Although the Millennium Development Goals provide countries with wellrounded objectives for achieving human development over a period of 25 years, Pakistan is not on track to achieving the health-related goals. With the eighth highest newborn death rate in the world, in 2001–07 one in every ten children born in Pakistan died before reaching the age of five. Similarly, women have a 1 in 80 chance of dying of maternal health causes during reproductive life. Compared to other South Asian countries, Pakistan currently lags behind in immunization coverage, contraceptive use, and infant and child mortality rates. Expenditure as a percentage of private expenditure on health is about 98 percent, positioning Pakistan among those countries with the highest share of out-of-pocket payments relative to total health expenditure (World Health Organization, 2009). Pakistan is also going through an epidemiological transition where it faces the double burden of communicable diseases combined with maternal and perinatal conditions, as well as chronic, noninfectious diseases. The landscape of public health service delivery presents an uneven distribution of resources between rural and urban areas: The rural poor are at a clear disadvantage in terms of primary and tertiary health services, and also fail to benefit fully from public programs such as the immunization of children. The poor state of public facilities overall has contributed to the diminished role of public health facilities, while the private sector’s role in the provision of service delivery has increased enormously. Following the 18th Amendment to the Constitution, the health sector has been devolved to the provinces, but the distribution of responsibilities and sources of revenue generation between the tiers remains unclear. A multipronged national health policy is needed that tackles the abysmal child and maternal health indicators, and reduces the burden of disease. Moreover, it is imperative to improve the provision of primary and tertiary healthcare with a strong monitoring system in place.
KEYWORDS: Millenium Development Goals, public health, Pakistan.

JEL: I18.

Pakistan has a large and dispersed primary public health system that gives citizens access to trained doctors and staff, and to subsidized medicines. However, both the use of these facilities and health outcomes remain low. Improvements in information and communications technology provide exciting opportunities to leverage technology to improve management. This paper presents a detailed qualitative and quantitative study of the institutional context in which such interventions in the public health sector in Punjab would be trialed. We describe the structure and management of primary healthcare facilities, present selected results from a survey of a representative sample of basic health units, and identify some key issues. We also report and discuss officials’ responses to the question of how services might be improved.
KEYWORDS: Healthcare infrastructure, public sector management, Pakistan.

JEL: I18.

This paper examines the effects of increased connectivity in rural areas on child health outcomes. In particular, it studies whether improved access to markets for rural areas through an upgraded road network and greater openness, as measured by village electrification status, has had a positive impact on child health outcomes and awareness of health practices such as immunization and prenatal care. Using a 16-year panel dataset from rural Pakistan, we estimate two iterations of a probit model, where one examines the probability of child i being vaccinated and the second estimates the incidence of use of prenatal care. The results support the hypothesis that greater connectivity, as measured by road connectivity and electrification, improves health outcomes by increasing the likelihood of immunization and uptake of prenatal care.
KEYWORDS: Child immunization, prenatal care, access to markets, electrification, rural Pakistan.

JEL: I10.

Pakistan has launched two far reaching social protection programs. The federal government’s Benazir Income Support Program has, at its core, an unconditional cash grant for the poorest households. Responding to the concern that this runs the risk of creating a large pool of permanent government handout recipients, the federal government has also launched an ambitious skills development program. At the provincial level, the government of Punjab is implementing skills development as social welfare in the four poorest Southern Punjab districts. The paper discusses the structure of the two programs, their success at reaching the poor and the monitoring challenges to assess their overall effectiveness.
KEYWORDS: Social protection, targeted transfer program, skills development, Pakistan.

JEL: R58, 020.

This study makes the case that economic uncertainties—i.e., the extent to which economies face systemic uncertainties—need to be considered another dimension of human development because they render development vulnerable, diminish social welfare, and constrain human capabilities. We propose a methodology for adjusting the human development index (HDI) for economic uncertainties, using the time variability of income changes as a proxy. We construct an adjusted index associated with the income component for the 2011 HDI. Our analysis indicates that such an index contains additional information. The percentage loss in the income component of the HDI seems to reflect the variability in economic indicators arising from the political and economic tribulations experienced by each country. In Pakistan’s case, the results of a timeseries analysis of the percentage loss from the uncertainty adjustment appear to closely trace the country’s political and economic upheavals.
KEYWORDS: Human development index, capabilities, human development, economic growth, economic vulnerability, uncertainty, risk.

JEL: D63, I32, I38.

