Comparative analysis of the quality of European institutions 2003-2009: convergence or divergence?

This paper gives a comparative cross-country analysis of the quality of the institutional framework that underpins economic governance in European countries. The paper attempts to identify the trends of change in the quality of institutions and determine if there is a convergence in the quality of EU institutions. The countries included in the analysis are selected groups of EU countries and the Western Balkan Countries. The analysis is based on the results of the executive officers’ opinion surveys conducted by the World Economic Forum for the Global Competitiveness Index 2003-2009. In order to identify the relative quality of public institutions and the trend towards convergence/divergence for different clusters of EU countries, a three-pillar composite indicator of institutional quality was constructed from available WEF indicators. The analysis was conducted at the aggregated level as well as for individual countries and pillars, measured in terms of difference to an average rank of survey response in the EU-14 + EU-8 members

Towards universal health coverage: lessons from 10 years of healthcare reform in China.

Universal health coverage (UHC) is driving the global health agenda. Many countries have embarked on national policy reforms towards this goal, including China. In 2009, the Chinese government launched a new round of healthcare reform towards UHC, aiming to provide universal coverage of basic healthcare by the end of 2020. The year of 2019 marks the 10th anniversary of China's most recent healthcare reform. Sharing China's experience is especially timely for other countries pursuing reforms to achieve UHC. This study describes the social, economic and health context in China, and then reviews the overall progress of healthcare reform (1949 to present), with a focus on the most recent (2009) round of healthcare reform. The study comprehensively analyses key reform initiatives and major achievements according to four aspects: health insurance system, drug supply and security system, medical service system and public health service system. Lessons learnt from China may have important implications for other nations, including continued political support, increased health financing and a strong primary healthcare system as basis

Comparative analysis of the quality of European institutions 2003-2009: convergence or divergence?

This paper gives a comparative cross-country analysis of the quality of the institutional framework that underpins economic governance in European countries. The paper attempts to identify the trends of change in the quality of institutions and determine if there is a convergence in the quality of EU institutions. The countries included in the analysis are selected groups of EU countries and the Western Balkan Countries. The analysis is based on the results of the executive officers’ opinion surveys conducted by the World Economic Forum for the Global Competitiveness Index 2003-2009. In order to identify the relative quality of public institutions and the trend towards convergence/divergence for different clusters of EU countries, a three-pillar composite indicator of institutional quality was constructed from available WEF indicators. The analysis was conducted at the aggregated level as well as for individual countries and pillars, measured in terms of difference to an average rank of survey response in the EU-14 + EU-8 members.quality of institutions, economic performance, eu, Western Balkans, composite indicators

Towards universal health coverage: achievements and challenges of 10 years of healthcare reform in China.

Universal health coverage (UHC) has been identified as a priority for the global health agenda. In 2009, the Chinese government launched a new round of healthcare reform towards UHC, aiming to provide universal coverage of basic healthcare by the end of 2020. We conducted a secondary data analysis and combined it with a literature review, analysing the overview of UHC in China with regard to financial protection, coverage of health services and the reported coverage of the WHO and the World Bank UHC indicators. The results include the following: out-of-pocket expenditures as a percentage of current health expenditures in China have dropped dramatically from 60.13% in 2000 to 35.91% in 2016; the health insurance coverage of the total population jumped from 22.1% in 2003 to 95.1% in 2013; the average life expectancy increased from 72.0 to 76.4, maternal mortality dropped from 59 to 29 per 100 000 live births, the under-5 mortality rate dropped from 36.8 to 9.3 per 1000 live births, and neonatal mortality dropped from 21.4 to 4.7 per 1000 live births between 2000 and 2017; and so on. Our findings show that while China appears to be well on the path to UHC, there are identifiable gaps in service quality and a requirement for ongoing strengthening of financial protections. Some of the key challenges remain to be faced, such as the fragmented and inequitable health delivery system, and the increasing demand for high-quality and value-based service delivery. Given that China has committed to achieving UHC and 'Healthy China 2030', the evidence from this study can be suggestive of furthering on in the UHC journey and taking the policy steps necessary to secure change

Climate change adaptation, flood risks and policy coherence in integrated water resources management in England

Integrated water resources management (IWRM) assumes coherence between cognate aspects of water governance at the river basin scale, for example water quality, energy production and agriculture objectives. But critics argue that IWRM is often less ‘integrated’ in practice, raising concerns over inter-sectoral coherence between implementing institutions. One increasingly significant aspect of IWRM is adaptation to climate change-related risks, including threats from flooding, which are particularly salient in England. Although multiple institutional mechanisms exist for flood risk management (FRM), their coherence remains a critical question for national adaptation. This paper therefore (1) maps the multi-level institutional frameworks determining both IWRM and FRM in England; (2) examines their interaction via various inter-institutional coordinating mechanisms; and (3) assesses the degree of coherence. The analysis suggests that cognate EU strategic objectives for flood risk assessment demonstrate relatively high vertical and horizontal coherence with river basin planning. However, there is less coherence with flood risk requirements for land-use planning and national flood protection objectives. Overall, this complex governance arrangement actually demonstrates de-coherence over time due to ongoing institutional fragmentation. Recommendations for increasing IWRM coherence in England or re-coherence based on greater spatial planning and coordination of water-use and land-use strategies are proposed

