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In early March 2020, a few cases of COVID-19 were diagnosed in Abidjan, the capital city of Côte d’Ivoire. To combat the spread of the disease, large restrictions to mobility and gatherings were introduced between mid-March and late May 2020. We collected panel survey data on over 2,500 individuals from the Greater Abidjan area over the period immediately before and after the start of the pandemic. We document striking drops in employment, hours worked, income, and food consumption in the first months after the onset of COVID-19, when lockdown was in place. We also find that, in response, survey respondents received more private transfers from other parts of the country, at a time when remittances from abroad fell – and that some respondents moved either temporarily or permanently. In terms of recovery, we find that subjective well-being was lower on average in December 2020 than it was at baseline. Yet, despite schools being closed between mid-March and July 2020, school enrollment suffered little: by December 2020, enrollment rates had bounced back to their baseline level. Our results finally indicate that government policies aimed at alleviating the worst effects of lockdown only reached a few people, and not necessarily those most in need.

Digital credit has expanded rapidly in Africa, mostly in the form of short-term, high-interest loans offered via mobile money. Loan terms are often opaque and consumer financial literacy is low, providing opportunities for predatory lending. A regression discontinuity analysis shows no negative effect of access to digital loans on financial well-being, but the majority of borrowers fail to repay on time and incur high late fees. We randomize exposure to a short phone-based financial literacy intervention. The intervention improved knowledge and marginally improved loan repayment but increased loan demand, increasing overall default risk.

Following the widespread adoption of free primary education, African policymakers are now considering making secondary school free, but little is known about the private and social benefits of free secondary education. We exploit randomized assignment to secondary school scholarships among 2,064 youths in Ghana, combined with 12 years of data, to establish that scholarships increase educational attainment, knowledge, skills, and preventative health behaviors, while reducing female fertility. Eleven years after receipt of the scholarship, only female winners show private labor market gains, but those come primarily in the form of better access to jobs with rents (in particular rationed jobs in the public sector). We develop a simple model to interpret the labor market results and help think through the welfare impact of free secondary education.

Using administrative data on over 4 million hospital visits, we document striking gender disparities within a government health insurance program that entitles 46 million poor individuals to free hospital care in Rajasthan, India. Females account for only 33% of hospital visits among children and 43% among the elderly. These shares are lower for more expensive types of care, and far lower than sex differences in illness prevalence can explain. Almost two-thirds of non-childbirth spending is on males. We combine these data with patient survey, census, and electoral data to show that 1) the program is unable to fully offset the costs of care-seeking, which results in disparities in hospital utilization because some households are willing to allocate more resources to male than female health; 2) lowering costs does not reduce disparities, because males benefit as much as females do; and 3) long-term exposure to village-level female leaders reduces the gender gap in utilization, but effects are modest and limited to girls and young women. In the presence of gender bias, increasing access to and subsidizing social services may increase levels of female utilization but fail to address gender inequalities without actions that specifically target females.

We document large gender disparities within a government program that entitles 46 million poor individuals to free hospital care. We show that care is not free in practice and higher costs are associated with larger disparities. Lowering care costs increases female utilization but does not reduce gender disparities because marginal beneficiaries are as likely to be male as inframarginals. Long-term exposure to local female leaders reduces disparities by addressing factors lowering female care. In the presence of gender bias, subsidizing social services may fail to address gender inequalities without actions that specifically target females. (JEL H51, I12, I13, I14, J16, O15) [ABSTRACT FROM AUTHOR]

Distributing subsidized health products through existing health infrastructure could substantially and cost-effectively improve health in sub-Saharan Africa. There is, however, widespread concern that poor governance - in particular, limited health worker accountability - seriously undermines the effectiveness of subsidy programs. We audit targeted bednet distribution programs to quantify the extent of agency problems. We find that around 80% of the eligible receive the subsidy as intended, and up to 15% of subsidies are leaked to ineligible people. Supplementing the program with simple financial or monitoring incentives for health workers does not improve performance further and is thus not cost-effective in this context.

Results from a randomized experiment conducted with teenage schoolgirls in Cameroon suggest that HIV prevention interventions can be effective at reducing the incidence of teen pregnancy in the following 9-12 months by over 25 percent. We find little difference in effectiveness between one-time, one-hour sessions delivered directly to students by specialized consultants and sessions delivered through regularschool staff trained over two days by specialized consultants. We also find little difference between the standard “Abstain, Be Faithful, Use Condoms” curriculum and an enriched curriculum that includes informationon the heightened risk of cross-generational sex. Lastly, a one-time, one-hour self-administered questionnaire on HIV and sexual behavior has an equally large impact on teen pregnancy. These results suggest that rural teenage schoolgirls’ sexual behavior is highly responsive to even small interventions that make the risks of HIV and pregnancy salient. We find no effects among urban schoolgirls, who are more exposed to information and experience much lower rates of teenage pregnancy under the statusquo.

