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This study analyzes the effects of Indonesia's conditional cash transfer program on the local health care market in terms of price, utilization, and quality of care. The CCT program is associated with increased delivery fees and increased utilization of prenatal care and trained attendants for delivery assistance. Consequently, program participants experience improvements in prenatal care quality. 

Margaret Triyana is the Asia Health Policy Post-doctoral fellow. Her main interests are inequality and human capital investments, particularly early health investments in developing countries.

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2013-2014 Asia Health Policy Postdoctoral Fellow
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Margaret (Maggie) Triyana’s main research interests are inequality and human capital investments in developing countries. In particular, she is interested in the effects social policy changes on children’s health outcomes. As a Postdoctoral Fellow, she will analyze the effects of rural-urban migration in Indonesia and China, as well as the impact of health insurance expansion in Indonesia and Vietnam.

Triyana received a PhD in Public Policy from the University of Chicago in 2013.

 

Working Papers

“Do Health Care Providers Respond to Demand-Side Incentives? Evidence from Indonesia“

“The Effects of Community and Household Interventions on Birth Outcomes: Evidence from Indonesia”

“The Longer Term Effects of the ‘Midwife in the Village’ Program in Indonesia”

“The Sources of Wage Growth in a Developing Country” (with Ioana Marinescu)

Margaret Triyana Postdoctoral Fellow in Asia Health Policy Speaker Stanford University
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The US-Japan alliance is the longest, most stable, and most indispensable alliance in the modern history of East Asia.  It has served as the foundation for the region's security structure for well over a half-century.  However, with China's emergence as a rising economic and military power, and given territorial disputes involving China, Japan, and South Korea, and with escalating nationalistic rhetoric and fundamental disagreements over historical interpretations of the Pacific War, the United States and Japan are now facing worrisome tensions and strains that could undermine the solidarity of the US-Japan alliance.  Is the time-tested US-Japan alliance capable of managing both the shifts in the regional balance of power, and the threat of conflict over disputed territories, and the rising thermometer of nationalistic sentiments?   

Ambassador Ryozo Kato, former Ambassador of Japan to the United States from 2001 - 08, the longest tenure of any Japanese Ambassador to the United States, and former Commissioner of Nippon Professional Baseball from 2008 - 2013, has had a long and distinguished career in the Ministry of Foreign Affairs of the Japanese Government. A graduate of Tokyo University Faculty of Law and Yale Law School, he served his country in Australia, Egypt, and the United States, in addition to multiple global assignments within the Ministry in Tokyo.

Positions which Ambassador Kato served in the United States include the Third Secretary in the Embassy (1967–1969), Minister in the Embassy (1987–1990), and Consul-General in San Francisco (1992–1994). He returned to Japan to serve as the Director-General of the Asian Affairs Bureau (1995–1997) and the Deputy-General of the Foreign Policy Bureau (1997–1999). After serving as the Deputy Minister for Foreign Affairs (1999–2001), he was appointed the Ambassador of Japan to the United States of America from 2001 to 2008. He has been recognized and respected on both sides of the Pacific for his outstanding understanding of the issues and his clarity in direction to resolve them.

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Ryozo Kato former Ambassador of Japan to the United States Speaker
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Myanmar's opening to the outside world and the country's tentative steps from military rule to democracy has captivated many observers of the region. But Aung Zaw, an exiled Burmese journalist pushing for democratic change, warns that the image of rapid reform does not necessarily match reality these days.

“What we see now is serious backsliding,” Zaw told a packed house at the Bechtel Conference Center on March 6.  “The changes have become more superficial; the changes are not real.” 

Zaw, the founding editor of The Irrawaddy newsmagazine, delivered these remarks at Stanford upon receiving the Shorenstein Journalism Award. This annual award is conferred upon a journalist who promotes mutual understanding between the U.S. and Asia, and also honors Asian journalists who have been at the forefront of the effort to create an independent media in the Asia-Pacific.

Zaw joined scholars Donald K. Emmerson and Daniel C. Sneider from the Walter H. Shorenstein Asia Pacific Research Center in the Freeman Spogli Institute for International Studies and Yale University’s Nayan Chanda at a lunchtime panel discussion of the question – “Burma's Democracy: How Real?