Microinsurance in Pakistan is still in its nascent stages. More than half of the current microinsurance policies in effect in Pakistan are offered through the Benazir Income Support Program (BISP), with the remainder provided in conjunction with microcredit services offered by various microfinance institutions (MFIs), microfinance banks, nongovernment organizations, and rural support programs (RSPs). The policies offered by the microcredit sector are mainly creditlife policies, which cover loan balances in the event of the borrower’s death. In addition, some lenders—principally the RSPs—offer small health insurance policies covering the hospitalization of the borrower and (sometimes) their spouse. As catastrophic health expenses and deaths in the family are among the most important economic stressors that households face, it makes sense that microinsurance should first make inroads in these areas. It is difficult to say what impact microinsurance has had in Pakistan, since few rigorous evaluations have been undertaken to date. What we do know is that utilization has been low, explained by providers as limited client awareness of the benefits and coverage. In the short to medium term, microinsurance outreach can be expanded by offering health microinsurance (HMI) coverage to microcredit borrowers’ entire households, and by offering HMI to all community members within an RSP, rather than only microloan borrowers and their spouses. Partnering with mobile phone operators for automated, digital payments can also significantly expand potential customer volume while reducing transaction costs. HMIs might also be combined with health savings accounts that households can use to pay for medications and outpatient services not covered by HMI plans. Provinces could also leverage the existing database of poverty scorecards implemented by BISP to channel partially government-subsidized microinsurance policies toward poor households just above the BISP threshold.
KEYWORDS: Microinsurance, social insurance, poor, Pakistan.

JEL: G21.

This study aims to capture volatility patterns using GARCH (1,1) models. It evaluates these models to obtain one-step-ahead forecastabilities by employing four major forecasting evaluation criteria, and compares two different currencies— the Pakistan rupee and the US dollar—as domestic and foreign currency-valued exchange rates, respectively. The results show that using an international vehicle currency is favorable in Pakistan’s context. However, the Kuwaiti dinar, Canadian dollar, US dollar, Singapore dollar, Hong Kong dollar, and Malaysian ringgit are found to be preferable when performing direct international transactions. Using the root mean square errors and mean absolute errors techniques, the study also assess the robustness of measuring one-step-ahead forecasts.
KEYWORDS: Time series analysis, GARCH models, foreign exchange markets, forecasting, exchange rate volatility, Pakistan.

JEL: C53, F31, C22, F37, F44.

This article empirically examines the interest rate pass‐through mechanism for Pakistan, using six‐month treasury bills as a proxy for the policy rate (the exogenous variable) and the weighted average lending rate and weighted average deposit rate as endogenous variables representing the lending and deposit channels, respectively. We use data for a six‐year period from June 2005 to May 2011, published by the central monetary authority in Pakistan. The widely accepted error correction mechanism is used to examine the short‐run and longrun pass‐through; a vector error correction mechanism impulse response function helps measure the short‐run speed of the pass‐through. We find that there is an incomplete pass‐through in Pakistan for both the lending and deposit channels. The impact is greater on the lending channel than on the deposit channel in both the short and long run, while the adjustment speed is higher for the lending channel.
KEYWORDS: Interest rate pass‐through, interest rate channel, transmission mechanism, monetary policy, Pakistan.

JEL: E58, E43.

This paper examines the behavior of beta coefficients (systematic risk) for underlying stocks around the introduction of single-stock futures (SSFs) contracts in the Pakistani market, by employing models that account for nonsynchronous and thin trading and varying market conditions as “bull” and “bear” markets. Unlike the results of earlier studies on US markets, the empirical evidence tends to support a decline in systematic risk for the majority of underlying stocks in the post-futures listings period. Nevertheless, similar to SSFs stocks, we also find empirical evidence of a decrease in systematic risk for many of the control group stocks. This indicates that changes in beta estimates for SSFs-listed stocks might not be induced by the introduction of SSFs contract trading, but could be attributed to other market-wide or industry changes that have affected the overall market. Several plausible reasons, such as lack of program trading activities normally associated with index futures, market microstructure differences between developed markets and a developing market such as Pakistan, and the capturing of the “bear” and “bull” market effects on stock betas in our estimation procedure could explain these different results for Pakistan’s market.
KEYWORDS: Systematic risk, beta, stock index futures, single-stock futures, stock price volatility, GARCH model, bear and bull markets, thin trading, Pakistan.

JEL: G10, G13.

