Search

This study analyzes education, training, and the youth labor market in central and eastern Europe.

We study a mechanism that gives students the option of paying higher tuition to attend their preferred schools. This seat‐purchasing mechanism is neither strategyproof nor stable. Our paper combines administrative and survey data to estimate students' preferences and conducts welfare analysis. We find that changing from a deferred acceptance mechanism to the cadet‐optimal stable mechanism reduces students' welfare but that adopting the observed seat‐purchasing mechanism alleviates this welfare loss. Moreover, students from affluent communities prefer to pay higher tuition to stay at preferred schools, while those from less affluent communities are more likely be priced out to lower‐quality schools. [ABSTRACT FROM AUTHOR]

The study explored students’ perception regarding how ethical considerations are integrated into accounting curricula at the tertiary level in Ghana, guided by both the International Education Standards (IES) and the CIPP model. It questions the effectiveness of accounting education in adequately preparing students to face ethical challenges, with a specific focus on tertiary institutions in Ghana. Using a positivist paradigm and a cross-sectional survey methodology, the study targeted final-year undergraduate accounting students in public tertiary institutions. Multiple sampling techniques, including proportionate, stratified, and simple sampling, were utilized to select 307 students for the study. The collected data underwent analysis using descriptive statistics (frequency, percentage, mean and standard deviation) and inferential statistics (multiple linear regression). The study found a significant 70% alignment between the curricula of the sampled universities and the requirements of IES 4. Moreover, it revealed a limited use of participative teaching approaches in ethics within accounting lessons. Additionally, the findings revealed that students have a low perception of the effectiveness of accounting curricula in addressing their professional ethical needs. This perception was influenced by factors such as age, religiosity and, to a lesser extent, gender.

The research purpose of this paper was to explore the evaluation of skills by academic staff to improve the quality of the administration process in higher education institutions (HEIs) from two perspectives. Firstly, the authors investigated whether there are statistically significant differences between the genders of academic staff in higher education institutions regarding the evaluation of their skills and competencies. Secondly, the study aimed to determine if there are statistically significant differences in competencies perceived between academic staff of STEM sciences and those with academic experience in other sciences in terms of assessing their professional competencies. The purpose was determined by the impact of self-assessment of professional competencies on the improvement of administrative processes.

A skilled principal is an invaluable asset in the evolving landscape of higher education institutions, where challenges continually arise and the global economy demands adaptability. This study explored the essential skills and knowledge necessary for principal roles in Islamic Economics and Finance (IEF) schools. A qualitative multiple-case study approach was employed, and semi-structured interviews were conducted with 34 academics from four IEF schools at public universities in Saudi Arabia and Malaysia. The study revealed six essential skill and knowledge areas that IEF school principals must possess to thrive: advocacy for IEF education, developing and communicating a clear strategic vision, efficiently managing resources and workloads, fostering a collegial environment, providing effective instructional leadership, and building and sustaining strong partnerships. Improving the skills and knowledge of IEF principals can lead to better school management and education. The findings of this study hold significant importance in the advancement of leadership programs designed for IEF school principals and provide valuable insights for policymakers and stakeholders regarding the indispensable knowledge and skills that principals of IEF schools must possess.

Academic probation policies place restrictions on low-performing college students, incentivizing them to improve their performance or leave the program. We examine the effect of an intensive academic probation policy that includes mandatory study time. Using a regression discontinuity analysis and administrative data from the U.S. Air Force Academy, we find that placement on academic probation increases performance without increasing attrition and increases completion of science, technology, engineering, and mathematics (STEM) degrees. These impacts are surprising in light of research showing increased attrition and shifts towards easier course loads at other institutions, suggesting that more intensive interventions may help low-performing college students without discouraging program completion. [ABSTRACT FROM AUTHOR]

School-based mental health services (SBMH) may increase students' access to care, which could yield benefits for mental health status and human capital-related outcomes. We use a difference-in-differences design with 19 years of survey and administrative data to estimate the impacts of SBMH on a range of K–12 student outcomes. SBMH increases average outpatient mental health service use and reduces self-reported suicide attempts. There is weaker evidence that SBMH reduces suspensions and juvenile justice involvement and no evidence that SBMH affects average attendance, standardized test scores, or self-reported substance use. [ABSTRACT FROM AUTHOR]

Degrees are presumably the most important institution in education markets. However, despite their high relevance, degrees and their design features remain poorly understood within the economics of education. This study addresses this gap. We provide an accurate formal definition of what constitutes a degree and formulate the first theory of degree design. This theory is based on a technological platform view that interprets degrees as modules within a hierarchical structure resembling that of software architectures. This approach provides new opportunities to address questions of degree optimization. Furthermore, a novel strategy to optimize the design of school degrees is proposed. This strategy is expected to improve the learning environment of weaker students across all school types, leaving higher-performing students rather unaffected. The implications and limitations of our approach are also discussed.