The welfare impact of expanding access to bank accounts depends on whether accountscrowd out pre-existing financial relationships, or whether private gains from accounts are shared within social networks. To study the effect of accounts on financial linkages, we provided free bank accounts to a random subset of 885 households. Across households, we document positive spillovers: treatment households become less reliant on grown children and siblingsliving outside their village, and become more supportive of neighbors and friends within their village. Within households, we randomized which spouse was offered an account and find no evidence of negative spillovers.

Both under- and over-treatment of communicable diseases are public bads. But efforts to decrease one run the risk of increasing the other. Using rich experimental data on household treatment-seeking behavior in Kenya, we study the implications of this tradeoff for subsidizing life-saving antimalarials sold over-the-counter at retail drug outlets. We show that a very high subsidy (such as the one under consideration by the international community) dramatically increases access, but nearly half of subsidized pills go to patients without malaria. We study two ways to better target subsidized drugs: reducing the subsidy level and introducing rapid malaria tests over-the-counter.

Using data from a field experiment in Kenya, we document that providing individuals with simple informal savings technologies can substantially increase investment in preventative health and reduce vulnerability to health shocks. Simply providing a safe place to keep money was sufficient to increase health savings, through a mental accounting effect. Adding an earmarking feature was only helpful when funds were put towards emergencies; earmarking for preventative health reduced savings on average, because the liquidity cost of tying up money was too great. Providing social pressure and credit through a ROSCA-based savings scheme had very large effects.

Short-run, targeted subsidies for health products are common in poor countries. How do they affect long-run adoption? Standard economic theory predicts that they may increase long-run adoption through experience and social learning effects. Those effects will be muted, however, if subsidized products are unused or misused. Subsidies have also been argued to generate “entitlement effects”: people may refuse to pay for products that were once free. A field experiment was designed to estimate the relative importance of these competing effects. We find that, for a health product with high private returns (an antimalarial bednet), positive experience and social learning effects largely dominate.

Some education policymakers focus on bringing down pupil-teacher ratios. Others argue that resources will have limited impact without systematic reforms to education governance, teacher incentives, and pedagogy. We examine a program under which Kenyan Parent-Teacher Associations (PTAs) at randomly selected schools were funded to hire an additional teacher on a renewable contract, outside normal Ministry of Education civil-service channels, at one-quarter normal compensation levels. For students randomly assigned to stay with existing classes, test scores did not increase significantly, despite a reduction in class size from 82 to 44. In contrast, scores increased for students assigned to be taught by locally-hired contract teachers. One reason may be that contract teachers had low absence rates, while centrally-hired civil-service teachers in schools randomly assigned PTA contract teachers endogenously reduced their effort. Civilservice teachers also captured rents for their families, with approximately 1/3 of contract teacher positions going to relatives of existing teachers. A governance program that empowered parents within PTAs reduced both forms of capture. The best contract teachers obtained civil service jobs over time, and we estimate large potential dynamic benefits from supplementing a civil service system with locally-hired contract teachers brought in on a probationary basis and granted tenure conditional on performance.

To what extent does the lack of access to formal financial services impede business growth in low-income countries? While most research on this issue has so far focused on credit market failures, this paper focuses on the role of access to formalsavingservices. We conducted a field experiment in which a randomly selected sample of self-employed individuals in rural Kenya got access to an interest-free bank account. As the bank charged substantial withdrawal fees, the de facto interest rate on the account was negative. Despite this, take-up and usage of the account was high among our sample of market vendors, primarily composed of women. Access to an account had a substantial, positive impact on levels of productive investments among market women, and, within 6 months, led to higher income levels, as proxied by expenditures. These results imply that a substantial fraction of women entrepreneurs have difficulty saving and investing as much as they would like, and have a demand for formal saving devices - even those that offer negative interest rates. Our results also imply a relatively high upper bound on the rate of return to capital for the women in our sample, estimated at 5.5% per month at the median. Note that these results do not necessarily imply gender differences: our sample of male entrepreneurs is too small to generate results for that group.

This paper studies the microeconomic impacts of the political crisis and civil con�flict that immediately followed the December 2007 Presidential Election in Kenya. Income, expenditures, and consumption dramatically declined for a broad segment of the rural population for the duration of the con�flict. To make up for the income shortfall, women who supply transactional sex engaged in higher risk sex both during and after the crisis. While this particular crisis was likely too short for these behavioral responses to seriously increase the risk of HIV or other STIs for these women, such responses could have long-term repercussions for health in countries with longer or more frequent crises. Overall, our results suggest that social unrest can be an important channel through which political instability can affect long-term outcomes such as health.

