Growth and financial reforms trajectory: an optimal matching sequence analysis approach

This paper makes two important , even if preliminary, methodological contributions to the financial reforms literature. The first contribution is that it introduces a new framework for the metric of sequence analysis, namely, Optimal Matching Sequence Analysis. The second is that it provides an innovative framework namely synthetic counterfactual approach for the assessment of the impact of financial reforms sequence. It shows that the trajectory of financial reforms followed by countries, affects the level and the volatility of GDP per capita growth.Financial reforms trajectory Mundell trilemma Optimal matching sequence analysis

Stability periods between financial crises : The role of macroeconomic fundamentals and crises management policies

The aim of this paper is to identify which factors explain why some countries are more prone to enjoy long durations of stability, while others experience crises in shorter intervals. To this end, we analyze the duration of stability periods between currency, debt, and banking crises from 1980 to 2008. We find that durations of tranquility between currency and debt crises are bimodally distributed, making conventional econometric models unsuitable. Therefore, we introduce an innovative econometric strategy, the Finite Mixture Model. Real and financial variables are found to have high predictive power for the spell of stability between currency crises, while for debt crises, the real interest rate is observed to be the best predictor. The time between the occurrence of systemic financial crises is prolonged through large-scale government interventions and IMF aid programs, while recapitalization turns out to have a negative impact.Financial crises, Finite mixture model, duration, bimodality.

Do financial reforms complementarity and reforms sequence matter for international capital inflows?

As economic reforms are mutually interdependent, a liberal policy package needs internal coherence. How can a coherent reform strategy be achieved for a well-balanced and functional economic system? In this paper, we analyze the relationship between financial reforms coherence and international capital inflows (foreign direct investments (FDI) and portfolio investments). We consider a package of eight financial reforms, comprising interest rate deregulation, credit ceiling and directed-credit programs liberalization, elimination of banking sector entry barriers, privatization of state owed banks, development of security markets and banking sector supervision measures. Complementarity is measured through the reciprocal of the Herfindahl-Hirschman concentration index. The results suggest that the manner with which financial reforms are implemented matters. Particularly, complementarity increases FDI inflows by 0.10%. Moreover, this effect depends on the location of the countries on the distribution of financial reforms level. Indeed, the countries located above the median value of financial reform level experience larger FDI and portfolio investment inflows than others. Finally, when privatization of state owned banks and the adoption of a capital adequacy ratio based on the Basle I standard occur after other preliminary financial reforms, the returns to complementarity are higher. In others words, a developed and relatively safe domestic financial system attracts more FDI and portfolio investments than a developed but unsafe financial system

Eliminating extreme poverty in Africa: the role of policies and global governance

Serious commitment to eliminating extreme poverty in Sub-Saharan Africa requires a three-pronged approach: Structural transformation: requires stable macroeconomic policies, infrastructure investments and inclusive growth prioritising productive employment. Cautious regional integration: inviting trade and FDI flows to support regional growth. Improved global governance: creating space for meaningful representation of African perspectives

Stability periods between financial crises : The role of macroeconomic fundamentals and crises management policies

URL des Documents de travail ; http://centredeconomiesorbonne.univ-paris1.fr/bandeau-haut/documents-de-travail/Documents de travail du Centre d'Economie de la Sorbonne 2011.64 - ISSN : 1955-611XThe aim of this paper is to identify which factors explain why some countries are more prone to enjoy long durations of stability, while others experience crises in shorter intervals. To this end, we analyze the duration of stability periods between currency, debt, and banking crises from 1980 to 2008. We find that durations of tranquility between currency and debt crises are bimodally distributed, making conventional econometric models unsuitable. Therefore, we introduce an innovative econometric strategy, the Finite Mixture Model. Real and financial variables are found to have high predictive power for the spell of stability between currency crises, while for debt crises, the real interest rate is observed to be the best predictor. The time between the occurrence of systemic financial crises is prolonged through large-scale government interventions and IMF aid programs, while recapitalization turns out to have a negative impact.L'objectif de cet article est d'identifier les facteurs qui expliquent pourquoi certains pays ont tendance à expérimenter des durées de stabilité financière plus longues que d'autres. A cette fin, en considérant la période 1980-2008, nous analysons la durée de tranquilité séparant respectivement les crises de change, d'endettement et bancaires. En partant du constat que les distributions de la durée séparant l'occurrence des crises de change et celle séparant l'occurrence des crises d'endettement sont bimodales, nous estimons un modéle économétrique du type "modèle de mélange gaussien". Les résultats empiriques suggèrent d'une part qu'en ce qui concerne les crises de change, les variables d'économie réelle et les financières augmentent significativement la qualité prédictive de notre modèle ; d'autre part, que le taux d'intérêt réel est le meilleur "prédicteur" de la durée de tranquilité entre les crises d'endettement. Nous trouvons également que l'ampleur du soutien public au secteur bancaire ainsi que l'adoption des programmes du FMI prolongent la durée de stabilité entre les crises bancaires systémiques mais que les mesures de recapitalisation sont de nature à précipiter l'occurrence de nouvelles crises

Does enrollment status in community-based insurance lead to poorer quality of care? Evidence from Burkina Faso

