In Zambia, 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 research below offer promising insights into everyday issues that affect the lives of the Zambian poor.
We embed a field experiment in a nationwide recruitment drive for nurses in Zambia to test whether career benefits attract talent at the expense of prosocial motivation. We randomize the offer of career benefits at the recruitment stage. In line with common wisdom, treatment attracts less prosocial applicants. However, the trade-off only exists at low levels of talent; the marginal applicants in treatment are more talented and equally pro-social. These are hired, and they perform better at every step of the chain: they deliver more services, promote institutional childbirth, and reduce child malnutrition by 25% in the communities they serve.
In Zambia, 40% of children under the age of five are stunted. Addressing stunting in children requires continuous efforts by caregivers; if caregivers are unaware of their child’s growth faltering, increased attention to child nutrition in the household seems unlikely. In 2015, we conducted a cluster- randomized trial to test a pair of interventions designed to provide caregivers with information on their children’s physical growth. This report describes a qualitative follow-up study with participants of that trial. The aim of the follow-up study was to learn about parents’ perceptions of the original interventions and to understand the general views of parents on early child physical growth. The learnings generated by this follow-up study will be used to refine the design of the interventions and will also shed light on challenges in addressing child growth in Zambia more generally.
Maternal mortality remains very high in many parts of the developing world, especially in sub-Saharan Africa. Limited awareness of risk factors for maternal mortality such as maternal age and birth spacing may contribute to persistently high death rates, and public health campaigns to increase awareness of risk factors could help curb maternal mortality. Research shows that men, in particular, tend to underestimate maternal mortality risk, which may lead to their lower demand for contraception. Researchers worked in close collaboration with Zambia’s Ministry of Health and local NGOs to evaluate the impact of providing information to men and women about maternal mortality risk on knowledge of risk, demand for family planning, and maternal and child health outcomes. Preliminary results indicate that providing husbands with the information led to a reduction in fertility in the year that followed, while providing information to women had no comparable impact.
- Simple growth charts, which allowed parents to see if their child had a normal height for their age, did not reduce reduce growth deficits on average among the 547 children in the study, but among malnourished children, reduced stunting by 22 percentage points.
- In contrast, inviting caregivers to quarterly meetings to learn if their children had a normal height and weight and providing food supplements to malnourished children had no impact on rates of stunting.
- Neither home-based growth charts nor community-based monitoring were found to impact children’s cognitive development.
- Home-based growth charts appear to be a cost-effective tool to reduce physical growth deficits in this context. For every dollar that was invested in growth charts, children who otherwise would have been stunted gained an estimated $16 in additional lifetime wages.