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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.
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Brief
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June 20, 2019
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...
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Working Paper
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June 20, 2019
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Background Globally, there has been increasing attention to women’s experiences of care and calls for a person-centered care approach. At the heart of this approach is the patient-provider relationship. It is necessary to examine the extent to which providers and women agree on the care that is provided and received. Studies have found that incongruence between women’s and providers’ perceptions may negatively impact women’s compliance, satisfaction, and future use of health facilities. However, there are no studies that examine patient and provider perspectives on person-centered care. Methods To fill this gap in the literature, we use cross-sectional data of 531 women and 33 providers in seven government health facilities in Kenya to assess concordance and discordance in person-centered care measures. Additionally, we analyze 41 in-depth interviews with providers from three of these facilities to examine why differences in reporting may occur. Descriptive statistical methods were use...
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Published Paper
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June 10, 2019
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In Ghana, 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 in this brief offer promising insights into everyday issues that affect the lives of the Ghanaian poor.
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Brief
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June 06, 2019
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For the most vulnerable, even small negative shocks can have significant short- and long-term impacts. Few interventions that improve shock-coping are widely available in sub-Saharan Africa. Researchers test whether individual pre- cautionary savings can mitigate a shock-coping behavior with potentially neg- ative spillovers: transactional sex. Sex for money is a common shock-coping behavior in sub-Saharan Africa and is believed to be a leading driver of the HIV/AIDS epidemic. In a field experiment in Kenya, researchers randomly assigned half of 600+ participating, vulnerable women to a savings intervention that consists of opening a mobile banking savings account labeled for emergency expenses and individual goals. The intervention led to an increase in total mobile savings, reductions in transactional sex as a risk-coping response to shocks, and a decrease in symptoms of sexually transmitted infections.
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Working Paper
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June 05, 2019
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Financial knowledge is critical for making sound decisions that foster financial health and protect consumers from predation. A widely-used tool for building this capability is financial education. Yet evidence suggests that conventional approaches which teach concepts in classroom-style settings are ineffective and expensive at scale, especially for lower-income users. More recent findings indicate that customizing financial education to the needs, interests, and location of participants may increase impact, though doing so in a cost-effective and scalable way remains challenging. This randomized evaluation of a tablet-based financial education program with mostly female recipients of a conditional cash transfer (CCT) program in Colombia offers evidence for how to design and scale an effective digital-based financial education program. Results indicate that the LISTA Initiative had significant positive impacts on financial knowledge, attitudes, practices, and performance, increasing f...
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Working Paper
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June 01, 2019
We test whether the provision of multiple labeled savings accounts affects savings decisions and downstream outcomes in a field experiment with 481 entrepreneurs in urban Malawi. Treatment respondents received either one or multiple savings boxes, while a control group received nothing. Multiple accounts increased savings in treatment accounts by about 30%. Savings boxes had sizeable effects on a number of outcomes, including farming decisions, household expenditures, land purchases, credit extended to customers, and interpersonal transfers. However, we find no evidence that multiple accounts had larger downstream effects than single accounts.
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Working Paper
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May 17, 2019
This paper examines the effects of a government-sponsored apprenticeship training program designed to address high levels of youth unemployment in Ghana. The study exploits randomized access to the program to examine the short-run effects of apprenticeship training on labor market outcomes. The results show that apprenticeships shift youth out of wage work and into self-employment. However, the loss of wage income is not offset by increases in self-employment profits in the short run. In addition, the study uses the randomized match between apprentices and training providers to examine the causal effect of characteristics of trainers on outcomes for apprentices. Participants who trained with the most experienced trainers or the most profitable ones had higher earnings. These increases more than offset the program’s negative treatment effect on earnings. This suggests that training programs can be made more effective through better recruitment of trainers.
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Working Paper
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May 01, 2019
Differences in management quality are an important contributor to productivity differences across countries. A key question is how to best improve poor management in developing countries. This paper tests two different approaches to improving management in Colombian auto parts firms. The first uses intensive and expensive one-on-one consulting, while the second draws on agricultural extension approaches to provide consulting to small groups of firms at approximately one-third of the cost of the individual approach. Both approaches lead to improvements in management practices of a similar magnitude (8–10 percentage points), so that the new group-based approach dominates on a cost-benefit basis. Moreover, the paper finds some evidence that the group-based intervention led to increases in firm size over the next three years, while the impacts on firm outcomes are smaller and statistically insignificant for the individual consulting. The results point to the potential of group-based approa...
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Working Paper
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May 01, 2019
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Working with a private bank in Ghana, this study examines the impacts of a commitment savings product designed to help clients taking repeated overdrafts break their debt cycles. Overall, the product significantly increased savings with the bank without increasing overdrafts. However, after accounting for other sources of savings, the study finds that clients with above-median baseline overdraft histories do not accrue new savings during the commitment period. Rather, they draw down other savings to offset the committed amount and take on new debt. In contrast, individuals with below-median overdraft histories significantly increase savings during and after the commitment period.
