing 16 Egyptian and 16 Palestinian firms. The majority of the considered firms are found to be trans-formal moving in a space of decision-making representing our new, broadened notion of borderland showing that policies aiming at formalization processes misrepresent the realities of significant numbers of firms.
Revisiting the Nature vs. Nurture Debate: Patterns of Cognitive Development of Filipino Children
with Stella Quimbo, Aylin Küntay, Xylee Javier and John Peabody
Using the QIDS panel dataset collected in 2003 and 2007, we analyze the determinants of cognitive abilities among Filipino children. We are interested in distinguishing between the effects of the learning and family environment versus health and nutrition in children aged 6 months to 7 years. Cognitive abilities are measured using the Bayley Scales of Infant Development and the Wechsler Preschool and Primary Scale of Intelligence. The home learning environment is assessed using the Home Observation for Measurement of the Environment. Health and nutrition markers include weight-for-age, height-for-age, hemoglobin and lead levels in blood. Employing a child fixed effects model, we find that the home learning environment has a significant positive effect on cognitive ability explaining more than one fourth of the standard deviation of cognitive development. Nutrition markers, particularly, weight-for-age and hemoglobin levels in blood also have significant positive effects on cognitive ability. Genetic predisposition and other time-invariant traits explain roughly 40 percent of the variation in cognitive ability. A one standard deviation increase in the home learning environment explains 30.4 percent of the standard deviation in cognitive ability whereas a one standard deviation increase in weight-for-age explains another 8.9 percent. Our results indicate that parental inputs or nurture can compensate for weak preconditions and foster cognitive development among young children.
Shedding light on the shadows of informality: A meta-analysis of formalization interventions targeted at informal firms
[Submitted to Labour Economics]
with Andrea Floridi and Binyam A. Demena
Governments and policy-makers promote formalization through various interventions ranging from simplifying registration procedures to increasing enforcement of the law. But despite various efforts, not much is known about the effects of interventions aiming at formalizing informal firms. This meta-analysis examines the empirical literature on the impact of such formalization interventions. We systematically assessed the literature on the impact of formalization policies resulting in 568 observations from 18 studies conducted by 33 researchers and published until June 2018. We analyzed the meta-impact of (i) cost, (ii) benefit and (iii) enforcement policy interventions and assessed whether the resulting outcomes are influenced by the type of data, econometric approach, and specification as well as publication bias. The findings suggest that policies increasing the benefits after formalization are associated with the highest formalization rates. Yet, the overall impact of the studied policy interventions remains weak when we control for publication quality and method heterogeneity. Overall, we only find modest evidence for increased formalization associated with the so far implemented interventions suggesting that further piloting and experimenting is needed to achieve large-scale formalization of the informal economy.
Adaptation and biomedical transition of people living with HIV to antiretroviral treatment
[Submitted to BMC Public Health]
with Luis Artavia-Mora , Boundia Alexandre Thiombiano and Arjun Bedi
Background: This paper uses a nationally representative sample from Burkina Faso to assess adaptation and biomedical transition of people living with HIV (PLHIV) to antiretroviral treatment (ART). Subjective and objective measures of health (CD4 count) are compared for short-term (≤24 months) versus longer-term ART adherents (>24 months) to test for adaptation and biomedical transition in the health measures and their socio-economic correlates.
Methods: Two steps are employed: First, changes in subjective health and the socio-economic determinants of subjective health are assessed in a descriptive as well as a multivariate regression analysis. Second, the subjective health findings are contrasted with the dynamics in an objective indicator of health, namely a patient’s T-lymphocytes cells known as the CD4 count.
Results: Good health is reported by 92% of the sampled PLHIV compared to 79% in the general population; subjective health is high in short-term (90%) and longer-term (94%) patients. However, the objective measure of good health increases from 27% among short-term to 42% among longer-term patients. These dynamics show that the two measures capture different health dimensions. Related, the socio-economic health correlates were assessed. For short-term adherents, subjective health is associated with short-lived pleasures while for longer-term patients it is correlated with economic characteristics. Objective health is associated with factors that determine ART adherence such as membership in a self-help group.
Discussion: Subjective and objective measures of health capture different aspects of wellbeing. The subjective health measure provides an overly optimistic indication while the objective measure underestimates the actual beneficial effects of ART. Our results highlight the relevance of recognizing variations in emotions and health stages over time to account for the variability in living requirements and constraints. Since nutrition is the single parameter that consistently predicts higher levels of subjective and objective health across disease stages our research provides further evidence for integrating food support in ART programs.
Conclusions: The analysis yields insights to better understand and support PLHIV in the adaptation process. Recognizing the different stages of adaptation is important for resources allocation and the conceptualization of well-targeted policies.
