Esta pesquisa aborda a relação entre território e moeda. O objetivo central é analisar a relação entre a expansão territorial do crédito bancário e a desigualdade econômica inter-regional no Brasil contemporâneo (2000-2010). A hipótese subjacente é que a redução das desigualdades econômicas inter-regionais favoreceu a expansão territorial do crédito bancário no país durante o período analisado. Para alcançar o objetivo e comprovar a hipótese central, a metodologia utilizada abarca uma análise teórica por meio do diálogo entre três das principais abordagens sobre o tema, a saber: marxista, pós-keynesiana e economia cultural. Além disso, analisamos o contexto histórico e apresentamos um estudo empírico, que abrange tanto as análises estatísticas de regressões temporais quanto as análises cartográficas. Os resultados principais da pesquisa mostram que as quebras das barreiras financeiras, sobretudo regulatórias e macroeconômicas, associadas com políticas sociais propiciaram um maior poder de compra em especial às populações de regiões com alta demanda reprimida, como também um maior acesso ao crédito para consumo para essas regiões. Isso acarretou no maior crescimento do crédito que o país já presenciou e também em uma significativa expansão territorial do crédito dos bancos comerciais.; This research addresses the relationship between territory and money. The main objective is to analyze the relationship between territorial expansion of bank credit and interregional economic inequality in contemporary Brazil (2000-2010). The underlying hypothesis is that the reduction of inter-regional economic inequalities favored the territorial expansion of bank credit in the country during the above period. To achieve the objective and prove the central hypothesis a methodology is used...
The relationship between the use of prenatal care and factors that may impede access to care was examined in a sample of low-income, inner-city women. Situational and financial barriers to care were not important correlates of utilization. In unadjusted analyses, only insurance status and employment status were associated with utilization. Of the sociodemographic characteristics studied, only parity was strongly associated with the use of prenatal care. When the apparent associations between utilization and insurance status and utilization and employment were analyzed controlling for parity, the estimated strength and statistical significance of these relationships diminished considerably. Multiparous women who were more likely than primiparous women to be underutilizers were also more likely to be on medical assistance and to be unemployed. These findings suggest that situational and financial barriers are not important correlates of utilization for low-income, adult women living in urban areas where there are accessible clinic facilities and public transportation. Efforts to identify and surmount other kinds of barriers may prove to be a more effective approach to prenatal outreach for women in these circumstances.
This study investigates the impact of subsidising community-based health insurance (mutuelle) enrolment, removing point-of-service co-payments, and improving service delivery on health facility utilisation rates in Mayange, a sector of rural Rwanda of approximately 25,000 people divided among five ‘imidugudu’ or small villages. While comprehensive service upgrades were introduced in the Mayange Health Centre between April 2006 and February 2007, utilisation rates remained similar to comparison sites. Between February 2007 and April 2007, subsidies for mutuelle enrolment established virtually 100% coverage. Immediately after co-payments were eliminated in February 2007, patient visits levelled at a rate triple the previous value. Regression analyses using data from Mayange and two comparison sites indicate that removing financial barriers resulted in about 0.6 additional annual visits for curative care per capita.
Along with the growing interest in greenhouse gas reduction, the effect of greenhouse gas energy reduction from implementing green buildings is gaining attention. The government of the Republic of Korea has set green growth as its paradigm for national development, and there is a growing interest in energy saving for green buildings. However, green buildings may have financial barriers that have high initial construction costs and uncertainties about future project value. Under the circumstances, governmental support to attract private funding is necessary to implement green building projects. The objective of this study is to suggest a financing model for facilitating green building projects with a governmental guarantee based on Certified Emission Reduction (CER). In this model, the government provides a guarantee for the increased costs of a green building project in return for CER. And this study presents the validation of the model as well as feasibility for implementing green building project. In addition, the suggested model assumed governmental guarantees for the increased cost, but private guarantees seem to be feasible as well because of the promising value of the guarantee from CER. To do this, certification of Clean Development Mechanisms (CDMs) for green buildings must be obtained.
This cross-sectional study examined potential demand-side barriers to women’s use of basic health services in rural southern Egypt (Upper Egypt). Face-to-face interviews with a structured questionnaire were carried out on 205 currently-married women, inquiring about their use of health facilities: regular antenatal care (ANC) during the last pregnancy and medical treatment services when they suffered from common illness. Questions about their perceptions of barriers to the use of health services were categorized into three primary dimensions: structural, financial, and personal/cultural barriers. Distance and transportation to health facilities (structural barriers) prevented about 30 % of the women from seeing a doctor. Forty-two percent of them felt the difficulty paying for health services (financial barriers). Approximately a quarter of women answered that gaining family permission, allocating time to go to health facilities, or concern about lack of female physicians (personal/cultural barriers) was a big problem for them. After controlling for potential confounding factors, structural barriers showed an inverse association with the use of health services. Financial barriers indicated a strong association (OR=0.18, P<0.001) with the use of curative services (medical treatment)...
