IDEAS home Printed from https://ideas.repec.org/p/wbk/wbrwps/1611.html

Economic analysis for health projects

Author

Listed:
  • Hammer,Jeffrey S.

Abstract

The author applies to the health sector an approach to analyzing projects advocated in a recent paper by Devarajan, Squire, and Suthiwart-Narueput. In the health sector, a project evaluation should: 1) Establish a firm justification for public involvement. The author identifies a number of common failures in the markets for both health services and insurance but argues that this should be the starting place for economic analysis, not a reason to ignore economics; 2) Establish the counterfactual: what happens with and without the project. Project outputs should be predicted net of the reaction of consumers and providers in the private sector. This requires knowledge of the market structure (supply, demand, and equilibrium) for health services; 3) Determine the fiscal effect of the project. The issue of appropriate levels for fees should be handled jointly with project evaluation; and 4) Acknowledge the fungibility of project resources and examine the incentives facing public servants. Ministries of health may shift their own resources away from activities that are funded by project to those that are not evaluated at all. Project outputs depend on the incentives for civil servants to provide good service--a consideration rarely taken into account in project evaluations. The author concludes that much of the analysis relevant to projects should be done before project evaluation. If the issues of fungibility and incentives are given due respect, thedonors'best form of intervention may not be traditional projects at all but rather general loans with conditions related to general sector strategy and reform. For a standard project, a fair amount of information from supporting sector work is needed before evaluation. If clinical services (or anything depending on people s behavior) are part of the project, information is needed about the supply and demand for substitute services. The market structure of health care is an essential part of the background work.

Suggested Citation

  • Hammer,Jeffrey S., 1996. "Economic analysis for health projects," Policy Research Working Paper Series 1611, The World Bank.
    • Handle: RePEc:wbk:wbrwps:1611
    as

    Download full text from publisher

    File URL: http://documents.worldbank.org/curated/en/157291468765870219/pdf/multi0page.pdf
    Download Restriction: no
    ---><---

    Other versions of this item:

