While there is increasing academic analysis and policy concern regarding growing inequality and the need for more inclusive development trajectories, it is equally important to advance our... Show moreWhile there is increasing academic analysis and policy concern regarding growing inequality and the need for more inclusive development trajectories, it is equally important to advance our understanding of the pathways to attain more inclusive development in practice. This paper serves as the introduction to a special issue examining the empirical outcomes and processes of inclusive development policies in selected countries in Africa. The paper presents a policy implementation and assessment framework as a lens that connects the diferent case studies. The framework links general inclusive development strategies in employment, social protection and governance, to the participation and representation of the various stakeholders as well as the monetary and non-monetary transaction costs in accessing and/or implementing these programmes on the ground in diferent national and sub-national contexts. Based on the fndings of the 9 case studies, the paper also advances policy directions and operational frameworks to attain more inclusive development in practice.[Résumé]. Bien qu’il existe une analyse académique croissante, et une préoccupation politique envers la montée des inégalités et la nécessite de trajectoires de développement plus inclusives, il est tout aussi important d’avancer notre compréhension des chemins qui permettent—dans la pratique—d’atteindre un développement plus inclusif. Cet article sert d’introduction à un numéro spécial examinant les résultats empiriques et les processus de développement inclusifs dans certains pays en Afrique. L’article présente un cadre d’implémentation et évaluation des politiques, tel que un prisme qui connecte les diférents études de cas. Ce cadre relie des stratégies de développement générales (dans l’emploi, la protections sociale, et la gouvernance) à la participation et la représentation de diférents partis intéressés, aussi qu’aux aux couts de transaction (monétaires et autres) dans l’accès à ces programmes et à leur implémentation sur le terrain, dans des contextes nationales et sous-nationales. Nous basant sur les résultats de ces 10 études de cas, l’article avance des directions de politique et des cadres opérationnels, ayant comme but la réalisation pratique d’un développement plus inclusif. Show less
Motivation: Higher education is regarded as a key instrument to enhance socioeconomic mobility and reduce inequalities. Recent literature reviews have examined inequalities in the higher education... Show moreMotivation: Higher education is regarded as a key instrument to enhance socioeconomic mobility and reduce inequalities. Recent literature reviews have examined inequalities in the higher education systems of high-income countries, but less is known about the situation in low- and middle-income countries, where higher education is expanding fast.Purpose: The article reviews the academic literature on higher education in low- and middle-income countries using a research framework inspired by social justice and capability approaches. It considers the financial, sociocultural, human and political resource domains on which people draw, and how they relate to access, participation and outcomes in higher education.Methods: A literature search for studies explicitly discussing in-country in equalities in higher education revealed 22 publications. Substantial knowledge gaps remain, especially regarding the political (and decision-making) side of inequalities; the ideologies and philosophies underpinning higher education systems; and the linkages between resource domains, both micro and macro.Findings: The review highlights key elements for policy-makers and researchers: (1) the financial lens alone is insufficient to understand and tackle inequalities, since these are also shaped by human and other non-financial factors; (2) sociocultural constructs are central in explaining unequal outcomes; and (3) inequalities develop throughout one’s life and need to be considered during higher education, but also before and after. The scope of inequalities is wide, and the literature offers a few ideas for short-term fixes, such as part-time and online education.Policy implications: Inclusive policy frameworks for higher education should include explicit goals related to (in)equality, which are best measured in terms of the extent to which certain actions or choices are feasible for all. Policies in these frameworks, we argue, should go beyond providing financial support, and also address sociocultural and human resource constraints and challenges in retention, performance and labour market outcomes. Finally, they should consider relevant contextual determinants of inequalities. Show less
We use three years of household panel data to analyze the effects of ill-health on household economic outcomes in rural Ethiopia. We examine the immediate effects of various ill-health measures on... Show moreWe use three years of household panel data to analyze the effects of ill-health on household economic outcomes in rural Ethiopia. We examine the immediate effects of various ill-health measures on health expenditure and labor supply, the subsequent coping responses, and finally the effect on income and consumption. We find evidence of substantial economic risk in terms of increased health expenditure and reduced agricultural productivity. Households are able to smooth consumption by resorting to intra-household labor substitution, borrowing and depleting assets. However, maintaining current consumption through borrowing and depletion of assets is unlikely to be sustainable and displays the need for health financing reforms and safety nets that reduce the financial consequences of ill-health. Show less
