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China’s experience in pursuing universal health coverage pmassetti International Labour Organization (30.05.2025) China’s experience in pursuing universal health coverage: In recent years, China has made significant strides in extending health coverage. This technical report systematically summarizes China’s experience developing and strengthening its health system towards universal health protection. The report provides a clear picture of the recent evolution of the health system in China in the last decades and highlights remaining challenges. This technical report provides valuable insights for other countries to explore the possibility of universal health coverage and contribute to the advancement of global health protection. universal health coverage Health china
Publication: Working Toward Better Health: Expanding Community Health Services in Mozambique pmassetti worldbank.org (05.05.2025) In low-income countries, formal health systems are stretched thin, and rural and underserved areas often lack adequate primary healthcare coverage, delaying essential interventions and leaving populations vulnerable to preventable diseases. Mozambique was no exception. The country had particularly poor health outcomes among its peers, with high rates of stunting (40%) and malnutrition, as well as one of the highest rates of child marriage and adolescent fertility in the world. Its share of deaths from communicable diseases and maternal, perinatal, and nutritional conditions was 62% – three times the global average. Only half of births were attended by a skilled professional, and the neonatal mortality rate was 27.9 per 1,000 live births. But the problem went beyond reach and access: providers had weak competencies, clinical guidelines were often not adhered to, and there were high levels of dropout for child immunization. To improve health outcomes, Mozambique would have to increase both coverage and quality of service. Health mozambique
The Care Dividend pmassetti The Care Dividend Why and How Countries Should Invest in Long-Term Care
Italy moves to restore healthcare access for citizens abroad – but at a price pmassetti Euractiv (18.04.2025) Supporters argue the measure would encourage more Italians abroad to formally register with AIRE, putting an end to widespread avoidance. Health italy
Delivering shock-responsive social protection in the Sahel: Urban social cash transfer response amid rising food inflation – Lessons from Nouakchott, Mauritania pmassetti World Food Programme (11.04.2025) In 2023, people in Nouakchott, Mauritania, experienced a steep increase in the cost of food and an overall upward rise in the cost of living, putting many at risk of acute food insecurity and malnutrition as they struggled to meet their basic needs. WFP responded by working with the Government of Mauritania to pilot the extension of one of the country’s national shock-responsive social safety net programmes - El Maouna - to households in the Mauritanian capital. Shocks & extreme events mauritania
Publication: Participation in Pension Programs in Low- and Middle-Income Countries pmassetti worldbank.org (24.04.2025) Low- and middle-income countries are aging rapidly but stagnation of growth in participation in pension programs, due to widespread informal employment, presents a major fiscal challenge. Some claim that improving the design of pension program rules can encourage more pension contributions, while others push for universal non-contributory pensions. This paper reviews the recent academic literature on the determinants of active participation in pension systems in high- informality settings. An emerging body of evidence shows that participation responds significantly to financial incentives as well as nonfinancial obstacles. At the same time, pensions are imperfect substitutes for other strategies to cover longevity risk, including support through the family, which will remain crucial for many older people in fiscally constrained environments. Therefore, policy makers should integrate the design of contributory pensions, social pensions, and policies that facilitate other forms of elderly support and consider how all three interact. To inform such efforts, these interactions must be more systematically investigated, and the empirical evidence must be expanded beyond a small number of middle-income countries. Pensions
Revolutionizing health and safety: The role of AI and digitalization at work pmassetti ilo.org (23.04.2025) Digitalization and automation are transforming millions of jobs worldwide, creating powerful opportunities to enhance occupational safety and health. Automation and smart monitoring systems can reduce hazardous exposures, prevent injuries and improve overall working conditions. However, these advances also bring new potential risks that require proactive and adaptive policy responses. Safety and health at work
