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  1. 1
    Peer Reviewed

    Effects of Depression Alleviation on Work Productivity and Income Among HIV Patients in Uganda.

    Wagner GJ; Ghosh-Dastidar B; Robinson E; Ngo VK; Glick P; Musisi S; Akena D

    International Journal of Behavioral Medicine. 2017 Aug; 24(4):628-633.

    PURPOSE: Depression is common among people living with HIV, and it is associated with impaired work functioning. However, little research has examined whether depression alleviation improves work-related outcomes in this population, which is the focus of this analysis. METHOD: A sample of 1028 depressed HIV clients in Uganda enrolled in a comparative trial of depression care models and were surveyed over 12 months. Serial regression analyses examined whether depression alleviation (measured by the nine-item Patient Health Questionnaire) was associated with change in self-reported weekly amount of hours worked and income earned, and whether these relationships were mediated by change in work-related self-efficacy. RESULTS: Among those with major depression, depression alleviation was associated with nearly a doubling of weekly hours worked in bivariate analysis. The relationship between depression alleviation and hours worked was partially mediated by change in work self-efficacy among those with major depression, as well as those with minor depression, in multivariate regression analysis that controlled for demographic and health covariates. Depression alleviation was not significantly associated with change in weekly income. CONCLUSION: These findings suggest that depression alleviation benefits work functioning at least in part through improved confidence to engage in work-related activities. Integration of depression care services into HIV care may be important for improving the economic well-being of people living with HIV.
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  2. 2
    Peer Reviewed

    The Annual Economic Burden of Syphilis: An Estimation of Direct, Productivity, and Intangible Costs for Syphilis in Guangdong Initiative for Comprehensive Control of Syphilis Sites.

    Zou Y; Liao Y; Liu F; Chen L; Shen H; Huang S; Zheng H; Yang B; Hao Y

    Sexually Transmitted Diseases. 2017 Nov; 44(11):671-677.

    BACKGROUND: Syphilis has continuously posed a great challenge to China. However, very little data existed regarding the cost of syphilis. Taking Guangdong Initiative for Comprehensive Control of Syphilis area as the research site, we aimed to comprehensively measure the annual economic burden of syphilis from a societal perspective. METHODS: Newly diagnosed and follow-up outpatient cases were investigated by questionnaire. Reported tertiary syphilis cases and medical institutions cost were both collected. The direct economic burden was measured by the bottom-up approach, the productivity cost by the human capital method, and the intangible burden by the contingency valuation method. RESULTS: Three hundred five valid early syphilis cases and 13 valid tertiary syphilis cases were collected in the investigation to estimate the personal average cost. The total economic burden of syphilis was US $729,096.85 in Guangdong Initiative for Comprehensive Control of Syphilis sites in the year of 2014, with medical institutions cost accounting for 73.23% of the total. Household average direct cost of early syphilis was US $23.74. Average hospitalization cost of tertiary syphilis was US $2,749.93. Of the cost to medical institutions, screening and testing comprised the largest proportion (26%), followed by intervention and case management (22%) and operational cost (21%). Household average productivity cost of early syphilis was US $61.19. Household intangible cost of syphilis was US $15,810.54. CONCLUSIONS: Syphilis caused a substantial economic burden on patients, their families, and society in Guangdong. Household productivity and intangible costs both shared positive relationships with local economic levels. Strengthening the prevention and effective treatment of early syphilis could greatly help to lower the economic burden of syphilis.
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  3. 3
    Peer Reviewed

    Cost of visceral leishmaniasis care in Brazil.

    Ferreira de Carvalho IPS; Peixoto HM; Sierra Romero GA; Fernandes de Oliveira MR

    Tropical Medicine and International Health. 2017 Dec; 22(12):1579-1589.