Zaw, who was forced into exile after the abortive democratic revolt of 1988, described Myanmar’s dynamic history as “up and down.” During the long period of military rule in the country, “Burma was a pariah,” he observed. The military government repressed all opposition, enriching itself while Burma slide into deep poverty, while the country was largely cut off from the outside world except for a trickle of tourists. But the regime made a clear decision to open the doors to the outside and, in response to international and domestic pressure, take tentative steps toward political change, including releasing political prisoners and allowing the media to operate more freely.

The panelists agreed that the uprisings within Burma, such as the Buddhist monk led revolt in 2007, and the leadership of Burmese human rights activist Aung San Suu Kyi pushed the regime toward change. In addition, Chanda and Emmerson pointed to the geopolitics of Burma, the desire of the regime to free itself from isolation and dependence only on China and North Korea as backers.

Zaw credited these changes with bringing some semblance of “communal balance” to the society. Emmerson argued, however, that the West has colored their view of Burma with a romantic notion of democratization that tends to overlook the still tentative, and somewhat transient, nature of the changes to date.

“The regime has carefully manipulated… international [public] opinion in trying to open the doors to the international community,” Zaw said. Especially in the past year, there have been efforts by the government to curb public protest and censorship has become pervasive once again. A commentary piece written by Zaw provides an analysis of the contemporary media environment in Myanmar.

The panel members pointed in particular to the rise of tensions between the Buddhist Burmese majority and ethnic and religious minorities in the country. In particular, they expressed concern over the discrimination against and violence suffered by minority Muslims, the ethnic Rohingya who live along the border with Bangladesh, often taking place with the complicity of government officials, or at least with their indifference. They suggested the government played upon anti-Muslim feelings to boost its popularity among the majority Buddhist populace.

With elections looming in 2015, the government may now feel it has been “moving too fast” toward reform and begun to ratchet back, warned Zaw. Conservative factions in Myanmar’s leadership who fear losing power may be gaining influence.

Nayan Chanda, the former editor of the Far Eastern Economic Review and a previous recipient of the Shorenstein Award, pointed to Myanmar’s long tradition of despotism. “Burmese rulers have had a way of governing the country that is still present among the generals we see in Burma today,” he said.

Emmerson focused his remarks on the significance of the changes in Burma to American foreign policy in the region. The Burmese shift away from Chinese domination and its opening to the West has been seen as a key part of the so-called U.S. “pivot” to Asia and its attempts to balance Chinese influence in East Asia. These changes allowed Myanmar to assume its role as chairman of the Association of Southeast Asian Nations (ASEAN), an annual rotation in leadership. But it is far from clear if the Burmese leadership is prepared to go toward a deeper democratic transformation. The upcoming presidential elections in 2015 remain an uncertainty. Aung San Suu Kyi is still constitutionally barred from running for president but she has been allowed to resume a powerful role in the system itself, no longer simply a “Joan of Arc” symbol of purity sitting on the outside.

In all this, the role of a free press in Burma is even more vital than ever. After his arrest in 1988 for his role in the uprising against General Ne Win’s regime, Zaw had to flee to neighboring Thailand where he has spent 25 years in exile. Zaw created The Irrawaddy, an émigré-based publication that is widely acclaimed for its on-the-ground analysis of Myanmar. In 2012, the publication reopened offices in Burma. 

The Irrawaddy’s diverse contributors offer an independent platform to unravel the complex developments within the country. The Shorenstein Award given to Zaw recognizes his history of leadership as a journalist in Burma.

“It is very exciting for us this year to give this award to Aung Zaw,” said Sneider, a member of the jury that selects the awardees. “He has been intimately involved in the process of not only creating independent media for Burma but also in the process of independent change itself, starting with his own activism in the 1980s.”

Zaw received the award at a dinner ceremony later on March 6 attended by students, faculty and prominent members of the Stanford community. “I feel very humbled,” Zaw told the Voice of America in an interview. “It is an acknowledgement to our work, our commitment and our independent journalism as we try to make things different [in Myanmar].”