This study uses a structural model to analyze the co-determinants of capital structure and stock returns. Applying a generalized method of moments (GMM) model to a panel dataset for 100 nonfinancial firms for the period 2006– 10, our results indicate that both leverage and stock returns affect each other but that the former has a dominant effect on the latter. The results illustrate that profitability, growth, and liquidity are significant determinants of leverage and stock returns. Profitability negatively affects leverage and positively affects stock returns. Growth has a positive effect, while liquidity has a negative effect on leverage and stock returns. Firm size does not have any significant effect on either capital structure or stock returns.
KEYWORDS: Capital structure, stock returns, GMM, Pakistan.

JEL: C33, C36, G30.

This paper analyzes the impact of major factors on the export of mangoes from Pakistan. We use a cointegration approach and error correction mechanism applied to data for the period 1970–2005. Mango exports are regressed against the index of relative prices of mango exports (2000 = 100), the quantity of domestic mango production, real agricultural gross domestic product (GDP), the length of all-weather roads, and international standardization, i.e., the impact of the World Trade Organization agreement. The results of the augmented Dickey-Fuller test reveal that all the data series are I(1). Applying Johansen’s test shows that the highest elasticity coefficients are found for mango production in the short and long run, followed by real agricultural GDP. The Granger causality test points to the bi-directional causality of mango exports with the relative price index and allweather roads, and unidirectional causality with real agricultural GDP and mango production. The study recommends promoting proper orchard management, developing the appropriate infrastructure, and stabilizing export prices to increase mango exports from Pakistan.
KEYWORDS: Mango, unit root, cointegration, Granger causality, Pakistan.

JEL: Q11.

This study examines the impact of health information provision on healthrelated knowledge and corresponding behaviors. Our main assumption is that women’s health can be improved by adopting health protective and healthenhancing behaviors. The study employs a before–after, no-control-group design, aimed at examining whether exposure to health knowledge concerning breast cancer can change participants’ behavior in relation to breast self-examination. Our sample consists of 50 young females whose knowledge and behavior related to breast cancer was assessed in a pre-exposure phase, followed by an exposure session during which they were shown a video film, participated in a discussion, and were given health education literature about breast cancer to take home. Two weeks later, the participants were reassessed, using the same measures. Their health knowledge and behavior were found to have improved significantly. We recommend that formal education should incorporate health education as part of the curricula at all academic levels, especially for women. The mass media can also play an important role in improving public health protective behavior.
KEYWORDS: Health, breast cancer, behavior, Pakistan.

JEL: I10.

This paper investigates the causal impact of public school enrolment on child labor. Our main hypothesis is as follows: Is school enrolment a substitute for child labor? Recognizing that schooling and work choices are jointly determined by parents in a utility maximizing framework, the study applies an instrumental variable solution to the problem of simultaneity. This approach entails using the receipt of free textbooks and access to a public primary facility as instruments for public school enrolment. Using data from the Multiple Indicator Cluster Survey for 2007/08, our working sample consists of children between 5 and 14 years of age, which makes up 25 percent of the surveyed population. The results suggest that public school enrolment can be used as a substitute for child labor. On average, a 1 percentage point increase in a household’s enrolment ratio has the potential to reduce the number of hours of paid labor by almost 5 percentage points, ceteris paribus. This substitutability is highest among poor, urban, male children. Moreover, the incidence of child labor is higher among larger poor families.
KEYWORDS: Child labor, school enrolment, instrumental variable, tobit, fixed effects, education subsidy, Pakistan.

JEL: F66.

The economic and institutional structure required to successfully adopt and implement an inflation targeting framework (ITF) is often lacking in emerging economies. This paper evaluates these structures both qualitatively and quantitatively for Pakistan’s economy. Although our comprehensive assessment finds that many of the core requirements remain unrealized, the literature and real-time experience argue that an ITF remains possible for emerging economies even in the absence of these conditions. We investigate whether—were the State Bank of Pakistan to adopt an ITF—there exists a stable and significant relationship between the policy rate (monetary tool) and inflation measure (objective). It is important to analyze this bivariate relationship, given the key role of the interest rate in mitigating deviations between actual and target inflation when working within an ITF. To illustrate this relationship, we use Granger Causality test, but our estimates fail to find any significant link between the interest rate and inflation. On the basis of our overall findings, we suggest that Pakistan, in the absence of most of the fundamental requirements of an ITF, is perhaps not yet ready for it.
KEYWORDS: Inflation targeting, Pakistan, monetary policy.

JEL: E52, E30, E58.