    Objective To estimate the Brazilian direct and indirect costs of human visceral leishmaniasis (VL) in 2014. Methods Cost-of-illness study on the Brazilian public health system and societal perspective. VL cases registered in the Notifiable Diseases Information System in the year of 2014 were considered. Direct medical costs regarding diagnostic, treatment and care provided to patients with VL were estimated through the top-down approach. The indirect costs related to productivity loss due to premature mortality and morbidity were estimated by means of the human-capital method. Results In 2014, 9895 suspected cases of VL were reported in the Notifiable Diseases Information System, and 3453 were later confirmed. There were 234 patients with Leishmania-HIV coinfection underwent a secondary prophylaxis. The total cost of VL in Brazil was US$ 14 190 701.50 (US$ 14 189 150.10 to 14 199 940.53) that varied according to the sensitivity analysis. The total of direct medical costs corresponded to US$ 1 873 681.96 (US$1 872 130.55 to 1 882 920.99), and the majority of costs was associated with hospitalization (40%), followed by treatment (22%), and secondary prophylaxis (18%). Productivity loss corresponded to US$ 11 421 683.37 for premature mortality and US$ 895 336.18 for work absence due to hospitalization by the illness. Conclusions VL represents an expensive health problem for the Brazilian public health system and society, mainly because of its productivity loss due to premature mortality. Interventions to reduce VL lethality could have a great impact on decreasing the cost of illness.
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  4. 4
    Peer Reviewed

    Estimated economic impact of vaccinations in 73 low-and middle-income countries, 2001-2020.

    Ozawa S; Clark S; Portnoy A; Grewal S; Stack ML; Sinha A; Mirelman A; Franklin H; Friberg IK; Tam Y; Walker N; Clark A; Ferrari M; Suraratdecha C; Sweet S; Goldie SJ; Garske T; Li M; Hansen PM; Johnson HL; Walker D

    Bulletin of the World Health Organization. 2017 Aug; 95(8):629-638.

    Objective To estimate the economic impact likely to be achieved by efforts to vaccinate against 10 vaccine-preventable diseases between 2001 and 2020 in 73 low- and middle-income countries largely supported by Gavi, the Vaccine Alliance. Methods We used health impact models to estimate the economic impact of achieving forecasted coverages for vaccination against Haemophilus influenza type b, hepatitis B, human papillomavirus, Japanese encephalitis, measles, Neisseria meningitidis serogroup A, rotavirus, rubella, Streptococcus pneumoniae and yellow fever. In comparison with no vaccination, we modelled the costs -expressed in 2010 United States dollars (US$) -of averted treatment, transportation costs, productivity losses of caregivers and productivity losses due to disability and death. We used the value-of-a-life-year method to estimate the broader economic and social value of living longer, in better health, as a result of immunization. Findings We estimated that, in the 73 countries, vaccinations given between 2001 and 2020 will avert over 20 million deaths and save US$ 350 billion in cost of illness. The deaths and disability prevented by vaccinations given during the two decades will result in estimated lifelong productivity gains totaling US$ 330 billion and US$ 9 billion, respectively. Over the lifetimes of the vaccinated cohorts, the same vaccinations will save an estimated US$ 5 billion in treatment costs. The broader economic and social value of these vaccinations is estimated at US$ 820 billion. Conclusion By preventing significant costs and potentially increasing economic productivity among some of the world’s poorest countries, the impact of immunization goes well beyond health.
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  5. 5

    The Macroeconomic Loss due to Violence Against Women: The Case of Vietnam.

    Raghavendra S; Duvvury N; Ashe S

    Feminist Economics. 2017 Oct 2; 23(4):62-89.

    Violence against women (VAW) is now acknowledged as a global problem with substantial economic costs. However, the current estimates of costs in the literature provide the aggregate loss of income, but not the macroeconomic loss in terms of output and demand insofar as they fail to consider the structural interlinkages of the economy. Focusing on Vietnam, this study proposes an approach based on the social accounting matrix (SAM) to estimate the macroeconomic loss due to violence. Using Vietnam’s 2011 SAM, the study estimates the income and multiplier loss due to VAW. From a policy point of view, the study argues that the macroeconomic loss due to VAW renders a permanent invisible leakage to the circular flow that can potentially destabilize, weaken, or neutralize the positive gains from government expenditure on welfare programs.
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  6. 6

    The U.S. Government's Global Food Security Research Strategy. Reducing global hunger, malnutrition and poverty through science, technology and innovation.

    United States. Feed the Future

    [Washington, D.C.], Feed the Future, [2017]. 38 p.

