Chasing Informality: Evidence from Increasing Enforcement in Large Firms in Peru

2021 ◽  
Author(s):  
Mariano Bosch ◽  
Stephanie González ◽  
María Teresa Silva Porto
Keyword(s):  
Social Security ◽  
Social Insurance ◽  
Large Firms ◽  
Middle Income ◽  
Labor Control ◽  
Middle Income Countries ◽  
Self Employment ◽  
One Year ◽  
Labor Market Regulations ◽  
Proactive Monitoring

Evasion of labor market regulations in middle income countries is systemic. This is generally known as informality. In Latin America, where less than 50% of workers are registered with social security, this is a permanent phenomenon and encompasses a variety of economic realities ranging from subsistence self-employment to evasion of certain regulations including social security contributions. In this study we analyze the role of enforcement in curbing informality in large formal firms in Peru, where informality levels are around 70%. Through the Peruvian National Labor Control Superintendence (SUNAFIL) we randomly sent 697 letters to formal Peruvian firms of more than 50 workers, indicating their obligation to enroll workers in social insurance systems (health and pensions). Two types of letters were sent, one with a deterrence message and one emphasizing the benefits of formalization. One year after the letters were sent, we found a positive and statistically significant effect on the number of workers enrolled in social security (9.8% on average). Only strict deterrence messages had a significant impact, and only in very large firms. This evidence suggests that there is room for improvement in compliance with labor regulations through more proactive monitoring and behavioral tools such as reminders, but effects could be concentrated in the largest firms.

Factors associated with willingness to pay for health insurance and pension scheme among informal economy workers in low- and middle-income countries: a systematic review

2020 ◽  
Vol 48 (1) ◽  
pp. 17-37
Author(s):  
Jairous Joseph Miti ◽  
Mikko Perkio ◽  
Anna Metteri ◽  
Salla Atkins
Keyword(s):  
Systematic Review ◽  
Health Insurance ◽  
Social Security ◽  
Willingness To Pay ◽  
Informal Economy ◽  
Middle Income ◽  
Content Type ◽  
Informal Workers ◽  
Middle Income Countries ◽  
Pension Schemes

PurposeThe purpose of this paper is to establish the main factors influencing willingness to pay for health insurance and pension schemes among informal workers in low- and middle-income countries (LMICs). Historically, informal economy workers have been excluded from social protection coverage. There is a growing need, interest and policy discourse in LMICs to extend social security to informal economy workers. However, little is known about informal workers' willingness to pay (WTP) for social security services in different LMIC settings.Design/methodology/approachThe authors conducted a systematic review and searched five databases from 1987 to 2017. Included papers focused on “social security”, “social insurance”, “pension”, “informal economy”, “informal sector” and “informal workers” in LMICs. Authors conducted independent data appraisal and data extraction. A total of 1790 papers were identified. After exclusion, 34 papers were included in the analysis. Given the heterogeneous results, the authors performed a narrative synthesis to consolidate the findings of the different studies.FindingsIn total, 34 studies from 17 countries were included in the review, out of which 23 studies focused on health insurance, 7 studies on pension schemes and 4 studies on social security in general. The study showed that income and trust were associated with WTP for both health insurance and pension schemes. In addition, family size, age, education and residential area were common factors for both forms of social security. For health insurance, experience of sickness, attitude and presence of medical doctors as well as distance from the healthcare facility all played a role in determining WTP. For pension schemes, low and flexible contribution rates, benefit package, government subsidies and quality of administration of the schemes influenced enrolment and contributions.Research limitations/implicationsMore evidence is needed for WTP for pensions among informal workers.Practical implicationsThe findings show that socio-economic differences, scheme-type (health or pension) and level of trust influence WTP for health insurance or pension among informal sector workers. The review results suggest that the factors influencing WTP for health insurance and pensions interplay in a complex web of relations. More evidence is needed on WTP for pensions among informal workers.Social implicationsFurther studies are particularly needed on the interrelationship of the influences to WTP, including gender issues, access barriers and socioeconomic factors, among program design issues for social security.Originality/valueThis paper is based on a systematic review methodology and contributes to the discourse on extending social security to informal economy workers based on evidence from various countries.

What are the costs of violence?