The impact of the Ethiopian health extension program and health development army on maternal mortality: A synthetic control approach
[Revise & Resubmit from Social Science & Medicine]
with Matthias Rieger, Anagaw Mebratie, G. Alemu and Arjun Bedi
The Ethiopian government has implemented nationwide strategies to improve access to basic health services and enhance health outcomes. The Health Extension Program (HEP) launched in 2003, expanded basic health infrastructure and local human resources. In 2011, the government introduced the Health Development Army (HDA). HDA is a women-centered community movement inspired by military structures and discipline. Its special objective is to improve maternal health outcomes. The paper uses a synthetic control approach to assess the effects of HEP and HDA on maternal mortality ratios (MMR). The MMR data are from the Global Burden of Diseases (GBD) database. A pool of 42 Sub-Saharan African countries, covering the period 1990 to 2016, is used to construct a synthetic comparator which displays a mortality trajectory similar to Ethiopia prior to the interventions. On average, since 2004, maternal mortality in the control countries exhibits a moderate downward trend. In Ethiopia, the downward trend is considerably steeper as compared to its synthetic control. By 2016, maternal mortality in Ethiopia was lower by 171 (p-value 0.048) maternal deaths per 100,000 live births as compared to its synthetic control. Between 2003 and 2016, Ethiopia’s maternal mortality ratio declined from 728 to 357. About 46% of this decline may be attributed to HEP/HDA. The Ethiopian experience of enhancing nation-wide access to and use of maternal health services in a short time-span is remarkable. Whether such a model may be transplanted is an open question.
Improving the quality of policing in Uganda: Impact Assessment of the police accountability and reform project
[Revision submitted to Review of Development Economics]
with Wil Hout and Rose Namara
Uganda and in particular the Ugandan police are perceived as highly corrupt. To address the quality of policing, the Police Accountability and Reform Project (PARP) was implemented between 2010 and early 2013 in selected police districts. This paper studies the impact of PARP for a sample of 600 police officers that were interviewed about the quality of policing by means of twelve hypothetical vignette cases depicting undesirable behaviour of varying degrees of severity. The assessments of the cases by the police officers are analysed using propensity score matching and in-depth interviews. We show that self-selection of police officers into the program is unlikely to drive the results. The results suggest that officers participating in PARP activities (i) judge the presented cases of misconduct more severely, (ii) are more inclined to report misconduct and (iii) also expect their colleagues to judge misbehaviour at the level of the police more critically although the latter coefficient estimates are halved in size. This suggests that PARP activities have affected the perception of police officers but only encouraged them slightly to take action against bad practices.
A study of Egyptian and Palestine trans-formal firms – a neglected category operating in the borderland between formality and informality
with Andrea Floridi and John Cameron
This article outlines a new approach to firm behaviour different from both ‘dichotomist’ and ‘continuum’ formal/informal models. The approach adopts a new heuristic based on the notion of a borderland as space of interaction between dimensions of formality, and creates an umbrella category of trans-formal firms, which are neither purely formal nor informal. Three formality dimensions are adopted: (i) registration of the firm, (ii) existence of a bank account in the name of the firm, and the (iii) presence of an official balance sheet. After elucidating the new approach theoretically, the paper assesses the analytical capacity of the approach with quantitative and qualitative information representing 16 Egyptian and 16 Palestinian firms. The majority of the considered firms are found to be trans-formal moving in a space of decision-making representing our new, broadened notion of borderland showing that policies aiming at formalization processes misrepresent the realities of significant numbers of firms.
Revisiting the Nature vs. Nurture Debate: Patterns of Cognitive Development of Filipino Children
with Stella Quimbo, Aylin Küntay, Xylee Javier and John Peabody
Using the QIDS panel dataset collected in 2003 and 2007, we analyze the determinants of cognitive abilities among Filipino children. We are interested in distinguishing between the effects of the learning and family environment versus health and nutrition in children aged 6 months to 7 years. Cognitive abilities are measured using the Bayley Scales of Infant Development and the Wechsler Preschool and Primary Scale of Intelligence. The home learning environment is assessed using the Home Observation for Measurement of the Environment. Health and nutrition markers include weight-for-age, height-for-age, hemoglobin and lead levels in blood. Employing a child fixed effects model, we find that the home learning environment has a significant positive effect on cognitive ability explaining more than one fourth of the standard deviation of cognitive development. Nutrition markers, particularly, weight-for-age and hemoglobin levels in blood also have significant positive effects on cognitive ability. Genetic predisposition and other time-invariant traits explain roughly 40 percent of the variation in cognitive ability. A one standard deviation increase in the home learning environment explains 30.4 percent of the standard deviation in cognitive ability whereas a one standard deviation increase in weight-for-age explains another 8.9 percent. Our results indicate that parental inputs or nurture can compensate for weak preconditions and foster cognitive development among young children.
