Nancy Nafula

Bio: Nancy Nafula is an academic researcher from Kenya Institute for Public Policy Research and Analysis. The author has contributed to research in topics: Poverty & Primary education. The author has an hindex of 12, co-authored 14 publications receiving 444 citations.

User charges and utilisation of health services in Kenya

Abstract: This paper uses data from Kenya to examine the role played by user charges and the quality of health services in determining the choice of health care providers. We find that an increase in the price of using public facilities diverts demand from public to private facilities. The associated reduction in demand for modern healthcare, captured by an increase in the use of self–treatment, is minimal. In contrast, a decline in the quality of services at public facilities leads to a sharp reduction in the use of these facilities and to additional reliance on the self–care alternative. These demand patterns suggest that a programme of increasing the quality of services and enhancing drug availability through cost-sharing may be more effective in meeting the healthcare needs of the population than a programme of fully subsiding health services at low standards of care. However, since improved health services entail higher costs of provision and use, targeted subsidies are required to ensure that the poor are not denied access to basic care. Difficulties in enforcing statutory fee exemptions at public health facilities in Kenya have created interest in social health insurance as a dominant mechanism for financing health care. Demand effects of social insurance are briefly discussed.

The Decline in Primary School Enrolment in Kenya

Abstract: Since independence in 1963, Kenya has invested substantial resources in the education sector. For almost twenty-five years, these investments and other government policies led to impressive gains in educational access at all levels. However, since the mid- to late 1980s there appears to have been an erosion in educational participation and a reversal of the gains achieved in previous decades. Motivated by this trend, this paper uses temporal, cross-section and pseudo-panel data to assess the plausibility of various factors that may be responsible for the decline in primary school educational enrolment. In particular, we consider the role of school fees, school inputs and curriculum, school availability, the expected benefits of education and the spread of HIVsAIDS. We also try to identify the most effective policy interventions that may be used to prevent further declines in primary school enrolment rates. Copyright 2004, Oxford University Press.

Signaling and Screening of Workers' Motivation

Abstract: This paper develops a model in which workers to a certain extent enjoy working. We examine the implications of workers' intrinsic motivation for optimal monetary incentive schemes. We show that motivated workers work harder and, for a given level of effort, are willing to work for a lower wage. When people differ in their motivation to work at a particular firm, the profits of the firm depend on its capability to attract and select highly motivated workers. We show that when the firm has all the bargaining power and workers face application cost, the firm needs to commit to a minimum wage offer in order to attract workers. A higher minimum wage increases the probability to fill the vacancy, but decreases the expected average quality of job applicants, as it induces lower motivated workers to apply. The optimal level of the minimum wage depends on whether or not the firm can observe the motivation of the applicants. If applicants can credibly signal their motivation, a minimum wage not only helps to attract workers, but also to select the best-motivated worker among the job applicants.

Decentralized Taxation and the Size of Government: Evidence from Swiss State and Local Governments

Abstract: According to the Leviathan-Model, fiscal federalism is seen as a binding constraint on a revenue-maximizing government. The competitive pressure of fiscal federalism is supposed to reduce public sector size as compared to unitary states. However, empirical results concerning the Leviathan hypothesis are mixed. This study uses a state and local-level panel data set of Swiss cantons from 1980 to 1998 to empirically analyze the effect of different federalist institutions on the size and structure of government revenue. Because of the considerable tax autonomy of sub-national Swiss governments, it is possible to investigate different mechanisms by which fiscal federalism may influence government size. The results indicate that tax exporting has a revenue expanding effect whereas tax competition favors a smaller size of government. Fragmentation has essentially no effect on the size of government revenue for Swiss cantons. The overall effect of revenue decentralization leads to lower tax revenue but higher user charges. Thus, revenue decentralization favors a smaller size of government revenue and shifts government revenue from taxes to user charges.

Patent Pools and Cross-Licensing in the Shadow of Patent Litigation*

Abstract: This paper develops a framework to analyze the incentives to form a patent pool or engage in cross-licensing arrangements in the presence of uncertainty about the validity and coverage of patents that makes disputes inevitable. It analyzes the private incentives to litigate and compares them with the social incentives. It shows that pooling arrangements can have the effect of sheltering invalid patents from challenges. This result has an antitrust implication that patent pools should not be permitted until after patentees have challenged the validity of each other’s patents if litigation costs are not too large.