Demand-side Factors Research Articles

Dynamics of tourism demand in Turkey: Panel data analysis using gravity model

Turkey, an emerging economy, ranked 8th among the most visited countries in the world in 2017. Given the importance of the tourism sector in Turkey, it is of utmost importance to identify the dynamics of tourism demand to achieve sustainable tourism. The aim of this article is, therefore, to explore the demand-side factors that affect the number of international tourist arrivals to Turkey. To this end, an augmented gravity model has been employed to analyze the factors affecting the number of international tourists visiting Turkey from the top 25 originating countries from 1998 to 2017. The results show that the gravity model is very effective in explaining the tourist arrivals to Turkey. Empirical findings suggest that per capita income of both origin country and Turkey, relative exchange rate, and globalization positively affect the demand for tourism, while it is negatively affected by consumer price index, violence/terrorism, household debt level, and bilateral distance between Turkey and the origin country.

Tackling antimicrobial resistance in Bangladesh: A scoping review of policy and practice in human, animal and environment sectors.

BackgroundAntimicrobial resistance (AMR) has become an emerging issue in the developing countries as well as in Bangladesh. AMR is aggravated by irrational use of antimicrobials in a largely unregulated pluralistic health system. This review presents a ‘snap shot’ of the current situation including existing policies and practices to address AMR, and the challenges and barriers associated with their implementation.MethodsA systematic approach was adopted for identifying, screening, and selecting relevant literature on AMR situation in Bangladesh. We used Google Scholar, Pubmed, and Biomed Central databases for searching peer-reviewed literature in human, animal and environment sectors during January 2010-August 2019, and Google for grey materials from the institutional and journal websites. Two members of the study team independently reviewed these documents for inclusion in the analysis. We used a ‘mixed studies review’ method for synthesizing evidences from different studies.ResultOf the final 47 articles, 35 were primary research, nine laboratory-based research, two review papers and one situation analysis report. Nineteen articles on human health dealt with prescribing and/or use of antimicrobials, five on self-medication, two on non-compliance of dosage, and 10 on the sensitivity and resistance patterns of antibiotics. Four papers focused on the use of antimicrobials in food animals and seven on environmental contamination. Findings reveal widespread availability of antimicrobials without prescription in the country including rise in its irrational use across sectors and consequent contamination of environment and spread of resistance. The development and transmission of AMR is deep-rooted in various supply and demand side factors. Implementation of existing policies and strategies remains a challenge due to poor awareness, inadequate resources and absence of national surveillance.ConclusionAMR is a multi-dimensional problem involving different sectors, disciplines and stakeholders requiring a One Health comprehensive approach for containment.

Investigating the relationship between career planning, proactivity and employability perceptions among higher education students in uncertain labour market conditions

This paper addresses the limited empirical analysis of higher education students’ perceptions of contemporary labour market demands. It explores their perspectives on the health of the graduate labour market, what factors determine these and how their perceptions relate to self-perceived employability, career proactivity, career control and efforts to develop positional advantage. Further, the study examines determinants of students’ career planning, all in the context of a challenging graduate labour market and higher education systems that have become more market-driven. The paper draws on evidence from a survey among Australian and UK students (N = 433), from two institutions and across a range of disciplines. Data revealed a number of significant findings. Overall, students who reported more positive perceptions of the current labour market were more likely to develop higher self-perceptions of employability, believe they had a greater sense of control over their career yet were less engaged with proactive career behaviours. Students perceived employability, their sense of career control and their reported career proactivity positively determined their engagement in career planning. The study enhances our understanding of the impact of labour market demand-side factors on student approaches to careers. It raises significant implications for universities and their career practitioners in identifying ways of enhancing students’ career planning strategies within a more challenging labour market context.