    The United States has played a leading role in ending hunger and poverty. U.S. Government’s investments in global food security, and finding new and innovative ways to promote global food security does more than serve humanitarian goals; it is crucial to America’s continued security and prosperity. Evidence indicates that research investments enable the productivity gains that drive global improvements in food security and protect against tomorrow’s food security risks -- at home and abroad. In response to this imperative, U.S. government agencies that are part of Feed the Future developed a new U.S. Government’s Global Food Security Research Strategy to help reduce hunger, poverty and malnutrition through science, technology and innovation. The Research Strategy seeks to bring U.S. ingenuity to bear on the greatest challenges in achieving sustainable, global reductions of poverty, hunger and malnutrition.
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  7. 7

    Strengthening global competitiveness in sub-Saharan Africa: The role of family planning.

    Smith R

    Washington, D.C., Population Reference Bureau [PRB], 2017 Jul. 4 p.

    This policy brief is distilled from a report released in 2016 by Population Reference Bureau (PRB), entitled Fostering Economic Growth, Equity, and Resilience in Sub-Saharan Africa: The Role of Family Planning. Sustaining sub-Saharan Africa’s economic development will require the region to move towards more productive activities and address persistent competitiveness challenges. As any as three in four youth entering sub-Saharan Africa’s labor market will not find and sustain a wage job. Reducing fertility through expanded use of family planning can relieve pressure on future labor markets.
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  8. 8

    Benchmarking supply chains for better performance.

    Iyer A; Berenguer G; Yadav P; Glassman A

    Washington, D.C., Center for Global Development, 2015 Mar. 19 p. (CGD Policy Paper 057)

    Donors play a significant role in funding medicines and other commodities in global health. Of the approximately US $28.2 billion spent by donors in 2010, approximately 40% went towards medicines, vaccines and other health commodities, mainly in sub-Saharan Africa. The efficiency of this spend is therefore of great concern, given the large variability in supply chain costs. In this paper, we develop quantitative estimates of the feasible opportunity for efficiency improvement in country level reproductive health supply chains in sub-Saharan Africa. We used Data Envelopment Analysis (DEA) to identify peer groups of countries in the region (whose inputs and outputs are similar) that could share best practice to deliver efficiency improvements. Our first analysis suggested an opportunity to improve contraceptive prevalence rate (CPR) by on average 61% and timeliness by 32% for the set of initially classified as inefficient countries, which corresponds to 84% of the countries studied. We then identified country specific environmental variables that could affect outcomes, and estimated their impact on managerial efficiency. This analysis suggested that the observed output CPR values should be adjusted on average by a factor of 5.18 and the observed timeliness should be adjusted by an average factor of 0.86 -suggesting that environmental factors have a significant impact on health outcomes. Our adjusted outputs continue to suggest an opportunity to improve CPR by 56% and timeliness by 26% for the set of inefficient countries, which now corresponds to 75% of the countries. Thus, despite the impact of environmental variables, there continues to be an opportunity to improve both health outcomes and supply chain performance through process improvement and benchmarking. Finally, we document a significant relationship between donor funding fragmentation and efficiency and suggest steps to mitigate that effect. Our analysis suggests a set of concrete steps to improve supply chains for global health products along with an estimate of their impact.
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  9. 9

    Gender matters in economic empowerment interventions: a research review.

    Buvinic M; O'Donnell M

    Washington, D.C., Center for Global Development, 2017 May. 31 p. (Center for Global Development Working Paper 456)

    A review of the recent evaluation evidence on financial services and training interventions questions their gender neutrality and suggests that some design features in these interventions can yield more positive economic outcomes for women than for men. These include features in savings and ‘Graduation’ programs that increase women’s economic self-reliance and self-control, and the practice of repeated micro borrowing that increases financial risk-taking and choice. ‘Smart’ design also includes high quality business management and jobs skills training, and stipends and other incentives in these training programs that address women’s additional time burdens and childcare demands. Peer support may also help to increase financial risk taking and confidence in business decisions, and may augment an otherwise negligible impact of financial literacy training. These features help women overcome gender-related constraints. However, when social norms are too restrictive, and women are prevented from doing any paid work, no design will be smart enough. Subjective economic empowerment appears to be an important intermediate outcome for women that should be promoted and more reliably and accurately measured. More research is also needed on de-biasing service provision, which can be gender biased; lastly, whenever possible, results should be sex-disaggregated and reported for individuals as well as households.
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  10. 10

    Economic impacts of child marriage: global synthesis report.

    Wodon Q; Male C; Nayihouba A; Onagoruwa A; Savadogo A; Yedan A; Edmeades J; Kes A; John N; Murithi L; Steinhaus M; Petroni S

    Washington, D.C., World Bank, 2017 Jun 27. 99 p.