This document presents the preliminary findings from the quantitative data generation and analysisconducted as part of the project “Financial decision-making, gender and social norms in Zambia”... Show moreThis document presents the preliminary findings from the quantitative data generation and analysisconducted as part of the project “Financial decision-making, gender and social norms in Zambia”.Using a series of specially designed behavioural experiments,we generated an extensive set of insightsinto the normative environment within which spouses in Eastern Province, Zambia, make decisionsabout individual money holding and saving. Here are some of those insights. Spouses in EasternProvince, Zambia, are willing to compromise household-level earnings in order to maintain individualcontrol over money. Wives, but not husbands, are more likely to compromise household-levelearnings in order tomaintain individual control overmoney, when they can keep thatmoney and theiractions hidden from their spouses. Individually-held behavioural prescriptions, i.e., the “shoulds” and“oughts” that individuals have in mind and reference as guides for their own behaviour and asbenchmarks against which to evaluate others’ behaviour, inform decision-making about maintainingindividual control over money at a cost to the household. Further, when individuals know that theirspouses will find out about their descisions regarding maintaining individual control over money (ornot) at a cost to the household, the individuals take their spouses’ opinions about what they shoulddo into account, i.e., they compromise. There is strong but not unequivocal evidence pointing to theexistence of a social norm, i.e., a “should” or “ought” that is collectively held and enforced bymembers of a community, forbidding saving in secret from one’s spouse, with the secrecy not thesaving being the problem. Assuming it exists, this social norm forbidding saving in secret from one’sspouse applies to both husbands and wives, and this is acknowledged by both husbands and wives.However, the extent to which violations of this norm are tolerated depends on who is doing theviolating and who the evaluating. In patrilineal communities (as compared to matrilinealcommunities), both husbands and wives are especially intolerant of secret saving by husbands and inboth patrilineal and matrilineal communities, wives are less tolerant than husbands of secret savingby husbands and more tolerant than husbands of secret saving by wives. This relative tolerance ofsecret saving by wives notwithstanding, just under one in three wives and one in six husbands thinkthat a man is justified in beating his wife if he discovers that she is saving in an e-wallet or has joineda savings group without his knowledge and, as grounds for wife beating, saving in secret is on a parwith neglecting the children, visiting friends or family in secret and refusing to have sex. For furtherinsights, see the main text of the report. Show less
This document presents the preliminary findings from the quantitative data generation and analysis conducted as part of the project “Financial decision-making, gender and social norms in Zambia”.... Show moreThis document presents the preliminary findings from the quantitative data generation and analysis conducted as part of the project “Financial decision-making, gender and social norms in Zambia”. Using a series of specially designed behavioural experiments, we generated an extensive set of insights into the normative environment within which spouses in Eastern Province, Zambia, make decisions about individual money holding and saving. Here are some of those insights. Spouses in Eastern Province, Zambia, are willing to compromise household-level earnings in order to maintain individual control over money. Wives, but not husbands, are more likely to compromise household-level earnings in order to maintain individual control over money, when they can keep that money and their actions hidden from their spouses. Individually-held behavioural prescriptions, i.e., the “shoulds” and “oughts” that individuals have in mind and reference as guides for their own behaviour and as benchmarks against which to evaluate others’ behaviour, inform decision-making about maintaining individual control over money at a cost to the household. Further, when individuals know that their spouses will find out about their descisions regarding maintaining individual control over money (or not) at a cost to the household, the individuals take their spouses’ opinions about what they should do into account, i.e., they compromise. There is strong but not unequivocal evidence pointing to the existence of a social norm, i.e., a “should” or “ought” that is collectively held and enforced by members of a community, forbidding saving in secret from one’s spouse, with the secrecy not the saving being the problem. Assuming it exists, this social norm forbidding saving in secret from one’s spouse applies to both husbands and wives, and this is acknowledged by both husbands and wives. However, the extent to which violations of this norm are tolerated depends on who is doing the violating and who the evaluating. In patrilineal communities (as compared to matrilineal communities), both husbands and wives are especially intolerant of secret saving by husbands and in both patrilineal and matrilineal communities, wives are less tolerant than husbands of secret saving by husbands and more tolerant than husbands of secret saving by wives. This relative tolerance of secret saving by wives notwithstanding, just under one in three wives and one in six husbands think that a man is justified in beating his wife if he discovers that she is saving in an e-wallet or has joined a savings group without his knowledge and, as grounds for wife beating, saving in secret is on a par with neglecting the children, visiting friends or family in secret and refusing to have sex. For further insights, see the main text of the report. Show less
Barr, A.; Dekker, M.; Janssens, W.; Kebede, B.; Kramer, B. 2019
Using a carefully designed series of public goods games, we compare, across monogamous and polygynous households, the willingness of husbands and wives to cooperate to maximize household gains.... Show moreUsing a carefully designed series of public goods games, we compare, across monogamous and polygynous households, the willingness of husbands and wives to cooperate to maximize household gains. Compared to monogamous husbands and wives, polygynous husbands and wives are less cooperative, one with another, and co-wives are least cooperative, one with another. The husbands' and wives' behavior in a corresponding series of inter-household games indicates that these differences cannot be attributed to selection of less cooperative people into polygyny. Finally, behavior in polygynous households is more reciprocal and less apparently altruistic. Show less
