Evaluating the Impact of Health Programmes

This paper has two broad objectives. The first objective is broadly methodological and deals with some of the more pertinent estimation issues one should be aware of when studying the impact of health status on economic outcomes. We discuss some alternatives for constructing counterfactuals when designing health program evaluations such as randomization, matching and instrumental variables. Our second objective is to present a review of the existing evidence on the impact of health interventions on individual welfare.

Incentives to Learn

We report results from a randomized evaluation of a merit scholarship program for adolescent girls in Kenya. Girls who scored well on academic exams had their school fees paid and received a cash grant for school supplies. Girls eligible for the scholarship showed significant gains in academic exam scores (average gain 0.12-0.19 standard deviations) and these gains persisted following the competition. There is also evidence of positive program externalities on learning: boys, who were ineligible for the awards, also showed sizeable average test gains, as did girls with low pretest scores, who were unlikely to win. Both student and teacher school attendance increased in the program schools. We discuss implications both for understanding the nature of educational production functions and for the policy debate surrounding merit scholarships.

Education as Liberation?

Scholars have long speculated about education’s political impacts, variously arguing that it promotes modern or pro-democratic attitudes; that it instills acceptance of existing authority; and that it empowers the disadvantaged to challenge authority. To avoid endogeneity bias, if schooling requires some willingness to accept authority, we assess the political and social impacts of a randomized girls’ merit scholarship incentive program in Kenya that raised test scores and secondary schooling. We find little evidence for modernization theory. Consistent with the empowerment view, young women in program schools were less likely to accept domestic violence. Moreover, the program increased objective political knowledge, and reduced acceptance of political authority. However, this rejection of the status quo did not translate into greater perceived political efficacy, community participation, or voting intentions. Instead, the perceived legitimacy of political violence increased. Reverse causality may help account for the view that education instills greater acceptance of authority.

Incentives to learn

The authors report results from a randomized evaluation of a merit scholarship program for adolescent girls in Kenya. Girls who scored well on academic exams received a cash grant and had school fees paid. Girls eligible for the scholarship showed significant gains in academic examination scores (average gain 0.15 standard deviations). There was considerable sample attrition and no significant program impact in the smaller of the two program districts, but in the other district girls showed large gains (average gain 0.22-0.27 standard deviations), and these gains persisted one full year following the competition. There is also evidence of positive program externalities on learning-boys (who were ineligible for the awards) also showed sizable average test gains. Both student and teacher school attendance increased in the program schools.Primary Education,Gender and Development,Poverty and Social Impact Analysis,Education Finance,Access&Equity in Basic Education

Determinants Of Technology Adoption: Peer Effects In Menstrual Cup Take‐Up

We estimate the role of peer effects in technology adoption using data from a randomized distribution of menstrual cups in Nepal. Using individual randomization, we estimate causal effects of peer exposure on adoption. We find strong evidence of peer effects: two months after distribution, one additional friend with access to the menstrual cup increases usage by 18.6 percentage points. Using the fact that we observe both trial and usage of the product over time, we examine the mechanisms that drive peer effects. We show evidence that peers impact learning how to use the technology, but find less evidence that peers impact an individual desire to use the menstrual cup.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/94481/1/JEEA_1090_sm_online_appendix.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/94481/2/j.1542-4774.2012.01090.x.pd

Mother Tongue Education Improves Literacy in Uganda

Children whose first language is not the language of instruction in school are more likely to drop out or fail in early grades. Research from the Universities of Illinois and their Ugandan partners Mango Tree Educational Enterprises and the Ichuli Institute, Kampala, demonstrates that the provision of teacher support and educational resources produced in local languages can lead to large learning gains in rural, under-resourced and overcrowded classrooms.ESRC-DFI

Menstruation and Education in Nepal

This paper presents the results from a randomized evaluation that distributed menstrual cups (menstrual sanitary products) to adolescent girls in rural Nepal. Girls in the study were randomly allocated a menstrual cup for use during their monthly period and were followed for fifteen months to measure the effects of having modern sanitary products on schooling. While girls were 3 percentage points less likely to attend school on days of their period, we find no significant effect of being allocated a menstrual cup on school attendance. There were also no effects on test scores, self-reported measures of self-esteem or gynecological health. These results suggest that policy claims that barriers to girls' schooling and activities during menstrual periods are due to lack of modern sanitary protection may not be warranted. On the other hand, sanitary products are quickly and widely adopted by girls and are convenient in other ways, unrelated to short-term schooling gains.

Determinants of Technology Adoption: Private Value and Peer Effects in Menstrual Cup Take-Up

We estimate the role of benefits and peer effects in technology adoption using data from randomized distribution of menstrual cups in Nepal. Using individual randomization, we estimate causal effects of peer exposure on adoption; using differences in potential returns we estimate effects of benefits. We find both peers and value influence adoption. Using the fact that we observe both trial and usage of the product, we examine the mechanisms driving peer effects. We find that peers matters because individuals learn how to use the technology from their friends, but that they do not affect individual desire to use the cup.

Evaluating the Impact of Health Programmes on Productivity

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/96396/1/1467-8268.12002.pd