The World Bank report goes to great pains to argue that the proverbial angry young man in a poor country resorts to violence not because it is lucrative, though it sometimes can be, but because it provides a source of dignity not dissimilarto that provided by gang membership in poorer parts of the developed world.
One has to do with personal or family investment - that is higher education is thought tobe a personal or family investment and not all that dissimilar from an investment in the stock market or an investment in real estate.
As unpalatable as it may beto consider, hospitals are of necessity and in fact credit grantors, not entirely dissimilar from auto finance lenders, mortgage originators, or credit card companies.