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Working Paper
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April 24, 2019
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Los grupos armados urbanos—especialmente las bandas criminales—son un obstáculo para el desarrollo económico y la consolidación de entornos pacíficos en muchas ciudades del mundo. Frecuentemente, estos grupos actúan como cuerpos estatales, ejecutando acciones típicamente gubernamentales como la resolución de disputas, la provisión de justicia y seguridad, la prevención del crimen, la regulación de mercados y la recolección de impuestos. En Medellín, Colombia, en alianza con la alcaldía de la ciudad, un grupo de investigadores diseñó una intervención para aumentar la participación del gobierno municipal en la provisión de servicios públicos y evaluar el impacto de ésta sobre la legitimidad del Estado y las bandas criminales.
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Brief
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March 28, 2019
English
Over 700 million people live on less than US$1.90 per day.1 Many of these families depend on insecure and fragile livelihoods. Globally nearly half of all deaths in children under 5 are attributable to undernutrition, translating into the loss of about 3 million young lives a year.2 Recent research has shown that holistic livelihoods programs, such as the Graduation Approach can have a wide range of benefits for these poor families, from increasing household consumption and income to improving food security and mental health. The Graduation model provides families with a range of services, including income-generating assets, training, access to savings accounts, consumption support, and coaching visits, and variations of the model have been successfully replicated in several contexts. The aim of this research in Burkina Faso is to rigorously evaluate whether an adapted Graduation program design, which focuses on strengthening the household’s ability to cope with crises, leads to improv...
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Brief
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March 27, 2019
We evaluate the impact of a large-scale information and mobilization intervention designed to improve health service delivery in rural Uganda by increasing citizens’ ability to monitor and apply bottom-up pressure on underperforming health workers. Modeled closely on the landmark “Power to the People” study (Björkman and Svensson, 2009), the intervention was undertaken in 376 health centers in 16 districts and involved a three-wave panel of more than 14,000 households. We find that while the intervention had a modest positive impact on treatment quality and patient satisfaction, it had no effect on utilization rates or health outcomes (including child mortality). We also find no evidence that the channel through which the intervention affected treatment quality was citizen monitoring. The results hold in a wide set of pre-specified subgroups and also when, via a factorial design, we break down the complex intervention into its two most important components. Our findings cast doubt on t...
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Working Paper
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March 26, 2019
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We use a randomized experiment in Kenya to study the impact of unconditional cash transfers on intimate partner violence. Transfers to women of on average USD 709 led to a 0.26 standard deviation (SD) decrease in physical violence, and transfers to men to a 0.18 SD decrease. Sexual violence was reduced after transfers to women (0.22 SD), but not men. We construct a theory which together with our empirical findings suggests that husbands use violence to extract resources, but dislike it otherwise. We observe large and significant spillovers: nonrecipient women in treatment villages report a 0.16 SD reduction in physical violence.
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Working Paper
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February 24, 2019
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Background Novartis Access is a Novartis programme that offers a portfolio of non-communicable disease medicines at a wholesale price of US$1 per treatment per month in low-income and middle-income countries. We evaluated the effect of Novartis Access in Kenya, the first country to receive the programme. Methods We did a cluster-randomised controlled trial in eight counties in Kenya. Counties (clusters) were randomly assigned to the intervention or the control group with a covariate-constrained randomisation procedure that maximised balance on a set of demographic and health variables. In intervention counties, public and non-profit health facilities were allowed to purchase Novartis Access medicines from the Mission for Essential Drugs and Supplies (MEDS). Data were collected from all facilities served by MEDS and a sample of households in study counties. Households were eligible if they had at least one adult patient who had been diagnosed and prescribed medicines for one of the non-...
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Published Paper
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February 21, 2019
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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.
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Working Paper
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February 05, 2019
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Voter mobilization campaigns face trade-offs in young democracies. In a large-scale experiment implemented in 2013 with the Kenyan Electoral Commission (IEBC), text messages intended to mobilize voters boosted participation but also decreased trust in electoral institutions after the election, a decrease that was stronger in areas that experienced election-related violence, and for individuals on the losing side of the election. The mobilization backfired because the IEBC promised an electronic voting system that failed, resulting in manual voting and tallying delays. Using a simple model, we show signaling high institutional capacity via a mobilization campaign can negatively affect beliefs about the fairness of the election.
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Working Paper
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February 05, 2019
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Developing country lenders are taking advantage of fintech tools to create fully digital loans on mobile phones. Using administrative and survey data, we study the take up and impacts of one of the most popular digital loan products in the world, M-Shwari in Kenya. While 34% of those eligible for a loan take it, the loan does not substitute for other credit. The loans improve household resilience: households are 6.3 percentage points less likely to forego expenses due to negative shocks. We conclude that while digital loans improve financial access and resilience, they are not a panacea for greater credit market failures.
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Working Paper
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February 01, 2019
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Violence against women (VAW) is widespread in East Africa, with almost half of married women experiencing physical abuse. Those seeking to address this policy issue confront two challenges. First, some forms of domestic violence are widely condoned; majorities of men and women believe that a husband is justified in beating his wife in a variety of scenarios. Second, victims and bystanders are often reluctant to report incidents to authorities. Building on a growing literature showing that education-entertainment can change norms and behaviors, we present experimental evidence from a media campaign attended by over 10,000 Ugandans in 112 villages. In randomly assigned villages, video dramatizations discouraged VAW and encouraged reporting. Results from interviews conducted several months after the intervention show no change in attitudes condoning VAW yet a substantial increase in willingness to report to authorities, especially among women, and a decline in the share of women who exper...
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Working Paper
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January 31, 2019

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