Types of Research
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Many low- and middle-income countries remain challenged by a financial infrastructure gap, evidenced by very low numbers of bank branches and automated teller machines (ATMs) (e.g., 2.9 branches per 100,000 people in Ethiopia versus 13.5 in India and 32.9 in the United States (U.S.) and 0.5 ATMs per 100,000 people in Ethiopia versus 19.7 in India and 173 in the U.S.) (The World Bank 2015a; 2015b). Furthermore, only an estimated 62 percent of adults globally have a banking account through a formal financial institution, leaving over 2 billion adults unbanked (Demirgüç–Kunt et al., 2015). While conventional banks have struggled to extend their networks into low-income and rural communities, digital financial services (DFS) have the potential to extend financial opportunities to these groups (Radcliffe & Voorhies, 2012). In order to utilize DFS however, users must convert physical cash to electronic money which requires access to cash-in, cash-out (CICO) networks—physical access points including bank branches but also including “branchless banking" access points such as ATMs, point-of-sale (POS) terminals, agents, and cash merchants. As mobile money and branchless banking expand, countries are developing new regulations to govern their operations (Lyman, Ivatury, & Staschen, 2006; Lyman, Pickens, & Porteous, 2008; Ivatury & Mas, 2008), including regulations targeting aspects of the different CICO interfaces.
EPAR's work on CICO networks consists of five components. First, we summarize types of recent mobile money and branchless banking regulations related to CICO networks and review available evidence on the impacts these regulations may have on markets and consumers. In addition to this technical report we developed a short addendum (EPAR 355a) which includes a description of findings on patterns around CICO regulations over time. Another addendum (EPAR 355b) summarizes trends in exclusivity regulations including overall trends, country-specific approaches to exclusivity, and a table showing how available data on DFS adoption from FII and GSMA might relate to changes in exclusivity policies over time. A third addendum (EPAR 355c) explores trends in CICO network expansion with a focus on policies seeking to improve access among more remote or under-served populations. Lastly, we developed a database of CICO regulations, including a regulatory decision options table which outlines the key decisions that countries can make to regulate CICOs and a timeline of when specific regulations related to CICOs were introduced in eight focus countries, Bangladesh, India, Indonesia, Kenya, Nigeria, Pakistan, Tanzania, and Uganda.
The private sector is the primary investor in health research and development (R&D) worldwide, with investment annual investment exceeding $150 billion, although only an estimated $5.9 billion is focused on diseases that primarily affect low and middle-income countries (LMICs) (West et al., 2017b). Pharmaceutical companies are the largest source of private spending on global health R&D focused on LMICs, providing $5.6 billion of the $5.9 billion in total private global health R&D per year. This report draws on 10-K forms filed by Pharmaceutical companies with the U.S. Securities and Exchange Commission (SEC) in the year 2016 to examine the evidence for five specific disincentives to private sector investment in drugs, vaccines and therapeutics for global health R&D: scientific uncertainty, weak policy environments, limited revenues and market uncertainty, high fixed costs for research and manufacturing, and imperfect markets. 10-K reports follow a standard format, including a business section and a risk section which include information on financial performance, investment options, lines of research, promising acquisitions and risk factors (scientific, market, and regulatory). As a result, these filings provide a valuable source of information for analyzing how private companies discuss risks and challenges as well as opportunities associated with global health R&D targeting LMICs.
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.
This research considers how public good characteristics of different types of research and development (R&D) and the motivations of different providers of R&D funding affect the relative advantages of alternative funding sources. We summarize the public good characteristics of R&D for agriculture in general and for commodity and subsistence crops in particular, as well as R&D for health in general and for neglected diseases in particular, with a focus on Sub-Saharan Africa and South Asia. Finally, we present rationales for which funders are predicted to fund which R&D types based on these funder and R&D characteristics. We then compile available statistics on funding for agricultural and health R&D from private, public and philanthropic sources, and compare trends in funding from these sources against expectations. We find private agricultural R&D spending focuses on commodity crops (as expected). However contrary to expectations we find public and philanthropic spending also goes largely towards these same crops rather than staples not targeted by private funds. For health R&D private funders similarly concentrate on diseases with higher potential financial returns. However unlike in agricultural R&D, in health R&D we observe some specialization across funders – especially for neglected diseases R&D - consistent with funders’ expected relative advantages.