    The international community is increasingly aware of the negative impacts of child marriage on a wide range of development outcomes. Ending child marriage is now part of the Sustainable Development Goals. Yet investments to end the practice remain limited across the globe and more could be done. In order to inspire greater commitments towards ending child marriage, this study demonstrates the negative impacts of the practice and their associated economic costs. The study looks at five domains of impacts: (i) fertility and population growth; (ii) health, nutrition, and violence; (iii) educational attainment and learning; (iv) labor force participation and earnings; and (v) participation, decision-making, and investments. Economic costs associated with the impacts are estimated for several of the impacts. When taken together across countries, the costs of child marriage are very high. They suggest that investing to end child marriage is not only the right thing to do, but also makes sense economically.
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  11. 11

    Measuring gender equality.

    Posadas J; Paci P; Sajaia Z; Lokshin M

    Washington, D.C., International Bank for Reconstruction and Development / The World Bank, 2017 Apr. 302 p.

    Gender equality is a core development objective in its own right and also smart development policy and business practice. No society can develop sustainably without giving men and women equal power to shape their own lives and contribute to their families, communities, and countries. And yet, critical gender gaps continue to exist in all countries and across multiple dimensions. The gender module of the World Bank’s ADePT software platform produces a comprehensive set of tables and graphs using household surveys to help diagnose and analyze the prevailing gender inequalities at the country level and over time. This book provides a step-by-step guide to the use of the ADePT software and an introduction to its basic economic concepts and econometric methods. The module is organized around the framework proposed by the World Development Report 2012: Gender Equality and Development. It covers gender differences in outcomes in three primary dimensions of gender equality: human capital (or endowments), economic opportunities, and voice and agency. Particular focus is given to the analysis and decomposition techniques that allow for further exploring of gender gaps in economic opportunities.
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  12. 12
    Peer Reviewed

    Demographic transition and the emerging windows of opportunities and challenges in Bangladesh.

    Islam MM

    Journal of Population Research. 2016 May 28; 33(1):283-305.

    The aim of this paper is to examine the demographic transition and the emerging window of opportunities and challenges in Bangladesh. The study utilizes time series data from national level population surveys, censuses and the population projections and estimates produced by the United Nations Population Division. The ongoing demographic transition in Bangladesh leads to many changes in the size and age structure of the rapidly growing population of the country, giving rise to economic and social opportunities as well as policy challenges. The window of opportunity that has emerged since the 1990s will not last long and will not be repeated in the near future. It will reach its peak during the 2020s and will remain open until the 2030s. This demographic dividend needs to be managed efficiently in order to be transformed into better and sustainable economic growth. Understanding demographic challenges must therefore be a priority for the Government of Bangladesh, which must formulate policies to harvest the benefits of the demographic opportunities. Copyright: Springer Science+Business Media Dordrecht 2016
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  13. 13
    Peer Reviewed

    Demographic dynamics and long-run development: insights for the secular stagnation debate.

    Cervellati M; Sunde U; Zimmermann KF

    Journal of Population Economics. 2017 Apr; 30(2):401-432.

    This paper takes a global, long-run perspective on the recent debate about secular stagnation, which has so far mainly focused on the short term. The analysis is motivated by observing the interplay between the economic and demographic transition that has occurred in the developed world over the past 150 years. To the extent that high growth rates in the past have partly been the consequence of singular changes during the economic and demographic transition, growth is likely to become more moderate once the transition is completed. At the same time, a similar transition is on its way in most developing countries, with profound consequences for the development prospects in these countries, but also for global comparative development. The evidence presented here suggests that long-run demographic dynamics have potentially important implications for the prospects of human and physical capital accumulation, the evolution of productivity, and the question of secular stagnation. Copyright: Springer-Verlag Berlin Heidelberg 2016.
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  14. 14

    Health and economic growth: Are there gendered effects? Evidence from selected Southern Africa Development Community region.

    Licumba EA; Dzator J; Zhang X

    Journal of Developing Areas. 2016; 50(5 Spec No):215-227.

