Types of Research
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The share of private sector funding, relative to public sector funding, for drug, vaccine, and diagnostic research & development (R&D) differs considerably across diseases. Private sector investment in overall health R&D exceeds $150 billion annually, but is largely concentrated on non-communicable chronic diseases with only an estimated $5.9 billion focused on "global health", targeting diseases that primarily affect low and middle-income countries (LMICs). We examine the evidence for five specific disincentives to private sector global health R&D investment: scientific uncertainty, weak policy environments, limited revenues and market uncertainty, high fixed and sunk costs, and downstream rents from imperfect markets. Though all five may affect estimates of net returns from an investment decision, they are worth examining separately as each calls for a different intervention or remediation to change behavior.
Cash transfer programs are interventions that directly provide cash to target specific populations with the aim of reducing poverty and supporting a variety of development outcomes. Low- and middle-income countries have increasingly adopted cash transfer programs as central elements of their poverty reduction and social protection strategies. Bastagli et al. (2016) report that around 130 low- and middle-income countries have at least one UCT program, and 63 countries have at least one CCT program (up from 27 countries in 2008). Through a comprehensive review of literature, this report primarily considers the evidence of the long-term impacts of cash transfer programs in low- and lower middle-income countries. A review of 54 reviews that aggregate and summarize findings from multiple studies of cash transfer programs reveals largely positive evidence on long-term outcomes related to general health, reproductive health, nutrition, labor markets, poverty, and gender and intra-household dynamics, though findings vary by context and in many cases overall conclusions on the long-term impacts of cash transfers are mixed. In addition, evidence on long-term impacts for many outcome measures is limited, and few studies explicitly aim to measure long-term impacts distinctly from immediate or short-term impacts of cash transfers.
Land tenure refers to a set of land rights and land governance institutions which can be informal (customary, traditional) or formal (legally recognized), that define relationships between people and land and natural resources (FAO, 2002). These land relationships may include, but are not limited to, rights to use land for cultivation and production, rights to control how land should be used including for cultivation, resource extraction, conservation, or construction, and rights to transfer – through sale, gift, or inheritance – those land use and control rights (FAO, 2002). In this project, we review 38 land tenure technologies currently being applied to support land tenure security across the globe, and calculate summary statistics for indicators of land tenure in Tanzania and Ethiopia.
The concept of global public goods represents a framework for organizing and financing international cooperation in global health research and development (R&D). Advances in scientific and clinical knowledge produced by biomedical R&D can be considered public goods insofar as they can be used repeatedly (non-rival consumption) and it is difficult or costly to exclude non-payers from gaining access (non-excludable). This paper considers the public good characteristics of biomedical R&D in global health and describes the theoretical and observed factors in the allocation R&D funding by public, private, and philanthropic sources.
A growing body of evidence suggests that empowering women may lead to economic benefits (The World Bank, 2011; Duflo, 2012; Kabeer & Natali, 2013). Little work, however, focuses specifically on the potential impacts of women’s empowerment in agricultural settings. Through a comprehensive review of literature this report considers how prioritizing women’s empowerment in agriculture might lead to economic benefits. With an intentionally narrow focus on economic empowerment, we draw on the Women’s Empowerment in Agriculture Index (WEAI)’s indicators of women’s empowerment in agriculture to consider the potential economic rewards to increasing women’s control over agricultural productive resources (including their own time and labor), over agricultural production decisions, and over agricultural income. While we recognize that there may be quantifiable benefits of improving women’s empowerment in and of itself, we focus on potential longer-term economic benefits of improvements in these empowerment measures.
Water supply and sanitation is the responsibility of sub-national state governments under the Indian Constitution. At present, the national government sets water supply and sanitation policy while states plan, design, and execute water supply schemes accordingly. Furthermore, while state governments are in charge of operation and maintenance, they may pass the responsibility to village or district levels. Given the highly decentralized provision of water and sanitation services, there is no autonomous regulatory agency for the water supply and sanitation sector in India at the state or national level. This report reviews literature on India’s urban sanitation policy. The methodology includes Google, Lexis-Nexis, and University of Washington Library searches, searches of two major Indian newspapers, and searches of websites and blogs sponsored by non-governmental organizations. Sources also include the India Sanitation Portal, a forum on sanitation in India used by governmental and nongovernmental organizations, and WASH Sanitation Updates, a sanitation news feed with considerable material on India. We find that urban sanitation policy, as embodied in the National Urban Sanitation Plan of 2008, remains focused on decentralized approaches. Our research reveals no evidence of a change in official policy, nor evidence suggesting that government sanitation programs conflict with official policy.
