Public Health

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CDDRL Affiliated Scholar 2011-2012
Resident Physician in Internal Medicine, Stanford Medical Center
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Rajaie Batniji is a resident physician in internal medicine at Stanford and a CDDRL affiliate. His research examines the selection of priority diseases and countries in global health, and he is interested in global health financing and the priority-setting process of international institutions.  His work has also examined social determinants of health in the Middle East.  At FSI, Dr. Batniji is co-investigator on Global Underdevelopment Action Fund projects explaining U.S. global health financing and political causes of public health crisis.

Dr. Batniji received his doctorate in international relations (D.Phil) from Oxford University where he studied as a Marshall Scholar. He also earned a M.D. from the University of California, San Francisco School of Medicine and M.A. and B.A. (with distinction) degrees in History from Stanford University.   Dr. Batniji was previously based at Oxford's Global Economic Governance Program, and he has worked as a consultant to the World Health Organization. 

Publications

Protecting Health: Thinking Small. Sidhartha Sinha and Rajaie Batniji. Bulletin of the World Health Organization 2010; BLT.09.071530  http://www.ncbi.nlm.nih.gov/pubmed/20865078

Health as human security in the occupied Palestinian territory. Rajaie Batniji, Yoke Rabai’a, Viet Nguyen-Gillham, Rita Giacaman, Eyad Sarraj, Raija Leena Punamaki, Hana Saab, and Will Boyce. Lancet 2009 373:1133-43  http://www.ncbi.nlm.nih.gov/pubmed/19268352

Misfinancing global health: the case for transparency in disbursements and decision making. Devi Sridhar and Rajaie Batniji. Lancet 2008; 372: 1185-91  http://www.ncbi.nlm.nih.gov/pubmed/18926279

Coordination and accountability in the World Health Assembly. Rajaie Batniji. Lancet 2008; 372: 805 http://www.ncbi.nlm.nih.gov/pubmed/18774416

Barriers to improvement of mental health services in low-income and middle-income countries.  Benedetto Saraceno, Mark van Ommeren, Rajaie Batniji, Alex Cohen, Oye Gureje, John Mahoney, Devi Sridhar and Chris Underhill. Lancet 2007; 370:1164-74     http://www.ncbi.nlm.nih.gov/pubmed/17804061

An Evaluation of the International Monetary Fund's Claims about Public Health. David Stuckler, Sanjay Basu, Rajaie Batniji, Anna Gilmore, Gorik Ooms, Akanksha A. Marphatia, Rachel Hammonds, and Martin McKee. International Journal of Health Services 2010; 40:327-32  http://www.ncbi.nlm.nih.gov/pubmed/20440976

Reviving the International Monetary Fund: concerns for the health of the poor. Rajaie Batniji. International Journal of Health Services 2009; 39: 783-787    http://www.ncbi.nlm.nih.gov/pubmed/19927415

Mental and social aspects of health in disasters: relating qualitative social science research and the sphere standard. R Batniji, M van Ommeren, B Saraceno. Social Science & Medicine 2006; 62:1853–1864  http://www.ncbi.nlm.nih.gov/pubmed/16202495

Averting a crisis in global health: 3 actions for the G20. Rajaie Batniji & Ngaire Woods, 2009. Global Economic Governance Programme, http://www.globaleconomicgovernance.org/wp-content/uploads/averting-a-crisis-in-global-health.pdf.

Report of a High-Level Working Group, 11-13 May 2008. Rajaie Batniji, Devi Sridhar and Ngaire Woods, Global Economic Governance Programme, 2008, http://www.globaleconomicgovernance.org/project-health

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Tobacco is the single greatest cause of preventable death in the world today, including in China where cigarette smoking is a popular pastime. "The [tobacco] industry in China is run by the Tobacco Monopoly Administration, a central government administrative body created in the 1980s, also known as China Tobacco Corp.," said Matthew Kohrman in a February 2011 interview with NPR's Morning Edition. China nonetheless issued a nationwide indoor smoking ban on May 1. Speaking with Al Jazeera English on the first day of the ban, Kohrman predicted that Chinese citizens will increasingly comply with the ban even if in fits and starts initially. "It all has to do with implementation," he suggested. "It all has to do with changing the culture of smoking and people’s thinking about it—that takes time."



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Daniel Posner is Total Professor of Political Science at the Massachusetts Institute of Technology, and currently a fellow at the Center for Advanced Study in the Behavioral Sciences.  His research focuses on ethnic politics, research design, distributive politics and the political economy of development in Africa. His work investigates, among other topics, the sources of ethnic identification and the political, social and economic outcomes that ethnicity affects-coalition-building, voting, collective action, public goods provision, and economic growth-with special attention to the mechanisms through which it has its impact. His methodological approach is to find creative ways to maximize leverage for making strong descriptive and causal claims, through the use of experiments (in the lab, in the field, and occurring "naturally"), new data sources (including the re-appropriation of data collected for other purposes), and the adoption of techniques from other disciplines such as satellite geography, public health, and behavioral economics.