No. 59: The Third Wave: Mixed Migration from Zimbabwe to South Africa

Migration from Zimbabwe to South Africa has been extremely well-documented by researchers. In this paper, we suggest that there is a need to periodize these migration flows in order to understand how and why they have changed over time, not simply in terms of the volume of migration but the changing drivers of migration and the shifting nature of the migrant stream. Few previous studies have taken a longitudinal approach to Zimbabwean migration, primarily because most research takes place at one point in time. SAMP is in the fortunate position of having a large database at its disposal which allows us to compare migration from Zimbabwe at three different points in time: 1997, 2005 and 2010. Although migration from Zimbabwe since 1990 has consistently increased over time, it can be periodized into three ‘waves’ with distinctive drivers of migration, migration patterns and migrant profiles. The first wave occurred in the 1990s, the second from around 2000 to 2005 and the third in the years since. In this paper we identify continuities and shifts in migrant profiles and behaviours during each of these periods. The paper also examines contemporary migration from Zimbabwe during what we refer to as the third wave of migration.Our findings are based on a survey of Zimbaweans in Cape Town and Johannesburg conducted in late 2010. All of the respondents had come to South Africa for the very first time in 2005 or more recently. The main characteristics of third wave migrants are as follows: With regard to the feminization of migration, the proportion of female migrants in the third wave is the same as in the second wave (44%) which suggests that the gender balance has stabilised. However, unlike first and second wave migrants, females are now engaged in a much wider variety of occupations. There are more children and young people in the third wave. The proportion of young Zimbabwean migrants (aged 15-24) rose dramatically from 15% in 2005 to 31% in 2010. Our survey found that 28% of migrants in Johannesburg and Cape Town were children living with their parents or guardians. Consistent with the younger age profile of the third wave, the proportion of unmarried migrants continued to rise (from 25% in 1997 to 31% in 2005 to 49% in 2010). More of the third wave migrants are school-leavers (the proportion of those with a primary or secondary education rising from 48% in 2005 to 60% in 2010). Some 35% of third wave migrants have never had a job in Zimbabwe. The proportion of working age migrants has continued to increase, as it has since the 1990s. The unemployed in Zimbabwe are a major component of the migration flow. Half of the third wave migrants (50%) were unemployed before leaving Zimbabwe, whereas only 18% are unemployed in South Africa. Wage employment rose from 45% in Zimbabwe to 62% in South Africa and participation in the informal economy from 8% in Zimbabwe to 20% in South Africa. Sixty-two percent of third wave migrants are employed and another 20% work in the informal economy. However, the third wave of migrants do seem to occupy more menial jobs than their predecessors. In 2005, for example, over 40% of migrants from Zimbabwe were in skilled and professional positions. Only 15% of the third wave are employed in these types of position. Nearly a quarter (24%) are engaged in manual work (compared to only 7% in 2005), 13% are in the service sector (compared to 9.5% in 2005), 8% are in domestic work (compared to 2% in 2005) and 4% are in the security industry (compared to less than 1% in 2005). In addition, many migrants have a second job or source of income, the most common being casual work and informal trading. Only 11% of the migrants have no income at all but a quarter earn less than R2,000 per month. Another 32% earn between R2,000 and R5,000 per month. Only 14% earn more than R10,000 per month and 3% more than R20,000 per month. Although the majority of migrants still move in their individual capacity, social networks (including kin and friendship ties) are playing an increasingly important role. For example, 51% of third wave migrants were preceded to South Africa by immediate family members. In addition, 52% had extended family members, 63% had friends and 65% had community members already in South Africa. Social networking not only influences the decision to migrate to South Africa, it has a cumulative impact on the decisions of later migrants. For example, while 49% of migrants had no immediate family members in South Africa prior to migrating, the number without immediate family members had dropped to 26% at the time of the survey. A defining characteristic of migration from Zimbabwe since the 1990s has been that the vast majority of migrants engage in circular migration, only spending short periods in South Africa, returning home frequently and showing very little inclination to remain in South Africa for any length of time. In 2005, nearly a third of migrants returned to Zimbabwe at least monthly and 50% of migrants returned at least once every few months. Amongst third wave migrants, less than 1% return monthly and only 9% return once every few months. As many as 46% had not been back to Zimbabwe since coming to South Africa. South Africa is seen by many in the third wave as a longer-term destination rather than a temporary place to earn quick money. Nearly half of the respondents, for example, want to remain in South Africa for a few years. Another 13% wish to remain indefinitely and another 8% permanently. In other words, two thirds of the migrants view a long-term stay in South Africa as desirable. Like their compatriots, third wave migrants are significant remitters of cash and goods to Zimbabwe. However, they occupy lowlier jobs which impacts on their incomes and remitting behaviour. Remitting continues, though not with the frequency or in the same amounts as with earlier rounds of migrants. Nearly a quarter of the migrants (24%) had not remitted any money to Zimbabwe. In 2005, 62% of migrants remitted at least monthly. Amongst the third wave, only 27% remit this frequently. The third wave relies much more on informal remittance channels than its predecessors. The proportion of migrants using formal banking channels dropped from 27% in 2005 to only 11% in 2010. On the other hand, the proportion of migrants taking money home themselves also dropped (from 35% in 2005 to only 9% in 2010). This is consistent with the fact that the third wave visits Zimbabwe far less frequently. Instead, these migrants tend to use returning friends and co-workers (up from 11% in 2005 to 27% in 2010) and informal money transfer channels (up from 3% in 2005 to 30% in 2010). All of this indicates that the nature of migration from Zimbabwe to South Africa is undergoing a significant shift and that without major economic and political changes in Zimbabwe, and possibly even despite them, the trends identified in this analysis of the third wave are likely to continue and even intensify