Publication: The Road to Reforming Ethiopia’s Policies on Maternity and Paternity Leave pmassetti worldbank.org (17.04.2025) This brief provides insight into how Ethiopia increased the duration of paid maternity leave from 90 to 120 days and introduced three days of paid paternity leave in 2019. While ensuring job-protected leave of adequate length and pay for both parents is critical for a variety of health, economic, and social development outcomes, just slightly more than half of economies in the Sub-Saharan Africa region provide paid maternity and paternity leave. The brief highlights specific characteristics of Ethiopia’s socioeconomic environment that incentivized the reform. It explores the critical role of political momentum and tripartite negotiations among the Confederation of Ethiopian Trade Unions, Ethiopian Employers’ Federation, and the government, coupled with persistence by the country’s trade unions, that led to the adoption of the reform. It outlines key lessons learned that could be useful to other countries seeking to enhance their own leave policies for parents. It also describes remaining challenges to the implementation and presents recommendations on how to address these challenges to improve gender equality in Ethiopia. Parental leave ethiopia
Le Maroc sous le choc après le piratage de la Sécurité sociale : « Bienvenue en enfer où tout le monde sait combien gagne son voisin ! » pmassetti lemonde-fr (14.04,2025) Dès 2020, un journal local avait rapporté l’existence d’une « inquiétante faille de sécurité » au sein de la CNSS, dont les dispositifs de protection n’ont pas su empêcher le vol et la diffusion, le 8 avril, des attestations de salaire d’environ 2 millions d’affiliés. Information and communication technology morocco
Making social protection work for gender equality: What does it look like? How do we get there? pmassetti International Labour Organization (24.12.2024) This paper outlines the perspective and approach of the ILO’s Universal Social Protection Department to enhancing the gender-responsiveness of social protection policies, anchored in international social security standards and guided by a life-cycle approach to system-building. Gender equality
State of Social Protection Report 2025: The 2-Billion-Person Challenge pmassetti Social protection goes well beyond cash transfers; it includes policies and programs that bridge skill, financial, and information gaps, aiding people in securing better jobs. The three pillars of social protection—social assistance, social insurance, and labor market programs—support households and workers in handling crises, escaping poverty, facing transitions, and seizing employment opportunities. But despite a substantial expansion over the past decade, 2 billion people remain uncovered or inadequately covered across low- and middle-income countries. Drawing from administrative and household survey data from the World Bank’s Atlas of Social Protection Indicators of Resilience and Equity (ASPIRE), the "State of Social Protection Report 2025: The 2-Billion-Person Challenge" documents advances and challenges to strengthening social protection and labor systems across low- and middle-income countries, analyzing the evolution of expenditure, coverage, and adequacy of support. This report details four policy action areas governments can embrace to maximize the benefits of adequate social protection for all: extending social protection to those in need; strengthening the adequacy of social protection support; building shock-proof social protection systems; and optimizing social protection financing. The report discusses how the path of reforms will depend on country context, capacity, and fiscal space. The rising frequency of shocks and crises calls for major investments in the adaptability and preparedness of social protection and labor systems. Amid a world in transition, social protection is more important and necessary than ever.
Adaptive Social Protection Agenda Lessons from Responses to COVID-19 Shock: The State of Social Protection Report 2025 Background Paper #2 pmassetti worldbank.org (09.04.2025) The paper examines the social protection response to the COVID-19 pandemic across 76 emerging and developing economies (EDEs) to identify lessons on how to make these systems more resilient against risks, shocks, and crises at the individual, household, or national level. The COVID-19 pandemic triggered significant expansions in social protection systems across EDEs, with responses varying based on countries’ existing infrastructure and income levels. The analysis of 76 EDEs revealed that countries used approximately 37 percent of their social protection programs to respond to COVID-19, with social assistance programs being the most frequently used response (73 percent of total programs). EDEs increased their real per capita social protection spending by an average of 28 percent, with low-income countries (LICs) and high-income countries (HICs) showing the largest increases at around 40 percent and 32 percent, respectively. The effectiveness of responses was strongly correlated with preexisting social protection systems, economic conditions, labor market factors, and digital infrastructure. Countries with more developed social protection systems, formal labor markets, and digital payment infrastructure before the pandemic were better positioned to rapidly scale up their responses, highlighting the importance of maintaining robust routine social protection programs and delivery systems to enable effective crisis response. Shocks & extreme events
Country profiles on the rights and wellbeing of older persons: a how-to-guide from the Arab region pmassetti HelpAge International (22.03.2025) A practical guide to developing and using country profiles on the rights and wellbeing of older persons in the Arab region, based on HelpAge and UNFPA’s experience across 18 countries. Old-age pensions arabic countries