How development organizations, NGOs, and governments can best allocate scarce resources to those in need has long been debated. As opposed to universal allocation of resources, a more targeted approach attempts to minimize program costs while maximizing benefits among those with the greatest need or market opportunity. Drawing on literature from several sectors,this brief presents two categories of beneficiary targeting in the development context: administrative targeting and self-targeting. The paper includes a brief overview of targeting and segmentation in development, a summary of reasons for targeting, theoretical and practical critiques of targeting, and a discussion of targeting methods in research and practice, including examples from the literature. Implementation examples cited in this body of research include food aid program targeting by self-reported household income in Egypt; fertilizer use in low-potential zones of Uganda; and seven strategic initiatives to improve drought and disease resistance in crops in Asia and Sub-Saharan Africa. We find that beneficiary segmentation has several theoretical advantages. Improved targeting may increase the efficiency and equity of organizational and program efforts and help better match interventions to recipient preferences, increasing the likelihood of adoption and participation. Development organizations may improve the focus of both their strategic priorities and budgets through customized targeting methods. However, concerns exist regarding the accuracy, reliability, cost, and time-constraints of targeting methodologies. Creating valid and reliable target groups with implementation potential remains a significant challenge.
Limited sanitation infrastructure, poor hygienic practices, and unsafe drinking water negatively affect the health of millions of people in the developing world. Using sanitation interventions to interrupt disease pathways can significantly improve public health. Sanitation interventions primarily benefit public health by reducing the prevalence of enteric pathogenic illnesses, which cause diarrhea. Health benefits are realized and accrue to the direct recipients of sanitation interventions and also to their neighbors and others in their communities. In a report to the United Nations Development Programme (UNDP), Hutton et al. (2006) estimate that the cost-benefit ratio of sanitation interventions in all developing countries worldwide is 11.2. This literature review summarizes the risks of inadequate sanitation to public health and presents the empirical evidence on the public health benefits of complete, intermediate and multiple factor sanitation interventions. We find that complete or improved sanitary systems can offer concrete public health benefits by reducing exposure pathways to a variety of infectious diseases contained in human feces and wastewater. Substantial complementary economic gains are also predicted to accrue as a result of providing increased sanitation. In addition, community-wide sanitation interventions seem to offer the greatest promise for reducing pathogenic health risks from feces.
Without availability and access to a variety of foods, populations in the developing world are suffering from deficiencies in iron, zinc, iodine, vitamin A, and other micronutrients in addition to deficiencies in energy and protein. Supplementation and fortification programs have demonstrated effectiveness, but there is an increasing interest in potentially more sustainable solutions via agricultural interventions. The review examines the literature regarding agricultural interventions and pathways to diet diversification and whether desired nutritional outcomes are achieved. We find a strong sentiment that agricultural interventions can improve dietary diversity, and that dietary diversity can improve nutrition and related health outcomes. The programs with demonstrated ability to improve nutrition outcomes are most often cross-cutting interventions, borrowing from the agriculture, nutrition, and public health traditions. While these multi-platform programs can be costly to evaluate and difficult to implement, the evidence supports their potential to create sustainable quality-of-life improvements in target regions. The pathways by which agricultural interventions achieve impact are not fully clear, however. The greatest knowledge gaps are directly related to the lack of integration between program design and evaluation. Many evaluations are based on small sample sizes, lack control groups or baseline data, are subject to selection bias, or face other challenges to rigorous statistical analysis.
Market-oriented agricultural production can be a mechanism to increase smallholder farmer welfare, rural market performance, and contribute to overall economic growth. Cash crop production can allow households to increase their income by producing output with higher returns to land and labor and using the income generated from sales to purchase goods for consumption. However, in the face of missing and underperforming markets, African smallholder households are often unable to produce efficiently or obtain staple foods reliably and cheaply. This literature review summarizes the available literature on the impact of smallholder participation in cash crop and export markets on household welfare and rural markets. The review focuses exclusively on evidence from Sub-Saharan Africa regarding top and emerging export crops, with the addition of tobacco and horticulture due to the volume of research relevant to smallholder welfare gains from the production of these crops. It includes theoretical frameworks, case studies, empirical evidence, and historical analysis from 42 primary empirical studies and 112 resources overall.