Journal articles
“Building resilient health systems: Experimental evidence from Sierra Leone and the 2014 Ebola outbreak” (with D. Christensen, O. Dube, J. Haushofer & M. Voors). 2021. Quarterly Journal of Economics, Vol. 136 (May), 1145-98
» AbstractSkepticism about the quality of health systems and their consequent underuse are thought to contribute to high rates of mortality in the developing world. The perceived quality of health services may be especially critical during epidemics, when people choose whether to cooperate with response efforts and frontline health workers. Can improving the perceived quality of health care promote community health and ultimately help to contain epidemics? We leverage a field experiment in Sierra Leone to answer this question in the context of the 2014 West Africa Ebola crisis. Two years before the outbreak, we randomly assigned two interventions to government-run health clinics—one focused on community monitoring, and the other conferred non-financial awards to clinic staff. Prior to the Ebola crisis, both interventions increased clinic utilization and patient satisfaction. Community monitoring additionally improved child health, leading to 38 percent fewer deaths of children under five. Later, during the crisis, the interventions also increased reporting of Ebola cases by 62 percent, and community monitoring significantly reduced Ebola-related deaths. Evidence on mechanisms suggests that both interventions improved the perceived quality of health care, encouraging patients to report Ebola symptoms and receive medical care. Improvements in health outcomes under community monitoring suggest that these changes partly reflect a rise in the underlying quality of administered care. Overall, our results indicate that promoting accountability not only has the power to improve health systems during normal times, but can also make them more resilient to emergent crises.
» IPA policy brief and blog post
» Press: New York Times, NPR Hidden Brain, CBS Chicago, VoxEU
“Could gentrification stop the poor from benefiting from urban improvements?” (with C. Balboni, G. Bryan & M. Morten). 2021. American Economic Review Papers and Proceedings, Vol. 111 (May), 532-37
» AbstractWe develop a general equilibrium urban commuting model to investigate mechanisms that may lead to infrastructure induced gentrification, and to understand how policy choices can mitigate or accentuate it. We show that a standard urban model can lead to a full range of gentrification outcomes and illustrate, through model simulation, which elasticities are important for generating desired effects. We highlight the importance of accounting for general equilibrium forces when understanding the distributional impacts of urban change.
“Community-based crisis response: Evidence from Sierra Leone’s Ebola outbreak” (with D. Christensen, O. Dube, J. Haushofer & M. Voors). 2020. American Economic Review Papers and Proceedings, Vol. 110 (May), 260–64
» AbstractWe evaluate a large-scale policy effort that involved the construction of Community Care Centers (CCCs) across Sierra Leone in the midst of the country's Ebola outbreak. CCCs where designed to alleviate fears about western medicine and encourage reporting. Using a difference-in-differences research design, and geo-coded data on the number of reported cases in a given week and section, we find that CCCs roughly triple the increase in reported cases, relative to sections without CCCs. We find substantial increases in both the total number of cases, as well as the number of cases that eventually test positive for Ebola (i.e., confirmed cases). This suggests that CCCs increased the isolation of infected patients, a necessary step for containing the outbreak.
“Reconciling after civil conflict increases social capital but decreases individual wellbeing” (with J. Cilliers & O. Dube). 2016. Science, Vol. 352 (May), Issue 6287, 787–94
» AbstractCivil wars divide nations along social, economic, and political cleavages, often pitting one neighbor against another. To restore social cohesion, many countries undertake truth and reconciliation efforts. We examined the consequences of one such effort in Sierra Leone, designed and implemented by a Sierra Leonean nongovernmental organization called Fambul Tok. As a part of this effort, community-level forums are set up in which victims detail war atrocities, and perpetrators confess to war crimes. We used random assignment to study its impact across 200 villages, drawing on data from 2383 individuals. We found that reconciliation had both positive and negative consequences. It led to greater forgiveness of perpetrators and strengthened social capital: Social networks were larger, and people contributed more to public goods in treated villages. However, these benefits came at a substantial cost: The reconciliation treatment also worsened psychological health, increasing depression, anxiety, and posttraumatic stress disorder in these same villages. For a subset of villages, we measured outcomes both 9 months and 31 months after the intervention. These results show that the effects, both positive and negative, persisted into the longer time horizon. Our findings suggest that policy-makers need to restructure reconciliation processes in ways that reduce their negative psychological costs while retaining their positive societal benefits.