Hees, S.G.M. van; O'Fallon, T.; Hofker, M.; Dekker, M.; Polack, S.; Bank, L.M.; Spaan, E.J.A.M. 2019
Background. One way to achieve universal health coverage (UHC) in low- and middle-income countries (LMIC) is the implementation of health insurance schemes. A robust and up to date overview of... Show moreBackground. One way to achieve universal health coverage (UHC) in low- and middle-income countries (LMIC) is the implementation of health insurance schemes. A robust and up to date overview of empirical evidence assessing and substantiating health equity impact of health insurance schemes among specific vulnerable populations in LMICs beyond the more common parameters, such as income level, is lacking. We fill this gap by conducting a systematic review of how social inclusion affects access to equitable health financing arrangements in LMIC. Methods. We searched 11 databases to identify peer-reviewed studies published in English between January 1995 and January 2018 that addressed the enrolment and impact of health insurance in LMIC for the following vulnerable groups: female-headed households, children with special needs, older adults, youth, ethnic minorities, migrants, and those with a disability or chronic illness. We assessed health insurance enrolment patterns of these population groups and its impact on health care utilization, financial protection, health outcomes and quality of care. Results.The comprehensive database search resulted in 44 studies, in which chronically ill were mostly reported (67%), followed by older adults (33%). Scarce and inconsistent evidence is available for individuals with disabilities, female-headed households, ethnic minorities and displaced populations, and no studies were yielded reporting on youth or children with special needs. Enrolment rates seemed higher among chronically ill and mixed or insufficient results are observed for the other groups. Most studies reporting on health care utilization found an increase in health care utilization for insured individuals with a disability or chronic illness and older adults. In general, health insurance schemes seemed to prevent catastrophic health expenditures to a certain extent. However, reimbursements rates were very low and vulnerable individuals had increased out of pocket payments. Conclusion. Despite a sizeable literature published on health insurance, there is a dearth of good quality evidence, especially on equity and the inclusion of specific vulnerable groups in LMIC. Evidence should be strengthened within health care reform to achieve UHC, by redefining and assessing vulnerability as a multidimensional process and the investigation of mechanisms that are more context specific. Show less
Hollander, S.; Dekker, M.; Miroro, O.; Kesteren, F. van; Bossuyt, J. 2018
Previous analyses of the formation and composition of community-based organizations (CBOs) have used cross section data. So, causal inference has been compromised. We obviate this problem by using... Show morePrevious analyses of the formation and composition of community-based organizations (CBOs) have used cross section data. So, causal inference has been compromised. We obviate this problem by using data from a quasi-experiment in which villages were formed by government officials selecting and clustering households. Our findings are as follows: CBO co-memberships are more likely between geographically proximate households and less likely between early and late settlers, members of female-headed households are not excluded, in poorer villages CBO co-membership networks are denser and, while wealthier households may have been instrumental in setting up CBOs, poorer households engage shortly afterward. Show less
In 2011, in an attempt to increase access to health care and reduce household vulnerability to out-of-pocket health expenditure, the Government of Ethiopia launched a Community-Based Health... Show moreIn 2011, in an attempt to increase access to health care and reduce household vulnerability to out-of-pocket health expenditure, the Government of Ethiopia launched a Community-Based Health Insurance Scheme (CBHI). This paper uses three rounds of household survey data, collected before and after the introduction of the CBHI pilot, to assess the impact of the scheme on household consumption, income, indebtedness, and livestock holdings. We find that enrollment leads to a 5 percentage point-or 13%-decline in the probability of borrowing and is associated with an increase in household income. There is no evidence that enrolling in the scheme affects consumption or livestock holdings. Our results show that the scheme reduces reliance on potentially harmful coping responses such as borrowing. This paper adds to the relatively small body of work that rigorously evaluates the impact of CBHI schemes on economic welfare. Show less
Vlaminck, Z.; Dekker, M.; Leliveld, A.H.M.; Oberst, U. 2014
This article explores financial strategies used by smallholder farmers in the face of the challenging conditions following the economic crisis in the early 2000s in Zimbabwe. It considers the... Show moreThis article explores financial strategies used by smallholder farmers in the face of the challenging conditions following the economic crisis in the early 2000s in Zimbabwe. It considers the sources, circulation and importance of cash among farmers in the cash-scarce society that emerged with hyperinflation and subsequent dollarization and that rendered farmers' savings worthless. The article is based on transaction diaries from 20 farmers in two different rural communities in Zimbabwe. These diaries provided details of expenditures in a three-week period in November/December 2010 and intend to provide insight into the day-to-day realities that affects many in Zimbabwe. These diaries show the very limited inflow of cash and that many households did not have any cash at their disposal. Contrary to other sources, our data suggest that the importance of remittances in these villages is far less than expected. Furthermore, in contrast with standard economic thinking, farmers rarely reverted to 'instantaneous barter'. Instead, the shortage of cash resulted in an intensification of gift-giving in kind in which small gifts were exchanged between family members, neighbours and other close relations and that were especially important to meet daily household needs of farmers and their families. Show less