2017 ◽  
Vol 16 (4) ◽  
pp. 422-445 ◽  
Author(s):  
Anke Hoeffler
Keyword(s):  
Domestic Violence ◽  
Interpersonal Violence ◽  
Partner Violence ◽  
Middle Income ◽  
Middle Income Countries ◽  
Use Of Resources ◽  
Global Cost ◽  
One Year ◽  
Effective Use ◽  
The Cost

This article presents estimates of the global cost of collective and interpersonal violence for the period of one year. This includes war, terrorism, homicides, assaults and domestic violence against women and children. The cost of conventionally defined interpersonal violence, that is, homicides and assault, are about 7.5 times higher than the cost due to war and terrorism. I also estimate the costs of non-fatal domestic violence against children and women and suggest that these costs are much higher than the combined costs of homicide, assault, terrorism and war. The main reason is that the prevalence of these types of violence is very high: possibly as many as 16 per cent of all children are punished using violent methods and about 12 per cent of all women experience intimate partner violence. Richer societies have lower levels of violence, and there is evidence that prevalence rates have been declining over time. However, it is often unclear why this is the case. Much of the evidence from violence reducing interventions comes from high-income countries, and it is uncertain whether these programs would be similarly effective in low- and middle-income countries. However, although further research is needed to examine the effectiveness of violence-reducing interventions, it appears likely that some interventions would constitute a very effective use of resources.

scholarly journals Predictors of Delayed Entry into Medical Care of Children Diagnosed with HIV Infection: Data from an HIV Cohort Study in India

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Gerardo Alvarez-Uria ◽  
Praveen Kumar Naik ◽  
Manoranjan Midde ◽  
Raghavakalyan Pakam
Keyword(s):  
Cohort Study ◽  
Medical Care ◽  
Female Gender ◽  
Hiv Care ◽  
Hiv Diagnosis ◽  
Middle Income ◽  
Delayed Entry ◽  
Middle Income Countries ◽  
Scheduled Castes ◽  
One Year

Data about the attrition before entry into care of children diagnosed with HIV in low- or middle-income countries are scarce. The aim of this study is to describe the attrition before engagement in HIV medical care in 523 children who were diagnosed with HIV from 2007 to 2012 in a cohort study in India. The cumulative incidence of children who entered into care was 87.2% at one year, but most children who did not enter into care within one year were lost to followup. The mortality before entry into care was low (1.3% at one year) and concentrated during the first three months after HIV diagnosis. Factors associated with delayed entry into care were being diagnosed after mother’s HIV diagnosis, belonging to scheduled castes, age <18 months, female gender, and living >90 minutes from the HIV centre. Children whose parents were alive and were living in a rented house were at a higher risk of delayed entry into care than those who were living in an owned house. The results of this study can be used to improve the linkage between HIV testing and HIV care of children diagnosed with HIV in India.

scholarly journals The health sector cost of different policy responses to COVID-19 in low- and middle- income countries

2020 ◽  
Author(s):  
Sergio Torres Rueda ◽  
Sedona Sweeney ◽  
Fiammetta Bozzani ◽  
Anna Vassall
Keyword(s):  
Health System ◽  
Health Sector ◽  
Fiscal Impact ◽  
Middle Income ◽  
Middle Income Countries ◽  
Policy Responses ◽  
Bed Capacity ◽  
One Year ◽  
The Impact ◽  
Low And Middle Income

Much attention has focussed in recent months on the impact that COVID-19 has on health sector capacity, including critical care bed capacity and resources such as personal protective equipment. However, much less attention has focussed on the overall cost to health sectors, including the full human resource costs and the health system costs to address the pandemic. Here we present estimates of the total costs of COVID-19 response in low- and middle-income countries for different scenarios of COVID-19 mitigation over a one year period. We find costs vary substantially by setting, but in some settings even mitigation scenarios place a substantial fiscal impact on the health system. We conclude that the choices facing many low- and middle- income countries, without further rapid emergency financial support, are stark, between fully funding an effective COVID-19 reponse or other core essential health services.

scholarly journals Cost-effectiveness of COVID-19 vaccination in low- and middle-income countries

2021 ◽  
Author(s):  
Mark J. Siedner ◽  
Christopher Alba ◽  
Kieran P. Fitzmaurice ◽  
Rebecca F. Gilbert ◽  
Justine A. Scott ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Vaccine Coverage ◽  
Economic Benefits ◽  
Middle Income ◽  
Vaccination Programs ◽  
Middle Income Countries ◽  
One Year ◽  
The Cost ◽  
Benefits And Costs ◽  
Low And Middle Income

Despite the advent of safe and highly effective COVID-19 vaccines, pervasive inequities in global distribution persist. In response, multinational partners have proposed programs to allocate vaccines to low- and middle-income countries (LMICs). Yet, there remains a substantial funding gap for such programs. Further, the optimal vaccine supply is unknown and the cost-effectiveness of investments into global vaccination programs has not been described. We used a validated COVID-19 simulation model8 to project the health benefits and costs of reaching 20%-70% vaccine coverage in 91 LMICs. We show that funding 20% vaccine coverage over one year among 91 LMICs would prevent 294 million infections and 2 million deaths, with 26 million years of life saved at a cost of US$6.4 billion, for an incremental cost effectiveness ratio (ICER) of US$250/year of life saved (YLS). Increasing vaccine coverage up to 50% would prevent millions more infections and save hundreds of thousands of additional lives, with ICERs below US$8,000/YLS. Results were robust to variations in vaccine efficacy and hesitancy, but were more sensitive to assumptions about epidemic pace and vaccination costs. These results support efforts to fund vaccination programs in LMICs and complement arguments about health equity, economic benefits, and pandemic control11.

