More Than Good Intentions:
How a New Economics is Helping to Solve Global Poverty
Dean Karlan & Jacob Appel
Dutton Press, New York: 2011
WEBPAGE: StickK
Make students pledge to do something this quarter (turn in assignments, attendance, etc)
In U.S., individuals give more than $200 billion annually to charity
More than all foundations and corporations combined
2.3 Trillion spent by developed world in past 50 years
Is it being spent well?
Which is it?
Need to invest more in poverty alleviation: Jeffrey Sachs
Too many billions being flushed down the toilet: Easterly
New behavioral economic approach
Need to take human irrationality into account
Can improve well being of poor
Chapter 1: Introduction: The Monks and the Fish
Discuss the difference between traditional and behavioral economic approaches
through the example of “Econs” and “Humans”. Give specific examples of how
understanding behavioral economics is helping design better development projects (i.e.
identifiable victim, separating good and bad of giving, etc.)
Good intentions: LA monks purchase fish from fisherman and release them
Is there a better way?
-pay fisherman to stay home would save fish trauma, gas, time, bait
-but would it work? No joy in releasing the fish, fishermen might fish
anyways
would need to evaluate if a better way exists
Traditional economics vs. behavioral economics
Traditional economics
“Econs” term used by Thaler to represent economic humans who are
rational decision makers and use cost/benefit analysis to maximize
their satisfaction
Behavioral economics
“Humans” term used by Thaler to represent imperfect people who do not always
use cost/benefit analysis to make decisions
-things unrelated to money are important
-can be distracted, impulsive, and inconsistent
2 Pronged Attack to poverty alleviation
1. Understand problems
Systemic problems: way the population interacts, exchanges info., trades
Individual problems: insights from behavioral economics
Humans can be distracted, impulsive, and inconsistent
2. Rigorous evaluation
Compare competing solutions
-does it solve the problem?
-is the world better off because of it?
Types of insights from behavioral economics that helps increase giving
1. Identifiable victim
“Singer’s lake”
Peter Singer, utilitarian philosopher at Princeton
Walking down the street, you pass a lake with a drowning child. If you stop, you will
miss an important meeting that will cost you $200. Do you have an ethical obligation to
help?
-most say yes
What about sending $200 that will help a dying child survive? Do you have an ethical
obligation to help?
-most say no
Singer’s utilitarian reasoning
You should give all you have until you couldn’t spare $200
Typical objections
1. don’t know if $ will save life
better evaluation can help with this
2. “identifiable victim”
We like to see who we are helping: this is a “Human” response
Save the Children: give letters from kids
Kiva: show who is getting loan (this is actually deceptive)
Understanding this is helping increase giving
2. Separating the good part of giving from the bad
Good part: warm fuzzies
Bad part: parting with $
Bundle with bigger bill
Giving $1 at checkout
Feel good now, pay later
Text HAITI to give $10 now. Shows up on phone bill next month
Giving small amounts
Giving pennies, change
Chapter 2: To Work Against Poverty
Why does Karlan argue that there are “many paths forward” for poverty
alleviation? Define and discuss how Randomized Controlled Trials (RCT) might be a
helpful tool for the “many paths forward.”
Development work is like bloodletting. We used to think leaches would cure everything
but they didn’t. We need rigorous research to find out what works
Randomized Controlled Trials (RCTs)
-how people’s lives change with the program compared to how they would’ve changed
without it
Most impact studies are “Before/after” studies that only examine the first part of
Definition
-utilization of treatment and control group
-random selection of who is assigned to control or treatment group (flipping a coin)
Better than comparing groups with and without program… biased
“Many paths forward” out of poverty
Because of the heterogeneity of the poor
Each individual needs different things
Hard to design one-size-fits-all program
Need to think what works best for each type of need
Chapter 3: To Buy: Doubling the Number of Families with a Safety Net
What is the “last mile problem”? What kind of insights have we gained from
RCT in marketing of development projects? Include a discussion of “choice overload”.
