With rigorous economic research and practical policy solutions, we focus on the issues and institutions that are critical to global development. Explore our core themes and topics to learn more about our work.
In timely and incisive analysis, our experts parse the latest development news and devise practical solutions to new and emerging challenges. Our events convene the top thinkers and doers in global development.
Health economics, health financing and payment, results-based financing, social protection
Sebastian Bauhoff is a senior fellow at the Center for Global Development, where he focuses on health policies and programs that are scalable, sustainable, and improve the performance of health systems in low and middle-income settings. His current work investigates innovations in health care financing and service delivery that have the potential to improve access, efficiency and quality of care. Bauhoff’s prior work includes quantitative evaluations of provider and insurance payment systems, such as performance-based financing, and demand-side interventions to improve access and risk-protection of poor households. He holds a PhD in Health Policy/Economics and a MPA in International Development from Harvard University.
Bauhoff, Sebastian, and Dirk Göpffarth. 2018. “Asylum-Seekers in Germany Differ from Regularly Insured in their Morbidity, Utilizations and Costs of Care.” PLoS ONE 13 (6): e0197881. Published paper (open access)
Bauhoff, Sebastian, Lauren Mayer, and Lila Rabinovich. 2017. “Developing Citizen Report Cards for Primary Health Care in Low and Middle-Income Countries: Results from Cognitive Interviews in Rural Tajikistan.” PLoS ONE 12 (10): e0186745. Published paper (open access)
Recruiting community members with basic training for health promotion and care delivery is increasingly popular among development programs in low- and middle-income countries. This approach has great appeal: it could boost accountability and local ownership, and reduce program costs. Though the potential benefits of the approach are easily touted, the full costs remain murky and are often an afterthought.
Founded in 2002, the Global Fund to Fight AIDS, Tuberculosis and Malaria (the Global Fund) is one of the world’s largest multilateral health funders, disbursing $3–$4 billion a year across 100-plus countries. Many of these countries rely on Global Fund monies to finance their respective disease responses—and for their citizens, the efficient and effective use of Global Fund monies can be the difference between life and death.
Interest in the creation and use of citizen report cards (CRCs) is growing in many low- and middle-income countries. Bangalore has measured and reported citizens’ satisfaction with government agencies to the media; Kenya’s three largest cities have gauged citizens’ access to and use of waste management services; and townships in Myanmar have used CRCs to gather feedback on their provision of health and education services. Interest in social accountability tools is even echoed by officials at the highest levels. At a June summit on measurement and accountability in health, the World Bank, USAID, and WHO agreed to push for the increased use of citizen and community led reviews at every level of service and governance.
Using research to inform policy often involves reading scientific articles in costly books and journals. But for some policymakers and analysts these costs may be prohibitively expensive, leaving them without access to critical information.
Tobacco taxes are widely regarded as one of the most effective policy tools available for limiting the accessibility and availability of tobacco. Raising tobacco taxes has also been deemed the single most cost-effective way to save lives in developing countries. For China, which is home to roughly one-third of the world’s 820 million male smokers, the need for such a mechanism is dire. But do the gains in health and revenues raised from tobacco taxes outweigh the costs to households, especially poor ones?
Numerous studies find that child health suffers when children are exposed to conflict, and armed conflicts are more likely to occur in poor countries with weak states. Nigeria is among the most conflict-prone countries in the world, experiencing the highest number of conflict-related deaths of all Sub-Saharan African countries in many of the years since 2000, with a peak in 2012. In this paper, researchers at the Urban Institute and the Center for Global Development are studying the relationship between child health and conflict in Nigeria by combining geo-coded data from the Demographic and Health Survey (DHS) of 2013 and the Social Conflict Analysis Database. In both urban and rural areas of Nigeria, they find significant increases in child wasting (acute malnutrition) in 2013 associated with proximity to violent conflict in 2012. In urban areas, infant mortality also increased significantly in 2003-2013, when the mother was exposed to conflict during pregnancy. They will discuss these findings and their implications, as well as some of the challenges to studying health in conflict-torn places.
A central issue in designing performance incentive contracts is whether to reward the production of outputs versus use of inputs: the former rewards efficiency and innovation in production, while the latter imposes less risk. But the promise of output-based contracts may remain unmet if providers lack the requisite skills to innovate and increase performance. In this seminar, Manoj Mohanan will present on new research that uses a field experiment in Karnataka, India to explore three questions: How does an input versus an output incentive contract affect maternity care, as measured by rates of postpartum hemorrhage, pre-eclampsia, sepsis, and neonatal survival? Do providers under input incentive contracts use different strategies and input combinations than providers under output incentive contracts? And, finally, does the skill level of the provider make a difference for their performance under the input versus output incentive contracts?
This session will convene leading experts to address the critical issue of measuring and improving quality of healthcare in low income settings. In order to improve the health of the world's population, we need to increase access to healthcare and simultaneously ensure that the care provided is of sufficiently high quality (i.e. care that is safe, effective, patient-centered, timely, efficient, and equitable). Healthcare systems need to think beyond access and coverage of healthcare services; they need to start measuring and systematically improving quality of healthcare in LMICs.
Is there a way to improve health care services amidst the limited physical and human capital in some developing countries? In this seminar, David Evans and Mario Macis will discuss the findings from their field experiment in Nigeria, where 80 primary health centers were provided with varying degrees of management training from SafeCare, an international organization that designs quality of care standards specific to health facilities in low- and middle-income countries. Through their experiment, the authors were able to differentiate between the effects of solely providing assessments and feedback and the effects of providing assessments, feedback, and implementation support to facilities for meeting the quality standards set by SafeCare.