    Women’s economic participation has recently been at the centre of the debate on sustainable development. It is a widely held view that women have a strategic role in poverty reduction dynamics. The argument is that when women have equal access to education and full participation in business and economic decision-making, they are a significant driving force against poverty. Women economic empowerment increases earning power which in its turn raises household incomes while reducing fertility rates that triggers the population transition dynamics. This is eventually translated into well-being of children, reducing poverty of future generations. In fact currently World Bank Strategy to empower women among others includes the need to increase investment in women’s health. Recognising this issue, SADC region has developed a number of gender based health polices which are in line with regional and international commitments. As a result one of the key indicators of development in the region is now the state of women’s health. However overall health status has been an issue in SADC region, mostly due to HIV / AIDS infections and Tuberculosis. Globally SADC has the highest level of HIV prevalence and the most affected social group is women, between 15 and 24 years of age. Furthermore the review of literature indicates that much of what is known about the effects of health by gender in this region has been descriptive in nature. No previous study has empirically investigated the nature of these effects in this region. This chapter aims to fill this gap. This paper empirically investigates the link between improvements on health disaggregated by gender on productivity and hence economic growth in the SADC region between 1970 and 2010. Health improvement is measured by life expectancy and economic growth is measured by real GDP per capita at 2005 constant prices and data is taken from the WDI and PWT. Using Fixed Effect (FE) the findings presented in this analysis suggests that improvements in both female and male health can significantly improve economic growth in this region. However an increase in male health significantly raises economic growth greater than that of females. These effects are robust to changes in model specification. These findings may reflect women’s higher morbidity rates in the region compared to men in this region that might affect productivity. They also may reflect inequalities in accessing education or formal paid work that is required to trigger the population transition dynamics and eventually economic growth. These results imply the need of some policy adjustment in order to align all SADC gender policies particularly in education, employment and improvements in health in order to capitalize on the benefits of improvements on female health.
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  15. 15

    HIV Patients Drop Out in Indonesia: Associated Factors and Potential Productivity Loss.

    Siregar AY; Pitriyan P; Wisaksana R

    Acta Medica Indonesiana. 2016 Jul; 48(3):207-216.

    AIM: this study reported various factors associated with a higher probability of HIV patients drop out, and potential productivity loss due to HIV patients drop out. METHODS: we analyzed data of 658 HIV patients from a database in a main referral hospital in Bandung city, West Java, Indonesia from 2007 to 2013. First, we utilized probit regression analysis and included, among others, the following variables: patients' status (active or drop out), CD4 cell count, TB and opportunistic infection (OI), work status, sex, history of injecting drugs, and support from family and peers. Second, we used the drop out data from our database and CD 4 cell count decline rate from another study to estimate the productivity loss due to HIV patients drop out. RESULTS: lower CD4 cell count was associated with a higher probability of drop out. Support from family/peers, living with family, and diagnosed with TB were associated with lower probability of drop out. The productivity loss at national level due to treatment drop out (consequently, due to CD4 cell count decline) can reach US$365 million (using average wage). CONCLUSION: first, as lower CD 4 cell count was associated with higher probability of drop out, we recommend (to optimize) early ARV initiation at a higher CD 4 cell count, involving scaling up HIV service at the community level. Second, family/peer support should be further emphasized to further ensure treatment success. Third, dropping out from ART will result in a relatively large productivity loss.
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  16. 16

    Anaemia is the biggest cause of disability in India, worst in BRICS.

    Yadavar S

    Business Standard. 2016 Oct 27; [11] p.

    Iron-deficiency anaemia in India is rampant among children below the age of 3 (78.9%); women (55%); men follow at 24%. Iron deficiency anaemia was the top cause of maternal deaths in India (50%) and the associate cause in 20% of maternal deaths. Anaemia during pregnancy also increases the chances of foetal deaths, abnormalities, pre-term and underweight babies. Iron-deficiency anaemia has remained the top cause of disability in India for 10 years now, according to an IndiaSpend analysis of the last two Global Burden of Disease (GBD) surveys. The result of poverty, malnutrition, poor sanitation and imbalanced vegetarian diet, widespread anaemia has impacted the productivity of India’s workforce. The 2005 GBD survey ranked anaemia caused by shortage of mineral iron in the body as the top factor for disability in India. The latest report published last year shows that it caused 10.56% of all Years Lived with Disability (YLDs). The latest figures show a decline of 23% in disabilities caused by anaemia since 2005, but it is still the highest in the world. In 2015, 10.56% of total YLDs were due to iron-deficiency anaemia. Compared to BRICS nations, these percentages are twice Russia’s and thrice China’s. India also leads this list in the disability-adjusted life years (DALYs) figures. (Excerpts)
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  17. 17

    Disease control, demographic change and institutional development in Africa.