This book deals with financial
liberalization issues in the context of trade negotiations.
The liberalization of trade and investment in financial
services is only a subset of the broader financial
liberalization agenda. The purpose of trade and investment
liberalization is to increase financial market access and
remove discriminatory and other access-impeding barriers to
foreign competition. By contrast, the main purpose of
financial liberalization is to remove distortions in
domestic financial systems that impede competition and the
allocation of capital to its most productive and profitable
uses. In turn, financial liberalization can be divided into
domestic financial reform and capital account opening, and
there is a rich literature on its appropriate speed and
sequencing. The first part of the book covers the
fundamental principles that affect trade liberalization in
financial services at both the multilateral and the regional
levels. It analyzes the various models of preferential trade
agreements (PTAs) used by negotiators and the architectural
differences of these models. The second part of this book
provides concrete examples of how countries have negotiated
these agreements by focusing on the specific country
experiences of Chile...
Using information from 193 banks in 58 countries, the authors develop and analyze indicators of physical access, affordability, and eligibility barriers to deposit, loan, and payment services. They find substantial cross-country variation in barriers to banking and show that in many countries these barriers can potentially exclude a significant share of the population from using banking services. Correlations with bank- and country-level variables show that bank size and the availability of physical infrastructure are the most robust predictors of barriers. Further, the authors find evidence that in more competitive, open, and transparent economies, and in countries with better contractual and informational frameworks, banks impose lower barriers. Finally, though foreign banks seem to charge higher fees than other banks, in foreign dominated banking systems fees are lower and it is easier to open bank accounts and to apply for loans. On the other hand, in systems that are predominantly government-owned, customers pay lower fees but also face greater restrictions in terms of where to apply for loans and how long it takes to have applications processed. These findings have important implications for policy reforms to broaden access.
This paper provides empirical evidence
regarding the performance of community-based health care
financing in terms of (a) social inclusion and (b) financial
protection. Five non-standardized household surveys were
analyzed from India (two samples), Senegal, Rwanda, and
Thailand. Common methodology was applied to the five data
sets. Logistic regression was used to estimate the
determinants of enrolling in a community financing scheme. A
two-part model was used to assess the determinants of
financial protection: part one used logistic regression to
estimate the determinants of the likelihood of visiting a
health care provider; part two used ordinary least-squares
regression to estimate the determinants of out-of-pocket
payments. The research finds: (a) Social inclusion. The
findings suggest that community financing can be inclusive
of the poorest even in the most economically deprived
context. Nevertheless, this targeting outcome is not
automatically attributable to the involvement of the
community; rather it depends on key design and
implementation characteristics of the schemes. (b) Financial
protection. Community financing reduces financial barriers
to health care as demonstrated by higher utilization and
simultaneously lower out-of-pocket expenditure of scheme
members controlling for a range of socioeconomic variables.
The paper concludes: (a) Social inclusion. Design and
implementation characteristics of community financing
schemes matter to achieve good targeting outcome-community
involvement alone does not guarantee social inclusion.
Further research is needed to delineate which design and
implementation characteristics allow better inclusion of the
poor. (b) Financial protection. Prepayment and risk sharing...
This policy paper explores the relative
importance of the software regulatory barriers to growth in
Pakistan. Such software barriers have been identified as
part of the major constraint in the Framework for Economic
Growth of the Government of Pakistan. Indeed, adequate
software is needed to provide an environment in which the
hardware of growth (physical infrastructure) could be
expanded and made more productive. Among possible software
constraints, the findings of various international surveys
allow to disentangle the relative importance of multiple
possible regulatory barriers; first by identifying what is
in the books, and then by assessing what is actually
experienced on the ground by entrepreneurs. Following the
ensuing prioritization of the identified barriers, this
paper suggests that the new growth strategy would benefit
from focused policy efforts in seven key areas, where
regulatory barriers and perceived obstacles are most
constraining to business development: getting electricity,
Improvement of energy efficiency is one
of the main options to reduce energy demand and to reduce
greenhouse gas emissions in Ukraine. However, large-scale
deployment of energy efficient technologies has been
constrained by several financial, technical, information,
behavioral, and institutional barriers. This study assesses
these barriers through a survey of 500 industrial and
commercial firms throughout Ukraine. The results from the
survey were used in a cumulative multi-logit model to
understand the importance of the barriers. The analysis
shows that financial barriers caused by high upfront costs
of energy efficient technologies, higher costs of finance,
and higher opportunity costs of energy efficiency investment
are key barriers to the adoption of energy efficiency
measures in Ukraine. Institutional barriers particularly
lack government policies, which also contributes to the slow
adoption of energy efficient technologies in the country.