» Replication data
» IPA policy brief
» Press: Washington Post, NPR Hidden Brain, Voice of America, Le Monde, Science Daily, The Daily Mail, Pacific Standard, Público, El Espectador, El Economista, Diariomedico, El Digital de Asturias, Sinc, Infosalus
“The white-man effect: How foreigner presence affects behavior in experiments” (with J. Cilliers & O. Dube). 2015. Journal of Economic Behavior and Organization, Vol. 118 (Oct), 397–414
» AbstractWe experimentally vary white foreigner presence in dictator games across 60 villages in Sierra Leone, and find that the simple presence of a white foreigner increases player contributions by 19 percent. To separate the impact of the white foreigner’s race and nationality from other characteristics, we test additional predictions. First, the white foreigner’s presence may heighten demand effects, prompting players to try to impress the white foreigner by being more generous. This should make behavior in the game less indicative of true generosity. Consistent with this, we find that game contributions are no longer predicted by real-world public good contributions when the white foreigner is present. Second, those more familiar with aid may perceive the games as a form of means-testing, and therefore give less to signal that they are poor. Consistent with this, in the presence of the white foreigner, players in more aid-exposed villages give less, and are more likely to believe that the games are testing them for aid suitability. Together, these results suggest that players’ giving decisions respond to the white foreigner’s race and nationality. Behavioral measures are increasingly used to infer cross-national differences in social preferences or to assess aid effectiveness—our results suggest that we should be cautious in these uses.
» Online appendix
» Press: NY Magazine, Quartz, Debraj Ray
“Global Fund grant programmes: An analysis of evaluation scores” (with S. Radelet). 2007. Lancet, Vol. 369 (May), 1807-1813
» AbstractThe Global Fund to Fight AIDS, Tuberculosis and Malaria evaluates programme performance after 2 years to help decide whether to continue funding. We examine the correlation between programme evaluation scores and characteristics of the programme, the health sector, and the recipient country. Using data on the first 140 Global Fund grants evaluated in 2006, we find that programmes that had government agencies as principal recipients, a large amount of funding, were focused on malaria, had weak initial proposals, or were evaluated by the accounting firm KPMG, scored lowest. Countries with a high number of doctors per head, high measles immunisation rates, few health-sector donors, and high disease-prevalence rates had higher evaluation scores. Poor countries, those with small government budget deficits, and those that have or have had socialist governments also received higher scores. Our results provide some early indications of characteristics that can help the Global Fund identify and monitor programmes that might be at risk. The results should not be used to influence the distribution of funding, but rather to allocate resources for oversight and risk management.
Working papers
“In-group bias in the Indian judiciary: Evidence from 5 million criminal cases” (with E. Ash, S. Asher, A. Bhowmick, S. Bhupatiraju, D. Chen, T. Devi, C. Goessmann & P. Novosad). 2021.
» AbstractWe study judicial in-group bias in Indian criminal courts, collecting data on over 5 million legal case records from 2010–2018. We exploit quasi-random assignment of judges to examine whether defendant outcomes are affected by assignment to a judge with a similar identity. We estimate tight zero effects of in-group bias along gender and religious identity. We do find limited in-group bias in some (but not all) settings where identity is particularly salient, and even here the effect sizes are smaller than those in much of the prior literature.
» Paper summary and blog
» Dataset
» Press: Economic & Political Weekly [pdf], Hindustan Times, Telegraph, The Print, Indian Express, News18, Logical Indian, Data for Justice, Bar and Bench
“Can biometric verification get more cash to poor women? Evidence from Pakistan” (with M. Haseeb, A. Jalal & K. Vyborny). 2021.
» AbstractMany countries target low-income women for cash transfer programs but struggle to ensure that eligible recipients personally receive and retain control over these funds. Biometric verification systems, which require recipients to personally withdraw funds after authenticating their fingerprints, could reduce inclusion errors by reducing identity theft, unauthorized withdrawals, and capture of funds by intermediaries. However, they could increase exclusion errors by raising the time and money costs of withdrawals. We exploit the staggered rollout of biometric verification over 2017–2019 to 5.4 million recipients of Pakistan's largest cash transfer program to assess its impact on the delivery of cash to low-income women. We find that biometric verification increases women's control over how to spend cash. However, we also find an increase in reports of side payments paid involuntarily to access the cash transfer, and a decline in recipient satisfaction with the payment system. We explore mechanisms for the effects, including mobility constraints faced by female recipients and the market power of payment agents.
“Transportation, gentrification, and urban mobility: The inequality effects of place-based policies” (with C. Balboni, G. Bryan & M. Morten). 2020.
» AbstractRoads, rail, and other public transport in a city are ``place-based,'' in that they are built in specific neighborhoods. Do such investments benefit the poor? If people are mobile within a city, then any such place-based investment can lead to neighborhood changes, such as rent increases, which change who can afford to live near these investments and hence who benefits from them. We provide a tractable urban commuting model to study the distributional effects of urban infrastructure improvements. We derive intuitive ``exact hat'' expressions for the welfare change of initial residents after investment. We then apply the method to study the Dar es Salaam BRT system, using original panel data tracked on two dimensions (following households if they move and surveying all new residents of buildings). Preliminary results suggest that the BRT was a pro-poor investment: we estimate a welfare gain of 3.0% for incumbent low-income residents living near the BRT, compared with a 2.5% gain to incumbent high-income residents; across the city, poor gained on average 2.4% and rich gained 2.3%.