The video and transcript of the event, and the original press release on Zaw being named the 2013 Award recipient are posted below.

 
 

An article was published by The Irrawaddy on Zaw’s acceptance of the award. Interviews conducted with Voice of America's Kyaw Zan Thaw in Burmese and Kaye Lin in English aired internationally on March 13 and are posted below. An interview was also conducted with LinkAsia and is scheduled to air in the upcoming week and will be subsequently posted online. 
 

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Ezra F. Vogel is the Henry Ford II Professor of the Social Sciences Emeritus at Harvard. After graduating from Ohio Wesleyan in 1950 and serving two years in the U.S. Army, he studied sociology in the Department of Social Relations at Harvard, receiving his Ph.D. in 1958. He then went to Japan for two years to study the Japanese language and conduct research interviews with middle-class families. In 1960-1961 he was assistant professor at Yale University and from 1961-1964 a post-doctoral fellow at Harvard, studying Chinese language and history. He remained at Harvard, becoming lecturer in 1964 and, in 1967, professor. He retired from teaching on June 30, 2000.

Vogel succeeded John Fairbank to become the second Director (1972-1977) of Harvard's East Asian Research Center and Chairman of the Council for East Asian Studies (1977-1980). He was Director of the Program on U.S.-Japan Relations at the Center for International Affairs (1980-1987) and, since 1987, Honorary Director. He was Chairman of the undergraduate concentration in East Asian Studies from its inception in 1972 until 1991. He was Director
of the Fairbank Center (1995-1999) and the first Director of the Asia Center (1997-1999). Vogel was Chairman of the Harvard Committee to Welcome President Jiang Zemin (1998). He has also served as Co-director of the Asia Foundation Task Force on East Asian Policy Recommendations for the New Administration (2001).

Drawing on his original field work in Japan, he wrote Japan's New Middle Class (1963). A book based on several years of interviewing and reading materials from China, Canton Under Communism (1969), won the Harvard University Press faculty book of the year award. The Japanese edition of his book Japan as Number One: Lessons for America (1979) is the all-time best-seller in Japan of non-fiction by a Western author. In Comeback (1988), he suggested things America might do to respond to the Japanese challenge. He spent eight months in 1987, at the invitation of the Guangdong Provincial Government, studying the economic and social progress of the province since it took the lead in pioneering economic reform in 1978. The results are reported in One Step Ahead in China: Guangdong Under Reform (1989). His Reischauer Lectures were published in The Four Little Dragons: The Spread of Industrialization in East Asia (1991). His most recent publication is Is Japan Still Number One? (2000). He has visited East Asia every summer since 1958 and has spent a total of over six years in Asia.

Vogel has received honorary degrees from Kwansei Gakuin (Japan), the Monterrey Institute, the Universities of Maryland, Massachusetts (Lowell), Wittenberg, Bowling Green, Albion, Ohio Wesleyan, Chinese University (Hong Kong) and Yamaguchi University (Japan). He received The Japan Foundation Prize in 1996 and the Japan Society Prize in 1998. He has lectured frequently in Asia, in both Chinese and Japanese.

From fall 1993 to fall 1995, Vogel took a two-year leave of absence from Harvard to serve as the National Intelligence Officer for East Asia at the National Intelligence Council in Washington. He directed the American Assembly on China in November 1996 and the Joint Chinese-American Assembly between China and the United States in 1998.

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Ezra Vogel Henry Ford II Professor of Social Sciences, Emeritus Speaker Harvard University
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Mr. Rudd served as Australia’s 26th Prime Minister from 2007 to 2010, then as Foreign Minister from 2010 to 2012, before returning to the Prime Ministership in 2013. As Prime Minister, Mr. Rudd led Australia’s response during the Global Financial Crisis. Australia's fiscal response to the crisis was reviewed by the IMF as the most effective stimulus strategy of all member states. Australia was the only major advanced economy not to go into recession. Mr. Rudd is also internationally recognized as one of the founders of the G20 which drove the global response to the crisis, and which in 2009 helped prevent the crisis from spiraling into a second global depression.

