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Eswatini has notably high levels of poverty and inequality. Recurrent, negative shocks are an important contributing factor. This study assesses the performance of the largest social assistance programs in Eswatini, based on 2016/17 national household survey data. It examines the coverage rates of these programs, and their incidence and effectiveness in reducing poverty and inequality. The study also examines the association between program participation and negative shocks reported by households, in particular, drought and food price shocks associated with the 2015-2016 El Nino event. Across programs, benefits are concentrated among poor households. However, the performance of programs in reducing poverty and inequality tends to be limited because of low intended or actual benefit levels and shortfalls in intended or actual coverage of the poor. Households that receive program benefits are more likely to report a drought shock. Except in the case of emergency food aid, which is provided ex post, we interpret this pattern to indicate that programs tend to provide ex-ante coverage to those vulnerable to this shock. At a minimum, enhancing the performance of programs in addressing poverty, inequality, and the adverse effects of shocks would require that actual benefit levels equal intended levels (for example, by procuring sufficient food commodities to meet the needs of the school feeding program) and that intended benefit levels are fully aligned with program aims (for example, by providing grant amounts to schools that are large enough to allow for tuition-free government secondary education for orphaned and vulnerable children). Absent greater budgetary allocations to programs, addressing these benefit-related disconnects may require improving the targeting of select program benefits to poorer households such as by using a proxy means test. We simulate the effects of programs on poverty and inequality reduction from such hypothetical reforms.

Access of Poor to Social Services --- Inequality --- Poverty Reduction --- Services and Transfers to Poor --- Social Protections and Assistance --- Social Protections and Labor

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This paper estimates the monetary value of financial risk reduction associated with membership in Ghana's National Health Insurance Scheme, based on recent national household survey data. The paper compares the risk premiums for distributions of out-of-pocket healthcare expenditures with and without insurance and find that the difference is small. This does not mean that the National Health Insurance Scheme has no value to members. Indeed, the findings show that the insured pay significantly less for healthcare than the uninsured on average. But that average reduction does not translate into a reduced spread of consumption net of out-of-pocket healthcare expenditures. Thus, the benefit of the National Health Insurance Scheme is entirely a transfer benefit, not a reduction in financial risk.

Health insurance. --- Health insurance

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AFR / Africa - Afrika - Afrique --- 338.340 --- 331.33 --- Algemene ontwikkeling in de Derde Wereld. --- Structureel beleid. Reglementering. Dereglementering. Ordnungspolitik. --- Algemene ontwikkeling in de Derde Wereld --- Structureel beleid. Reglementering. Dereglementering. Ordnungspolitik

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Development aid. Development cooperation --- Africa --- Economic development projects --- Case studies --- Africa, Sub-Saharan --- Economic policy --- Case studies.