In a collective effort bringing together 15 studies, researchers from over 30 institutions surveyed over 20,000 individuals between June 2020 and January 2021 on questions regarding respondents’ vaccine acceptance and hesitancy and their most trusted sources for vaccination advice. During some surveys, results from COVID-19 vaccine clinical trials had yet to be announced, and during later surveys, governments had started approving vaccines for use. The fast-moving nature of COVID-19 information may change people’s perceptions about vaccines by the time they are widely available in low- and middle-income countries (LMICs). Over the past six months, the body of evidence demonstrating the safety and efficacy of available COVID-19 vaccines, which have been given to millions of people, has become clearer. At the same time, severe, but rare, side effects may have undermined public confidence.
Widespread acceptance of COVID-19 vaccines is crucial for achieving sufficient immunization coverage to end the global pandemic, yet few studies have investigated COVID-19 vaccination attitudes in lower-income countries, where large-scale vaccination is just beginning. We analyze COVID-19 vaccine acceptance across 15 survey samples covering 10 low- and middle-income countries (LMICs) in Asia, Africa and South America, Russia (an upper-middle-income country) and the United States, including a total of 44,260 individuals. We find considerably higher willingness to take a COVID-19 vaccine in our LMIC samples (mean 80.3%; median 78%; range 30.1 percentage points) compared with the United States (mean 64.6%) and Russia (mean 30.4%). Vaccine acceptance in LMICs is primarily explained by an interest in personal protection against COVID-19, while concern about side effects is the most common reason for hesitancy. Health workers are the most trusted sources of guidance about COVID-19 vaccines. Evidence from this sample of LMICs suggests that prioritizing vaccine distribution to the Global South should yield high returns in advancing global immunization coverage. Vaccination campaigns should focus on translating the high levels of stated acceptance into actual uptake. Messages highlighting vaccine efficacy and safety, delivered by healthcare workers, could be effective for addressing any remaining hesitancy in the analyzed LMICs.
This presentation summarizes findings related to the impact of COVID-19 on food security and hunger, based on Round 1 of the RECOVR Survey. Countries surveyed: Burkina Faso, Côte d’Ivoire, Ghana, Rwanda, Sierra Leone, Zambia, Colombia, Mexico, and the Philippines.
We use a randomized experiment to compare a workforce training program to cash transfers in Rwanda. Conducted in a sample of poor and underemployed youth, this study measures the impact of the training program not only relative to a control group but relative to the counterfactual of simply disbursing the cost of the program directly to beneficiaries. While the training program was successful in improving a number of core outcomes (productive hours, assets, savings, and subjective well-being), cost-equivalent cash transfers move all these outcomes as well as consumption, income, and wealth. In the head-to-head costing comparison cash proves superior across a number of economic outcomes, while training outperforms cash only in the production of business knowledge. We find little evidence of complementarity between human and physical capital interventions, and no signs of heterogeneity or spillover effects.
Accumulating evidence suggests that pay-for-performance (P4P) contracts can elicit greater effort from incumbent civil servants, but less is known about how these contracts affect the composition of the public sector workforce. We provide the first experimental evidence of the impact of P4P on both the compositional and effort margins. In partnership with the Government of Rwanda, we implemented a ‘pay-for-percentile’ scheme (Barlevy and Neal 2012) in a novel two-tier experimental design. In the first tier, we randomly assigned teacher labor markets to either P4P or equivalent fixed-wage contracts. In the second tier, we implemented a ‘surprise’, school-level re-randomization, allowing us to separately identify the compositional effects of advertised P4P contracts and the effort effects of experienced P4P contracts. Our pre-analysis plan sets out a theoretical framework that helps to define a set of hypotheses, and conducts simulations on blinded data to develop high-powered tests. We find that P4P contracts did change the composition of the teaching workforce, drawing in individuals who were more money-oriented, as measured by a framed Dictator Game. But these recruits were not less effective teachers—if anything the reverse. On the effort margin, we observe substantial and statistically significant gains in teacher value added, mirrored in positive effects on teacher presence and observed pedagogy in the classroom. In Year 2, we estimate the total effect of P4P, across compositional and effort margins, to be 0.21 standard deviations of pupil learning. One quarter of this impact can be attributed to selection at the recruitment stage, with the remaining three-quarters arising from increased effort.
In Rwanda, we have continued our global tradition of rigorous, applicable research by building foundational research capacity and conducting evaluations in areas of pressing national concern. Examples of our work below offer promising insights into everyday issues that affect the lives of the Rwandan poor.