As Prime Minister and Foreign Minister, Mr. Rudd was active in global and regional foreign policy leadership. He was a driving force in expanding the East Asia Summit to include both the US and Russia in 2010. He also initiated the concept of transforming the EAS into a wider Asia Pacific Community to help manage deep-routed tensions in Asia by building over time the institutions and culture of common security in Asia. On climate change, Mr. Rudd ratified the Kyoto Protocol in 2007 and legislated in 2008 for a 20% mandatory renewable energy target for Australia. Mr. Rudd launched Australia's challenge in the International Court of Justice with the object of stopping Japanese whaling in the Southern Ocean. Mr Rudd drove Australia’s successful bid for its current non-permanent seat on the United Nation’s Security Council and the near doubling of Australia's foreign aid budget.

Mr. Rudd remains engaged in a range of international challenges including global economic management, the rise of China, climate change and sustainable development. He is on the International Advisory Panel of Chatham House. He is a proficient speaker of Mandarin Chinese, a Visiting Professor at Tsinghua University and funded the establishment of the Australian Centre on China in the World at the Australian National University. He was a co-author of the recent report of the UN Secretary General's High Level Panel on Global Sustainability – “Resilient People, Resilient Planet" and chairs the World Economic Forum's Global Agenda Council on Fragile States. He also remains actively engaged in indigenous reconciliation.

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Kevin Rudd 26th Prime Minister of Australia Speaker
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In the next 20 years, the middle class in Asia is projected to swell from 600 million to 3.2 billion.  If managed successfully, this could not merely be the single largest reduction in poverty in human history, but it could also substantially improve the fortunes of many non-Asian nations, especially the U.S.   Ambassador Bleich’s remarks will discuss the planning of America’s economic, diplomatic, and security rebalance to Asia, its progress to date, and the challenges that will ultimately determine whether Asia rises peacefully and successfully or whether it fails to meet its promise or worse.  Ambassador Bleich will address in particular the choice of Australia as the focal point for the rebalance, and how the U.S. alliance with Australia and leveraging of that relationship with other allies and partners in Southeast Asia are critical elements of ensuring a successful Indo-Pacific century.

Ambassador Jeffrey Bleich served as United States Ambassador to Australia from 2009-2013. His tenure in Australia was marked by a commitment to expanding Australia and the United States’ broad alliance by promoting security, advancing free trade, promoting human rights and expanding collaboration in education, space, energy and technology. He recently received the State Department's highest award for a non-career ambassador, the Sue Cobb Prize for Exemplary Diplomatic Service. Immediately prior to his nomination for ambassador in 2009, Ambassador Bleich served as Special Counsel to President Obama in the White House.

Ambassador Bleich recently rejoined Munger Tolles & Olson as a partner resident in the San Francisco office and will focus on international and domestic litigation and counseling, with a particular focus on privacy and data security, investigations, trade and cross-border disputes.

Ambassador Bleich received his law degree in 1989 from the University of California at Berkeley, Boalt Hall School of Law, where he was editor-in-chief of the California Law Review and Order of the Coif. He graduated from Amherst College magna cum laude with a B.A. in political science and holds a masters degree from Harvard University’s School of Government. He has also been awarded honorary doctorates from both U.S. and Australian universities.

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Jeffrey Bleich Former Ambassador to Australia Speaker
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We estimate the degree of supplier-induced demand for newborn treatment by exploiting changes in reimbursement arising from the introduction of the partial prospective payment system (PPS) in Japan. Under the partial PPS, neonatal intensive care unit (NICU) utilization became relatively more profitable than other procedures, since it was excluded from prospective payments. We find that hospitals have responded to PPS adoption by increasing NICU utilization and by more frequently manipulating infants’ reported birth weights which in large part determine their maximum allowable stay in the NICU. This induced demand substantially increases the reimbursements received by hospitals.

Published: Shigeoka, Hitoshi, and Kiyohide Fushimi. "Supplier-induced demand for newborn treatment: Evidence from Japan." Journal of health economics 35 (2014): 162-178.