The Healthcare Financing and Health Outcomes in Zambia

2019 ◽  
pp. 65-86 ◽  
Author(s):  
Ali Syed ◽  
Urooj Afshan Jabeen
Keyword(s):  
Health Outcomes ◽  
Health Expenditure ◽  
Social Insurance ◽  
Government Expenditure ◽  
Healthcare Financing ◽  
Middle Income ◽  
Healthcare Facilities ◽  
Middle Income Countries ◽  
Capita Health Expenditure ◽  
To Receive

This chapter aims to find out the sources of healthcare financing in Zambia to provide health facilities for protecting the people's right to receive healthcare and to know the health outcomes. The study revealed that significant progress is made in addressing the MDGs of health. But the achievement is less than the targets. The total health expenditure and the per capita health expenditure is less than other middle-income countries and the global average. The percent of government expenditure on healthcare to total government expenditure is also less than the target. The donor financing and out-of-pocket health expenditure are higher than the limit suggested by WHO. The private medical insurance and social insurance schemes are still in the initial stages of development. There is regional inequality in the healthcare facilities.

scholarly journals Training the Next Generation of Academic Global Neurosurgeons: Experience of the Association of Future African Neurosurgeons

2021 ◽  
Vol 8 ◽  
Author(s):  
Ulrick Sidney Kanmounye ◽  
Yvan Zolo ◽  
Stéphane Nguembu ◽  
Francklin Tétinou ◽  
Lorraine Arabang Sebopelo ◽  
...  
Keyword(s):  
Research Capacity ◽  
Primary Objective ◽  
Research Experience ◽  
Middle Income ◽  
Middle Income Countries ◽  
Scholarly Output ◽  
Research Collaborations ◽  
Research Cycle ◽  
Set Up ◽  
One Year

Introduction: Although the past decade has seen a substantial increase in African neurosurgeons' academic productivity, productivity remains low compared to their colleagues from other regions. Aspiring neurosurgeons can contribute to the academic neurosurgery workforce by taking care of less technical and time-consuming research tasks. Fortunately, global neurosurgery institutions have also made efforts to increase research exposure and scholarly output in academic global neurosurgery. The Association of Future African Neurosurgeons (AFAN) created a research incubator for aspiring academic global neurosurgeons in Africa to provide enrollees with mentorship, skills, and experience. This study assesses and reports the activities and results of the research incubator.Methods: Aspiring academic global neurosurgeons were enrolled in the AFAN Research Incubator Program (ARIP), whose primary objective was to provide enrollees with foundational skills in all aspects of the research cycle. ARIP enrollees participated in didactic and practical activities with the aim of publishing ≥1 article and presenting ≥1 abstracts at international conferences in one year.Results: Fifteen AFAN members aged 25.0 ± 3.0 years enrolled in ARIP: 7 (46.7%) medical students, 4 (26.7%) general practitioners, and 4 (26.7%) residents. Eleven (73.3%) were male, 6 (40.0%) were from Cameroon and 6 (40.0%) had no previous research experience. Two (13.3%) enrollees dropped out. ARIP enrollees published a total of 28 articles, and enrollees published a median of 1.0 (IQR = 2) first-author articles on neurosurgical system strengthening. Additionally, ARIP enrollees presented 20 abstracts with a median of one abstract (IQR = 3.0).Conclusion: South-South research collaborations like ARIP can contribute to improving global neurosurgery research capacity and output. These collaborations can set up the foundations for robust research in low- and middle-income countries.

scholarly journals Informal work in sub-Saharan Africa: Dead end or stepping-stone?

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Michael Danquah ◽  
Simone Schotte ◽  
Kunal Sen
Keyword(s):  
Sub Saharan Africa ◽  
Middle Income ◽  
Middle Income Countries ◽  
Lower Tier ◽  
Self Employment ◽  
Rapid Economic Growth ◽  
Job Opportunities ◽  
Dead End ◽  
Regulatory Barriers ◽  
Sub Saharan

Abstract Despite rapid economic growth in recent decades, informality remains a persistent phenomenon in the labor markets of many low- and middle-income countries. A key issue in this regard concerns the extent to which informality itself is a persistent state. Using panel data from Ghana, South Africa, Tanzania, and Uganda, this paper presents one of the very few analyses providing evidence on this question in the context of sub-Saharan Africa. Our results reveal an important extent of heterogeneity in the transition patterns observed for workers in upper-tier versus lower-tier informality. Given the limited alternative job opportunities available, particularly to those in lower-tier informal self-employment who often remain locked in a situation of inferior pay and conditions, specific policies that seek to enhance the livelihoods of workers in this most disadvantaged segment may be more relevant in the sub-Saharan context than policies that aim to reduce the regulatory barriers to formalization.

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