Importance of marketing for development
Dev. Solutions aren’t adopted on their merits alone
The poor must choose to participate (or purchase insurance, microloans,etc.)
Marketing is lagging behind of our knowledge!
i.e. OU’s Chagas disease…. We know what to do but how do we change
ehavior?
“The last mile” problem
Sendhil Mullainathan, MIT economist
We employ great minds and resources to solve problem and complete 999 miles
out of 1000 journey
put solution out there but don’t follow through
i.e. oral rehydration therapy: plastic envelope of salts that allow body to retain
water. Highly effective against diarrhea and only pennies
but 2 m children die from diarrhea each year
bad marketing, lack of adoption
Marketing RCT: South African financial institution
53,000 on mailing list
Presented dozens of different flyers
Changed interest rates, photos (of pretty women), # of example loans
All were significant
Adding photo of pretty woman has same impact as lowering i 40%!
“choice overload”
Too many examples of different loans and breaking down their
Payments drove off customers
This is against standard economic theory: more choices/info better
More insight from India
Greater take up of rainfall insurance when farmers visited personally
Even more when sales person introduced by trusted MFI agent
Idea: students compare solicitation of participation in a project (or even just raising $)
using different marketing approaches (test for choice overload)
Chapter 4: To Borrow: Why the Taxi Driver Didn’t Take a Loan
What have recent studies found about the impact on microfinance? Why don’t more poor
people use microfinance when it’s offered?
Microfinance vs. moneylending
-explicit social mission
-emphasis on entrepreneurship and microbusiness
-group lending and/or group meetings
-women’s empowerment
Grameen Bank: Yunus 2006 Nobel prize
2011 6 million clients
16 decisions: link credit to behavioral changes
-schooling
-smaller families
-sanitary latrines in homes
-growing vegetables at home
Impact of microfinance
Bono: “Give a man a fish, he’ll eat for a day. Give a woman microcredit, she, her
husband, her children, and her extended family will eat for a lifetime.”
RCT South Africa study (Karlan)
50% of applicants in financial institutions routinely regjected
All applicants with “maybe” creditworthiness would randomly get offered credit
-could study effects of making loans to marginal clients
-compare whether or not ones with loans were better off on year later
Results: Those with credit
-more likely to have kept jobs
-higher income
-Increased family prosperity
-less hungry
-loans more likely to deal with unexpected shocks (illness, broken vehicles)
RCT Sri Lanka study (De Mel, McKenzi, Woodruff)
408 microentrepreneurs
½ got grant of either $100 or $200
½ got nothing
Results: Those with credit
-increased monthly profit by 6% of grant amount
-70% annual return… great!
But people don’t take loans!
Taxi driver excited about loan, says he wants one, but never bothers to apply
2007 Banerjee, et. al study on community effects in Hyderabad, India
RCT 100 communities
½ selected to receive branch
Fewer than 1/5 eligible borrowers took loan
Most borrowed to pay off debt
No community effects
SO WHY DON’T THE POOR TAKE LOANS?
1. Av. Returns are high but suppose some get high returns, others get 0 or (-)
Risk aversion
Some people with lower returns
Sri Lanka study
Men did better than womenn
Rich got better payoff
Better results from cutting costs and shrinking rather than growing
2. Excessive restrictions on the use of borrowed $
People self select out if too many conditions
Sri Lankan study
$ given with no-strings was used 58% business, 42% consumption
Other ideas (not in book)
What about depression? Inability to make decisions
What about choice overload?
Better terms and conditions, convenience with moneylenders
Marketing
Chapter 5: To Pursue Happiness: Having Better Things to Do
How can concepts like opportunity cost of time and daily targeting help us understand
why taxi drivers might not maximize their profits? What are some unintended
consequences of restrictive rules in development projects (such as requiring certain
behavior or loan use) and how can list randomization shed light on real behavior?
