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Cover of Working Paper 480
March 22, 2018

Does Deforestation Increase Malaria Prevalence? Evidence from Satellite Data and Health Surveys - Working Paper 480

In this paper we combine fourteen years of high-resolution satellite data on forest loss with individual-level survey data on malaria in more than 60,000 rural children in 17 countries in Africa, and fever in more than 470,000 rural children in 41 countries in Latin America, Africa, and Asia. We did not find that deforestation increases malaria prevalence nor that intermediate levels of forest cover have higher malaria prevalence.

Cover of Working Paper 472
December 13, 2017

Meeting the Sustainable Development Goal Zero Targets: What Could We Do? - Working Paper 472

The Sustainable Development Goals are an ambitious set of targets for global development progress by 2030 that were agreed by the United Nations in 2015. A review of the literature on meeting "zero targets" suggests very high costs compared to available resources, but also that in many cases there remains a considerable gap between financing known technical solutions and achieving the outcomes called for in the SDGs. In some cases, we (even) lack the technical solutions required to achieve the zero targets, suggesting the need for research and development of new approaches.

Cover of Working Paper 470
December 7, 2017

Family Planning and Fertility Behavior: Evidence from Twentieth Century Malaysia - Working Paper 470

There is longstanding debate about the contribution of family planning programs to fertility decline. Studying the staggered introduction of family planning across Malaysia during the 1960s and 1970s, we find modest responses in fertility behavior. Overall, Malaysia’s total fertility rate declined by about one quarter birth under family planning, explaining only about 10 percent of the national fertility decline between 1960 and 1988. Our findings are consistent with growing evidence that global fertility decline is predominantly due to underlying changes in the demand for children.

Kimberly Singer Babiarz , Jiwon Lee , Grant Miller , Tey Nai Peng and Christine Valente
Cover of Working Paper 471
December 7, 2017

Family Planning and Women’s Economic Empowerment: Incentive Effects and Direct Effects among Malaysian Women - Working Paper 471

Although family planning programs can improve women’s welfare directly through changes in realized fertility, they may also have important incentive effects by increasing parents’ investments in girls not yet fertile. We study these potential incentive effects, finding that family planning may have raised raise girls’ educational attainment substantially. We also find that these early investments are linked to gains in women’s paid labor at prime working ages and to greater support for women’s elderly parents (a marker for women’s bargaining power within the household). Notably, these incentive effects may be larger than the direct effects of family planning alone.

Kimberly Singer Babiarz , Jiwon Lee , Grant Miller , Tey Nai Peng and Christine Valente
Cover of Working Paper 467
October 23, 2017

Urban Water Disinfection and Mortality Decline in Developing Countries - Working Paper 467

We analyzed a large-scale municipal water disinfection program in Mexico in 1991 that rapidly increased access to chlorinated water. Our results suggest that childhood diarrheal disease mortality in Mexico would have declined by 86 percent if all municipalities had good quality infrastructure—a decline consistent with historical experience.

Sonia R. Bhalotra , Alberto Diaz-Cayeros , Grant Miller , Alfonso Miranda and Atheendar S. Venkataramani
Cover of Working Paper 464
October 11, 2017

Different Strokes for Different Folks: Experimental Evidence on the Effectiveness of Input and Output Incentive Contracts for Health Care Providers with Different Levels of Skills - Working Paper 464

A central issue in designing performance incentive contracts is whether to reward the production of outputs versus use of inputs: the former rewards efficiency and innovation in production, while the latter imposes less risk on agents.

Manoj Mohanan , Grant Miller , Katherine Donato , Yulya Truskinovsky and Marcos Vera-Hernández
Cover of Working Paper 461
August 18, 2017

Evaluating Evaluations: Assessing the Quality of Aid Agency Evaluations in Global Health - Working Paper 461

We assessed the methodological quality of global health program evaluations from five major funders between 2009 and 2014. We found that most evaluations did not meet social science methodological standards in terms of relevance, validity, and reliability. Nevertheless, good quality evaluations made it possible to identify ten recommendations for improving evaluations, including a robust finding that early planning is associated with better quality.

Julia Goldberg Raifman , Felix Lam , Janeen Madan Keller , Alexander Radunsky and William Savedoff
Estimating the Avertable Disease Burden and Cost-Effectiveness in Millions Saved Third Edition
July 14, 2016

Estimating the Avertable Disease Burden and Cost-Effectiveness in Millions Saved Third Edition - Working Paper 429

Millions Saved (2016) is a new edition of detailed case studies on the attributable impact of global health programs at scale. As an input to the book, this paper provides an independent assessment of the cost-effectiveness of a selection of the cases using ex post information from impact evaluations, with the objective of illustrating how economic evaluation can be used in decision making and to provide further evidence on the extent of health gains produced for the funding provided.

March 24, 2016

Population Policy: Abortion and Modern Contraception Are Substitutes - Working Paper 426

There is longstanding debate in population policy about the relationship between modern contraception and abortion.  Although theory predicts that they should be substitutes, the existing body of empirical evidence is difficult to interpret.  In this paper, we study Nepal’s 2004 legalization of abortion provision and subsequent expansion of abortion services.

February 27, 2016

Designing Contracts for the Global Fund: Lessons from the Theory of Incentives - Working Paper 425

This paper uses contract theory to suggest simple contract designs that could be used by the Global Fund. Using a basic model of procurement, we lay out five alternative options and consider when each is likely to be most appropriate. We ultimately provide a synthesis to guide policy makers as to when and how 'results-based' incentive contracts can be used in practice.

February 26, 2016

Global Health Donors Viewed as Regulators of Monopolistic Service Providers: Lessons from Regulatory Literature - Working Paper 424

Controlling healthcare costs while promoting maximum health impact in the recipient countries is one the biggest challenges for global health donors. This paper views global health donors as the regulators of monopolistic service providers, and explores potential optimal fund payment systems under asymmetric information. It provides a summary and assessment of optimal price regulation designs for monopolistic service providers.

February 22, 2016

Family Planning Program Effects: A Review of Evidence from Microdata - Working Paper 422

This paper reviews empirical evidence on the micro-level consequences of family planning programs in middle- and low-income countries. In doing so, it focuses on fertility outcomes (the number and timing of births), women’s health and socio-economic outcomes, and children’s health and socio-economic outcomes throughout the life cycle. In practice, family planning programs may only explain a modest share of fertility decline in real-world settings, and may also have quantitatively modest - but practically meaningful - effects on the socio-economic welfare of individuals and families.

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