Does Financial Inclusiveness Matter for the Formal Financial Inflows? Evidence from Pakistan

The remittance inflows are the major source of financial transfers received by households to maintain their livelihood. However, the formal inflows can play an immense role in improving the indigenous economy by affecting household welfare, these flows further strengthen the economy at micro and macro levels. Previously, various studies found a determinant relationship between supply-side factors and financial inclusion. Whereas, this paper emphasizes a sweltering issue of formal financial inflows in Pakistan especially focusing on the demand side factors on the household level. The analysis uses Heckman Selection Technique to assess the demand for formal financial inclusion which can only be realized for the households receiving remittances, where the determinants for both depend upon the distinctive demographic, individuals and household characteristics. The study appraises household survey data from the Household Integrated Economic Survey (HIES) for the period 2013–2014. The results demonstrate the strong effects of households' demand-side factors on financial inclusion. The demographic features such as education and the highest earner's age are found to have a positive and significant impact on financial inclusion. Whereas, the household characteristics such as household living conditions, asset accumulation, household savings, and borrowings also strongly affect the formal financial inclusive decision. It is therefore suggested to employ a comprehensive policy regarding the enhancement of households' awareness by the spread of formal and financial literacy.

Triggers and Barriers of Financial Inclusion: A Country-Wise Analysis

The objective of this study was twofold. The first goal was to construct a composite multi-dimensional index for financial inclusion using two stage principal component analysis for 91 countries for two benchmark years, 2011 and 2014 which includes both supply and demand side factors and compare the rank mobility using the World Bank Findex database. The second goal was to track the binding determinants of financial inclusion using a panel fixed effects model. A panel ordered probit model was used to judge the extent of causality between growth, sectoral share, female workforce participation, poverty reduction with different levels of financial inclusion. The middle- and low-income countries can reach their potential if the sources of barriers have been tracked efficiently as this is the main constraint for an inclusive financial system. Toreduce the multidimensional poverty through endogenous stimulus of the poor population in South-Asian, Sub-Saharan and few Latin American countries, it is essential to reinforce the provision of financial resources for the working-age female population and to improve the affordability and accessibility of inclusive investment for rural populations.

Understanding the underutilisation of healthcare interventions in low- and middle-income countries: demand-side and supply-side factors

Poor accessibility of healthcare interventions in low- and middle-income countries (LMICs) has resulted in increased suffering and lower health benefits. This is caused by a host of demand-side and supply-side barriers that need to be investigated to design effective strategies. The rate of underutilisation of healthcare interventions is high in LMICs and the utilisation is lower at the lowest tier of the population ladder. The supply-side factors include inefficient resources, inappropriate allocations and inadequate quality. The demand-side factors include income, price, non-price cost, location, nature of household decision-making and broader cultural influences. Policy interventions at the demand and supply side should be aligned together to achieve balanced progress. This can be achieved by exploring options of financial rewards, pre-payment schemes, supporting community-based financing, influencing household preferences, addressing cultural and societal sensitivities and empowering healthcare professionals, especially in the rural areas.

Infrastructure Index and Female Labor Force Participation in Developing-8 Countries: A Demand Side Approach

The goal of the present paper is to determine the relationship between overall infrastructure and female labor force participation (FLFP) in developing-8 (D-8) countries consisting of Bangladesh, Egypt, Indonesia, Iran, Malaysia. Nigeria, Pakistan, and Turkey. This study incorporated the new global infrastructure index and its relevance to FLFP in D-8 countries for data period of 1980 to 2018. The index constructed through principal component analysis based upon three subcategories such as transportation, electricity, and Information and Communication Technology (ICT) consisting of 17 components. For empirical estimation of the long term relationship between FLFP and infrastructure in the macroeconomic environment, we employed a pooled mean group (PMG) based upon the Hausman Specification Test. Our analysis revealed that infrastructure is highly significant and positive for FLFP in D-8 countries. This implies women in developing-8 countries labor market participation can be enhanced by providing them better transportation, access to electricity, ICT access, ease of access to the workplace, and other market opportunities. This demonstrated that FLFP in D-8 countries constrained by demand-side factors such as lack of infrastructure facilities, barriers to access the job market, lack of internet and electricity facilities rather less likely constrained by individual or supply-side factors such as wages, education, household income, and cultural norms, etc. The government of the D-8 countries should increase the opportunities for FLFP by improving the access and quality of infrastructure as evident from the Overall infrastructure index and its long term impact on FLFP. Secondly, the government must also include gender dimension while framing the trade and investment policies so that more jobs can be created for females in these countries