Ghanaian cab drive 2 hours late
Opportunity cost of time is low in LDCs: no problem waiting
NY cabs: Thaler
On busy rainy days, cabs earn more but work shorter hours
Why?
Daily targeting theory
-go home once hit target
-stay trolling for fares longer on sunny days
Economist showed that they could increase income by reallocating hours
Question: Is this the result of a short time horizon (high discount rate?)
Why don’t people excel in their businesses?
1. Training
RCT found practical, concrete lessons with personalized approach
Increased income, repayment and were cost effective
2. Being entrepreneur isn’t the main goal in their life
Opportunity cost of their time
Pursue happiness in other ways
The problem with restrictive rules that go against what people want (i.e. loan use)
Forces people to lie
Might make people self-select out of program
Fungibility of $
Hard to see where aid actually goes
$ may actually help out in
List randomization approach
Technique for allowing people to admit to behavior anonymously
Found in Peru that people spend lots on consumption with microcredit
In Indonesia, about 50% on consumption
Example: Are people stealing Milky Way bars from corner store?
Hand one list (randomly chosen) to each customer and ask
“How many (not which ones) of the following statements are true?”
List 1
List 2
1. I visit the corner store at least
1. I visit the corner store at least
once a week.
once a week.
2. Milky Way is my favorite
2. Milky Way is my favorite
candy bar.
candy bar.
3. I eat at least one candy bar
3. I eat at least one candy bar
per week.
per week.
4. I have stolen a candy bar from
the store.
Statements 1-3 should have the same average agreement. To get theft answer, subtract
the average agreement of 1-3 from all of list 2.
Good for sexual behavior, theft, breaking rules
Chapter 6: To Cooperate in Groups: What About the Weakness of the Crowd?
What are the advantages and disadvantages of group lending with joint liability? How
did Grameen II overcome some disadvantages associated with group lending? What are
some interesting lessons gleaned from RCTs that have examined cooperation in groups?
Group lending with joint liability
Advantages:
1. information on client identity, creditworthiness
2. collateral substitute
3. monitoring, peer pressure
4. members help one another repay
5. saves MFI $ - spreads screening and monitoring costs to group
6. empowerment from being part of group
Disadvantages
1. penalizes good clients who are forces to screen, monitor, and repay for bad
2. client time and transaction costs
3. might encourage over-indebtedness for smaller borrowers who get larger
loans that their group members want
4. domino effect
Solution: hybrid: individual loans with group mechanism
Grameen II used this with great success
2004 RCT Giné and Karlan in Philippines
Group vs. ind.
Clients preferred ind. & invited more friends to join
But pushed more costs onto loan officers (longer meetings)
No difference in repayment
Building cooperation and trust through groups
RCT using the Trust game
Player 2 decides how much $ to give to dictator
$ is doubled
Dictator decides how much $ to give Player 2
FINCA Peru
Karlan gives everyone in room 3 soles ($1)
Everyone forms pairs (sometimes with people in your credit group, sometimes
With other groups)
B’s leave the room
Play trust game
Do more trusting people pay back FINCA better?
Yes!
Group meeting frequency affects altruism and risk sharing
RCT in India (Field and Pande)
1 year after initial loan, clients got altruism experiment
Groups of 10 clients
Some have weekly meetings
Some have biweekly or monthly meetings
Client approached and given lottery ticket. Told that 10 other tickets were
Given to other groups
Chance of winning 1/11
Prize: some offered 200 rupee gift card (for only one person)
Others offered 4 50 rupee gift cards
Given option of getting up to 9 more lottery tickets to give to their
group members making odds now 1/20
Results:
more tickets were handed in groups with weekly meetings
More tickets were handed out when 50 rupee cards were prize
-risk sharing
Weekly meetings also had lower default rates
Impact: MF design might actually have impact through real social
transformation allowing for greater risk sharing and cooperation
Chapter 7: To Save: The Unfun Option
Why is savings both good and hard for poor people? Explain how commitment savings
programs use insights from behavioral economics to help people overcome their nosavings inertia. Who does it seem to help the most?
