The Effect of Health Service Quality on Health Facility Choice and Health Outcomes in Malawi

We study the impact of health care service quality on health facility choice and health outcomes in Malawi. We use Malawi Demographic and Health Survey (MDHS) 2015 and Malawi Service Provision Assessment (MSPA) 2013-2014 to examine the effect. MSPA provides many useful health care service quality information that has not been examined much in the previous studies. We create health care service quality measures to represent infrastructure quality, medical supplies quality and health facility management quality. We examine the impact of these quality measures on the demand for health services and health outcomes. We find that people who live closer to quality health facilities are more likely to utilize health services such as facility delivery. However, we do not find strong and significant evidences that healthcare quality is associated with positive health outcomes due to the insufficient data and the weak identification strategies

Essays on Education and Health in Developing Countries

This dissertation contains three essays on development economics in the areas of education and health in developing countries. The first chapter evaluates the impacts of girls' education support program on human capital development of 3,997 female students (9th ~ 11th grades) at 33 secondary schools located outside Lilongwe, Malawi. We find that female students treated with one-year tuition and monthly cash stipends are more likely to attend school and have better test scores. We also find that cognitive ability in the treatment group increases by 0.215 standard deviations, and those treated also display higher aspirations for educational achievement. Moreover, there is a significant improvement in time preference (increased patience). In the second chapter, written jointly with Cristian Pop-Eleches and Hyuncheol Bryant Kim, we address two questions: 1) How to promote demand for male circumcision and 2) What is the role of peer effects in demand for male circumcision. We randomly provided free male circumcision and transportation voucher to male students in 124 classrooms across 33 secondary schools near Lilongwe, Malawi. Using a two-step randomized design, we first assigned classrooms into three groups (100% Treatment, 50% Treatment, or No Treatment classrooms) and then also randomly selected half of male students in 50% Treatment classrooms for treatment. We find that our intervention substantially increased the demand for male circumcision by on average 14.2 percentage points (243%). We also find evidence of peer effects since untreated students in 50% Treatment classrooms were 3.8 percentage points (79%) more likely to get circumcised than students in No Treatment classrooms. Finally, we provide evidence of important reinforcement effects when close friends within the same classroom receive the intervention together. The third chapter, written jointly with Cristian Pop-Eleches and Hyuncheol Bryant Kim, explores complementarities of three HIV/AIDS prevention interventions: HIV/AIDS Education, Male Circumcision for boys, and Girls' Education Support aimed at keeping girls in school. The study is based in 33 secondary schools near Lilongwe, Malawi and we focus on the behaviors within the existing 124 classrooms in these schools. Our research design to study the complementarities of these interventions is based on the randomized allocation of the different mix of interventions across classrooms. Our preliminary results indicate limited evidence of complementarities among the three interventions

How Learner-Centered Teaching is associated with Teacher Self-Efficacy and Job Satisfaction: Analysis of Data from 31 Countries

The expansion of learner-centered teaching has been the focus of education policy makers and teachers throughout the world. While most of the attention has been given to how learner-centered teaching influences student outcomes, it is important to consider how teachers are associated with learner-centered teaching. Using data from the OECD TALIS database, this study analyzes how the use of learner-centered teaching is associated with teacher self-efficacy and job satisfaction. Controlling for a wide range of teacher and classroom characteristics, as well as country and school fixed effects, we find that learner-centered teaching has a significant and positive association with both teacher self-efficacy and job satisfaction

Teachers’ Monitoring and Schools’ Performance: Evidence from Public Schools in Pakistan

This paper evaluates the impact of an innovative monitoring system on teacher attendance and school performance in Pakistan. In 2014, the government in Khyber Pakhtunkhwa province introduced the Independent Monitoring Project aiming at increasing teacher attendance in primary and secondary public schools by distributing to the government-hired monitors smart phones with a special data collection software installed. Our analysis is based on a difference-in-differences approach using the country wide Annual Status of Education Report from 2012 to 2016. Our findings suggest that monitoring of government schools has increased teacher attendance by 7.5 percentage points in the first year of intervention. But the positive effect wears off to 2.7 percentage points in the second year. Child attendance and test scores also increased in the first year, but in the second year they disappeared. Especially, in the first year, the monitoring system improved students’ math, reading, and English test scores by 0.13, 0.14, and 0.15 standard deviation, respectively, if they are grades 1-5. This result suggests that teacher attendance has an important role in delivering better student outcomes, but that monitoring should be coupled with appropriate incentive mechanism in order to have a lasting impact

Endline Report for the Self-Supporting Rural Development Project with Saemaul Undong's Participatory Approach in Myanmar

The Self-Supporting Rural Development Project with Saemaul Undong's Participatory Approach (hereafter SMU) in Myanmar, implemented jointly by Korea International Cooperation Agency (KOICA) and the Ministry of Agriculture, Livestock, and Irrigation (MOALI) from 2014 to 2019, is the largest rural development project in Southeast Asia implemented by KOICA. Excluding the budget for the construction of the Saemaul Undong Training Institute in Myanmar, the project is worth more than 10 billion Korean won (equivalent to USD 9 million), which includes the budget for the implementation of rural community development projects in 100 pilot villages across nine regions in Myanmar over three years. As the scale of KOICA's development projects has expanded dramatically, and projects with large budgets of over 10 billion won, including Myanmar's rural community development projects, have increased significantly, there have been increasing discussions on how to evaluate various projects implemented by KOICA. The evaluation method used by KOICA can be described as Process Evaluation using Project Design Matrix(PDM), which summarizes the logical framework based on the Theory of Change. While the PDM evaluated in the order of inputs, activities, outputs, outcomes, and impacts has the advantage of being particularly useful for process evaluation, it assumes a causal relationship between inputs/activities and outcomes/impacts and thus cannot be scientifically proven. In an effort to address these limitations of process evaluation, impact evaluation method focused on identifying causal relationships has received increasing attention. Abhijit Banerjee (University of MIT), Esther Duflo (University of MIT), and Michael Kremer (University of Harvard) have conducted impact evaluations applying a randomized controlled trial (RCT) to various development projects since the mid-1990s. They have also received the 2019 Nobel Prize in Economics for their contributions to poverty alleviation and development policies based on scientific evidence derived from impact evaluation findings. National aid agencies such as USAID and DFID, and inter-governmental organizations such as the World Bank and the Asian Development Bank have been actively conducting impact evaluations of their development projects. In particular, the World Bank has established the Development Impact Evaluation Initiative (DIME) in order to evaluate their major projects. KOICA also carried out an impact evaluation, along with process evaluation, when implementing the Myanmar rural community development project in line with these international evaluation trends