    References listed on IDEAS

    as
    1. Korte, R. & Richter, Heide & Merkle, F. & Görgen, H., 1992. "Financing health services in Sub-Saharan Africa: Options for decision makers during adjustment," Social Science & Medicine, Elsevier, vol. 34(1), pages 1-9, January.
    2. Kloos, Helmut, 1990. "Utilization of selected hospitals, health centres and health stations in Central, Southern and Western Ethiopia," Social Science & Medicine, Elsevier, vol. 31(2), pages 101-114, January.
    3. Hammer, Jeffrey S. & Berman, Peter, 1995. "Ends and means in public health policy in developing countries," Health Policy, Elsevier, vol. 32(1-3), pages 29-45.
    4. Germano Mwabu & Martha Ainsworth & Andrew Nyamete, 1993. "Quality of Medical Care and Choice of Medical Treatment in Kenya: An Empirical Analysis," Journal of Human Resources, University of Wisconsin Press, vol. 28(4), pages 838-862.
    5. Pitt, Mark M & Rosenzweig, Mark R & Gibbons, Donna M, 1993. "The Determinants and Consequences of the Placement of Government Programs in Indonesia," The World Bank Economic Review, World Bank, vol. 7(3), pages 319-348, September.
    6. Paul Gertler & John Molyneaux, 1994. "How economic development and family planning programs combined to reduce indonesian fertility," Demography, Springer;Population Association of America (PAA), vol. 31(1), pages 33-63, February.
    7. Alderman, Harold & Lavy, Victor, 1996. "Household Responses to Public Health Services: Cost and Quality Tradeoffs," The World Bank Research Observer, World Bank, vol. 11(1), pages 3-22, February.
    8. Hammer, Jeffrey S, 1997. "Prices and Protocols in Public Health Care," The World Bank Economic Review, World Bank, vol. 11(3), pages 409-432, September.
    9. Pritchett, Lant H. & DEC, 1994. "Desired fertility and the impact of population policies," Policy Research Working Paper Series 1273, The World Bank.
    10. Kim, A. & Benton, B., 1995. "Cost-Benefit Analysis of the Onchocerciasis Control Program (OCP)," Papers 282, World Bank - Technical Papers.
    11. Alderman, H. & Gertler, P., 1989. "The Substitutability Of Public And Private Health Care For The Treatment Of Children In Pakistan," Papers 57, World Bank - Living Standards Measurement.
    12. Hammer, Jeffrey S, 1993. "The Economics of Malaria Control," The World Bank Research Observer, World Bank, vol. 8(1), pages 1-22, January.
    13. Anand, S. & Hanson, K., 1995. "Disability-Adjusted Life Years: A Critical Review," Economics Series Working Papers 99174, University of Oxford, Department of Economics.
    14. Anand, Sudhir & Hanson, Kara, 1997. "Disability-adjusted life years: a critical review," Journal of Health Economics, Elsevier, vol. 16(6), pages 685-702, December.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. repec:pri:rpdevs:hammer_its_all_about_me is not listed on IDEAS
    2. Chaudhury, Nazmul & Hammer, Jeffrey S., 2003. "Ghost doctors - absenteeism in Bangladeshi health facilities," Policy Research Working Paper Series 3065, The World Bank.
    3. Gertler, Paul J. & Hammer, Jeffrey S., 1997. "Strategies for pricing publicly provided health services," Policy Research Working Paper Series 1762, The World Bank.
    4. Harold Alderman & Peter F. Orazem & Elizabeth M. Paterno, 2001. "School Quality, School Cost, and the Public/Private School Choices of Low-Income Households in Pakistan," Journal of Human Resources, University of Wisconsin Press, vol. 36(2), pages 304-326.
    5. Devarajan, Shantayanan & Hammer, Jeffrey S., 1998. "Risk reduction and public spending," Policy Research Working Paper Series 1869, The World Bank.
    6. Lant Pritchett & Salimah Samji & Jeffrey Hammer, 2012. "It’s All About MeE: Using Structured Experiential Learning (‘e’) to Crawl the Design Space," CID Working Papers 249, Center for International Development at Harvard University.
    7. Bichaka Fayissa, 2001. "The determinants of infant and child mortality in developing countries: The case of Sub-Sahara Africa," The Review of Black Political Economy, Springer;National Economic Association, vol. 29(2), pages 83-98, December.
    8. Filmer, Deon & Pritchett, Lant, 1997. "Child mortality and public spending on health : how much does money matter?," Policy Research Working Paper Series 1864, The World Bank.
    9. Jack, William, 2000. "Health insurance reform in four Latin American countries : theory and practice," Policy Research Working Paper Series 2492, The World Bank.
    10. Hentschel, Jesko, 1998. "Distinguishing between types of data and methods of collecting them," Policy Research Working Paper Series 1914, The World Bank.
    11. Lant Pritchett & Salimah Samji & Jeffrey Hammer, 2012. "It’s All About MeE: Using Structured Experiential Learning (‘e’) to Crawl the Design Space," CID Working Papers 249, Center for International Development at Harvard University.
    12. Belli, Pedro, 1997. "The comparative advantage of government : a review," Policy Research Working Paper Series 1834, The World Bank.
    13. World Bank, 2002. "Guyana : Public Expenditure Review," World Bank Publications - Reports 14574, The World Bank Group.