In this report, we analyze the evidence that improved and expanded access to financial services can be a pathway out of poverty in Bangladesh and Tanzania. A brief background review of finance and poverty reduction evidence at the country, household, and individual level emphasizes the importance of a functioning financial system and the need to remove individual and household barriers to capital accumulation. We follow with an in-depth literature review on studies that link poverty reduction in Bangladesh or Tanzania with one or more of five financial intervention categories: remittances; government subsidies; conditional and unconditional cash transfers; credit; and combination programs. The resulting empirical evidence from these sources reveal a high share (61%) of positive reported associations between a financial intervention and outcome measure related to our five chosen financial interventions. The remaining studies found insignificant or mixed associations, but very few (3 out of 56) indicate that access to a financial mechanism was associated with worsened poverty. The heterogeneity of study types and interventions makes it difficult to draw conclusions about the efficacy of one intervention over another, and more research is needed on whether such approaches constitute a durable, long-term exit from poverty.
The literature on poverty’s causes and cures in developing countries posits a variety of contributing factors. Most researchers acknowledge that a sustained exit from poverty is complex and no single causal pathway from poverty to non-poverty exists. In this review, we present a summary framework for categorizing the various theorized pathways out of poverty, and evaluate the empirical evidence for which interventions and resulting outcomes are most frequently and most strongly associated with poverty alleviation. We conducted a literature review on pathways out of poverty for low-income households in developing countries and identified and categorized general strategies and outcomes demonstrated to be empirically associated with poverty alleviation. We organized the general strategies into four asset groups that could be targeted to alleviate poverty: human, natural, built / financial, and social / political. Much of the literature presents positive results on poverty alleviation, but it is difficult to compare across studies because many of the studies were conducted in different countries and at different scales, and use a variety of outcome measures.
This report reviews approaches to results measurement used by multilateral and bilateral donor organizations and highlights trends and gaps in how donors measure and report on their performance. Our review consists of assessing donor organizations in terms of their institutional design and levels of evaluation for results measurement, their organizational processes for measuring types of results including coordination and alignment with recipients, outputs and implementation, outcomes and impacts, and costs and effectiveness, and their processes for reporting and using results information. We collect evidence on 12 bilateral organizations and 10 multilateral organizations. The evidence review includes multi-country reviews of aid effectiveness, peer reviews by other donor organizations, donor evaluation plans and frameworks, and donor results and reporting documents. The report is based on an accompanying spreadsheet that contains the coded information from the 22 donor organizations. We find that donors report several types of results, but that there are challenges to measuring certain results at the aggregate donor level, due to challenges with funding and coordination for results measurement at the project, country, portfolio, and donor levels. Approaches to results measurement vary across donor organizations. We identify some trends and differences among groups of donors, notably between bilateral and multilateral donors, but overall there are no clear delineations in how donors approach results measurement.
Aid results information is often not comparable, since monitoring and evaluation frameworks, information gathering processes, and definitions of “results” differ across donors and governments. This report reviews approaches to results monitoring and evaluation used by governments in developing countries, and highlights trends and gaps in national monitoring and evaluation (M&E) systems. We collect evidence on 42 separate government M&E systems in 23 developing countries, including 17 general national M&E systems and 25 sector-specific national M&E systems, with 14 focused on HIV/AIDS, 8 on health, and 3 on agriculture. The evidence review includes external case studies and evaluations of M&E systems, government M&E assessments, M&E plans, strategic plans with an M&E component, and multi-country reviews of M&E, accountability, and aid effectiveness. We evaluate harmonization of government and development partner M&E systems, coordination and institutionalization of government M&E, challenges in data collection and monitoring, and analysis and use of results information. We also report on key characteristics of M&E systems in different sectors.