    McMillan MS; Masters WA; Kazianga H

    Cambridge, Massachusetts, National Bureau of Economic Research, 2013 Jul. 34 p. (NBER Working Paper Series No. 19245)

    This paper addresses the role of tropical disease in rural demography and land use rights, using data from Onchocerciasis (river blindness) control in Burkina Faso. We combine a new survey of village elders with historical census data for 1975-2006 and geocoded maps of treatment under the regional Onchocerciasis Control Program (OCP). The OCP ran from 1975 to 2002, first spraying rivers to stop transmission and then distributing medicine to help those already infected. Controlling for time and village fixed effects, we find that villages in treated areas acquired larger populations and also had more cropland transactions, fewer permits required for cropland transactions, and more regulation of common property pasture and forest. These effects are robust to numerous controls and tests for heterogeneity across the sample, including time-varying region fixed effects. Descriptive statistics suggest that treated villages also acquired closer access to electricity and telephone service, markets, wells and primary schools, with no difference in several other variables. These results are consistent with both changes in productivity and effects of population size on public institutions.
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  18. 18

    Gender inequality and economic growth.

    Cuberes D; Teignier M

    [Washington, D.C.], World Bank, 2011 May. 24 p.

    Gender inequality is a pervasive feature in many developing countries. The gaps between male and female outcomes and opportunities are present in several dimensions: education, earnings, occupation, access to formal employment, access to managerial positions, access to productive inputs, political representation, or bargaining power inside the household. These gaps are particularly dramatic in developing countries. Dollar and Gatti (1999) estimate the following education gap in schooling: in the poorest quartile of countries in 1990, only 5% of adult women had any secondary education, one-half of the level for men. In the richest quartile, on the other hand, 51% of adult women had at least some secondary education, 88% of the level for men. On the other hand, the gaps in employment and pay are closing much faster in developing countries than they did in industrialized ones (Tzannatos, 1999), but the prevalence of gender inequality is still sizable, especially in South Asia and the Middle East and North Africa (Klasen and Lamanna, 2009). Moreover, the majority of family workers are women and, often unpaid. Women are also underrepresented among top positions in most countries: even in the most developed ones, the average incidence of females among managers is less than 30% (World Bank 2001).The data also shows that women are typically employed in a reduced number of industrial sectors: more than two-thirds of the global labor force in garment production is females and 1/5th of the total female labor force is in manufacturing. While these inequalities are undesirable in terms of social justice, one could also argue that a better use of women’s potential in the market may result in greater efficiency. However, the microeconomic literature on the efficiency effects of gender inequality is much more extensive than the macroeconomic one.2 In this paper we study the relationship between gender inequality and economic growth at the macroeconomic level, emphasizing the efficiency losses generated by these inequalities. As argued in Dollar and Gatti (1999) if one interprets gender inequality as evidence of either prejudice or market failure, the gap between males and females is effectively a distortionary tax that has a negative impact on economic growth. Under this interpretation, it is justified to estimate the negative consequences of gender inequality on aggregate productivity. The paper is organized as follows. In Section 1 we review the theoretical links between the gender gap and economic growth. We first explore the effect of economic growth on gender inequality, and then we document different models in which the causality goes in the opposite direction. The same division is used in Section 2, where we review the empirical evidence on the relationship between these two variables. Section 3 discusses several caveats and drawbacks of the existing theories and empirical studies. Finally, in Section 4 we show a simple theoretical model of talent allocation and gender discrimination and its calibration, and we describe the estimated effects of gender discrimination for different countries.
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  19. 19

    Enterprising women: expanding economic opportunities in Africa.