In a world that has rapidly transformed through the advent of artificial intelligence (AI), our systematic review, guided by the PRISMA protocol, investigates a decade of AI research, revealing insights into its evolution and impact. Our study, examining 3,767 articles, has drawn considerable attention, as evidenced by an impressive 63,577 citations, underscoring the scholarly community's profound engagement. Our study reveals a collaborative landscape with 18,189 contributing authors, reflecting a robust network of researchers advancing AI and machine learning applications. Review categories focus on systematic reviews and bibliometric analyses, indicating an increasing emphasis on comprehensive literature synthesis and quantitative analysis. The findings also suggest an opportunity to explore emerging methodologies such as topic modeling and meta-analysis. We dissect the state of the art presented in these reviews, finding themes throughout the broad scholarly discourse through thematic clustering and BERTopic modeling. Categorization of study articles across fields of research indicates dominance in Information and Computing Sciences, followed by Biomedical and Clinical Sciences. Subject categories reveal interconnected clusters across various sectors, notably in healthcare, engineering, business intelligence, and computational technologies. Semantic analysis via BERTopic revealed nineteen clusters mapped to themes such as AI in health innovations, AI for sustainable development, AI and deep learning, AI in education, and ethical considerations. Future research directions are suggested, emphasizing the need for intersectional bias mitigation, holistic health approaches, AI's role in environmental sustainability, and the ethical deployment of generative AI.

The paper investigates the short-run job mobility of educationally mismatched workers, examining the validity of the Sicherman-Galor hypothesis, which predicts that overeducation is a temporary condition from a worker’s perspective associated with higher upward occupational and wage mobility. The study uses data from the Polish Labour Force Survey, investigating yearly changes in employment status, occupation, and wages. The results show that overeducated workers are more likely to remain employed compared to their properly matched colleagues. Both overeducated and undereducated workers tend to move towards jobs for which they are better matched. However, the rate of this adjustment is very low, contradicting the Sicherman-Galor hypothesis. On the other hand, overeducated workers, but mostly prime-aged ones, are found to experience faster wage growth compared to properly matched individuals, aligning with the Sicherman-Galor hypothesis. The higher wage growth of overeducated workers can be partially attributed to workers improving their match status over time.

This paper evaluates the long-run effects of Head Start using large-scale, restricted administrative data. Using the county rollout of Head Start between 1965 and 1980 and age-eligibility cutoffs for school entry, we find that Head Start generated large increases in adult human capital and economic self-sufficiency, including a 0.65-year increase in schooling, a 2.7 percent increase in high school completion, an 8.5 percent increase in college enrollment, and a 39 percent increase in college completion. These estimates imply sizable, long-term returns to investments in means-tested, public preschool programs.

Lifelong education includes formal and nonformal forms of learning during an individual's life cycle for the conscious and continuous development of one's quality and the quality of life in society.

We assess the effectiveness of an intervention aimed at improving the reading skills of struggling third-grade students in Colombia. In a series of randomized experiments, students participated in remedial tutorials conducted during school hours in small groups. Trained instructors used structured pedagogical materials that can be easily scaled up. Informed by the outcomes of each cohort, we fine-tuned the intervention tools for each subsequent cohort. We found positive and persistent impacts on literacy scores and positive spillovers on some mathematics scores. The effectiveness of the program grew over time, likely because of higher dosage and the fine-tuning of materials. [ABSTRACT FROM AUTHOR]

This work examines how to detect, document, and prevent plagiarism in exams. First, to identify and quantify plagiarism, we propose methods that compare similarities in multiple-choice answers between seat neighbors and nonneighbors. Second, we document cheating in undergraduate exams. Under baseline monitoring, at least 7.7 percent of the row-wise neighbor pairs plagiarized. Pairs composed of academically weaker students cheated more. Third, using a field experiment, we demonstrate that close monitoring eliminated cheating. By contrast, signing an honesty declaration doubled cheating relative to the control group. Complementary experiments suggest that the declaration backfired because it weakened the social norm of academic integrity. [ABSTRACT FROM AUTHOR]