Saving is good
Informal lenders take most of profit
Prepares for shocks, income smoothing, precautionary, life cycle needs, business
Savings is hard
1. it is not fun… give up immediate benefits. Boring.
We are impatient (high discount rate)
2. easy to procrastinate
future is “hazy”
repeated procrastination leads to “inertia”
not saving is a “matter of momentum”
this is documented in psych and behavioral econ. lit.
procrastinate healthy eating, quitting smoking, exercise
3. barriers and “beasties”
fees and requirements
family demands (beasties)
husband drinks
4. people lack self control
temptations
5. People are time inconsistent
Impatient now but patient later
Will start exercising, putting more away for retirement next month
Would you prefer to get $5 now or $6 in a month?
Would you prefer $5 in one month or $6 in two months?
If answer differently: time inconsistent
plan on saving in the future but don’t save now
Can access to savings accounts make people better off?
RCT Kenya Dupas & Roninson, 2006
Entrepreneurs keep daily logs of income, expenditures, and health
½ offered no frills savings account (0% interest with withdrawal fees)
½ nothing
Results:
89% opened account
Especially women and ROSCA members
Logs showed S used for business, food, coping with illness
Commitment savings plans
Tying Odysseus to the Mast: Evidence from a Commitment Savings
Product in the Philippines.”
Sirens were three dangerous bird-women, portrayed as seductresses who
lured nearby sailors with their enchanting music and voices to shipwreck on the
rocky coast of their island. Odysseus (Homer’s Odyssey) was curious as to what
the Sirens sounded like, so, on Circe's advice, he had all his sailors plug their ears
with beeswax and tie him to the mast. He ordered his men to leave him tied
tightly to the mast, no matter how much he would beg. When he heard their
beautiful song, he ordered the sailors to untie him but they bound him the tighter.
The ship made it through.
StickK.com
Behavioral economic webpage
Punishment if fail
Send $ to friend, charity or “anti-charity” (something you hate)
1. Making saving easier: SEED “Save Earn Enjoy Deposit” Philippines
Cannot withdrawal $ until goal is reached
the program allowed participants to add to their savings account but not
withdraw from it until they had reached a self-defined goal. Many chose goals
associated with a major event—a birthday, religious celebration, or graduation.
When a participant enrolled, they could opt to deposit savings in an account at the
bank or to make the deposits at home into a locked money box. Most chose the
box, similar to a piggy bank, instead of handing over the money. The key to the
box was held by the bank so the participant could put $ in, but not take it out.
Sunny tried savings $200 for home improvement
but every time S got to $50, she used it for something else
Impact:
SEED worked well for time inconsistent clients
50% more likely to sign up
Helped women
For those that signed up, there was a 4 fold increase in savings balances
After 12 months
2. Christmas clubs
Can’t withdrawal until goal or date
Other savings insights
Text reminders worked at increasing savings by 6% in the Philippines and Bolivia
2006 Saez examined incentives to IRA contributions
Found that people gave more if it was matched rather than given as a rebate
Should be the same but people act “irrationally”
Could use for charitable giving, savings
Chapter 8: To Farm: Something from Nothing
Explain why Kenyan farmers have difficulties reaching specialized export markets and
finding the correct seed and fertilizer mix. What are some behavioral economic insights
that have promise in helping farmers move out of their “inertia”?