Economic Studies on the Opioid Crisis: A Review

The United States has experienced an unprecedented crisis related to the misuse of and addiction to opioids. As of 2018, 128 Americans die each day of an opioid overdose, and total economic costs associated with opioid misuse are estimated to be more than $500 billion annually. The crisis has evolved in three phases, starting in the 1990s and continuing through 2010 with a massive increase in use of prescribed opioids associated with lax prescribing regulations and aggressive marketing efforts by the pharmaceutical industry. A second phase included tightening restrictions on prescribed opioids, reformulation of some commonly misused prescription medications, and a shift to heroin consumption over the period 2010 to 2013. Since 2013, the third phase of the crisis has included a movement towards synthetic opioids, especially fentanyl, and a continued tightening of opioid prescribing regulations, along with the growth of both harm reduction and addiction treatment access policies.Economic research, using innovative frameworks, causal methods, and rich data, has added to our understanding of the causes and consequences of the crisis. This body of research also identifies intended and unintended impacts of policies designed to address the crisis. Although there is general agreement that the causes of the crisis include a combination of supply- and demand-side factors, and interactions between them, there is less consensus regarding the relative importance of each. Studies show that regulations can reduce opioid prescribing but may have less impact on root causes of the crisis and, in some cases, have spillover effects resulting in greater use of more harmful substances obtained in illicit markets, where regulation is less possible. There are effective opioid use disorder treatments available, but access, stigma, and cost hurdles have stifled utilization, resulting in a large degree of under-treatment in the U.S.How challenges brought about by the COVID-19 pandemic may intersect with the opioid crisis is unclear. Emerging areas for future research include understanding how societal and healthcare systems disruptions affect opioid use, as well as which regulations and policies most effectively reduce potentially inappropriate prescription opioid use and illicit opioid sources without unintended negative consequences. Institutional subscribers to the NBER working paper series, and residents of developing countries may download this paper without additional charge at www.nber.org.

The Demand for Maternal and Child Health Care Services in Sub-Saharan Africa: A Review of Latest Available Data for Selected Countries

It is evident that maternal and under-five child deaths have gradually reduced in Sub-Saharan Africa (SSA) in the last three decades. In a bid to improve access and utilization of maternal and child health care services in the region, actors in public, private and civil society arenas at all levels have engaged in familiar circles towards service provisioning. Nevertheless, evidence from several SSA countries shows less utilization of some maternal and child health care services. The demand remains low for some services such as attendance of four antenatal visits as recommended by World Health Organization, delivery skilled birth attendants, postnatal care especially for newborns, child immunization, and use of modern contraceptives. The concern remains whether the less demand is influenced by supply-side or demand-side factors. The personal, socio-cultural, economic, health systems related factors may condition a person’s demand choices regardless of the need for a particular health service. Improved access may not necessarily translate into utilization because of these interrelated determinants of demand. Therefore, policy-makers might need to turn to Sen’s capability approach viewpoint to gaze at how expanding people’s choices-especially poor women might help to improve the demand for maternal and child health services in SSA. Policy interventions may include pro-poor healthcare service provisioning through public financing, improving women’s education, improving women’s access to information, etc. However, a multi-sectoral approach is necessary for addressing all demand determinants at all levels and the interventions should be context-specific.

Liquidity Connectedness in the Foreign Exchange Market

We estimate the liquidity connectedness in the spot foreign exchange (FX) market based on an empirical network model. We find that the liquidity connectedness reflects the dynamic market uncertainties around the world. Supply- and demand-side factors are important drivers of liquidity connectedness, especially for the fear sentiment of investors and economic policy uncertainty. The relation between liquidity connectedness on the subsequent carry-trade return in the FX market is nonlinear and V-shaped. Overall, our research indicates that liquidity connectedness is a good measure of currency risk and can reflect the fragility of the FX market.