Non-random assignment of students to teachers can bias value added estimates of teachers' causal effects. Rothstein (2008a, b) shows that typical value added models indicate large counter-factual effects of 5th grade teachers on students' 4th grade learning, indicating that classroom assignments are far from random. This paper quantifies the resulting biases in estimates of 5th grade teachers' causal effects from several value added models, under varying assumptions about the assignment process. If assignments are assumed to depend only on observables, the most commonly used specifications are subject to important bias but other feasible specifications are nearly free of bias. I also consider the case where assignments depend on unobserved variables. I use the across-classroom variance of observables to calibrate several models of the sorting process. Results indicate that even the best feasible value added models may be substantially biased, with the magnitude of the bias depending on the amount of information available for use in classroom assignments.

Recent proposals would strengthen the dependence of teacher pay and retention on performance, in order to attract those who will be effective teachers and repel those who will not. I model the teacher labor market, incorporating dynamic self-selection, noisy performance measurement, and Bayesian learning. Simulations indicate that labor market interactions are important to the evaluation of alternative teacher contracts. Typical bonus policies have very small effects on selection. Firing policies can have larger effects, if accompanied by substantial salary increases. However, misalignment between productivity and measured performance nearly eliminates the benefits while preserving most of the costs.

Education, innovation, the labour force, and new businesses are considered the key important sectors (factors) for developed and emerging economies. The paper analyses are performed by using the Cobb Douglas production function for analysing the impact and correlation of these factors (variables) on the economic growth of Kosova during the period 2013 - 2021. The variables of public expenditures on education as a percentage of GDP and the labour force have shown a negative impact on growth and they have operated under decreasing returns to scale (based on the Cobb-Douglas function), while the variables of information, computer and telecommunication services (which refer to innovation technology) and new business creation have indicated a positive impact on growth and they have operated under increasing returns to scale (based on the Cobb-Douglas function). In addition, this paper summarized a few useful conclusions: first, public expenditure on education should provide an important contribution on growth; second, enhancing the role of education to improve and develop new knowledge for the labour force in Kosova, and at the same time, to adapt with new labour market demand; third, information, computer and telecommunication is one of the leading export sectors and this sector should provide higher potential and contributions on the economic growth of Kosova; fourth, new businesses creation should provide a significant contribution to increase economic growth. These variables in many countries have made a key value contribution to the economy by driving it toward sustainability, development, and growth.

The COVID-19 pandemic has changed the learning process, which was previously carried out conventionally with face-to-face interaction, into an online learning activity (e-learning). e-Learning has several benefits, but it also has some challenges that need to be addressed. A preliminary survey has been conducted by asking open-ended questions regarding students’ experience and obstacles during e-learning to determine their perceptions of e-learning, and the results showed that there were problems faced by students in implementing e-learning, especially pertaining to student loyalty. Previous research has stated that e-learning service quality exercises an influence on student satisfaction and student loyalty. This research focusses on the influence of e-learning service quality factors on student perceived value (SPV) and student satisfaction, and ultimately on its role in influencing student loyalty. This research was conducted using a quantitative approach, wherein data were gathered, using judgement sampling, from 309 undergraduate students enrolled across six universities in Tangerang. These data were analysed by partial least squares structural equation modelling (SEM-PLS), and the results of the analysis indicated the presence of a positive and significant relationship between these variables. Resultant to the analysis, there emerged some useful suggestions for educational institutions and lecturers that would enable them to improve the quality of e-learning. The findings of the present study imply that improving the factors of e-learning service quality will inculcate in students a favourable value perception towards the university, as well as create a feeling of satisfaction in them, arising from the fulfilling character of the experience to which they were exposed during the e-learning process; these phenomena are expected in turn to increase students’ loyalty towards the university.