Farming challenges
1. environmental hazards
a. droughts
b. floods
c. bugs
d. disease
2. technological gap
a. equipment
b. cultivation practices
3. structural deficiencies
a. limited access to profitable markets
b. limited info. about prices
c. transportation costs
d. storage limitations
4. price fluctuations
DrumNet case study: The Kitchen Sink Approach
Integrated suite of services
Attempt to nudge them to adopt new cultivation techniques or new crops
Central Kenya NGO
PRIDE AFRICA (US MF and ag. NGO in E. Africa)
Set up to recover cost
Offered:
-training in farming practices
-information (Europeans love baby corn and French beans)
-training in European standards
-liaising with exporters
-help opening S account
-in kind loans of inputs
-soil, water, sunlight analysis to see which crops work
Obstacles to diversifying to specialized export market
1. info: no access to current prices
2. trust:
farmers thought exporters would rip them off with low prices for inferior goods
exporters feared farmers wouldn’t produce enough or would refuse to sell at
agreed P
3. credit constraints need to pay for grading, certification, inputs
4. transportation to market
RCT evaluation
½ invited to join drumNet
Results:
-farmers who joined were 50% more likely to grow export crops
-farmers who were already exporting weren’t as likely to change to beans
And baby corn
-subsistence farmers or local cash crop farmers were more likely to switch
-switching hhs increased income by 1/3
Failure of DrumNet
2005 new food safety standards: EurepGAP certification
Each Kenyan farmer now needed:
-grading shed
-chemical storage facility with flush toilets and cement floors
-mechanized sprayers
-protective suits
-detailed records
-professional water and soil analysis
Cost: $581 impossible
Exporters refused to buy w/o certification
Harvest rotted
The O-Ring theory
Challenger plastic o-ring threw off great effort
Examples:
1. new European regulation
2. coupon for fertilizer resulted in greater fertilizer use
3. cell phone introduction
Kerala, India fisherman example
Fishermen bring catch to local market
Sometimes shortage, surplus
Wild price fluctuations
1997-2000 cell phones introduced
Allowed farmers to call ports to see which one had best prices
Immediate stabilization of prices
Why don’t farmers put on fertilizer to increase yield?
Kenyan Ministry of Agriculture had ideal hybid seed and fertilizer combo for every
location based on test farms
but less than 25% of farmers had used ANY fertilizer and fewer hybrid seeds
Why?
Variations in soil, rainfall, sun?
Ignorance of plan?
Refusal of plan?
Behavioral inertia?
2000 RCT in Kenya
Findings:
-gov. suggested mix had highest yield but led to net loss due to cost
-found right mix
Some adopted
Others did not
Why don’t people adopt optimal input mix?
“non-fully-rational” behavior
1. INERTIA (professors stick with same retirement portfolio and never change it)
2. Choice overload (when offered samples of too many jam varieties in store, we
choose nothing but when offered 2 or 3, we are likely to buy)
3. Use anecdotes from friends and family instead of full cost/benefit analysis
Do what neighbors do (or learn from failings)
give farmers a behavioral nudge: Savings and Fertilizer Initiative coupon program
created by Duflo, Kremer and Robinson
-visit farmer after harvest to give chance to buy fertilizer coupon for following
season
why? At harvest, ag. is on mind & have $
people buy earthquake insurance right after earthquake even though
odds of it happening again haven’t changed
-pay up front
-fertilizer delivered for free
RESULT: 50% increase in fertilizer use for farmers offered coupons
It was just a test and not continued
The following year, farmers reverted to their old ways
Chapter 9: To Learn: The Importance of Showing Up
Discuss one example of the following efforts designed to increase school attendance: i.)
conditional cash transfer, ii.) providing school uniforms, and iii.) deworming programs.
Contrast the lessons and cost effectiveness of each approach.
MDGs 2000
#1. hunger & poverty
#2. universal primary education
These are goals that everyone agrees on
Story: Antony from small village in Ghana
Family invested all $ in him for secondary school, sibs taken out
Couldn’t afford college entrance exam fee
Didn’t really understand what college was
Ended up being a teacher but didn’t get paid for first 4 months
Cost of ed (even if free)
1. opportunity cost
2. uniforms, supplies, lunch, transportation
3. fees, PTA, exam fees
School uniform program
RCT: Do supplying uniforms & supplies make a difference?