Towards a European Framework for Quality in Social Services pmassetti Social services play a crucial role in supporting individuals and communities across Europe, but ensuring consistent quality standards remains a challenge. The European Social Network (ESN) is leading efforts to develop a renewed European Social Services Quality Framework, designed to address current challenges and set clear, practical, and measurable quality standards. What does this briefing cover? Why a new framework is needed – examining the limitations of the 2010 EU Voluntary Framework and why many countries have not adopted it. Key principles of quality social services – including human rights, person-centered care, community-based support, safety, and effective management. Draft quality standards – structured using I-Statements and We-Statements to reflect the perspectives of both service users and providers. Research & development process – insights from 18 countries, incorporating feedback from public authorities, quality agencies, researchers, and people using social services. Implementation recommendations – practical steps providers can take to meet the proposed standards. Next steps – how the framework will be finalized in 2025 and its expected impact on social services across Europe. This briefing provides essential insights for public regulators, policymakers, service providers, and quality assurance Service quality Europe
English Version of "Long-term Care Tech Portal" Newly Launched, Introducing Latest Care and Age Tech in Japan pmassetti finance.yahoo.com (24.03.2025) The long-term care robot portal site management office released the English version of the Long-term Care Tech Portal (https://robotcare.jp/en/home/index?type=pw), a portal site providing information on state-of-the-art care and age tech in Japan. The portal site provides a wide range of information on long-term care technology with the aim of promoting its development and utilization in nursing care sites. The office has launched an English site for overseas visitors in order to introduce Japan's latest technologies. Visitors can learn how these technologies are being used in Japan's super-aged society. The sponsor of this site is the Japan Agency for Medical Research and Development Long-term care japan
The Care Dividend: Why and How Countries Should Invest in Long-Term Care pmassetti eurohealthobservatory.who.int (03.04.2025) Long-term care often falls by the wayside in national policy dialogues. In some countries cultural norms compel families to look after older people at home. Some pundits may look at rising health care costs and argue that the public sector cannot shoulder more care responsibilities by expanding access to long-term care. Public long-term care systems are best placed to meet the needs of the present and the future than families. Yet in most countries, chronic underinvestment has left formal long-term care systems bereft of the resources needed to meet existing needs, let alone those of the future. Against this backdrop, the aim of this book is to set out the arguments, grounded in theory and evidence, for increased public investment in high-quality, universally accessible long-term care. Strong long-term care systems benefit everyone: households, economies, health systems, and societies. Experts from around the world provide a compelling case for why and how governments can (and should) take action. Long-term care
Undeclared care work in the EU: Policy approaches to a complex socioeconomic challenge pmassetti eurofound.europa.eu (25.03.2025) The scale of undeclared care work (paid care work that is lawful but not declared to public authorities) in the EU is considerable. Recent estimates suggest that 6.8 million undeclared workers provide care or household services across the EU, with 2.1 million specifically in the care sector. Undeclared care workers are predominantly women and often are migrants. They have poor working conditions and limited social protection and are at a heightened risk of exploitation. This report examines undeclared care work in the EU, its characteristics and the challenges faced by people working in this sector. It briefly describes the complex drivers of undeclared care work and presents a range of policy responses implemented across the EU to tackle it. The findings underscore the need for a comprehensive policy framework that not only addresses immediate enforcement challenges but also tackles structural barriers to formalisation while ensuring good working conditions and social protection for care workers Difficult-to-cover groups Europe
Dynamic Social Registries for Adaptive Social Protection in the Sahel : Four Recommendations pmassetti worldbank.org (01.03.2025) This policy note consolidates the highlights of a study funded by the Sahel Adaptive Social Protection Program (SASPP), exploring the role and operationalization of dynamic social registries in low-income and shock-prone contexts, including in the Sahel. The study is based on innovations in dynamic social registries in low- and middle-income countries, identifying what works and key considerations in the design and adaptation of social registries toward their dynamic updatability and scalability in contexts marked by high exposure and vulnerability to shocks, high levels of poverty, and/or low levels of digital penetration. Information and communication technology Africa