His most recent co-authored book, Coethnicity: Diversity and the Dilemmas of Collective Action (Russell Sage, 2009) employs experimental games to probe the sources of poor public goods provision in ethnically diverse communities. His first book, Institutions and Ethnic Politics in Africa (Cambridge, 2005), explains why and when politics revolves around one dimension of ethnic cleavage rather than another. He has received several awards for his work, including the Luebbert Award for best book in Comparative Politics (2006 and 2010), the Heinz Eulau Award for the best article in the American Political Science Review (2008), the Michael Wallerstein Award for the best article in Political Economy (2008), the best book award from the African Politics Conference Group (2006), and the Sage Award for the best paper in Comparative Politics presented at the APSA annual meeting (2004). He has been a Harvard Academy Scholar (1995-98), a National Fellow at the Hoover Institution (2001-02), a Carnegie Scholar (2003-05) and, this year, a Fellow at the Center for Advanced Study in the Behavioral Sciences (2010-11). He currently serves on the editorial boards of World Politics, PS, and the Annual Review of Political Science. He is the co-founder of the Working Group in African Political Economy (WGAPE). He received his BA from Dartmouth College and his PhD from Harvard University. Before moving to MIT, he taught for twelve years at UCLA.

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Daniel Posner Total Professor of Political Science Speaker Massachusetts Institute of Technology
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The new health reform started in 2009 has shown the determination of the Chinese government, especially the central government, to increase its responsibility in the health sector. The most obvious manifestation of this commitment would be to increase government health expenditure (GHE). But there is still a hot debate about whether the government should allocate more public finds to health or just deepen the marketization of the health sector. Moreover, commitments at the central and local levels are not the same: local government responsibility for GHE is high, and commitments by the central government to increase GHE have not translated into increases in local government GHE as much as proposed in the national health reform.

Our research seeks to answer two questions: What was the actual pattern of GHE? And why did China’s local governments respond as they did? We first discuss the necessity of public financing for health care, and then analyze how intergovernmental economic competition affects local governments’ behavior under “Chinese-style decentralization” (known as fiscal decentralization with political centralization). Empirically, we apply a dynamic panel data model to provincial panel data from 1991 to 2007 to identify the effect of GHE on health performance in each province over time, using infant mortality and some morbidity metrics as health performance variables. We also examine differences across regions, as well as before and after the Severe Acute Respiratory Syndrome (SARS) epidemic of 2003.

Our analysis provides evidence that Chinese-style decentralization negatively impacted GHE. The main findings are as follows:

  1. Increasing GHE did improve health performance, and this improvement was mainly driven by the GHE through the health department directly, not through spending by other governmental departments that also impact health. However, pursuit of economic performance lowered local governments’ GHE, mainly by decreasing GHE through local health departments.
  2. Compared with in the eastern and western regions, this health improvement was not significant in China’s middle regions, where the intergovernmental economic competition leads to much less GHE through health departments.
  3. The outburst of SARS in 2003 further increased the positive effect from GHE through local health departments, while the effect from GHE through other departments was not equally significant.

All these results suggest that adjusting the structure of public health financing, reforming the fiscal system, and improving the performance evaluation system for local governments are critical for the success of China’s on-going health reform.

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Shorenstein APARC
Stanford University
Encina Hall, Room C335
Stanford, CA 94305-6055

(650) 736-0771 (650) 723-6530
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2011 Shorenstein-Spolgi Fellow in Comparative Health Policy
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Qiulin Chen is a postdoctoral fellow of Shorenstein APARC and a member of the center's Asia Health Policy Program. His main interest of research is health economics and public finance, focusing on policy and outcome comparison of health care systems and Chinese health reform. His dissertation focused on performance comparison between public (or governmental) and private health care financing, between local and central government responsibility on health care, between contracted and integrated health care system. In particular, his dissertation examined under Chinese-style decentralization, known as fiscal decentralization with political centralization, how economic competition affect local government's behaviour on health investment, and why public contracted system obstructs health performance and provides one channel of such effects in terms of preventive care and public health. He is currently involved in a comparative research project on demographic change in East Asia based on the National Transfer Accounts data and analysis.

