rafmacalaba/data-use-mentions-extended huggingface dataset:
Policy Research Working Paper 9689

# **Abstract**

Containing rapidly growing health care costs in the Latin American and the Caribbean region, especially amid the COVID-19 pandemic, requires an in-depth analysis of prices from a novel perspective. This paper documents hitherto understudied variations in prices paid for pharmaceuticals, equipment, and medical supplies within countries and markets. It also identifies effective procurement strategies for lowering prices within existing regulatory frameworks. The analysis uses public procurement data gathered by governments’ electronic procurement systems in nine countries and territories across the region. The data are uniquely detailed and complete, encompassing the minute detail of purchasing decisions and processes made across all regulated public entities in the study countries and territories. Traditional regression analysis and machine learning (random forests) methods are used to explain prices as a function of procurement decisions and outputs, such as the number of bidders. Based on in-depth discussions with policy makers, the paper also devises realistic policy interventions, which in turn can be used to estimate savings scenarios. First, the findings show that the prices paid vary greatly across and within countries. The latter is surprising given that the regulatory and institutional framework is largely fixed within each country. Second, a high proportion of within-country and -market variation can be explained by standard features of procurement policy implementation, such as the length of advertising tenders. Third, the explanatory models point to the potential for lowering prices across the region by about 14 percent by implementing low-level, yet impactful changes to how purchasing is done.

This paper is a product of Latin America and the Caribbean Region. It is part of a larger effort by the World Bank to provide open access to its research and make a contribution to development policy discussions around the world. Policy Research Working Papers are also posted on the Web at http://www.worldbank.org/prwp. The authors may be contacted at aoliveira@worldbank.org.

_The Policy Research Working Paper Series disseminates the findings of work in progress to encourage the exchange of ideas about
considerable decline after 2000, coinciding with the country’s economic recovery and the implementation of Plan Colombia..Moreover, we use two quantitative methods to estimate the stock of laundered assets in the country’s economy. We ...rst use a calibration method based on a parameterization of the solution equation for laundered assets in the theoretical model. Next, we use a Kalman ...lter method for the estimation of an unobserved variable, which is an innovation in the crime literature.

To implement these quantitative methods, we develop a macroeconometric system of equations that is derived directly from the theoretical model. The system includes two equations: The ...rst one is a transition equation that speci...es the dynamic nature of asset laundering in the economy in terms of its determinants. The second is a measurement equation that represents the mechanisms through which asset laundering a¤ects the stock of physical capital in the economy. The estimable system is applied to data for Colombia in the period 1985 to 2013 in order to estimate the volume of assets and money laundered in this economy. We see our contribution as a ...rst step to measure and quantify these elusive unobservable but relevant variables for any economy.

On a normative perspective, we expect that this study can contribute to improve the country’s regulatory, preventive and anti-criminal systems by providing an economic analysis of the incentives, mechanisms, and e¤ects of illicit activities. Likewise, it can contribute by quantifying the size and e¤ects of illicit income and corresponding money laundering in the economy. Finally, the model and 3
The results strongly suggest a moderate negative effect on informality when _SP_ is deployed in a given municipality. The results are very similar across the two columns, and indicate that the introduction of _SP_ increases informality by about 0.7 percentage points, which amounts to an additional 1.5 percent of the baseline level.

We next assess the robustness of our results to the introduction of random and individual fixed effects (Columns 3 and 4, respectively), making full use of the longitudinal nature of the data. It should be emphasized that this identification strategy is very demanding, as it is based on comparing the change in the probability of being formal of a _given household_ around the introduction of _SP_ in a given municipality. Because we can follow households during at most five quarters, our windows of observation around given thresholds are small. The advantage of this methodology is that it ensures that we compare the same households over time and therefore that the results are not due to composition effects resulting from aggregating different households over time—or due to the migration of individuals with a higher probability of being informal toward locations with _SP_ . This aspect is particularly important because household surveys in Mexico are not designed to be representative at the municipality level. This implies that cross sectional estimates may suffer from the aggregation at the municipality level of non-representative averages over time, a problem avoided with fixed effects estimates, as they are based on comparing the behavior of given households over time. Given their superior possibilities to control for unobservables and make good use of existing data, most of our results are inferred from estimates that take full advantage of the longitudinal nature of the survey.