Making Progress on Parental Benefits in Low- and Middle-Income Countries pmassetti worldbank.org (24.03.2025) The World Bank estimates that closing the gender gap in employment would increase long-run gross domestic product (GDP) per capita by 20 percent (Pennings 2022). Realizing this achievement, however, depends not only on removing gender barriers to employment but also and most emphatically on improving the quality of women’s employment. Women’s labor force participation has been stagnant since 1990, at around 53 percent for women compared to 80 percent for men, with the largest gaps in lower-middle-income countries (World Bank 2023). Moreover, as noted by the World Bank’s most recent gender strategy, “Women in the labor force are half as likely as men to have a full-time wage job, their jobs tend to be more vulnerable, and they earn 77 cents for every dollar men earn” (World Bank 2023). This note compiles findings from a study undertaken in two countries—one low income (Nepal) and one middle income (Argentina)—to examine the take-up of existing parental benefits and how parental benefit policies (or the lack thereof) influenced women’s labor market choices, childcare responsibilities, and well-being. Family benefits
Leaving no parent behind: Lessons from family friendly policies in Nepal pmassetti worldbank.org (07.03.2025) Designing family-friendly policies in low- and middle-income countries (LMICs) requires being cognizant of the diverse labor markets, administrative challenges, fiscal constraints, and prevailing social norms. A World Bank study in Nepal evaluated parental leave and related benefits to identify implementation gaps and opportunities to expand coverage to parents, especially those in the informal sector. It used a framework with six salient elements: parental leave, cash benefits, medical benefits, workplace protections, non-discrimination for return to work, and childcare. Family benefits nepal
Counterfactual impact evaluations of active labour market policies pmassetti oecd.org (20.03.2025) Public employment services and active labour market policies (ALMPs) have an important role to play in providing adaptable and responsive support to connect people with jobs. This policy report synthesises findings from a joint OECD-EC project on using linked administrative data to evaluate the impact of ALMPs. The report brings insights across a range of dimensions. It shows the power that evaluation brings to policymaking to design effective and efficient ALMPs. It demonstrates the necessity for high-quality and rich data, linked across registers. It discusses how institutions, actors and legislation co-ordinate to generate systematic and credible evidence. Despite the considerable progress made, the report identifies areas where further improvements are needed. The report is written jointly by the OECD and the Directorate General for Employment, Social Affairs and Inclusion of the European Commission. Employment policies
How does population ageing affect health system financial sustainability and affordable access to health care in Europe? pmassetti (18.03.3025) This brief aims to improve our understanding of how population ageing affects the financial sustainability of health systems, focusing on its likely impact on affordable access to health care (‎financial protection)‎. It uses the Population Ageing Financial Sustainability Gap for Health Systems (‎PASH)‎ Simulator to forecast the impact of population ageing on health system revenue and spending between now and 2060 to estimate the likely size of the ageing-related health financing gap in selected countries in Europe (‎Bulgaria, Italy, Slovakia, Slovenia and Spain)‎. It then simulates the impact of filling this gap through out-of-pocket payments on the incidence of impoverishing and catastrophic health spending – two key indicators of affordable access to health care – and discusses the policy implications for countries in Europe and beyond. Health, Old-age pensions Europe
A brief history of Medicaid and America’s long struggle to establish a health care safety net pmassetti theconversation.com (18.03.2025) The Medicaid system has emerged as an early target of the Trump administration’s campaign to slash federal spending. A joint federal and state program, Medicaid provides health insurance coverage for more than 72 million people, including low-income Americans and their children and people with disabilities. It also helps foot the bill for long-term care for older people. In late February 2025, House Republicans advanced a budget proposal that would potentially cut US$880 billion from Medicaid over 10 years. President Donald Trump has backed that House budget despite repeatedly vowing on the campaign trail and during his team’s transition that Medicaid cuts were off the table. United States
Nigeria: NSITF partners media to deepen social protection safety net pmassetti Vanguard News (17.03.2025) In a strategic move to expand Nigeria’s  social protection safety net, the Nigeria Social Insurance Trust Fund, NSITF, has announced a partnership with the Nigerian Union of Journalists, NUJ. Communication nigeria
Supporting the transition to digital cash transfers in rural Mexico pmassetti voxdev.org (21.01.2025) Women in Mexico who switched to digital cash transfers face higher costs and time accessing payments but gain bargaining power. Improving ATM access, reducing fees, providing timely information on the date of transfers and boosting financial literacy could mitigate these challenges. cct Digital inclusion, Service delivery mexico