Dynamic Risk Sharing in the United States and Europe

This paper uses a panel VAR model to improve upon the existing literature on interregional risk sharing channels (e.g. Asdrubali, Sorensen and Yosha, 1996) in several respects. First, it endogenizes the output process within a multi-equation framework, capturing the dynamic feedback between output and various risk sharing channels. Second, in contrast to previous research's analysis of static risk sharing in the presence of exogenous output shocks, it uses impulse response functions to trace the role of each risk sharing channel over time, in the presence of different structural shocks (temporary vs. persistent and output vs. risk sharing channels). Third, the paper extends the risk sharing channels typically analyzed, by considering the consumption smoothing role of changes in the nominal exchange rate and relative commodity prices across regions. The empirical method is applied to the U.S. states, 23 OECD countries, and 15 countries in the European Union from 1960 to 1990. Regarding the dynamic responses of each risk sharing channel to exogenous output shocks, the results suggest that the dynamics are substantially different among different channels. First, most capital market smoothing is achieved on impact while fiscal smoothing is achieved over time. Second, credit market plays a positive role on impact, but a negative role later. Regarding the substitutability of channels, first, fiscal smoothing is fully substituted by credit market channel in the U.S. while only half of capital market smoothing is substituted in OECD and EU countries. Second, fiscal smoothing is not substituted by any other channels in the U.S. while half of fiscal smoothing is substituted by credit market smoothing in the OECD and EU countries. The results also suggest that nominal and real exchange rate movements are very important in analyzing international risk sharing in OECD and EU countries.

Comparison of governance approaches for the control of antimicrobial resistance: Analysis of three European countries

Policy makers and governments are calling for coordination to address the crisis emerging from the ineffectiveness of current antibiotics and stagnated pipe-line of new ones – antimicrobial resistance (AMR). Wider contextual drivers and mechanisms are contributing to shifts in governance strategies in health care, but are national health system approaches aligned with strategies required to tackle antimicrobial resistance? This article provides an analysis of governance approaches within healthcare systems including: priority setting, performance monitoring and accountability for AMR prevention in three European countries: England, France and Germany. Advantages and unresolved issues from these different experiences are reported, concluding that mechanisms are needed to support partnerships between healthcare professionals and patients with democratized decision-making and accountability via collaboration. But along with this multi-stakeholder approach to governance, a balance between regulation and persuasion is needed

On the relationship between economic freedom and economic growth

Often it is maintained that economic freedom may further high levels of economic growth. This paper compares various indicators for economic freedom. It is concluded that although these measures differ somewhat in their coverage, they show similar rankings for the countries covered. Some elements in these measures are, however, questionable. The robustness of the relationship between freedom and growth is also examined. Our main conclusion is that more economic freedom fosters economic growth.

Annulment proceedings and multilevel judicial conflict

This open access book provides an exhaustive picture of the role that annulment conflicts play in the EU multilevel system. Based on a rich dataset of annulment actions since the 1960s and a number of in-depth case studies, it explores the political dimension of annulment litigation, which has become an increasingly relevant judicial tool in the struggle over policy content and decision-making competences. The book covers the motivations of actors to turn policy conflicts into annulment actions, the emergence of multilevel actors’ litigant configurations, the impact of actors’ constellations on success in court, as well as the impact of annulment actions on the multilevel policy conflicts they originate from