The results for the random and fixed effects model yield very similar coefficients and in both cases about half the ones obtained in the cross sectional model. Thus, the coefficient of _SP_ is negative and statistically significant and it indicates a magnitude of the impact of 0.4 percentage points. Nonetheless, the Hausmann test rejects the null hypothesis of equality between random and fixed effects.
Figure 2: Children’s highest grade completed, by five-year birth cohort <!-- Start of picture text --> a.Comoros b.Ghana c.Guinea<br>1939 1949 1959 1969 1979 1948 1958 1968 1978 1988 1937 1947 1957 1967 1977<br>5−years birth cohorts 5−years birth cohorts 5−years birth cohorts<br>d.Madagascar e.Malawi f.Nigeria<br>1940 1950 1960 1970 1980 1946 1956 1966 1976 1986 1946 1956 1966 1976 1986<br>5−years birth cohorts 5−years birth cohorts 5−years birth cohorts<br>g.Rwanda h.Tanzania i.Uganda<br>1935 1945 1955 1965 1975 1945 1955 1965 1975 1985 1941 1951 1961 1971 1981<br>5−years birth cohorts 5−years birth cohorts 5−years birth cohorts<br>No education (Son) Primary (Son) Secondary (Son) Tertiary (Son)<br>No education (Daughter) Primary (Daughter) Secondary (Daughter) Tertiary (Daughter)<br>100 100 100<br>75 75 75<br>50 50 50<br>Proportion 25 Proportion 25 Proportion 25<br>0 0 0<br>100 100 100<br>75 75 75<br>50 50 50<br>Proportion 25 Proportion 25 Proportion 25<br>0 0 0<br>100 100 100<br>75 75 75<br>50 50 50<br>Proportion 25 Proportion 25 Proportion 25<br>0 0 0<br><!-- End of picture text -->

# **5 Results**

We present the estimates of the two intergenerational educational persistence measures, intergenerational elasticity ( _β_<sup>ˆ</sup> ) and the correlation coefficient (ˆ _ρ_ ), in six stages. First, we present our baseline estimates at the country level using a pooled sample of all children in each
with information on inter-firm relationships and firm-level information for the period 2012 to 2021. These multi-country firm-level data cover buyer-supplier relationships, thereby allowing us to inspect for evidence of dissemination of green technologies across global value chains. Furthermore, they contain information on innovation partnerships between firms.

The textual analysis of earnings conference calls transcripts points to a rapidly growing importance of green technologies after 2019, as revealed by a rapid increase in the share of ECTs mentioning keywords associated with specific green technologies, as well as in the set of firms that have ECTs mentioning these green technologies. This rise is primarily driven by a few green technologies, including construction material, carbon capture technology, hybrid/electric vehicles, and wind turbines, which tend to be mentioned together in the same ECT. It is concentrated in firms operating in a few industries—notably manufacturing and utilities—and among larger firms within sectors. We also find evidence of an increased geographical spread in the location of these green firms, with a growing presence in large emerging countries in Asia, Latin America, and the Middle East and North Africa, in addition to North America and Europe. Importantly, we find that high-emissions firms that mention green technologies in their ECTs are significantly more likely to observe a subsequent reduction in their carbon emissions, which supports the hypothesis that ECTs capture firm investments in green technologies among these firms.

We then examine the extent to which the diffusion of green technologies between firms is shaped by firm-to-firm linkages, notably buyer-supplier relationships and innovation partnerships. We find robust evidence that suppliers and buyers of firms that mention green technology keywords in their earnings calls are significantly more likely to mention them as well in their own ECTs. These effects are especially relevant when firms are linked to high-emissions firms that mention green technologies in their own ECTs. Our data consists mainly of multinational enterprises (MNEs), but we also find some evidence of diffusion of green technologies through firms-to-firm linkages to (and from) firms that are not MNEs.

In addition to the papers cited above,
_Social Capital, Household Welfare and Poverty in Indonesia_ 8 A recent study by Narayan and Pritchett (1997) has demonstrated econometrically that the ownership of social capital by households in Tanzania has strong effects on households' welfare. The study found that the magnitude of the estimated effect exceeds that of education and physical assets owned by the household. It also concluded that the effects of social capital operate primarily at the village level. Instrumental variable methods were used to rule out reverse causation from income to social capital. The authors measured social capital as a single index, combining (interactively) the number of local groups in a village, kin and income heterogeneity, and effective group functioning. The relevance of these aspects of social capital have been demonstrated in the literature. Putnam (1993) has suggested that it is the density of associations that primarily explains the difference in economic performance between North and South Italy. Other authors have focused on the nature of participation in groups and the structure of the groups (Uphoff, 1992; Narayan, 1995; Ostrom, 1995).

