Showing papers by "Dean T. Jamison published in 2008"

The burden of surgical conditions and access to surgical care in low- and middle-income countries

Abstract: Surgery is an essential component of health systems but has generally been neglected within global public health. This is despite growing evidence documenting the cost-effectiveness of essential surgical care in low- and middle-income countries (LMICs).1 The overall burden of disease that may be cured, palliated or treated with surgical intervention is large and (probably) rapidly growing, and this concept must therefore be revisited. There are major gaps in knowledge related to surgery in LMICs. What exactly is the burden and distribution of surgical conditions in LMICs? What is the unmet surgical need? What resources (human, financial, physical) are required to improve access to surgical care? What impact would this have on global health disparities, and how does this compare with other interventions? How can essential surgical services be integrated into health systems’ surveillance and evaluation? This paper outlines a research agenda and argues that enough is already known to justify accelerated action.

Education and economic growth

Abstract: This article reviews the role of education in promoting economic growth, with a particular focus on the role of educational quality. It concludes that there is strong evidence that the cognitive skills of the population - rather than mere school attainment - are powerfully related to long-run economic growth. The relationship between skills and growth proves extremely robust in empirical applications. The effect of skills is complementary to the quality of economic institutions. Growth simulations reveal that the long-run rewards to educational quality are large but also require patience.

Education and economic growth: It’s not just going to school, but learning something while there that matters

Abstract: Even before and certainly ever since the 1983 release of A Nation at Risk by the National Commission on Excellence in Education, national economic competitiveness has been offered as a primary reason for pushing school reform. The commission warned, "If only to keep and improve on the slim competitive edge we still retain in world markets, we must dedicate ourselves to the reform of our educational system for the benefit of all--old and young alike, affluent and poor, majority and minority." Responding to these urgent words, the National Governors Association, in 1989, pledged that U.S. students would lead the world in math and science achievement by 2000. According to the latest international math and science assessment conducted by the Organisation of Economic Co-operation and Development's (OECD) Programme for International Student Assessment (PISA) (see Figure 1), the United States remains a long distance from that target. Rather than worrying about the consequences, some have begun to question what all the fuss was about. Education researcher Gerald Bracey, for example, has argued that no one has "provided any data on the relationship between the economy's health and the performance of schools. Our long economic boom suggests there isn't one--or that our schools are better than the critics claim." Truth be told, the Bracey critique is not entirely misplaced. Most commentators rely more on the commonsense understanding that countries must have good schools to succeed economically rather than presenting conclusive empirical evidence that connects what students learn in school to what subsequently happens in a nation's economy. Even economists, the people who think the most systematically about the way in which "human capital" affects a nation's economic future, have skirted the heart of the question by looking only at "school attainment," namely the average number of years students remain in school. [FIGURE 1 OMITTED] Using average years of schooling as an indicator of a country's human capital has at least two major drawbacks. First and foremost, the approach assumes that students in diverse school systems around the world receive the same educational benefits from a year of schooling. A year of schooling in Papua New Guinea and a year of schooling in Japan are treated as equally productive. Second, this measure does not account for learning that takes place outside the classroom--within families, among peers, or via the Internet, for example. [FIGURE 1 OMITTED] A more direct measure of a country's human capital is the performance of students on tests in math and science, something that might be called the average level of "cognitive skills" among those entering a country's work force. At one time, internationally comparable information on student performance was not available for a sufficient number of countries over a long enough period of time to allow for systematic study, which is why economists relied upon the less informative measures of school attainment. Now that test-score data for many countries over an extended period of time are readily available, it is possible to supplement measures of educational attainment with these more direct measures of cognitive skills. In a series of studies conducted over several years, the four of us have explored the role of both school attainment and cognitive skills in economic growth. Beginning in the mid-1960s, international agencies started conducting tests of students' performance in mathematics and science at various grade levels. We used performance on 12 of these standardized tests as rough measures of the average level of cognitive skill in a given country. With this information, we could assess how human capital relates to differences in economic growth for 50 countries from 1960 to 2000, more countries over a longer period of time than any previous study. We were also able to pay close attention to institutional factors that influence economic growth, such as openness of the economy and protection of property rights. …

Education and economic growth: It’s not just going to school, but learning something while there that matters

Abstract: Even before and certainly ever since the 1983 release of A Nation at Risk by the National Commission on Excellence in Education, national economic competitiveness has been offered as a primary reason for pushing school reform. The commission warned, "If only to keep and improve on the slim competitive edge we still retain in world markets, we must dedicate ourselves to the reform of our educational system for the benefit of all--old and young alike, affluent and poor, majority and minority." Responding to these urgent words, the National Governors Association, in 1989, pledged that U.S. students would lead the world in math and science achievement by 2000. According to the latest international math and science assessment conducted by the Organisation of Economic Co-operation and Development's (OECD) Programme for International Student Assessment (PISA) (see Figure 1), the United States remains a long distance from that target. Rather than worrying about the consequences, some have begun to question what all the fuss was about. Education researcher Gerald Bracey, for example, has argued that no one has "provided any data on the relationship between the economy's health and the performance of schools. Our long economic boom suggests there isn't one--or that our schools are better than the critics claim." Truth be told, the Bracey critique is not entirely misplaced. Most commentators rely more on the commonsense understanding that countries must have good schools to succeed economically rather than presenting conclusive empirical evidence that connects what students learn in school to what subsequently happens in a nation's economy. Even economists, the people who think the most systematically about the way in which "human capital" affects a nation's economic future, have skirted the heart of the question by looking only at "school attainment," namely the average number of years students remain in school. [FIGURE 1 OMITTED] Using average years of schooling as an indicator of a country's human capital has at least two major drawbacks. First and foremost, the approach assumes that students in diverse school systems around the world receive the same educational benefits from a year of schooling. A year of schooling in Papua New Guinea and a year of schooling in Japan are treated as equally productive. Second, this measure does not account for learning that takes place outside the classroom--within families, among peers, or via the Internet, for example. [FIGURE 1 OMITTED] A more direct measure of a country's human capital is the performance of students on tests in math and science, something that might be called the average level of "cognitive skills" among those entering a country's work force. At one time, internationally comparable information on student performance was not available for a sufficient number of countries over a long enough period of time to allow for systematic study, which is why economists relied upon the less informative measures of school attainment. Now that test-score data for many countries over an extended period of time are readily available, it is possible to supplement measures of educational attainment with these more direct measures of cognitive skills. In a series of studies conducted over several years, the four of us have explored the role of both school attainment and cognitive skills in economic growth. Beginning in the mid-1960s, international agencies started conducting tests of students' performance in mathematics and science at various grade levels. We used performance on 12 of these standardized tests as rough measures of the average level of cognitive skill in a given country. With this information, we could assess how human capital relates to differences in economic growth for 50 countries from 1960 to 2000, more countries over a longer period of time than any previous study. We were also able to pay close attention to institutional factors that influence economic growth, such as openness of the economy and protection of property rights. …

Financing Health Improvements In India

Abstract: India faces major challenges in sustaining the health gains achieved in the better-performing states and ensuring that the lagging states catch up with the rest of the country. In this paper we examine the current status of health financing in India, as well as alternatives for realizing maximal health gains for the incremental spending. A principal conclusion is that public expenditures of an additional US$6–US$7 per person per year (about 1 percent of gross domestic product) would, if focused on about sixteen key interventions, provide universal access to those interventions and have a favorable affect on population health.