Introduction: In 2004, a community-based health insurance (CBI) scheme was introduced in Nouna health district, Burkina Faso, with the objective of improving financial access to high quality health services. We investigate the role of CBI enrollment in the quality of care provided at primary-care facilities in Nouna district, and measure differences in objective and perceived quality of care and patient satisfaction between enrolled and non-enrolled populations who visit the facilities. Methods: We interviewed a systematic random sample of 398 patients after their visit to one of the thirteen primary-care facilities contracted with the scheme; 34% (n = 135) of the patients were currently enrolled in the CBI scheme. We assessed objective quality of care as consultation, diagnostic and counselling tasks performed by providers during outpatient visits, perceived quality of care as patient evaluations of the structures and processes of service delivery, and overall patient satisfaction. Two-sample t-tests were performed for group comparison and ordinal logistic regression (OLR) analysis was used to estimate the association between CBI enrollment and overall patient satisfaction. Results: Objective quality of care evaluations show that CBI enrollees received substantially less comprehensive care for outpatient services than non-enrollees. In contrast, CBI enrollment was positively associated with overall patient satisfaction (aOR = 1.51, p = 0.014), controlling for potential confounders such as patient socio-economic status, illness symptoms, history of illness and characteristics of care received. Conclusions: CBI patients perceived better quality of care, while objectively receiving worse quality of care, compared to patients who were not enrolled in CBI. Systematic differences in quality of care expectations between CBI enrollees and non-enrollees may explain this finding. One factor influencing quality of care may be the type of provider payment used by the CBI scheme, which has been identified as a leading factor in reducing provider motivation to deliver high quality care to CBI enrollees in previous studies. Based on this study, it is unlikely that perceived quality of care and patient satisfaction explain the low CBI enrollment rates in this community

Health Worker Preferences for Community-Based Health Insurance Payment Mechanisms: A Discrete Choice Experiment

Background: In 2004, a community-based health insurance scheme (CBI) was introduced in Nouna health district, Burkina Faso. Since its inception, coverage has remained low and dropout rates high. One important reason for low coverage and high dropout is that health workers do not support the CBI scheme because they are dissatisfied with the provider payment mechanism of the CBI. Methods: A discrete choice experiment (DCE) was used to examine CBI provider payment attributes that influence health workers’ stated preferences for payment mechanisms. The DCE was conducted among 176 health workers employed at one of the 34 primary care facilities or the district hospital in Nouna health district. Conditional logit models with main effects and interactions terms were used for analysis. Results: Reimbursement of service fees (adjusted odds ratio (aOR) 1.49, p < 0.001) and CBI contributions for medical supplies and equipment (aOR 1.47, p < 0.001) had the strongest effect on whether the health workers chose a given provider payment mechanism. The odds of selecting a payment mechanism decreased significantly if the mechanism included (i) results-based financing (RBF) payments made through the local health management team (instead of directly to the health workers (aOR 0.86, p < 0.001)) or (ii) RBF payments based on CBI coverage achieved in the health worker’s facility relative to the coverage achieved at other facilities (instead of payments based on the numbers of individuals or households enrolled at the health worker’s facility (aOR 0.86, p < 0.001)). Conclusions: Provider payment mechanisms can crucially determine CBI performance. Based on the results from this DCE, revised CBI payment mechanisms were introduced in Nouna health district in January 2011, taking into consideration health worker preferences on how they are paid

An exploratory analysis of the regionalization policy for the recruitment of health workers in Burkina Faso

BACKGROUND: Health personnel retention in remote areas is a key health systems issue wordwide. To deal with this issue, since 2002 the government of Burkina Faso has implemented a staff retention policy, the regionalized health personnel recruitment policy, aimed at front-line workers such as nurses, midwives, and birth attendants. This study aimed to describe the policy’s development, formulation, and implementation process for the regionalization of health worker recruitment in Burkina Faso. METHODS: We conducted a qualitative study. The unit of analysis is a single case study with several levels of analysis. This study was conducted in three remote areas in Burkina Faso for the implementation portion, and at the central level for the development portion. Indepth interviews were conducted with Ministry of Health officials in charge of human resources, regional directors, regional human resource managers, district chief medical officers, and health workers at primary health centres. In total, 46 indepth interviews were conducted (February 3 - March 16, 2011). RESULTS: Development The idea for this policy emerged after finding a highly uneven distribution of health personnel across urban and rural areas, the availability of a large number of health officers in the labour market, and the opportunity given to the Ministry of Health by the government to recruit personnel through a specific budget allocation. Formulation The formulation consisted of a call for job applications from the Ministry of Health, which indicates the number of available posts by region. The respondents interviewed unanimously acknowledged the lack of documents governing the status of this new personnel category. Implementation During the initial years of implementation (2002-2003), this policy was limited to recruiting health workers for the regions with no possibility of transfer. The possibility of job-for-job exchange was then approved for a certain time, then cancelled. Starting in 2005, a departure condition was added. Now, regionalized health workers can leave the regions after undergoing a competitive selection process. CONCLUSION: The policy was characterized by the absence of written directives and by targeting only one category of personnel. Moreover, there was no associated incentive—financial or otherwise—which poses the question of long-term viability

National user fee abolition and health insurance scheme in Burkina Faso : how can they be integrated on the road to universal health coverage without increasing health inequities?

Incorporating the free health care policy into a Universal Health Insurance (UHI) scheme was recently introduced (2019) as a solution to the debate about free health care in Burkina Faso. The article discusses options for linking free health care to an insurance plan while limiting the risk of adding to existing health inequities. In line with Universal Health Coverage and improved access to health care, the long-term ambition is for the new UHI national fund to generate surpluses that can partly contribute to sustaining the free health care policy