The Narayan/Pritchett study is a pioneering effort in the way different social capital dimensions are combined to estimate quantitatively their impact on household welfare based on a national-level household survey. The study's remarkable finding that in Tanzania social capital matters more for household welfare than human capital, constitutes a challenge to investigate this issue for other countries to assess how general this finding is. We undertake this task for Indonesia in this paper, and for Bolivia and Burkina Faso in companion papers (Grootaert and Narayan, 1999; Grootaert, Oh and Swamy, 1999). However, in these papers, we go well beyond replication and extend the analysis in several directions, which will shed additional light on the way social capital embodied in local institutions affects household welfare.
connections of few firms lead to political privileges, such as subsidies or regulatory protection, shielding these firms from competition and potentially reducing long-term growth.<sup>10</sup> We contribute to this literature by focusing on the impact of enforcing the elimination of regulatory barriers to market entry and competition that are inconsistent with national legislation on establishment productivity and markups within the controlled institutional environment of a single country. For this, we construct a unique data set of eliminated barriers to entry across 1,800 municipalities in Peru merged with establishment census panel data from 2008-15. The unique reform of Peru’s competition agency’s legal mandate further warrants that the roll-out of eliminated barriers can be considered as exogenous since the case against a specific municipality could only be made for a specific regulation that had already been confirmed as illegal based on the complaint of an individual firm elsewhere.

Importantly, a growing literature discussing shortcomings in the measurement of firm productivity is relevant for this study. Foster, Haltiwanger, and Syverson (2008) use U.S. data with information on producer-level quantities and prices to distinguish physical productivity from revenue productivity which is derived by deflating firms’ revenues with industry-level prices. They show that revenue productivity is positively correlated with firms’ markups which undermines the identification of the impact of regulatory reforms on firms’ technical efficiency. In fact, both measures are only proportional under perfect competition. But market power due to product differentiation or rents results in markups, driving a wedge between physical and revenue productivity. And it has been well documented that market power due to product differentiation is ubiquitous (Katayama, Lu, and Tybout, 2009; De Loecker and Goldberg, 2014). The elimination of subnational regulatory barriers to market entry may thus result in higher (lower) markups as firms face more demand and may be better able to differentiate their products (face more price competition reducing local rents).

Against this background, De Loecker and Warzynski (2012) apply the control function approach of Ackerberg (2015)
child anthropometric indicators are typically considered to reflect shorter-term nutritional deprivation and morbidity, while stunting reflects longer-term conditions. It would therefore be useful for future research to examine lagged effects of gas flaring in prior years. It is important to note that our results may also be picking up other channels of pollution such as oil spillage which are rampant in this region, and which could adversely affect child growth through deleterious effects of on agricultural output.

Relatedly, an important caveat to associations between flaring and child health is that omitted variable bias may still be a problem. In future work, we will investigate the possibility of identifying a causal impact of pollution on health outcomes by comparing the health outcomes of siblings born to the same mother before and after flaring. Sometimes technical factors cause wells to stop flaring for a long period of time before resuming, and this gives an opportunity to compare outcomes of siblings born to the same mother before and after flaring for locations with long stoppages in flaring. By comparing siblings born to the same mother, we can control for a host of other unobservable characteristics that may confound the identification of the causal relationship between gas flaring and child health.

# 5. Conclusion

We use a newly available dataset on satellite detected gas flaring to examine the relationship between flaring and various child-health outcomes. Our results show a positive association between flaring and incidence of diseases (particularly cough, respiratory symptoms, and fever) and short-term nutritional outcomes (wasting and underweight). Our results are in line with earlier evidence from a smaller subset of flaring communities where flaring has been found to be associated with a host of diseases and poor agricultural production. Our analysis provides the first comprehensive overview of flaring and child health outcomes in the Niger-Delta region, one of the regions with the highest flare activity in the world and where earlier efforts to examine the impact of flaring activity were limited due to the lack of data. While the methods described above can be used to show an association between flaring and human health, omitted variable bias may still
In table 5, we first present the regressions including each set of BE indicators (ES, DB, and GC) separately,<sup>14</sup> and then pull all three sets of BE indicators together to compare the explanatory power of each set of BE indicators. Here, we control only for several basic countrylevel controls; we do not control for country fixed effects because the _Doing Business_ and the Global Competitiveness indicators are collinear with the country fixed effects.The results that contain the coefficients of the firm- and country-level controls are presented in appendix table A1. The patterns of the BE effects tend to be quite similar when using TFP instead of log labor productivity (log LP), although the sample size is smaller (less than half). Our discussion thus centers on log LP.

All three groups of BE indicators have independent explanatory power, but the Enterprise Survey indicators have a slight edge. In terms of adjusted R-squared, the specification with the Enterprise Survey indicators has the highest explanatory power among the three groups, closely followed by the Global Competitiveness indicators: see columns (1) to (3) and (5) to (7). In unreported specifications that are otherwise identical except excluding all BE indicators, the adjusted R-squareds are 0.050 for the employment growth specification and 0.302 for the log LP specifications. In terms of incremental changes in adjusted R-squared, the Enterprise Survey specification again has an edge, surpassing specifications relying on the _Doing Business_ or the Global Competitiveness indicators by more than 100 percent.<sup>15</sup> Moreover, the qualitative results for each group of indicators tend to be similar when they are entered alone and when they are entered jointly with other groups of indicators, indicating a reasonable amount of independent variations for each group of BE indicators.

