The Black Atlantic

The Black Atlantic: Colonial and Contemporary Exchanges“, an interdisciplinary conference hosted by the Stanford Forum for African Studies, is taking place today and tomorrow at the Stanford Humanities Center. All are welcome to attend! Conference opening and keynote by Bruce Hall at 2:30pm.


The Black Atlantic: Colonial and Contemporary Exchanges

The Stanford Forum for African Studies (of which I am a member) is hosting its annual interdisciplinary conference on October 28th and 29th. Program details can be found here. Below is the conference poster. Please spread the word! All are welcome to attend.


Voter behavior: does information matter?

The findings of Banerjee et al. (2011) from a field experiment in India using politician report cards seem to suggest yes:

Each report card contained information about incumbent performance along three dimensions – legislative activity, committee attendance and spending of discretionary constituency development funds across eight public good categories. It also provided information on the wealth, education and criminal record of the incumbent and the two main challengers in that jurisdiction. In a random sample of 200 slums, households received a pamphlet on legislator responsibilities and a free copy of a newspaper that featured the report card for their jurisdiction. Households in the 575 control slums did not receive any informational material.
Relative to control slums, we observe several significant changes in voter behavior in treatment slums. First, average voter turnout increased by 3.5 percent, or two percentage points (from 57.5% to 59.5%). Second, cash-based vote-buying was 19 percent less likely to occur in treatment polling stations. Third, while the campaign did not influence the average incumbent vote share, worse performing incumbents and those facing better qualified challengers received significantly fewer votes. The increases in turnout were relatively higher in treatment slums located in jurisdictions where the incumbent was a worse performer.

A similar study has been undertaken in Uganda, using the parliamentary scorecards, by Macartan Humphreys and Jeremy Weinstein. Results linking the scorecard to the most recent 2011 elections forthcoming. There are a number of other studies underway around the world looking at the relationship between information and voter behavior, but the findings are far from being universally conclusive.

Prof. Banerjee will be presenting at the Political Economy Faculty Seminar at the Stanford GSB tomorrow.

reading in global health: ACCESS

Several months ago I downloaded ACCESS: How do good health technologies get to poor people in poor countries?, a book listed on Karen Grepin‘s excellent global health recommended reading list, but only just now have gotten around to reading it.

What is “access” in this context?

Stated simply, access refers to people’s ability to obtain and appropriately use good quality health technologies when they are needed. Access is not only a technical issue involving the logistics of transporting a technology from the manufacturer to the end-user. Access also involves social values, economic interests, and political processes. Access requires a product as well as services and is linked to how health systems perform in practice. We think of access not as a single event but as a process involving many activities and actors over time. Access is not a yes-or-no dichotomous condition, but rather a continuous condition of different degrees; more like a rheostat than an on-off switch.

Understanding the factors that help or hinder access to health technologies is a topic I am hoping to explore further in my own dissertation, so I’m looking forward to reading the rest of the book. ACCESS is available as a free download.

Earlier this summer, I read another of Karen Grepin’s suggestions, The Making of a Tropical Disease: A Short History of Malaria. It was fascinating, and highly recommended. I will post some excerpts and “fun” facts I learned soon. This one isn’t available as a free download, but is available on Kindle. And yes, I am a Kindle Convert.

Impact evaluation and RCTs in health

I am currently working on a proposal for a pilot of performance-based contracts (PBC) in Uganda’s health sector, and have been busy navigating the literature out there. Fortunately for me, there is also a lot of discussion on randomized controlled trials (RCTs) and impact evaluation in the development blogosphere of late.

Today I’ve been reading “Performance Incentives for Global Health,” published by the Center for Global Development, and available for purchase or downloadable chapter-by-chapter here. It has proven very useful so far in helping me think through the various ways in which PBC pilots could be designed. In Chapter 5, A Learning Agenda, the authors write:

Impact evaluation is more than a tool for gauging impacts at the end of a program and providing the inputs into a cost-effective analysis. It can also help a program to evolve. For example, in the initial phase of a pay-for-performance program, three contracts with different risk levels can be piloted. Based on the results from an early evaluation, the most effective contract can be scaled up. Several parameters lend themselves to this kind of experimentation, including the relative effects of supply versus demand interventions, the level of rewards offered for performance, and the balance of trade-offs between access and use.

Rwanda is often noted as a pay-for-performance (P4P) success story, and Chapter 10 is devoted to this case study. The original study by Basinga et al. (2010) is available here (and co-authored by Rwanda’s current Minister of Health, Agnes Binagwaho, also available at @agnesbinagwaho). The authors find that P4P has a significant effect on the number of deliveries in health facilities, quality of prenatal care, and number of preventive care visits for children, but they find no effect on the number of prenatal care visits or immunizations.

In Uganda, a similar pilot, this time of private-not-for-profit (PNFP) facilities, found no effect of bonuses on health facilities’ performance in achieving self-selected health targets. They did find that financial autonomy improved health facilities’ performance, however. The study, “Contracting for Primary Health Care in Uganda”, remains an unpublished World Bank manuscript, as far as I can tell (publication bias at work), but the slides from the 2007 CGD presentation are available here.

I’d like to examine the effect of PBC on health outcomes in the public rather than PNFP sector (hopefully using a few variations of the contract “treatment”), as well as better understand why performance-based pay (in the form of bonuses) did not seem to have an effect on health outcomes in the Uganda pilot. Finally, I am interested in understanding the relative efficacy of supply-side (such as PBC) vs. demand-side (such as conditional cash transfers) efforts in improving various health outcomes. More updates on this to come.

I’m back!

So I fell off the bloggingwagon in a major way. Apologies. But 7 weeks into grad school and back in California (for a while anyway) I think I can credibly commit to staying on-board. There’s lots to catch up on, but instead I think I’ll just pick up where we left off and fill in the gaps as we go along.

One of the most interesting things I have read so far? “Tax Me If You Can: Ethnic Geography, Democracy and the Taxation of Agriculture in Africa,” in APSR by Kimuli Kasara, Stanford Political Science PhD graduate who is now teaching at Columbia. Basically she finds that cash crop farmers who are the same ethnicity as the head of state face higher taxes than farmers of a different ethnicity. This goes against the classical  ethnically-based patronage argument. A more thorough understanding of how exactly patronage works is clearly in order.

Ok, back to nuclear weapons reading.

PS This post is dedicated to Anna. She knows why.