I examine how undocumented immigrants respond to the threat of deportation by contrasting daily public school attendance among undocumented Hispanic, documented Hispanic, and white students. This is the first study that is able to quantify undocumented individuals' responses to immigration enforcement. I find that undocumented Hispanic students are acutely responsive to the rollout of a state immigration-enforcement law, with large spikes in absenteeism on days when the law overcomes court challenges. Increased withdrawals from school immediately followed the law clearing federal court. These laws seem to resonate more than Immigration and Customs Enforcement (ICE) operations in the local area. [ABSTRACT FROM AUTHOR]

Hurricane Katrina was one of the nation's worst natural disasters. It also triggered one of the nation's most intense market-based school reforms, in which almost all traditional public schools were turned into charter schools. We study the effects of these combined events on students who attended New Orleans public schools before and after the storm. Using matched difference-in-differences, we find that student test scores, high school graduation, college attendance, and college graduation all rose sharply. Most racial and income gaps in outcomes declined. The school reforms appear to have been the main mechanism. [ABSTRACT FROM AUTHOR]

The aim of this paper is to discuss the role and impact of Generative Artificial Intelligence (AI) systems in higher education. The proliferation of AI models such as GPT-4, Open Assistant and DALL-E presents a paradigm shift in information acquisition and learning. This transformation poses substantial challenges for traditional teaching approaches and the role of educators. The paper explores the advantages and potential threats of using Generative AI in education and necessary changes in curricula. It further discusses the need to foster digital literacy and the ethical use of AI. The paper’s findings are based on a survey conducted among university students exploring their usage and perception of these AI systems. Finally, recommendations for the use of AI in higher education are offered, which emphasize the need to harness AI’s potential while mitigating its risks. This discourse aims at stimulating policy and strategy development to ensure relevant and effective education in the rapidly evolving digital landscape.

Background: The pandemic of Covid-19 brought significant changes to the education system and forcibly accelerated the process of digitizing teaching. Students and educators had to adapt to the new way of education, facing challenges such as technical problems and a lack of technical skills and social contact.

Background: Due to the Covid 19 pandemic, in many countries, higher, secondary and even primary education experienced the unannounced shift from traditional classroom lessons to distance teaching using different technologies.

Background: In this paper, the focus is on the application of digital and mobile technologies as supporting tools for the implementation of gamification in the field of education of future economists.

Subject and purpose of work: This study focuses on vocational education. It explores the role of international internships in the vocational education of the students of technical secondary schools.

Perceived peer discrimination in the classroom reduces school performance. Considering the context of rural migrants in urban China, we find that migrant students' test scores are lower when local classmates report more antimigrant discrimination. Our empirical strategy relies on isolating exogenous variation in locals' discriminatory attitudes toward rural migrants across randomly assigned classrooms in the same school. We use whether locals had migrant friends outside school in their first year of middle school to instrument for discrimination in the classroom. The negative effects of perceived discrimination are largest for migrant students with less-educated parents, lower ability, and lower self-confidence. [ABSTRACT FROM AUTHOR]

While the literature has documented negative effects of conflict on educational outcomes, there is little evidence on the effect of conflict termination. We show how the permanent ceasefire declared by FARC's insurgency during peace negotiations with the Colombian government caused a differential improvement on several educational outcomes in the areas affected by FARC violence prior to the ceasefire. These effects are not explained by peace building and post-war recovery investments, and they are only partially driven by wartime child soldiering. Instead, we find support for other mechanisms, such as the post-ceasefire plummeting of victimization and new economic opportunities in treated areas. [ABSTRACT FROM AUTHOR]

We study the causal impact of intellectually gifted students on their nongifted classmates'school achievement, enrollment in post-compulsory education, and occupational choices. Using student-level administrative and psychological data, we find a positive effect of exposure to gifted students on peers' school achievement in both math and language. This impact is heterogeneous: larger effects are observed among male students and high-achievers, and female students benefit primarily from female gifted students. Effects are driven by gifted students not diagnosed with emotional or behavioral disorders. Exposure to gifted students increases the likelihood of choosing a selective academic track and occupations in STEM fields. [ABSTRACT FROM AUTHOR]

As the evidence linking test scores to long-run student outcomes has grown, standardized assessments have become a widely used management tool in education including addressing the racial education gap. One of the concerns with the use of standards tests is the perverse incentive for teachers to alter test scores. The consequences for educators found cheating can be substantial, although little is known about how students are impacted by cheating. Using an 11-year panel of individual-level data on students and teachers from a predominantly Black urban school district where widespread test-score manipulation occurred, we investigated the impact of teacher cheating on subsequent student test scores. To access the impact, we used school-grade and classroom fixed effects as well as measure potential omitted variable bias (OVB). We found that for each additional wrong-to-right altered test question it is associated with a reduced future achievement of between 0.003 and 0.014 standard deviations depending on the specification. Although the evidence from OVB analysis does not suggest that test-score manipulation itself harmed or benefited students. Our evidence also contributes to a growing literature on the importance of sensitivity tests for OVB. We show how failure to conduct such tests could lead to erroneous findings. [ABSTRACT FROM AUTHOR]