Competition is associated with lower employment growth and higher productivity. Compared to firms that report no competitors, those facing one or more competitors have lower employment growth. In contrast, relative to
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their illness.<sup>25</sup> Given these patterns, we conclude that a soft-skills channel alone is unlikely to account for the impacts we observe.

# **5 Conclusion**

Consistent with research in other low-income settings, we document significant gaps in the quality of malaria care at Malian medical clinics. These gaps are especially striking given that easy-to-administer, low-cost rapid diagnostic tests (RDTs) for malaria are readily available.

We present descriptive and experimental evidence that providers’ beliefs about the quality of RDTs are part of the problem. Before the intervention, health workers were too pessimistic regarding the tests’ accuracy. We evaluate the impact of an information intervention that provided information to health providers about RDTs’ accuracy using data from quality assurance testing and field research in a Malian setting. In response, providers positively updated their beliefs about RDT accuracy.

Importantly, beliefs translated into diagnostic and treatment outcomes. First, we find changes in testing behavior that indicate providers were more comfortable relying on RDTs to establish a malaria diagnosis. Second, we find evidence that this led to improved quality – of care post-consultation, the match between underlying malaria status and prescribed treatment improved significantly. We estimate that the share of patients receiving the “right” malaria treatment (an antimalarial if malaria positive, no antimalarial if malaria negative) increased by 7-13 percentage points at treated clinics, relative to the 41-44 percent rate of correct treatment in the comparison group.

Despite these benefits, our results also highlight important risks of health information interventions, associated with the incorrect (and persistent) beliefs of _patients_ . First, even though the extended provider training improved patient knowledge, demonstrated by their increased ability to predict the outcome of their home malaria RDT, the training reduced patient satisfaction by 0.09 standard deviation units, with evidence that this effect was concentrated among patients who had incorrect pre-consultation beliefs about their underlying malaria status. Second, an intensive, one-on-one patient-centered information intervention designed to increase demand for correct diagnosis of malaria (via malaria tests
categorizing aggregate sectors into four categories, based on a combined assessment of market structure characteristics and public policy objectives: finance, commercial sectors, strategic sectors (oil, mining), and utilities (gas, water, electricity). Nyman, Dauda and Koschorke (2018) analyze along similar lines the economic rationale for state presence of South Africa’s state-owned enterprises across 40 vertically integrated markets. Dauda and Drozd (2020) present the economic rationale for state participation in 44 sectors captured in the 2018 vintage of the Product Market Regulation indicators.

> 5 The Statistical Classification of Economic Activities in the European Community, referred to as the NACE classification, is the industry standard classification system used in the European Union to classify economic activities.

4
a lack of privacy causes women to underreport, then the prevalence differences seen in this more private study setting between face-to-face and the two more private methods are likely to be smaller than the differences that might be observed in standard interview settings.

> 14Sectors are administrative units two levels below province, and 2 levels above village. Within the selected sectors, existing VSLAs were identified in 128 villages. The researchers ruled out 30 villages with fewer than three VSLAs each, and villages that were very close. This was done to minimize the risk of cross-village contamination for the separate randomized controlled trial, detailed in the RCT pre-analysis plan (Alik-Lagrange et al., 2017). Within the 98 study villages, the final sample included 2,042 intervention-eligible couples where at least one partner was a member of a VSLA, and 686 couples who were community members selected at random from a village household roster and who were ineligible for the intervention. VSLA couples’ treatment status was assigned by the research team only after baseline surveys were completed. Assignment was based on their ranking in a public lottery process that they applied to. The intervention, called ‘Indashyikirwa 2’, is a weekly couples group discussion that encourages couples to question traditional gender norms and build communication skills. Data were collected from December 2017 to February 2018.

> 15When all respondents reached the main section on IPV (which was to be asked through ACASI), they were shown how to use the ACASI module on the tablet and then instructed through practice questions. After the enumerator was satisfied that the respondent could use ACASI, respondents were left to answer the module while the enumerator stood approximately 5 meters away. Over 95% of female respondents and 98% of male respondents got the first ACASI practice question correct. After being assisted again, 99% of male and female respondents were able to answer the ACASI module in a way that maintained their privacy but with some support, for example, if they could not touch the tablet screens, they listened in the headphones and