This paper revisits the widely held idea of a "human resources crisis" in primary health care (PHC) across low- and middle-income countries (LMICs). First, we review micro- and macro-level evidence, finding little empirical support for generalized workforce shortages. Providers in LMICs appear to operate with substantial excess capacity, characterized by low caseloads, short consultation lengths, and modest wait times. Second, using nationally representative data from 7,915 facilities across 10 African countries, we estimate that the median provider sees 10.9 patients per day. We suggest that the perceived experience of overcrowding arises from a highly unequal distribution of caseloads, with most visits concentrated among a minority of providers. In other words, the average provider is not busy, but the average patient visits a busy provider. Third, we assess allocative inefficiencies using matched data on provider caseload and competence, documenting that caseloads are not concentrated among more competent providers. Using simulations, we show that this misallocation reduces potential aggregate service quality by 4-33 percent, depending on the country. These findings suggest that failures in PHC service delivery cannot be addressed by simply expanding human resources under existing systems arrangements-the competence, allocation, and utilization of both new and existing providers must be improved to meaningfully impact care quality.
Tariff protection has declined substantially over recent decades, even though tariffs increased in some countries in 2025. Trade restrictions have not disappeared; they have changed form. Non-tariff measures (NTMs) have become central instruments of trade policy, particularly in high-income countries and in highly regulated sectors. Many NTMs pursue legitimate objectives such as food safety, environmental protection, and consumer protection. Yet they also shape market access in less visible ways. Because compliance costs vary widely, NTMs can act as capability-based filters that sort exporters according to regulatory capacity, technological sophistication, and export structure. Drawing on recent advances in estimating ad valorem equivalents (AVEs), this paper examines how the growing importance of NTMs relative to tariffs alters effective protection. Three patterns emerge. Higher-income countries rely relatively more on NTMs than on tariffs; exporters from low- and middle-income countries face higher effective protection in advanced markets; and NTMs disproportionately burden smaller firms, increasing the likelihood of export exit and potentially contributing to greater market concentration. Together, these mutually reinforcing patterns highlight the importance of transparency, careful policy design, and regulatory cooperation to ensure NTMs achieve legitimate objectives without reinforcing fragmentation or inequality in global trade.
This paper draws on newly available data to examine the sources of labor productivity growth in Africa and to identify key emerging patterns. We show that while recent structural change in Africa has been growth-enhancing, overall labor productivity growth remains modest. Manufacturing-traditionally a cornerstone of structural transformation-has played a limited role since the 1990s. Instead, services, especially wholesale and retail trade, have been the main drivers. These trends are evident not only in value added and employment data but also in trade patterns, where services increasingly contribute to export growth. We argue that Africa's modest productivity growth reflects deeper structural constraints, including limited physical and social infrastructure. The former category includes electricity access and roads; but we also argue that productivity growth is constrained by extreme poverty, poor health, and inadequate education. Against this backdrop, we argue for an African-led development strategy that recognizes both traditional and overlooked sources of productivity growth while addressing foundational barriers to transformation.
We perform a meta-analysis of the infrastructure research done over several decades, using over a thousand estimates from 221 papers reporting outcome elasticities. We include the transport, energy, and digital or information and communication technology (ICT) sectors, and the whole set of outcomes covered in the literature, including output, employment and wages, inequality and poverty, trade, education and health, population, and environmental aspects. Our results update the underlying parameters of interest, the "true" underlying infrastructure elasticities, accounting for publication bias, as well as for heterogeneity stemming from study design and context, with a particular focus on developing countries. Our results support a positive and significant impact of infrastructure on development outcomes, but also important heterogeneity across sectors and countries. While effects appear larger in developed countries for digital and energy studies, cross-sectoral and transport studies based on developing countries produce larger elasticities.
The role of fathers in parenting young children differs dramatically across societies. Policymakers in low- and middle-income countries (LMICs) are increasingly focused on increasing the amount of early childhood stimulation and other investments received by young children in an attempt to increase human capital accumulation, promote school readiness, and improve long-run outcomes. Until recently, few interventions targeted fathers, and most impact evaluations implicitly assumed that fathers played no meaningful role in parenting. We survey the emerging literature on fathers' involvement in early childhood stimulation and parenting in LMICs and summarize the patterns of results from rigorous impact evaluations. We find that fathers spend less time stimulating their children's development than do mothers or other adults who live in the same households in almost every country in our sample, and that mothers' and fathers' investments are positively associated. We also find evidence that fathers' take-up of parent training programs tends to be low, but that such programs have had effects on changing fathers' knowledge and-to a lesser degree-behaviors.