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The favelas of Rio de Janeiro are some of the most dangerous places in the world. Havens for drug lords and their booming narcotics businesses, the urban slums that are home to 20 percent of the city’s population are notorious for soaring murder rates and a dearth of public services. Police often have little or no presence in most of Rio’s 800 favelas. And when they do, their conflicts with criminals frequently result in the killing of bystanders.

Brazilian officials have tried to bring order to the favelas with a set of policies and initiatives launched in 2008. A so-called pacification program has trained special teams of police to take a more targeted approach to fighting crime. The program has increased stability and reduced violence in about 30 favelas.

But Stanford researchers have found a hitch: When criminals are put out of business in one favela, they relocate to another. And that can lead to an increase in violence in the non-pacified slums.

“The cost of violence is disproportionately felt by the poor,” said Beatriz Magaloni, an associate professor of political science and senior fellow at Stanford’s Freeman Spogli Institute for International Studies. “Where there is violence, there is no investment. We are working with the government and the police and the community on ways to make these places safer and reduce that poverty by improving the quality of the police and devising ways to reduce the level of lethality they tend to use.”

To support the research she’s doing and the relationships she’s building in Brazil, Magaloni is working with FSI’s International Policy Implementation Lab, a new initiative that will bolster impact-oriented international research, problem-based teaching and long-term engagement with urgent policy implementation problems around the world.

Collaborating with a team of Stanford students, Magaloni is working with community groups, police organizations, government officials and other scholars to study existing policies and training procedures that could broaden the pacification program and make it more effective. The relationships have paid off with access to high-level government data, exclusive research findings and a pipeline between academics and policymakers that can improve living conditions for some of Rio’s poorest and most vulnerable people.

Her project is an example of the work being supported by the International Policy Implementation Lab, which recently awarded Magaloni’s project and those led by five other researchers a total of $210,000.

The lab, which is being supported in part by an initial $2 million gift from two anonymous donors, will grant another round of funding later this fiscal year to support projects led by Stanford faculty.

Recognizing that many Stanford scholars are engaged in international policy analysis, the Implementation Lab will help researchers who want to better understand policy implementation – a process often stymied by bureaucracy, politicking and budget constraints, but also often reflecting deliberation and experimentation by people across different countries, organizations, and cultures.

“The Implementation Lab will help us better understand health, security, poverty and governance challenges in an evolving world,” said FSI Director Mariano-Florentino Cuéllar.  “It will serve as a resource to foster communication across projects, so we can learn more about how implementation plays out in different settings and regions. Through the Implementation Lab, we can better engage faculty and students in understanding how policymakers and organizations change longstanding practices and actually execute policy.”

The Implementation Lab will support long-term projects grounded in policy-oriented research on a specific international topic. The projects must strive to connect scholarly research to interdisciplinary teaching, and will often involve long-term engagement with particular problems or international settings to better understand and inform the implementation of policy.

The first round of funding from the Implementation Lab will help shore up projects aimed at bolstering rural education in China, improving health care in India, curbing violence in Mexico and Brazil, and training government officials and business leaders in developing countries to improve economic growth and development.

And it will support a project led by political scientist Scott Sagan that uses online polling to better gauge the public’s tolerance for the use of nuclear weapons under certain scenarios – work that will lead to the collection of data that can inform how government officials craft military and diplomatic strategy.

“I can imagine two big benefits of the Implementation Lab,” said Sagan, a senior fellow at FSI and the institute’s Center for International Security and Cooperation.

“It will help pay for specific tasks that are sometimes not adequately funded elsewhere, especially in terms of student involvement,” he said. “And it will create a greater focus on policy implementation work that allows us to present our research results and see whether those results will have an impact on change.”

To encourage and support these ventures, the Implementation Lab will provide targeted funding, space for research projects and teaching, and a variety of support functions, including connections to on-campus resources that can assist with data visualization, locating interested students, and other tasks.  Those activities will be phased in during the next year based on the advice and feedback of faculty and others who are early participants.

