Search

Are humans intuitively cooperative, or do we need to deliberate in order to be generous to others? The Social Heuristics Hypothesis (SHH) proposes that fast instinctive decision making promotes cooperation in social dilemmas. In this paper, we conduct a novel time-pressure experiment to shed light on the cognitive underpinnings of cooperation. Although we find no evidence for a time-pressure effect when considering all subjects, our results, together with a re-analysis of independent data, indicate that a single factor – payoff comprehension – accounts for some studies failure to replicate the finding that fast and intuitive decision making promotes cooperation. Given payoff comprehension, the SHH predicts behavior well. We believe this finding provides a unifying interpretation of the conflicting results in the literature.

In order to advance our understanding of why Results Based Financing (RBF) works or not, it is crucial that evaluations not only measure the impact of such an arrangement on final outcomes (population health), but also assess the changes in variables in the causal chain between intervention and final outcomes. Health worker performance is a key variable in this chain; it is only by changing health workers’ behaviors—their performance—that RBF can influence health outcomes. Careful assessment of impacts on health worker performance is therefore a natural and important element of any RBF impact evaluations. This paper discusses various approaches to evaluating the impact of RBF on health worker performance. The first part is a discussion of possible ways in which RBF may affect health worker behavior, based on economic theory and empirical evidence. The second part is a more practical discussion of how health worker performance and other relevant variables can be measured and how impacts can be estimated. This is followed by some practical steps that can be taken to ensure that the evaluation leads to actions that can be implemented; a brief conclusion completes the paper.