Kenya, ICS Africa, study by Kremer
12 primary schools
Randomly selected kids got uniforms and school supplies (all kids missing one
Or more parents also got)
Results:
-sponsored kids came to school more
Before 18% absenteeism
After 11% for participants
-attendance increased the most for those who previously had no uniform
Were embarrassed to go to school
Didn’t change for kids who already had uniform
-cost $100/ year/student
Conditional Cash Transfer program
Oportunidades
Must attend 85% of time to get paid
1997 originally Progresa
Largest and most ambitious CCT ever attempted
RCT: 2/3 communities get Progresa, 1/3 not
Results
-less likely to drop out
-impact especially in secondary school where dropouts were highest
-cost $1000/year/student
Subsidios Colombia: tweaking the methodology
1. 1/3 of $ paid when students re-enroll
Helps with school expenses
2. bonus for graduation
collect bonus early if matriculates in terciary school
wait for one year if not
Results good
-subtle improvements like timing of rewards don’t cost more but have big impact
Deworming Program
Hookworm, roundworm, whipworm, schistosomiasis
Very contagious through feces
Bad infection: abdominal pain, amnesia, malnutrition
Mild infection: lethary, lack of focus, people get use to these conditions
Kenya RCT by Kremer & Miguel
Give pill that kills 99% of worms to kids in school if parents sign waiver
Cost $0.20 per pill (one time only)
Results:
-80% of parents signed waiver
-worm infections cut in half
-not only for treated group, but fewer worms in others since it wasn’t being spread
-attendance increased a lot… absences fell by 25%
-in 2009, 20 m students in 26 countries participated in this program
-cost $3.50 /year/student
Teacher absenteeism
Some teachers don’t get paid for months
India: unscheduled visits to rural schools
50% teachers not teaching
25% absent
2005 survey
-65% kids grades 2-5 couldn’t read simple paragraph
-50% couldn’t do basic arithmetic
Problem: monitoring is time consuming and costly
RCT: Duflo and Hanna in India
Give tamper-proof camera and ask for photo of class & teacher at the beginning
And end of each day
Old pay: $23/month
New pay: $11.50 for 10 or fewer days in classroom
$1.15 for each day over ten
Results:
-teacher absences went from 42% to 21%
-better performance on tests
Other studies:
RCT Kenya found tracking helpful
RCT India found reading camps in villages helpful
Chapter 10: To Stay Healthy: From Broken Legs to Parasites
Why aren’t doctors and patients showing up at clinics in poor countries and how can we
improve on that record by incorporating behavioral incentives?
LDC health care
-lots of time waiting
-doctor absenteeism
-herbalists and shaman
Doctor incentive program
Seva Mandir NGO in India
RCT Banerjee, Duflo, Glennerster
Offered incentive scheme to ½ of 100 clinics
-full pay if worked at least half days
-fined penalty for each day worked if of worked less than half
-fired if less than ½ days present for 2 months
-had to punch in 3x day
Results:
1. at first attendance increase
60% attendance in treatment clinics
30-45% in control
2. over time, effects wore off
After 1 year, only 35% attendance (unannounced visits) in treatment
What happened?
-“broken” stamp machines
-signed in by hand
-superviors could excuse an absence (1/6 absences were excused)
-Monitoring system must be corruption-proof
Progresa CCT for health
Poor families earn $ by making use of public clinics
-free preventative care, immunizations, educational programs, pre-natal
-amount is equivalent to 25% of monthly income
RCT Gertler, huge sample
Results:
-97% of treatment families signed up for program
-99% of enrolled got paid
-no evidence of systemic fraud
-after 2 years, kids in program showed
23% decrease in illness
18% decrease in anemia
1-4% increase in height
70% of cash went to increase quantity and quality of hh food
Health benefits to all age brackets
Changing relative prices of good and bad behavior
StickK.com: make your own incentives
CARES Philippines – Green Bank
“Committed Action to Reduce and End Smoking”
Make initial deposit of $1 and are visited weekly for 6 months to collect
additional deposits (voluntary)
At end of 6 months, one time urine test for nicotine
If yes: $ goes to orphanage
If no: get $ back
RCT: 640 offered CARES
12% accepted (75 smokers)
600 in control group
Results:
Treatment 45% more likely to pass nicotine test
Control: only 8% passed
Only 1/3 of CARES members recovered savings
After one year, people who were offered CARE (whether they took it or
Not) did better
Malaria
Negative externality: you infect mosquitos and they spread it more
Using bed nets not only protects you but lowers incidence of mosquito carriers
Free mosquito net programs
Recommended by Sachs
Easterly warns: wasteful 70% of recipient didn’t use
Should people spend something on nets?