The results suggest targeted policy and credit enhancements
could help trigger adoption of energy efficient measures.
The empirical analysis shows strong inter-linkages among the
barriers and finds heterogeneity between industrial and
commercial sectors on the realization of the barriers.
This update considers new findings since
the initial Stocktaking report, substantiating the
contribution of the private sector, and of small and medium
enterprises (SMEs) in particular, for new jobs and
investment. These findings further illustrate the key role
access to finance plays in SMEs abilities and willingness
to add jobs including the special circumstances of
fast-growing SMEs, or gazelles. The new findings further
detail availability and gaps in SME financing, including for
specific subsectors such as women-owned firms and
agri-enterprises. New trends include progress made in recent
years to improve financial markets infrastructure, and
expanded lending in countries such as China, which have made
progress in this area. The findings also include key private
sector innovations pioneered by the SME Finance Challenge
winners and other private sector institutions, focusing on
key sector opportunities (such as agribusiness and energy),
product innovation (such as expanded local currency
options), and risk management alternatives. The new findings
and trends highlight the potential of collaborative
platforms that have emerged from the G-20/GPFI (Global
Partnership for Financial Inclusion) process to combine
resources to improve SME access to finance...
Background: The cost of dental care may be a barrier to regular dental attendance with the proportion of the Australian population avoiding or delaying care due to cost increasing since 1994. This paper explores the extent to which age, period and cohort factors have contributed to the variation in avoiding or delaying visiting a dentist because of cost. Methods: Data were obtained from four national dental telephone interview surveys of Australian residents aged five years and over conducted in 1994, 1999, 2004 and 2010 (response rates 48% - 72%). The trend in the percentage of persons avoiding or delaying visiting a dentist because of cost was analysed by means of a standard cohort table and more formal age-period-cohort analyses using a nested models framework. Results: There was an overall increase in the proportion of people avoiding or delaying visiting a dentist indicating the presence of period effects. Financial barriers were also associated with age such that the likelihood of avoiding because of cost was highest for those in their mid-late twenties and lowest in both children and older adults. Cohort effects were also present although the pattern of effects differed between cohorts. Conclusion: The findings of this study suggest that...
Ghana has committed politically,
legislatively, and fiscally to providing universal health
insurance coverage for its population with the intent of
reducing financial barriers to utilization of health care.
In 2005, we launched a publically financed comprehensive
health benefits package that included within it preventive
care and treatment for communicable and non communicable
diseases. To attain universal coverage requires addressing
the health system holistically. The Ghana health sector is
going through a comprehensive set of reforms. The National
Health Insurance Scheme (NHIS) is a major step forward.
Reforms in the area of human resources have helped reduce
attrition, especially of physicians. Decentralization and a
policy on retention and use of internally generated
insurance funds have ensured a better availability of drugs
and incentivized staff in health facilities. The Ghana
health sector, like those in all emerging market countries,
is, however, facing challenges on many fronts. Health
outcomes are not on track to meet several of the
health-related Millennium Development Goals...
During the 2007 spring meetings, the
development committee endorsed the World Bank Group's
action plan on the Clean Energy Investment Framework (CEIF).
This progress report is a response to the committee's
request for an update on the implementation of the action
plan for the annual meetings in October 2007. It summarizes
accomplishments in the three areas of the action plan: 1)
energy for growth, with a particular emphasis on access to
energy in Sub-Saharan Africa; 2) transition to a low-carbon
development trajectory; and 3) adaptation to the impacts of
climate change. This report also outlines an approach to
scaling up actions on climate change and provides a review
of options to further reduce the financial barriers to
support low-carbon and adaptive growth in developing
countries. This Progress Report provides an update on the
implementation of the CEIF action plan.
To address the growth in resultant
out-of-pocket (OOP) payments and associated problems of
financial barriers to access, the government issued several
policies aimed at expanding coverage throughout the 1990s
and 2000s, particularly for the poor and other vulnerable
groups. Universal coverage (UC) can be an elusive concept
and is about three objectives: (a) equity (linking care to
need, and not to ability to pay); (b) financial protection
(ensuring that health care use does not lead to
impoverishment); (c) effective access to a comprehensive set
of quality services (ensuring that providers make the right
diagnosis and prescribe a treatment that is appropriate and
affordable; and (d) to ensure that the financing needed to
achieve UC is mobilized in a fiscally sustainable manner,
and is used efficiently and equitably. The objective of this
report is to assess the implementation of Vietnam social
health insurance (SHI) and provide options for moving toward
UC, with a view to contributing to the law revision process.
It analyzes progress to date on the two major goals of the
master plan. The report assesses Vietnam's readiness to
meet these goals...