    14. Gertler, Paul J., 1998. "On the road to social health insurance: the Asian experience," World Development, Elsevier, vol. 26(4), pages 717-732, April.
    15. F. Halsey Rogers & Shantayanan Devarajan, 2002. "World Bank Economists' Forum : Volume 2," World Bank Publications - Books, The World Bank Group, number 15227, April.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Gertler, Paul J. & Hammer, Jeffrey S., 1997. "Strategies for pricing publicly provided health services," Policy Research Working Paper Series 1762, The World Bank.
    2. Grant Miller, 2005. "Contraception as Development? New Evidence from Family Planning in Colombia," CID Working Papers 9, Center for International Development at Harvard University.
    3. World Bank, 2007. "Ethiopia - Capturing the Demographic Bonus in Ethiopia : Gender, Development, and Demographic Actions," World Bank Publications - Reports 7823, The World Bank Group.
    4. Lewis, Maureen & Eskeland, Gunnar & Traa-Valerezo, Ximena, 2004. "Primary health care in practice: is it effective?," Health Policy, Elsevier, vol. 70(3), pages 303-325, December.
    5. Michael Grimm & Robert Sparrow & Luca Tasciotti, 2015. "Does Electrification Spur the Fertility Transition? Evidence From Indonesia," Demography, Springer;Population Association of America (PAA), vol. 52(5), pages 1773-1796, October.
    6. Hatton, Timothy J. & Sparrow, Robert & Suryadarma, Daniel & van der Eng, Pierre, 2018. "Fertility and the health of children in Indonesia," Economics & Human Biology, Elsevier, vol. 28(C), pages 67-78.
    7. Portner, Claus C & Beegle, Kathleen & Christiaensen, Luc, 2011. "Family planning and fertility : estimating program effects using cross-sectional data," Policy Research Working Paper Series 5812, The World Bank.
    8. Jaikishan Desai & Alessandro Tarozzi, 2011. "Microcredit, Family Planning Programs, and Contraceptive Behavior: Evidence From a Field Experiment in Ethiopia," Demography, Springer;Population Association of America (PAA), vol. 48(2), pages 749-782, May.
    9. Tarp, Finn & Simler, Kenneth & Matusse, Cristina & Heltberg, Rasmus & Dava, Gabriel, 2002. "The Robustness of Poverty Profiles Reconsidered," Economic Development and Cultural Change, University of Chicago Press, vol. 51(1), pages 77-108, October.
    10. Magnus Lindelow, 2003. "Understanding spatial variation in the utilization of health services: does quality matter?," Economics Series Working Papers WPS/2004-12, University of Oxford, Department of Economics.
    11. Christopher J. Cronin & David K. Guilkey & Ilene S. Speizer, 2018. "The effects of health facility access and quality on family planning decisions in urban Senegal," Health Economics, John Wiley & Sons, Ltd., vol. 27(3), pages 576-591, March.
    12. Uma Radhakrishnan, 2010. "A Dynamic Structural Model of Contraceptive Use and Employment Sector Choice for Women in Indonesia," Working Papers 10-28, Center for Economic Studies, U.S. Census Bureau.
    13. Grönqvist, Hans, 2009. "Putting teenagers on the pill: the consequences of subsidized contraception," Working Paper Series 2009:8, IFAU - Institute for Evaluation of Labour Market and Education Policy.
    14. Rachel Connelly & Deborah DeGraff & Deborah Levison & Brian McCall, 2006. "Tackling The Endogeneity Of Fertility In The Study Of Women'S Employment In Developing Countries: Alternative Estimation Strategies Using Data From Urban Brazil," Feminist Economics, Taylor & Francis Journals, vol. 12(4), pages 561-597.
    15. Castro-Leal, Florencia & Dayton, Julia & Demery, Lionel & Mehra, Kalpana, 1999. "Public Social Spending in Africa: Do the Poor Benefit?," The World Bank Research Observer, World Bank, vol. 14(1), pages 49-72, February.
    16. Sinha, Nistha, 2003. "Fertility, Child Work and Schooling Consequences of Family Planning Programs: Evidence from an Experiment in Rural Bangladesh," Center Discussion Papers 28457, Yale University, Economic Growth Center.
    17. Donald, Aletheia Amalia & Goldstein, Markus & Koroknay-Palicz, Tricia & Sage, Mathilde, 2024. "The Fertility Impacts of Development Programs," Policy Research Working Paper Series 10848, The World Bank.
    18. Magnus Lindelow, 2004. "Understanding spatial variation in the utilization of health," Development and Comp Systems 0409058, University Library of Munich, Germany.
    19. Angeles, Gustavo & Guilkey, David K & Mroz, Thomas A, 2005. "The Effects of Education and Family Planning Programs on Fertility in Indonesia," Economic Development and Cultural Change, University of Chicago Press, vol. 54(1), pages 165-201, October.
    20. Grant Miller, 2005. "Contraception as Development? New Evidence from Family Planning in Colombia," NBER Working Papers 11704, National Bureau of Economic Research, Inc.

    More about this item

    Keywords

    ;
    ;
    ;
    ;
    ;
    ;

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:wbk:wbrwps:1611. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Roula I. Yazigi (email available below). General contact details of provider: https://edirc.repec.org/data/dvewbus.html .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.