-filters out those who don’t want
-provides sense of investment
Sunk cost effect
-Bought tickets to show, night comes & you don’t want to go but feel obligated
-feel like you should finish lobster dinner
Econs- ignore sunk cost
Humans – feel obligated
RCT Kenya: free or purchased mosquito net?
Pregnant women offered nets at different prices (up to 60 cents)
Results:
-Bought fewer nets when expensive (law of demand)
-no change in malaria levels regardless of price
-about ½ used them at any price
-will reach the most people if just give away
Diarrhea in Kenya
RCT Kremer, Gates Foundation
Try to get people to use chlorine in water (WaterGuard product)
Price incentives
-free: increased use by 70%
-coupons: increased use by 5-10%
Social learning
-ind. training
-village training: performed better but short term effect
Insider promotion
-outside expert
-local promoter: big effect!
Free stand with Waterguard at well or water source
-timing important: thinking about water when getting it
-best effect!
Chapter 11: To Mate: The Naked Truth
Access to complete information helps us make decisions. This chapter explores condom
use for avoiding pregnancy and HIV. Explain how access to information helped change
girls’ behavior in Kenya, but did not affect behavior in Malawi. Why do you think that
might be true?
“Humans” forget to use protection
In heat of moment, no cost/benefit analysis of probability of getting disease or
unwanted pregnancy
Hookers are not in throws of passion
1000 Mexico City sex workers 2001 Paul Gertler
9/10 used condoms
Charged 23% extra to go w/o
If man asks for condom, charge 8% more
If man asks for no condom, 43% more
INFORMATION ASYMMETRIES
Sex in LDCs
Limited information
S. Africa
Minister of Health 1999-1008 Dr. Manto Tshabalala Msimang (woman)
ARV drugs are toxic: should use garlic, beetroot & lemon
Kenya: trade-offs for having sugar daddy for young girls (14)
Older and will take care of financially
Much more likely to have HIV
Do girls knowingly make choice between older and younger man or would they
Change behavior with more info?
RCT: 328 schools 2004 Dupas
71 randomly selected for Relative Risk Info. Campaign
Explained risks of unprotected sex, gave HIV incidence by age groups
Film and talk
Also half schools were participating in G “no sex” teacher training
Results
Dupas program worked best: cut pregnancies by 1/3
Still had sex (actually a bit more) but with younger men and condoms
Gov. program: no effect
Do we act differently if we know we have HIV? No
2004 Malawi, Rebecca Thorton RCT
Saliva swab at house then offered vouch to come find results at clinic and offered
To purchase condoms once found out results
Results:
-people who were offered $ to get tested came more: anything >0 worked equally
-knowing didn’t change behavior
Chapter 12: To Give: The Takeaway
What are the seven ideas that work? Is there any theme that you notice in the list? Did
you like this book?
Caution in giving $
1. no correlation between low administrative cost & aid effectiveness
some are just more expensive to run
rewarding low overhead may reward those w creative accounting!
2. sometimes we need experimentation
3. proven aid can help people give intelligently
Seven ideas that work
1. microsavings
2. reminders to save
3. prepaid fertilizer sales
4. deworming
5. remedial education in small groups: reading camps
6. chlorine dispensers for clean water
7. commitment devices