To Compete or Retreat? The Global Diffusion of Precision Strike

After the publicized use of precision strike weapons in the First Gulf War, analysts predicted that they would spread rapidly around the world. In fact, it has happened much slower than predicted. To explain this puzzle, this paper draws on a novel dataset tracking country-level acquisition of eight aspects of the precision strike complex from 1989 to 2017. The results show that supply-side factors—like a state’s technological capacity and defense relationships with key exporters—significantly affect the likelihood of states developing advanced precision strike capabilities. Demand-side factors like interstate security threats also play an important role, but not in the way traditionally theorized. We find an inverted-U relationship between security threats and proliferation. When states have rivals or neighbors with moderate precision strike capabilities, they have security incentives to compete with them. However, when states face highly advanced adversaries, they have a tougher time competing, and thus have incentives to shift resources to other defense strategies.

Understanding the underutilization of healthcare interventions in low-and-middle-income countries: Demand-side and supply-side factors

Understanding the underutilization of healthcare interventions in low-and-middle-income countries: Demand-side and supply-side factors

Quantitative Easing and Bank Lending: The Liquidity Channel

This paper provides direct evidence on the effect of quantitative easing (QE) policies on bank lending through the liquidity channel. By looking at changes in banks' liquidity-lending sensitivity in different rounds of QE, our results show that banks with higher levels of cash & reserve holding (especially excess reserves) are more responsive to the large-scale asset purchases (LSAPs) after the 2007-08 financial crisis, compared to their liquidity-constrained counterparts. Interestingly, we find this liquidity channel to be almost equally significant for both C&I loans and real estate lending. Our results are robust to different specifications, alternative measures of banks' liquidity constraint, and inclusion of controls for demand-side factors. Further analysis indicates that this liquidity channel is distinct from the net-worth channel and capital requirement constraint documented in the literature.

The access to finance by SMSs in Turkey and the EU: acomparative study

Purpose-Access to finance is one of the major factors in the growth of Small and Medium-sized Enterprises (SMEs), which comprise 99% of companies in Turkey and the EU and have a large impact on GDP and unemployment. Therefore, the purpose of this study is to compare status and changes in the access to finance of SMEs in Turkey and the EU. And additionally, to evaluate the access to finance of Turkish SMEs according to their associate status, location, business area, exports, liquid assets, and establishment time. Methodology- In developing the questionnaire used in this survey, some of the questions from the Survey on the Access to Finance of Enterprises (SAFE 2017) conducted in October 2017 on the EU SMEs, were modified. The questionnaire was sent to SMEs in Turkey through KOSGEB (Small and Medium-Sized Enterprises Development and Support Agency (KucukveOrtaOlcekliIsletmeleriGelistirmeveDesteklemeIdaresiBaskanligi)) via e-mail. The response percentages obtained were compared with the response percentages from SAFE 2017. Also using analyses such as chi-square and multiple regression (SPSS) significant relations between answers of Turkish SMEs were determined. Findings- According to the results of the questionnaire conducted and SAFE 2017, the second biggest issue for SMEs in Turkey is the access to finance, while this issue is the least important for SMEs in the EU; the increase in availability of financial sources for SMEs in the EU is much larger and they use them mostly for new investments, while SMEs in Turkey use them mostly for inventories; expenses for SMEs in Turkey such as labor and raw material cost increased more, which probably led to a decrease in profit and an increase in debts. According to multiple regression and chi-square analysesata5% significance level, it is found that the amount of credit received by SMEs in Turkey, and the usage of loans from family and friends are significantly affected by the age, number of employees, turnover level, export level, business area, and geographical location of the company. The usage of government loans and incentives by SMEs in Turkey is significantly affected by age, the number of employees, and the export level of the company. The usage of bank loans by SMEs in Turkey is significantly affected by the age, turnover level, export level, and the number of employees of the company. The usage of leasing and trade credits by SMEs in Turkey is significantly affected by the age, the number of employees, turnover level, export level, business area, geographical location, and the partnership status of the company. Conclusion-There is a limited number of studies focusing on access to finance for SMEs in Turkey. They mostly tend to concentrate only on problematic supply-side factors and miss to show the significant relationship between demand-side factors, meaning SMEs' characteristics, and access to finance. At the same time, to our best knowledge, there is not any study directly comparing Turkish SMEs to the European SMEs except SAFE reports, which take only 300 SMEs in Turkey into consideration. On the other hand, this study takes 1,518 SMEs in Turkey into consideration and compares SMEs in Turkey and the EU according to their characteristics and access to finance.