This report provides a summary of Energy
Sector Management Assistance Program (ESMAP) supported
activities in Mexico focused on the creation of a pooled
financing program for multiple energy efficiency projects
through a single debt instrument. The report is organized as
eight chapters. Chapter one provides additional details
regarding the ownership, structure and operation of an
special purpose entity (SPE); it discusses the flexibility
of this structure and how it can serve a pool of private or
public sector projects. Chapter two provides an overview of
the Mexican energy sector with a focus on the electricity
supply, demand and pricing. Chapter three reviews the market
potential for energy efficiency investments and provides
comparative data on Mexico's energy prices and costs of
capital in other countries where the energy efficiency and
energy services company (ESCO) market is active. Chapter
four reviews the current financial market conditions in
Mexico, and the restrictive nature of commercial lending.
Chapter five identifies the market...
This case study describes and assesses Jamkesmas, Indonesia's government-financed health coverage program for the poor and near-poor. It provides a detailed description of the scope, depth, and breadth of coverage provided under Jamkesmas, and highlights ways in which the program interacts with the rest of Indonesia's health system. It also summarizes and discusses evidence on whether Jamkesmas is attaining its stated objectives of removing financial barriers and improving access to health care by the poor and near-poor, what could be improved, and what lessons can be learned from the experience of Jamkesmas that could help inform Indonesia's quest for universal coverage. The primary theme underlying the study is that supply-side constraints and supply-side subsidies have not been leveraged to increase the effectiveness of the Jamkesmas program. There are significant geographic deficiencies in the availability and quality of the basic benefits package, especially for those living in relatively remote and rural locations of the country, and this limits the effective availability of benefits for many Jamkesmas beneficiaries. The remainder of the case study is organized as follows. Section two provides general background and information on health system outcomes in Indonesia. Section three is an overview of health care financing and delivery. Section four describes the institutional architecture of Jamkesmas. Section five highlights the process of targeting...
Financial barriers to seeking care are
frequently cited as one of the main causes of
underutilization of child health care services. This paper
estimates the impact of Indonesia's healthcard on
health care use by children. Evaluation of the healthcard
effect is complicated by the fact that card allocation was
non-random. The analysis uses propensity score matching to
control for systematic differences between treatment and
control groups. A second potential source of bias is related
to contemporaneous, exogenous influences on health care use
unrelated to the healthcard itself. Using panel data
collected prior to and after the introduction of the
healthcard, a difference-in-differences estimator is
constructed to eliminate the effects of exogenous changes
over time. The author finds that although health care use
declined for all children during the crisis years of
1997-2000, use of public sector outpatient services declined
much less for children with healthcards. The protective
effect of the healthcard on public sector use was
concentrated among children aged 0-5 years. The healthcard
had no significant impact on use of private sector services.
The results highlight the need to provide adequate
protection against the financial burden of health care
Objectives. Low-income families may face financial barriers to management and treatment of chronic illnesses. No studies have explored how low-income individuals and families with anaphylactic food allergies cope with financial barriers to anaphylaxis management and/or treatment. This study explores qualitatively assessed direct, indirect, and intangible costs of anaphylaxis management and treatment faced by low-income families. Methods. In-depth, semistructured interviews with 23 participants were conducted to gain insight into income-related barriers to managing and treating anaphylactic food allergies. Results. Perceived direct costs included the cost of allergen-free foods and allergy medication and costs incurred as a result of misinformation about social support programs. Perceived indirect costs included those associated with lack of continuity of health care. Perceived intangible costs included the stress related to the difficulty of obtaining allergen-free foods at the food bank and feeling unsafe at discount grocery stores. These perceived costs represented barriers that were perceived as especially salient for the working poor, immigrants, youth living in poverty, and food bank users. Discussion. Low-income families report significant financial barriers to food allergy management and anaphylaxis preparedness. Clinicians...
This is the final version. It was first published by Elsevier in Appetite at http://www.sciencedirect.com/science/article/pii/S0195666314004413.; Background: Beyond quantity, variety of fruit and vegetable (FV) intake prevents chronic conditions and is widely recommended as critical to healthful eating. FV consumption is socially patterned, especially for women, but little is known about multiple economic determinants of variety or whether they differ from those of quantity.
Objective: To examine socioeconomic status and financial hardships in relation to variety and quantity of FV intakes among older British women and men.
Methods: Cross-sectional study of 9,580 adults (50?79 y) in the nationally representative EPIC cohort who responded to a postal Health and Life Experiences Questionnaire (1996-2000) and Food Frequency Questionnaire (1998-2002). Variety counted unique items consumed (items/month) and quantity measured total intake (g/d).
Results: No consistent differences by any economic factor were observed for quantity of fruits or vegetables, except education in men. Lower education, lower social class and renting were independently associated with lower fruit variety and vegetable variety (p-trend <0.001), with differences stronger in men. Mean vegetable variety differed between top and bottom social classes by 2.9 items/month for men and 2.5 for women. Greater financial hardships were also independently associated with lower variety...