Heterogeneous Relationship between Financial Literacy and Fund Investment Behaviors: Evidence from South Korea during the Financial Crisis

The importance of financial knowledge on efficient investment behaviors is well known. However, few studies have examined the relationship between financial literacy and investment behaviors under different economic situations. Using the 2007–2016 Fund Investors Survey from South Korea, we investigate the heterogeneous effects of financial literacy on individual investment decisions during and after the 2008 financial crisis. While differentiating objective and subjective financial knowledge, we find that only subjective knowledge is positively related to participation in financial markets and negatively related to fund exit decisions during the financial crisis (2007–2008). However, in the postcrisis period (2009–2016), both subjective and objective financial knowledge affect fund investment behaviors. We further examine these results through a knowledge calibration mechanism. We present suggestive evidence that the effect of subjective knowledge during the financial crisis is not driven by overconfident investors whose subjective knowledge level deviates from objective knowledge but by the group whose subjective and objective knowledge are highly calibrated

The Effect of Health Facility Births on Newborn Mortality in Malawi

We examine the effect of health facility births on newborn mortality in Malawi using data from a unique survey of mothers in the Chimutu district, Malawi and data from the Malawi Demographic and Health Survey 2015. The study exploits two instrumental variables to overcome endogeneity of health facility births—labor contraction time and interaction of distance to health facilities and rainfall at birth. The results show that health facility births significantly reduce 7-day and 28-day mortality rates. We find suggestive evidence that readily available medical resources are the potential mechanisms through which health facility births reduce newborn mortality

Leaders Need to Be Led: Complementary Followership through Interchangeable Roles among Leader-Follower Positions

Leadership is often recognized as a major driver for successful team effectiveness. However, even weak leadership may show good team performance, and it is worth studying how weak leadership can be helped and complemented by followership. To investigate this paradoxical mechanism behind leadership-followership practices, we examined (1) multi-dimensional figures of leadership and followership using the multifactor leadership questionnaire (MLQ), and (2) the impacts of the combinations of leadership and followership on team performances both during and after a community-driven development (CDD) program. To that end, this study examined a rural CDD case implemented by the Korea International Cooperation Agency (KOICA) and the Myanmar Ministry of Agriculture, Livestock, and Irrigation (MOALI). The CDD leaders of 100 villages (and randomly selected residents of each village) were surveyed. And the collected data were analyzed using regression analysis method. The analyses present some common patterns of how weak leadership and strong followership can lead to better performance than other combinations of leadership and followership. First, the W-S state (Weak leadership and Strong followership) could be better for CDD performances than S-S (Strong leadership and Strong followership) and S-W (Strong leadership and Weak followership). This means that W-S is a necessary condition for successful group performance, which implies that having weak leadership can be an opportunity for strengthening followership. In detail, from the followers’ perspective, strong followership in some factors (intellectual stimulation, individualized consideration, and contingent reward) may best complement weak leadership in the same factors during CDD program. For the sustainability of community development, followership in idealized influence (i.e., trustful dedication) can help complement weak leadership so as to sustain community development even after the CDD program completed. Second, strong leadership could be detrimental to CDD performances because there were some negative impacts of S-S (Strong leadership and Strong followership) and S-W (Strong leadership and Weak followership). We conclude with theoretical and practical conditions of “complementary followership” i.e., the complementary combinations of leadership and followership in group performance

English Education Program for North Korean Refugee College Students: Evaluations Based on Socio-educational Model

This study was designed to expand our understanding about the ways in which North Korean Refugee College Students (NKRCS) acquire English as their second language in their newly adapted South Korean society. Using a socio-educational model, we paid close attention to their perception toward English, which includes their openness and identification with the target language community and their culture. By examining the six-month English education program for NKRCS, we analyze factors that hinder NKRCS from success in English learning in relation to their motivations. Despite the instrumental goal of the English education program to improve English test scores, most of the participants were not ready to take the test but wished to learn more about basic and conversational knowledge of English, which reflected integrative motivation. Results suggest that this motivational discrepancy may demotivate the participants and lead to low attendance and low performance on the test

The Impact of Project-Based Learning on Teacher Self-Efficacy

The expansion of project-based learning has been advocated for as a solution and reform measure to the problem of rote learning-based teaching practices in Korean schools, deemed unfit for the development of diverse skills needed in the 21st century. While the ultimate goal of initiating project-based learning is to affect students in positive ways, it is important to analyze how conducting project-based learning affects teachers, as they are the direct implementers of teaching practices and are bound to have immense influence on the overall learning experience of students. By using the OECD TALIS database, we show that conducting project-based learning is strongly and positively associated with teacher self efficacy. Such results are in line with an analysis using data obtained from a field experiment on teacher training of project-based learning conducted on Daegu city middle schools