Educational upgrading and returns to skills in Latin America: evidence from a supply\u2013demand framework

This paper documents the evolution of wage differentials and the supply of workers by educational level for sixteen Latin American countries over the period 1991–2013. We find a pattern of rather constant rise in the relative supply of skilled and semi-skilled workers over the period. Whereas the returns to secondary education fell over time, in contrast, the returns to tertiary education display a remarkable changing pattern common to almost all economies: significant increase in the 1990s, strong fall in the 2000s, and a deceleration of that fall in the 2010s. We conclude that supply-side factors seem to have limited explanatory power relative to demand-side factors in accounting for changes in the wage gap between workers with tertiary education and the rest.

Breaking the Word Bank: Effects of Verbal Uncertainty on Bank Behavior

Banks differ from non-financial firms as banks must communicate to both regulators and shareholders. Also, unlike non-financial firms, banks possess opaque and complex balance sheets and are the main providers of credit to the real economy. In this paper, I propose a new index to detect the idiosyncratic uncertainty banks face at the bank-quarter level by applying natural language processing techniques to earnings conference call transcripts. The index reveals which banks at a given quarter signal more uncertainty about their balance sheets. Higher uncertainty is associated with lower lending and higher liquidity the next quarter, suggesting active management of uncertainty. The active management of uncertainty is more pronounced during periods of high aggregate volatility and for banks with more skin in the game. Using loan level data and firm fixed effects, I control for demand-side factors and find that higher bank level uncertainty is associated with lower loan issuances the following quarter.

Zwakala Ndoda: a cluster and individually randomized trial aimed at improving testing, linkage, and adherence to treatment for hard-to reach men in KwaZulu-Natal, South Africa

BackgroundMen in sub-Saharan Africa are less likely than women to get tested for HIV, less likely to present for treatment, less likely to be maintained in treatment, more likely to have detectable viral load, more likely to transmit HIV with unprotected intercourse, and more likely to progress to AIDS and die sooner from HIV. The ultimate objective of this research is to provide evidence-based strategies to improve HIV testing and treatment of HIV-infected men.MethodsThis study is being conducted in the Greater Edendale Area and Vulindlela region in KwaZulu-Natal, South Africa. It is a two-stage design of a cluster-randomized trial and an individual randomized trial to test how structural and individual-level interventions address the demand-side factors that affect HIV testing and treatment for hard-to reach, high-risk men. It combines male-focused mobilization, community-based mobile HIV testing services, and a small incentive to determine if the strategies singly and in combination can result in more men diagnosed with HIV, and more men linked to and maintained in care with undetectable viral load.DiscussionA priority for sub-Sahara Africa is developing and evaluating novel and cost-effective strategies for identifying hard-to-reach groups such as men, linking them to HIV testing and care services, and maintaining them in care to the point of viral suppression. We propose a combination prevention intervention that addresses men’s individual, interpersonal, and structural barriers to testing and care. This includes male-led mobilization to encourage uptake of testing and treatment, male-focused testing venues, male-only counselors, developing counseling models that are flexible and responsive to men, and strategies for adhering to clinic visits without missing work and navigating the healthcare system. By thoughtfully combining male-focused mobilization, and testing and addressing some of the barriers to male engagement with health facilities, this study hopes to add to the growing evidence base about how to reach, test, link, and maintain a hard-to-reach group such as men in HIV treatment and care services.Trial registrationClinicalTrials.gov, NCT03794245. Registered on 4 January 2019.

Emulation of Community Water Fluoridation Coverage Across US Counties.