Chen's recent publication is "The changing pattern of China's public services" (with Ling Li and Yu Jiang) in Population Aging and the Generational Economy: A Global Perspective (Ronald Lee and Andrew Mason, editors), forthcoming 2011. Before studying in Stanford, he has published more than 10 papers in academic journals in Chinese, such as Jing Ji Yan Jiu (Economic Research) and Zhong Guo Wei Sheng Jing Ji (Chinese Health Economics), and 5 book chapters. He has participated in about 20 research projects, such as A Design of Framework for Healthcare Reform in China which is commissioned by the State Council Working Party on Health Reform, Strategy Planning Study of "Healthy China 2020" which is commissioned by the Minister of Health, and Health Challenge in the Aging Society and It's Policy Implication funded by Chinese National Natural Science Foundation.

Chen earned his Ph.D. in Economics from Peking University in 2010, and earned a B.A. in Business Administration from Nanjing University in 2001. From 2004 through 2008, he was Executive Assistant of the Director of the China Centre for Economic Research at Peking University (CCER). He is also a postdoctoral fellow of National School of Development at Peking University (Its predecessor is CCER).

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Qiulin Chen 2011 Shorenstein-Spogli Fellow in Comparative Health Policy Speaker Stanford University
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Paul Wise is a clinical professor of pediatrics and a CHP/PCOR core faculty member. His work focuses on children's health policy; health disparities by race, ethnicity and socioeconomic status; and the interaction of genetics and the environment as these factors influence child and maternal health.

Before coming to Stanford in July 2004, he was a professor of pediatrics at Boston University and vice-chief of Social Medicine and Health Inequalities at Brigham and Women's Hospital. He previously served as director of emergency and primary care services at the Children's Hospital of Boston, and as director of the Harvard Institute for Reproductive and Child Health at Harvard Medical School. He has also served as a special expert at the National Institutes of Health and as special assistant to the U.S. Surgeon General.

Wise has worked to improve healthcare practices and policies in developing countries. He is involved in child health projects in India, South Africa and Latin America, targeting diseases such as tuberculosis and AIDS. He currently chairs the steering committee of the NIH's Global Network for Maternal and Child Health Research, and he has served on many other boards and committees including the Physicians' Task Force on Hunger and the American Academy of Pediatrics' Consortium on Health Disparities. He has received honors from organizations including the American Public Health Association, the March of Dimes, and the New York Academy of Medicine.

He received a BA in Latin American studies from Cornell University, an MD from Cornell University and an MPH from the Harvard School of Public Health. He completed a residency in pediatrics at Children's Hospital Medical Center in Boston.

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Richard E. Behrman Professor of Child Health and Society
Senior Fellow, Freeman Spogli Institute for International Studies
rsd15_081_0253a.jpg MD, MPH

Dr. Paul Wise is dedicated to bridging the fields of child health equity, public policy, and international security studies. He is the Richard E. Behrman Professor of Child Health and Society and Professor of Pediatrics, Division of Neonatology and Developmental Medicine, and Health Policy at Stanford University. He is also co-Director, Stanford Center for Prematurity Research and a Senior Fellow in the Center on Democracy, Development, and the Rule of Law, and the Center for International Security and Cooperation, Freeman Spogli Institute for International Studies, Stanford University. Wise is a fellow of the American Academy of Arts and Sciences and has been working as the Juvenile Care Monitor for the U.S. Federal Court overseeing the treatment of migrant children in U.S. border detention facilities.

Wise received his A.B. degree summa cum laude in Latin American Studies and his M.D. degree from Cornell University, a Master of Public Health degree from the Harvard School of Public Health and did his pediatric training at the Children’s Hospital in Boston. His former positions include Director of Emergency and Primary Care Services at Boston Children’s Hospital, Director of the Harvard Institute for Reproductive and Child Health, Vice-Chief of the Division of Social Medicine and Health Inequalities at the Brigham and Women’s Hospital and Harvard Medical School and was the founding Director or the Center for Policy, Outcomes and Prevention, Stanford University School of Medicine. He has served in a variety of professional and consultative roles, including Special Assistant to the U.S. Surgeon General, Chair of the Steering Committee of the NIH Global Network for Women’s and Children’s Health Research, Chair of the Strategic Planning Task Force of the Secretary’s Committee on Genetics, Health and Society, a member of the Advisory Council of the National Institute of Child Health and Human Development, NIH, and the Health and Human Secretary’s Advisory Committee on Infant and Maternal Mortality.

Wise’s most recent U.S.-focused work has addressed disparities in birth outcomes, regionalized specialty care for children, and Medicaid. His international work has focused on women’s and child health in violent and politically complex environments, including Ukraine, Gaza, Central America, Venezuela, and children in detention on the U.S.-Mexico border.  

Core Faculty, Center on Democracy, Development and the Rule of Law
Affiliated faculty at the Center for International Security and Cooperation
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Paul H. Wise Richard E. Behrman Professor of Child Health and Society and CHP/PCOR Core Faculty Member Speaker CDDRL, CISAC Affiliated Faculty
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