“Delivering justice to the poor: Experimental evidence from Liberia” (with J. Sandefur). 2015.
» AbstractCan progressive legal reform improve the lives of the poor in places where formal legal institutions have limited reach? We develop a simple model of forum choice highlighting the tradeoff faced by poor and socially disadvantaged plaintiffs between repressive, but proximate customary law, and a more progressive, but expensive and punitive formal justice system. We test our predictions using new survey data on over 4,500 legal disputes in rural Liberia, and a randomized trial of legal aid using paralegals trained in mediation and the formal law. Consistent with our model, plaintiffs facing bias under the custom—e.g., women suing men—are more likely to opt out of the customary system in favor of formal courts or mediation, and are relatively happier when they do. On average, plaintiffs offered legal aid are significantly more satisfied with case outcomes, pay fewer bribes, and report greater food security.
“The long-run impacts of colonial village institutions on development: Evidence from Pakistan” (with A. Cheema, A. Naqvi & F. Naseer). 2015.
» AbstractWe use a regression discontinuity design to estimate the long-run impacts of historical institutions that govern land rights. The subject of study is 390 Pakistani villages settled by the British colonial state under two distinct policy schemes in neighboring areas of one district. One scheme created proprietary landed estates that concentrated control of land rights in the hands of local elites. The other created peasant smallholder villages with a more egalitarian arrangement of land rights. The reach of prior irrigation technology determined the boundary between the two schemes, creating a discontinuity. We compare development outcomes on both sides of the boundary, and find that being in a landlord dominated estate lowered literacy by 15 percentage points and public goods provision by 1.05 standard deviations over a hundred-year period. Our estimates withstand boundary checks, sensitivity tests, and a wide range of specifications.
“The economics of due process: Police monitoring vs. legal aid in Sierra Leone” (with J. Sandefur & A. Varvaloucas). 2015.
» AbstractBribery is commonplace in Sierra Leone's police stations and courts, and is exacerbated by severe resource constraints in processing detainees. Indigent suspects who cannot pay bribes to accelerate their cases through a slow criminal justice system are often incarcerated for extended periods without being tried or convicted of any crime. Bribe payments by accusers further tilt the scales against many suspects. To address these challenges, we evaluate a program providing pro bono legal aid to police detainees and prisoners. We find a statistically significant 13% increase in detainees released without charge or on bail, and a 20% reduction in the share of prisoners held on remand. While there is evidence that addressing resource constraints in the system helped achieve these gains, there is no evidence that targeting police extortion had a substantial effect. While corruption appears to be a key source of the system's ills, preventing it does not appear to be the crux of the solution offered by paralegals and human rights lawyers.
Book
chapters
“Improving the justice sector: Law and institution building in Sierra Leone” (with A. Varvaloucas, S. Koroma, J. Sandefur & M. Turay). 2012. In O. Johnson (ed.) Economic Challenges and Policy Issues in Early 21st Century Sierra Leone. International Growth Centre.
“Rights or remedies? Shopping for justice in Liberia’s dualistic legal system” (with J. Sandefur). 2011. In E. Harper (ed.), Working with Customary Justice Systems in Post-Conflict and Fragile States. International Development Law Organization.
Policy and other publications
Impacts of judicial reforms to address court congestion and delays in justice in the Philippines (with A. Orbeta & V. Paqueo). 2021. International Initiative for Impact Evaluation.
Tracking concession activity: A census in Sierra Leone (with D. Christensen & M. Voors). 2019. International Growth Centre.
Reclaiming prosperity in Khyber-Pakhtunkhwa: A medium-term strategy for inclusive growth (with K. Ikram, T. Hussain, et. al.). 2015. International Growth Centre.
Impact evaluation of Timap for Justice’s Criminal Justice Project (with J. Sandefur & A. Varvaloucas). 2012. Centre for the Study of African Economies.
Customary justice and the rule of law in Liberia (with M. Best, J. Sandefur, G. Gordon, J. Ndebe, A. Varvaloucas & A. Zeitlin). 2009. Centre for the Study of African Economies.
US development aid and the Millennium Challenge Account: Emerging trends in appropriations (with K. Brown & M. Sessions). 2006. Center for Global Development.
“Aiding development: Tracking the flows” Finance & Development, 42(3), Sept. 2005. IMF & World Bank.
US pledges of aid to Africa: Let’s do the numbers (with S. Radelet). 2005. Center for Global Development
Towards a prosperous Pakistan: A strategy for rapid industrial growth (with F. Bari, A. Cheema, I. Nabi, A. Nasim, S. Kardar, et. al.). 2005. Islamabad: Ministry of Industries, Govt. of Pakistan.
Public expenditure allocation in the Federally Administered Tribal Areas of Pakistan, 1990-1999 (with A. Cheema & H. Rahman). 2002. Islamabad: National Reconstruction Bureau, Govt. of Pakistan.
