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In 2019, WHO worked alongside the Bhutan Ministry of Health (MOH) to assess the country’s health system as they look to restructure their health system to enable a more efficient and coherent service delivery model. Through the cross-programmatic efficiency analysis, specific areas of overlap, misalignment, or duplication that constrain implementation of effective service delivery have been identified with the aim to improve coverage of quality health care services, ensure government investment in health care is used efficiently, and to inform transition processes. This policy brief, which outlines the identified inefficiencies, their implications, and policy options, is written based on that analysis, with recognition that changes in the health system may have taken place since the study was conducted.
This project, based on the Public Expenditure and Financial Accountability (PEFA) data set, researched how PEFA can be used to shape policy development in public financial management (PFM) and other major relevant policy areas such as anticorruption, revenue mobilization, political economy analysis, and fragile states. The report explores what shapes the PFM system in low- and middle-income countries by examining the relationship between political institutions and the quality of the PFM system. Although the report finds some evidence that multiple political parties in control of the legislature is associated with better PFM performance, the report finds the need to further refine and test the theories on the relationship between political institutions and PFM. The report addresses the question of the outcomes of PFM systems, distinguishing between fragile and nonfragile states. It finds that better PFM performance is associated with more reliable budgets in terms of expenditure composition in fragile states, but not aggregate budget credibility. Moreover, in contrast to existing studies, it finds no evidence that PFM quality matters for deficit and debt ratios, irrespective of whether a country is fragile or not. The report also explores the relationship between perceptions of corruption and PFM performance. It finds strong evidence of a relationship between better PFM performance and improvements in perceptions of corruption. It also finds that PFM reforms associated with better controls have a stronger relationship with improvements in perceptions of corruption compared to PFM reforms associated with more transparency. The last chapter looks at the relationship between PEFA indicators for revenue administration and domestic resource mobilization. It focuses on the credible use of penalties for noncompliance as a proxy for the type of political commitment required to improve tax performance. The analysis shows that countries that credibly enforce penalties for noncompliance collect more taxes on average.
This overview of health financing tools, policies and trends--with a particular focus on challenges facing developing countries--provides the basis for effective policy-making. Analyzing the current global environment, the book discusses health financing goals in the context of both the underlying health, demographic, social, economic, political and demographic analytics as well as the institutional realities faced by developing countries, and assesses policy options in the context of global evidence, the international aid architecture, cross-sectoral interactions, and countries' macroeconomic frameworks and overall development plans.
Human capital—the knowledge, skills, and health that people accumulate over their lives—is a central driver of sustainable growth, poverty reduction, and successful societies. More human capital is associated with higher earnings for people, higher income for countries, and stronger cohesion in societies. Much of the hard-won human capital gains in many economies over the past decade is at risk of being eroded by the COVID-19 (coronavirus) pandemic. Urgent action is needed to protect these advances, particularly among the poor and vulnerable. Designing the needed interventions, targeting them to achieve the highest effectiveness, and navigating difficult trade-offs make investing in better measurement of human capital now more important than ever. The Human Capital Index (HCI)—launched in 2018 as part of the Human Capital Project—is an international metric that benchmarks the key components of human capital across economies. The HCI is a global effort to accelerate progress toward a world where all children can achieve their full potential. Measuring the human capital that children born today can expect to attain by their 18th birthdays, the HCI highlights how current health and education outcomes shape the productivity of the next generation of workers and underscores the importance of government and societal investments in human capital. The Human Capital Index 2020 Update: Human Capital in the Time of COVID-19 presents the first update of the HCI, using health and education data available as of March 2020. It documents new evidence on trends, examples of successes, and analytical work on the utilization of human capital. The new data—collected before the global onset of COVID-19—can act as a baseline to track its effects on health and education outcomes. The report highlights how better measurement is essential for policy makers to design effective interventions and target support. In the immediate term, investments in better measurement and data use will guide pandemic containment strategies and support for those who are most affected. In the medium term, better curation and use of administrative, survey, and identification data can guide policy choices in an environment of limited fiscal space and competing priorities. In the longer term, the hope is that economies will be able to do more than simply recover lost ground. Ambitious, evidence-driven policy measures in health, education, and social protection can pave the way for today’s children to surpass the human capital achievements and quality of life of the generations that preceded them.
Annotation Provides information on progress and trends, including poornonpoor disparities; health systems reform as a means of laying building blocks for the efficient and equitable delivery of effective interventions; the financing of health spending through domestic resources and aid; and improving the effectiveness of development assistance in health. Linking the health Millennium Development Goals? agenda with the broader poverty-reduction agenda, this book is a valuable resource for policymakers in developing countries and development practitioners working in the health, nutrition, and population sector as well as students and scholars of public health.
Women, Business and the Law 2021 is the seventh in a series of annual studies measuring the laws and regulations that affect women’s economic opportunity in 190 economies. The project presents eight indicators structured around women’s interactions with the law as they move through their lives and careers: Mobility, Workplace, Pay, Marriage, Parenthood, Entrepreneurship, Assets, and Pension. This year’s report updates all indicators as of October 1, 2020 and builds evidence of the links between legal gender equality and women’s economic inclusion. By examining the economic decisions women make throughout their working lives, as well as the pace of reform over the past 50 years, Women, Business and the Law 2021 makes an important contribution to research and policy discussions about the state of women’s economic empowerment. Prepared during a global pandemic that threatens progress toward gender equality, this edition also includes important findings on government responses to COVID-19 and pilot research related to childcare and women’s access to justice.
Bangladesh is committed to achieving universal health coverage (UHC) by 2032; to this end, the government of Bangladesh is exploring policy options to increase fiscal space for health and expand coverage while improving service quality and availability. Despite Bangladesh’s impressive strides in improving its economic and social development outcomes, the government still confronts health financing and service delivery challenges. In its review of the health system, this study highlights the limited fiscal space for implementing UHC in Bangladesh, particularly given low public spending for health and high out-of-pocket expenditure. The crisis in the country’s human resources for health (HRH) compounds public health service delivery inefficiencies. As the government explores options to finance its UHC plan, it must recognize that reform of its service delivery system with particular focus on HRH has to be the centerpiece of any policy initiative.
Why are carefully designed, sensible policies too often not adopted or implemented? When they are, why do they often fail to generate development outcomes such as security, growth, and equity? And why do some bad policies endure? World Development Report 2017: Governance and the Law addresses these fundamental questions, which are at the heart of development. Policy making and policy implementation do not occur in a vacuum. Rather, they take place in complex political and social settings, in which individuals and groups with unequal power interact within changing rules as they pursue conflicting interests. The process of these interactions is what this Report calls governance, and the space in which these interactions take place, the policy arena. The capacity of actors to commit and their willingness to cooperate and coordinate to achieve socially desirable goals are what matter for effectiveness. However, who bargains, who is excluded, and what barriers block entry to the policy arena determine the selection and implementation of policies and, consequently, their impact on development outcomes. Exclusion, capture, and clientelism are manifestations of power asymmetries that lead to failures to achieve security, growth, and equity. The distribution of power in society is partly determined by history. Yet, there is room for positive change. This Report reveals that governance can mitigate, even overcome, power asymmetries to bring about more effective policy interventions that achieve sustainable improvements in security, growth, and equity. This happens by shifting the incentives of those with power, reshaping their preferences in favor of good outcomes, and taking into account the interests of previously excluded participants. These changes can come about through bargains among elites and greater citizen engagement, as well as by international actors supporting rules that strengthen coalitions for reform.