Expansion of community water fluoridation has stalled in the United States, leaving 115 million Americans without fluoridated drinking water. This study used spatial regression methods to assess contributions of supply-side factors (neighboring counties' fluoridation coverage) and demand-side factors (health literacy, education, and population density of the local county) in predicting the extent of fluoridation in US counties. For this cross-sectional ecological analysis, data from the 2014 Water Fluoridation Reporting System for all 3,135 US counties were merged with sociodemographic data from the 2014 American Community Survey and county-level estimates of health literacy based on the National Association of Adult Literacy Survey. We employed multilevel geographically weighted autoregressive models to predict fluoridation coverage of each county as a function of fluoridation coverage of neighboring counties and local-county covariates: either health literacy or sociodemographic characteristics. Akaike's Information Criterion was used to distinguish the better model in terms of explanatory power and parsimony. In the best-fit model, an increase from the first to third quartile of neighboring counties' fluoridation coverage was associated with an increase of 27.76 percentage points (95% confidence limits [CI] = 27.71, 27.81) in a local county's fluoridation coverage, while an increase from the first to third quartile of local county's health literacy was associated with an increase of 2.8 percentage points (95% CL = 2.68, 2.89). The results are consistent with a process of emulation, in which counties implement fluoridation based upon their population's health literacy and the extent of fluoridation practiced in neighboring counties. These results suggest that demand for community water fluoridation will increase as health literacy increases within a county. Furthermore, when considering expansion of fluoridation, non-fluoridated communities can benefit from precedents from nearby communities that are fluoridated. Expanded coverage of community water fluoridation has stalled in the United States. The economic theory of diffusion describes how, over time and space, policy enacted in one community can influence public opinion in a neighboring community. This study applies geospatial analysis of county-level data and the theory of policy diffusion to demonstrate that fluoridated counties can promote the implementation of community water fluoridation in their neighboring, non-fluoridated communities.

A case study on the scaling-up of double fortified salt through the public distribution system of a food security program in Uttar Pradesh, India: experiences, challenges, and achievements

# Background Iron deficiency anemia (IDA) exerts an enormous public health burden in low-income countries, primarily affecting women and children. Double fortified salt (DFS) -- salt fortified with Iodine and Iron -- has the potential to prevent and correct iron deficiencies. Major challenges relate to the implementation and scaling-up of the production, distribution, and promotion of DFS. # Methods A pilot project for scaling up DFS through integration with the public distribution system (PDS) -- a federal food security program in India -- was implemented for a one-year period. One of the objectives was to test the scale-up model, critically evaluate its scalability, and assess and for the scale-up. Using the case study methodology, we reviewed program records, monitoring data, and key informant interviews with stakeholders. Scalability considerations and drivers and spaces framework from scale-up literature were used for synthesizing findings. # Results The PDS provided a readily available and expansive platform for DFS distribution, accelerating scale-up. Bundling DFS with other subsidized commodities increased the purchase of DFS, but not necessarily ensured utilization. Low demand due to lack of consumer awareness; consumer preference to the specific physical appearance of salt as a quality indication (premix particles in DFS perceived as impurities); slight discoloration of some food items, were main demand-side factors presenting a challenge to optimal scale-up. Inadequate state government resources for subsidizing DFS, lack of financial incentives to PDS shopkeepers for additional work, were significant supply-side challenges. The approach, however, provided for innovative financing (especially from the private sector) for investments in scaling-up nutrition interventions through multi-sectoral partnerships, while serving the interests of individual sectors. # Conclusion Introducing DFS in food security schemes with extensive outreach can accelerate the scaling-up of fortification interventions. Contextual factors critical to scaling-up, from both the supply and demand side, should be identified and addressed before and during scaling-up.

Economic policy uncertainty and credit growth: Evidence from a global sample

This study extends the research of Bordo, Duca, and Koch (2016) and Hu and Gong (2018) by examining the influences of economic policy uncertainty (EPU) at domestic and global levels on aggregate bank credit growth. The empirical analysis is conducted through both supply and demand side factors of bank credit growth in 22 economies over the period 2001–2015. This study employs different measures of EPU and applies panel-corrected standard errors (PCSE) and feasible generalized least squares (FGLS), which are suitable for unbalanced panel data models. Three principal findings are follows. First, higher level of EPU has negative impact on bank credit growth, which is significant for domestic EPU measures. Second, the positive change in EPU appears to have favorable effects on bank credit growth. The effects in both cases are different for the credit demand and supply sides. The findings suggest the need for appropriate measures to tackle bank credit risk-taking activities in uncertain conditions. Third, the impacts of EPU in emerging economies are negative and somewhat stronger than in advanced economies.