The Implementation Lab is poised to be different from – but complementary to – other Stanford initiatives like the Hasso Plattner Institute of Design. FSI’s Implementation Lab is specifically focused on supporting long-term relationships and engaging students and faculty in the study of policy implementation in different national, organizational, and cultural settings.

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FSI Senior Fellow Grant Miller is working on improving health care in India.

“The Stanford International Policy Lab is creating an exciting new community that will catapult our ability to have meaningful and sustained policy engagement and impact through common learning and sharing of experiences with like-minded scholars from all corners of campus,” said Grant Miller, an associate professor of medicine and FSI senior fellow whose project on improving health care in India is being supported by the Implementation Lab.

Ann Arvin, Stanford’s vice provost and dean of research, said the International Policy Implementation Lab will help and encourage faculty to make their scholarship more relevant to pressing problems.

Demands for specialized resources, narrowly focused engagement of students, the ability to consider a long-term horizon, and an understanding of the often opaque processes of policy formulation and implementation pose considerable challenges for researchers seeking to enhance the potential of their policy-oriented research to achieve real impact.

“The International Policy Implementation Lab will help our faculty and students address these obstacles,” Arvin said. “We anticipate that this novel program will bring together Stanford scholars who seek solutions to different policy-related problems at various places around the world, but whose work is linked by the underlying similarities of these challenges. The Implementation Lab will give them the opportunity to learn from each other and share ideas and experiences about what succeeds and what is likely to fail when it comes to putting policy into practice.”

That’s what attracts Stephen Luby to the lab.

“The mistake that researchers often make is that they work in isolation,” said Luby, whose work on reducing pollution caused by the brick making industry in Bangladesh is being supported by the Implementation Lab. “Then they think they’re ready to engage in the implementation process, and realize they haven’t engaged with all the stakeholders. Policy implementation is an iterative process. You need feedback from all the right people along the way.”

Luby, a professor of medicine and senior fellow at FSI and the Stanford Woods Institute for the Environment, is working with brick makers and suppliers, as well as anthropologists and government regulators, to identify better ways to curb the pollution created by the coal-burning kilns throughout Bangladesh.

“Pneumonia is the leading cause of death among kids in Bangladesh,” Luby said. “And the brick kiln pollution is largely responsible for that. They’re using a 150-year-old technology to bake bricks, and there are better, cleaner ways to do it.”

But swapping coal-burning kilns for ones that are fired with cleaner natural gas is expensive, and there is little incentive for brick makers to change.

The government has passed regulations aimed at reducing pollution, but corruption, toothless laws and poor enforcement continue to undermine those policies.

"The country is caught in an equilibrium where people are getting cheap bricks but at a high cost to health and the environment,” Luby said. “We need to disrupt that equilibrium, and I look to the Implementation Lab to help us think this through. There’s a community of scholars who want to transform their work into implementation, and the lab will help convene them.”


For more information about FSI's International Policy Implementation Lab, please refer to this Concept Note or contact Elizabeth Gardner.

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Koret Distinguished Lecture Series: Lecture IV

From early 2012, South Korea-Japan relations worsened due to what many Koreans regard as a series of Japanese provocations involving historical and territorial disputes. Unfortunately, the neighbors failed to utilize the opportunity to improve the situation following leadership changes in both countries at the beginning of 2013. Today their bilateral relationship, long considered a cornerstone of peace and stability in Northeast Asia, appears to the worst since the normalization of diplomatic ties in 1965. Former Korean ambassador to Japan Shin Kak-soo will analyze the complicated structural reasons behind this downward spiral and explore whether differences over history can be addressed and an early diplomatic "reset" achieved.

Ambassador Shin has served various diplomatic positions during his thirty-five year career in foreign affairs, including service as ambassador to the State of Israel from 2006 to 2008 and to Japan from 2011 to 2013. He is currently a professor at the Korean National Diplomatic Academy and also a special research fellow at the Institute of Japanese Studies, Seoul National University.

The Koret Distinguished Lecture Series was established in 2013 with the generous support of the Koret Foundation

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Shin Kak-soo former Korean Ambassador to Japan Speaker
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