    Hallward-Driemeier M

    Washington, D.C., World Bank, 2013. [302] p. (Africa Development Forum)

    This book brings together new household and enterprise data from 41 countries in Sub-Saharan Africa to inform policy makers and practitioners on ways to expand women entrepreneurs’ economic opportunities. Sub-Saharan Africa boasts the highest share of women entrepreneurs, but they are disproportionately concentrated among the self-employed rather than employers. Relative to men, women are pursuing lower opportunity activities, with their enterprises more likely to be smaller, informal, and in low value-added lines of business. The challenge in expanding opportunities is not helping more women become entrepreneurs but enabling them to shift to higher return activities. A central question addressed in the book is what explains the gender sorting in the types of enterprises that women and men run? The analysis shows that many Sub-Saharan countries present a challenging environment for women. Four key areas of the agenda for expanding women’s economic opportunities in Africa are analyzed: strengthening women’s property rights and their ability to control assets; improving women’s access to finance; building human capital in business skills and networks; and strengthening women’s voices in business environment reform. These areas are important both because they have wide gender gaps and because they help explain gender differences in entrepreneurial activities. It is particularly striking that while gender gaps in education tend to close with higher incomes, gaps in women’s property rights and in women’s participation in reform processes do not. As simply raising a country’s income is unlikely to be sufficient to give women equal ability to control assets or have greater voice, more proactive steps will be needed. Practical guidelines to move the agenda forward are discussed for each of these key areas.
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  20. 20

    Economic impacts of child marrige: Preliminary findings from analyses of existing data.

    Wodon Q; Petroni S; Male C; Onagoruwa A; Savadogo A; Edmeades J; Kes A; John N

    Washington, D.C., International Center for Research on Women (ICRW), 2015 Nov. 8 p. (Research Brief)

    This research brief discusses the preliminary findings of the Economic Costs of Child Marriage study. Analysis from existing data suggests that, in addition to the harmful effects on girls’ health, education, rights and well-being, the economic impacts are significant at both the individual and national level. The study makes a convincing case for donors and finance ministries to invest in child marriage not only as a human right issue but as a strategic investment for economic and human development.
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  21. 21
    Peer Reviewed

    Is the demographic dividend an education dividend?

    Crespo Cuaresma J; Lutz W; Sanderson W

    Demography. 2014 Feb; 51(1):299-315.

    The effect of changes in age structure on economic growth has been widely studied in the demography and population economics literature. The beneficial effect of changes in age structure after a decrease in fertility has become known as the “demographic dividend.” In this article, we reassess the empirical evidence on the associations among economic growth, changes in age structure, labor force participation, and educational attainment. Using a global panel of countries, we find that after the effect of human capital dynamics is controlled for, no evidence exists that changes in age structure affect labor productivity. Our results imply that improvements in educational attainment are the key to explaining productivity and income growth and that a substantial portion of the demographic dividend is an education dividend.
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  22. 22
    Peer Reviewed

    The fertility transition around the world.

    Strulik H; Vollmer S

    Journal of Population Economics. 2015 Jan; 28(1):31-44.

    In this paper, we study the evolution of the distribution of fertility rates across the world from 1950 to 2005 using parametric mixture models. We demonstrate the existence of twin peaks and the division of the world’s countries in two distinct components: a high-fertility regime and a low-fertility regime. Whereas the significance of twin peaks vanishes over time, the two fertility regimes continue to exists over the whole observation period. In 1950, about two thirds of the world’s countries belonged to the high-fertility regime and the rest constituted the low-fertility regime. By the year 2005, this picture has reversed. Within both the low- and the high-fertility regime, the average fertility rate declined, with a larger absolute decline within the high-fertility regime. Visually, the two peaks moved closer together. For the low-fertility regime, we find both ß- and s -convergence but we cannot establish any convergence pattern for the high-fertility regime. Our results support the idea of conditional convergence where the condition is the successful initiation of the fertility transition. The results are less supportive of the existence of a unique high-fertility equilibrium.
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  23. 23
    Peer Reviewed

    Counting the cost of child mortality in the World Health Organization African region.

    Kirigia JM; Muthuri RDK; Nabyonga-Orem J; Krigia DG

    BMC Public Health. 2015 Nov 6; 15(1103):1-13.