Clusters have the potential to grow, but their potential in Pakistan is rarely analyzed and examined. This study examines the knitwear cluster of Lahore in general and the performance of enterprises in particular. Most of the literature on clusters in Pakistan has not looked at the characteristics of the individual enterprises that play a pivotal role in cluster development. Using primary data collected from 59 finished-knitwear producers in Lahore, this study assesses the role of human capital in acquiring multifaceted innovations. We find that general human capital acquired by schooling and specific human capital acquired through operational experience is associated with the size of the enterprise. Additionally, specific human capital acquired through operational and marketing experience is strongly correlated with improved marketing channels.
KEYWORDS: Clusters, human capital, schooling, multifaceted, Pakistan.

JEL: H3, E620.

According to the Harberger-Laursen-Metzler (HLM) effect, an exogenous temporary increase in the terms of trade leads to an improvement in the current account balance. This paper uses a recursive vector autoregression to investigate empirically the existence of the HLM effect in Pakistan, using a time series dataset for the period 1980–2009. Two important results emerge. First, real income deteriorates with an improvement in the terms of trade. Second, the current account balance also responds negatively to innovations in the terms of trade, which implies that the HLM effect does not exist in Pakistan.
KEYWORDS: Terms of trade, current account, economic growth, recursive VAR, Pakistan.

JEL: C3, F32, F41.

Education is one of the most important means of economic development, and there is consensus among policymakers that it is better to be educated than not. The debate on education is not, therefore, whether it is good or bad, rather it centers on whether the state should intervene in its provision. Public provision of education at the school level is generally considered one of the most important investments for creating social opportunities to help the wider population actively participate in various economic activities. This study investigates whether public spending on education in Pakistan is pro-poor at various levels of schooling. We find that public spending at the primary and secondary level is progressive, while higher education spending is regressive. These results hold at the national and provincial level. Based on these findings, we recommend that the government increase its spending on primary, secondary, and technical education. Higher education, however, should be provided on merit, and the private sector should be encouraged to provide high-quality education.
KEYWORDS: Education, economic, development, Pakistan.

JEL: I25.

This study estimates a set of fixed effects/random effects models to ascertain the long-run relationships between poverty, income inequality, and growth using pooled data from eight household income and expenditure surveys conducted between 1992/93 and 2007/08 in Pakistan. The results show that growth and inequality play significant roles in affecting poverty, and that the effect of the former is substantially larger than that of the latter. Furthermore, growth has a significant positive impact on inequality. The results also show that the absolute magnitude of net growth elasticity of poverty is smaller than that of gross growth elasticity of poverty, suggesting that some of the growth effect on poverty is offset by the rise in inequality. The analysis at a regional level shows that both the gross and net growth elasticity of poverty are higher in rural areas than in urban areas, whereas the inequality elasticity of poverty is higher in urban areas than in rural areas. At a policy level, we recommend that, in order to reduce poverty, the government should implement policies focusing on growth as well as adopting strategies geared toward improving income distribution.
KEYWORDS: Poverty, inequality, growth, pooled data, Pakistan.

JEL: I32, O40.

McCartney, Mathew, Pakistan – The Political Economy of Growth, Stagnation and the State, 1951–2009, Routledge, London and New York, ISBN13: 978-0-415-57747-2 and ISBN13: 978-0-203-81476-5, 2011, pp. 241. This book is, one can assert without a doubt, sui generis, unique in that it provides an entirely new perspective on the development of Pakistan’s political economy. It is a thorough and objective analysis, an eye-opener, and the author leaves no stone unturned.
KEYWORDS: Pakistan, development, Growth, capital, political economy.

JEL: N/A.

The Lahore School’s Eighth Annual Conference on Management of the Pakistan Economy took place on 16 – 17 May, 2012 at the school’s Main Campus. The topic of this year’s conference was: “Towards Accelerated Economic Growth in Pakistan: Its Need and Feasibility”. It was attended by the country’s leading economists, Pakistani and foreign academics, and renowned researchers from India, Sri Lanka, United Kingdom, and United States. Some 25 research papers and oral presentations were made during the two days of the conference. The richness of the discussions during the two days of the conference cannot be adequately captured in a short report but, as a record of the salient issues raised, it could be useful for the participants as well as others interested in the subject. Since discussions in different sessions tended to overlap, what is offered here is a composite summing-up rather than a chronological account of the actual proceedings.
KEYWORDS: Pakistan, Lahore School, Annual Conference, Pakistan economy.

JEL: N/A.