Abstract Objectives This paper assesses the impact of effective access on out-of-pocket health payments and catastrophic health expenditure. Effective access cannot be attained unless both health services and financial risk protection are accessible, affordable, and acceptable. Therefore, it represents a key determinant in the transition from fragmented health systems to universal coverage that many low- and middle-income countries face. Methods We use a definition of effective access as the utilization of health insurance when available. We conducted a cross-sectional analysis using the 2018 Mexican National Health Survey (ENSANUT) at the household level. The analysis is performed in two stages. The first stage is a multinomial analysis that captures the factor associated with choosing effective access against the alternative of paying privately. The second stage consists of an impact analysis regarding the decision of not choosing effective access in terms of out-of-pocket (OOP) health payments and catastrophic health expenditures (CHE). The analysis corrects for both the decision to buy insurance and the decision to pay for health care. Results We found that, on average, not choosing effective access increases OOP health payments by around 2300 pesos annually. Medicine payments are the most common factor in this increase. Nevertheless, outpatient and medicines health care are the main drivers of the increase in OOP health payments in all insurance beneficiaries. Not having effective access increases the probability of CHE health expenditures by 2.7 p.p. for the case of Social Security Insurance and 4.0 p.p. for Social Government insurance. Household enrolled in Prospera program for the poor are more likely to choose effective access while having household heads with more education and assets value does the opposite. Diabetes illnesses are associated with a higher probability of effective access. Conclusion Improving effective access is a middle step that cannot be disregarded when seeking universal coverage because OOP health payments and catastrophic outcomes are direct consequences. Public insurance in general, has around 50% effective access which remains a challenge in terms of health services utilization and health public policy design, calling for the need of better coordination across insurance types and pooling mechanisms to increase sustainability of needed health services.

Financial education is a constant social concern since it is essential to improve the well-being of individuals and society in general. Wrong financial decisions can have serious consequences that lead to serious economic and even social problems. Therefore, an adequate financial base is necessary and must be instilled from an early age. This work aims to identify the potential effects of two demographic variables, age and gender, on acquiring financial knowledge, delving into the potential moderating interrelationships between them. Applying a set of multi-level (mixed-effects) regression models to a sample of 9917 pre-university students from 175 high schools in Andalusia, our results show that: age and gender are significantly related to the acquisition of financial knowledge of pre-university students. Moreover, gender plays a moderating role in the relationship between age and the acquisition of financial knowledge of pre-university students. This study has practical implications for teachers, students, heads of educational centres and those responsible for educational plans because this paper's results help to better understand the key factors of financial education at a pre-college stage as it identifies significant differences in both age and gender. Policymakers responsible for educational plans are provided with the necessary evidence to propose adapting specific actions to the different student profiles. By doing so, they may design measures to make citizens' financial inclusion possible, resulting in greater welfare for society.

This study investigates the augmentation of students’ engagement in the online learning process using Zoom platform. To engage students more in the online classes we have conducted a survey on four universities students in the four dimensions. To investigate effective online class, we have gone through descriptive statistics followed by principal component analysis (PCA) and factor regression model to identify predicted factors that engage students more in the Zoom online classes. The results of PCA confirmed that questions answer session, instructor asks question to them, break during the class, topic related examples, experience sharing scope, case studies, using Google classroom, screen share, screen annotation, video contents share, class recording, raise hand and reactions to topics can enhance students engagement in the Zoom online classes. The regression results validate all four dimensions have significant influence on effective zoom online class that enhance students learning process. Thus, findings of this study recommend educating course instructors for ensuring all the applications of online learning process while conducting online classes. We strongly believe this course of action will engage students in the online class to enhance learning activities using Zoom platform in Bangladesh.

The quality of online education is of interest to universities around the world. Only high quality and cyclical evaluation are the conditions for obtaining students’ satisfaction with this form of education. In the pandemic era, digital dissemination and open education have become a special obligation of academic education. This paper aims to present the opinions of postgraduate students on the quality of e-learning forced by the Covid-19 pandemic. The study was conducted using an online survey questionnaire sent to all 173 MBA and Executive MBA (EMBA) students studying during the pandemic era in Poland's leading Business School, 40% of whom returned completed valid surveys. Students assessed aspects of e-learning such as teaching materials, communication with lecturers, the attractiveness of online classes, networking, strategies, and criteria for evaluating didactic activities, e-learning platform, and support received from the university. The results showed that although most examined aspects are perceived very well or well by the students, there is always some space for improvement. Despite the fact that the study was conducted on a small sample of students, their opinions obtained during the survey provide valuable information to universities about the quality of postgraduate e-learning from its main actors, that is, students. Based on this, the paper presents clear recommendations to universities on how the quality of online education could be managed and improved.