    Background Worldwide, a total of 6.282 million deaths occurred among children aged less than 5 years in 2013. About 47.4 % of those were borne by the 47 Member States of the World Health Organization (WHO) African Region. Sadly, even as we approach the end date for the 2015 Millennium Development Goals (MDGs), only eight African countries are on track to achieve the MDG 4 target 4A of reducing under-five mortality by two thirds between 1990 and 2015. The post-2015 Sustainable Development Goal (SDG) 3 target is “by 2030, end preventable deaths of new-borns and children under 5 years of age”. There is urgent need for increased advocacy among governments, the private sector and development partners to provide the resources needed to build resilient national health systems to deliver an integrated package of people-centred interventions to end preventable child morbidity and mortality and other structures to address all the basic needs for a healthy population. The specific objective of this study was to estimate expected/future productivity losses from child deaths in the WHO African Region in 2013 for use in advocacy for increased investments in child health services and other basic services that address children’s welfare. Methods A cost-of-illness method was used to estimate future non-health GDP losses related to child deaths. Future non-health GDP losses were discounted at 3 %. The analysis was undertaken with the countries categorized under three income groups: Group 1 consisted of nine high and upper middle income countries, Group 2 of 13 lower middle income countries, and Group 3 of 25 low income countries. One-way sensitivity analysis at 5 % and 10 % discount rates assessed the impact of the expected non-health GDP loss. Results The discounted value of future non-health GDP loss due to the deaths of children under 5 years old in 2013 will be in the order of Int$ 150.3 billion. Approximately 27.3 % of the loss will be borne by Group 1 countries, 47.1 % by Group 2 and 25.7 % by Group 3. The average non-health GDP lost per child death will be Int$ 174 310 for Group 1, Int$ 57 584 for Group 2 and Int$ 25 508 for Group 3. Conclusions It is estimated that the African Region will incur a loss of approximately 6 % of its non-health GDP from the future years of life lost among the 2 976 000 child deaths that occurred in 2013. Therefore, countries and development partners should in solidarity sustainably provide the resources essential to build resilient national health systems and systems to address the determinants of health and meet the other basic needs such as for clothing, education, food, shelter, sanitation and clean water to end preventable child morbidity and mortality.
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  24. 24
    Peer Reviewed

    Impact of HIV/AIDS on labor productivity in Akaki fiber products factory, Ethiopia.

    Omer EM; Mariam DH

    Ethiopian Medical Journal. 2008 Apr; 46(2):123-31.

    BACKGROUND: HIV/AIDS has become a full-blown development crisis affecting all sectors of the economy in most developing countries. Its social and economic consequences are felt widely not only in health but in education, industry, agriculture as well as transport. OBJECTIVE: The study attempted to estimate the changes in worker's output and attendance associated with advancing HIV infection, and direct costs incurred by a fiber products factory due to illness and death related to HIV/AIDS. METHODS: The study is a retrospective cohort with accounting method of cost estimation. The study subjects were factory workers enrolled in a cohort study of HIV incidence and progression in Akaki, Ethiopia since February 1997. RESULTS: The mean incentive earnings were not significantly different between HIV positives and negatives at baseline (in 1997). However, in the following years (1998, 1999 and 2000) the incentive earnings of HIV positives were significantly lower than the incentive earnings of HIV negatives. Trend analysis showed that advancing HIV infection, as measured by drop in CD4 count and increasing viral load, is associated with reduction in productivity and increased sick leave days. CONCLUSION: The study has shown that there is a direct negative impact of HIV infection on the productivity of factory workers and recommends institution of ART centers and programs in work places to mitigate the socio economic impact of the pandemic.
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  25. 25

    A price too high to bear: The costs of maternal mortality to families and communities. Summary of research findings.

    Family Care International; International Center for Research on Women [ICRW]; KEMRI / CDC Research and Public Health Collaborative; Kenya. Ministry of Health

    Nairobi, Kenya, Family Care International, 2014 Mar. [12] p.

    Across the developing world, a woman dies every two minutes from complications of pregnancy and childbirth. Improving maternal health is widely acknowledged as a global public health priority and an urgent social justice and human rights issue. However, Kenya and other developing countries, continue to have a high maternal mortality ratio despite commitment from the government to address the issue. This new study, undertaken in three sub-counties in Western Kenya, documents the emotional as well as the financial costs of maternal mortality to households in poor remote communities and explores the impact of these costs on family well-being. The study clearly demonstrates the devastating impact of these needless deaths on the well-being of families, the survival of newborns, the health and opportunities of surviving children, and the economic productivity of communities. The findings show that when a woman dies from pregnancy or childbirth-related causes, her illness and death begin a chain of loss that harms her children’s health, education, and future opportunities; deepens household poverty; disrupts the life of her family; and devastates her loved ones with grief. The economic and human costs of maternal death are truly a price too high to bear. This study aims to catalyze renewed and strengthened efforts to ensure universal access to reproductive, maternal, newborn, and child health care; improve the quality of health services, including emergency obstetric care; strengthen referral services; and improve the financial and support for women and families facing maternal health crises.
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