This paper presents results from a field experiment designed to test whether savings constraints prevent the self-employed from increasing the size of their businesses. We opened interest-free savings accounts in a local village bank in rural Kenya for a randomly selected sample of poor daily income earners (such as market vendors), and collected a unique dataset constructed from self- reported logbooks that respondents filled on a daily basis. Despite the fact that the savings accounts paid no interest and featured substantial withdrawal fees, take-up and usage was high among women. In addition, we find that the savings accounts had substantial, positive impacts on productive investment levels and expenditures for women, but had no effect for men. These results imply that a substantial fraction of daily income earners face important savings constraints and have a demand for formal saving devices (even for those that offer negative de facto interest rates). We also find some suggestive evidence that female entrepreneurs draw down their working capital in response to health shocks, and that the accounts enabled the treatment group to cope with these shocks without having to liquidate their inventories.

This paper presents results from a field experiment designed to test whether savings constraints prevent the self-employed from increasing the size of their businesses. We opened interest-free savings accounts in a local village bank in rural Kenya for a randomly selected sample of poor daily income earners (such as market vendors), and collected a unique dataset constructed from selfreported logbooks that respondents filled on a daily basis. Despite the fact that the savings accounts paid no interest and featured substantial withdrawal fees, take-up and usage was high among women. In addition, we find that the savings accounts had substantial, positive impacts on productive investment levels and expenditures for women, but had no effect for men. These results imply that a substantial fraction of daily income earners face important savings constraints and have a demand for formal saving devices (even for those that offer negative de facto interest rates). We also find some suggestive evidence that female entrepreneurs draw down their working capital in response to health shocks, and that the accounts enabled the treatment group to cope with these shocks without having to liquidate their inventories. JEL Codes: O12, G21, L26

It is often argued that cost-sharing—charging a subsidized, positive price—for a health product is necessary to avoid wasting resources on those who will not use or do not need the product. We explore this argument through a field experiment in Kenya, in which we randomized the price at which prenatal clinics could sell long lasting anti-malarial insecticide-treated nets (ITNs) to pregnant women. We find no evidence that costsharing reduces wastage on those that will not use the product: women who received free ITNs are not less likely to use them than those who paid subsidized positive prices. We also find no evidence that costsharing induces selection of women who need the net more: those who pay higher prices appear no sicker than the average prenatal client in the area in terms of measured anemia (an important indicator of malaria). Cost-sharing does, however, considerably dampen demand. We find that uptake drops by 75 percent when the price of ITNs increases from zero to $0.75 (i.e. from 100 to 87.5 percent subsidy), the price at which ITNs are currently sold to pregnant women in Kenya. We combine our estimates in a cost-effectiveness analysis of ITN prices on child mortality that incorporates both private and social returns to ITN usage. Overall, our results suggest that free distribution of ITNs could save many more lives than cost-sharing programs have achieved so far, and, given the large positive externality associated with widespread usage of ITNs, it would likely do so at a lesser cost per life saved.

Many real-life settings of individual choice involve social interactions, causing targeted policies to have spillover effects. This article develops novel empirical tools for analysing demand and welfare effects of policy interventions in binary choice settings with social interactions. Examples include subsidies for health-product adoption and vouchers for attending a high-achieving school. We show that even with fully parametric specifications and unique equilibrium, choice data, that are sufficient for counterfactual demand prediction under interactions, are insufficient for welfare calculations. This is because distinct underlying mechanisms producing the same interaction coefficient can imply different welfare effects and deadweight-loss from a policy intervention. Standard index restrictions imply distribution-free bounds on welfare. We propose ways to identify and consistently estimate the structural parameters and welfare bounds allowing for unobserved group effects that are potentially correlated with observables and are possibly unbounded. We illustrate our results using experimental data on mosquito-net adoption in rural Kenya. [ABSTRACT FROM AUTHOR]

Digital credit has expanded rapidly in Africa, with opaque loan terms amidst low consumer financial literacy. Rich data from Malawi shows substantial demand for a digital loan with a base interest rate of 10% over 15 days, yet most borrowers are not aware of loan terms, repay late and incur substantial late fees. Regression discontinuity analyses show no evidence that access to small digital loans harms consumers' perceived well-being. A short, randomised, phone-based financial literacy intervention improved knowledge, but did not increase timely loan repayment and modestly increased loan demand, ultimately increasing the likelihood of ever defaulting. [ABSTRACT FROM AUTHOR]