Subject and purpose of work: The aim of this paper is to identify the professional expectations of students of Economics at the State School of Higher Education in Biała Podlaska. The paper presents also respondents’ opinions on particularly desirable values of potential employers.

We study the long-term impact of Protestant missions in colonial India on present-day literacy, education, and gender equality in human capital outcomes. We combine contemporary administrative and survey data with archival information on the spatial distribution of missions and the gender composition of missionaries in early 20th-century India. We document a positive long-run link between Protestant missions and human capital today. The relationship is particularly strong for women and for missions with higher female presence. While the data to fully explore the underlying mechanisms are limited, we show that exposure to Protestant missionaries may have induced shifts in gender attitudes. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to present differences in the perception of current and desired organizational culture between two different types of workers – academic and administrative staff – in non-public universities in Poland. A synthetic review of the literature on organizational culture at universities and the workplace attitudes of the two groups of university employees was conducted and presented. Research in the form of a survey based on Cameron and Quinn's model was conducted in three non-public universities in Poland. A sample of opinions of 115 workers was gathered and analyzed. It was found in the study that according to academic workers, the present culture was market culture, whereas for administrative workers, it was hierarchy culture. Both groups chose clan culture as the preferred culture. The findings may be useful for higher education decision makers in their attempts to transform universities into market-oriented, yet friendly workplaces. The study's limitations include a relatively small sample of respondents. A further, more comprehensive research into the subject will be worth conducting.

This study — carried out in May 2020, early on during the COVID-19 pandemic - examines the situation in the Polish e-education market, as perceived by secondary school and university students who consume e-education services and by the providers of such services. Firstly, to set the stage, in-depth interviews were carried out with eight owners of companies offering commercial e-education services. Next, an extensive online survey was carried out among secondary school and university students in the 2019–2020 school/academic year using the CAWI method on a sample of 803 respondents — with secondary school students (group I) accounting for 30% of the sample and university students (group II) making up the remaining 70% — concerning their satisfaction or dissatisfaction with e-education services. Taken together, the findings allow for an assessment of the advantages and disadvantages of distance learning and point to the increased demand for e-education services during the pandemic, in tandem with a continually shifting e-education services market.

Objectives: This paper assesses the impact of effective access on out-of-pocket health payments and catastrophic health expenditure. Effective access cannot be attained unless both health services and financial risk protection are accessible, affordable, and acceptable. Therefore, it represents a key determinant in the transition from fragmented health systems to universal coverage that many low- and middle-income countries face.Methods: We use a definition of effective access as the utilization of health insurance when available. We conducted a cross-sectional analysis using the 2018 Mexican National Health Survey (ENSANUT) at the household level. The analysis is performed in two stages. The first stage is a multinomial analysis that captures the factor associated with choosing effective access against the alternative of paying privately. The second stage consists of an impact analysis regarding the decision of not choosing effective access in terms of out-of-pocket (OOP) health payments and catastrophic health expenditures (CHE). The analysis corrects for both the decision to buy insurance and the decision to pay for health care.Results: We found that, on average, not choosing effective access increases OOP health payments by around 2300 pesos annually. Medicine payments are the most common factor in this increase. Nevertheless, outpatient and medicines health care are the main drivers of the increase in OOP health payments in all insurance beneficiaries. Not having effective access increases the probability of CHE health expenditures by 2.7 p.p. for the case of Social Security Insurance and 4.0 p.p. for Social Government insurance. Household enrolled in Prospera program for the poor are more likely to choose effective access while having household heads with more education and assets value does the opposite. Diabetes illnesses are associated with a higher probability of effective access.Conclusion: Improving effective access is a middle step that cannot be disregarded when seeking universal coverage because OOP health payments and catastrophic outcomes are direct consequences. Public insurance in general, has around 50% effective access which remains a challenge in terms of health services utilization and health public policy design, calling for the need of better coordination across insurance types and pooling mechanisms to increase sustainability of needed health services. [ABSTRACT FROM AUTHOR]