Health 

Explore J-PAL's current work in health and the policy lessons that have emerged. 
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Strategies to improve health outcomes in low-income settings have targeted a variety of issues, from demand-driven challenges such as lack of information and income constraints, to supply-driven problems such as health worker absenteeism. Existing research has identified several cost-effective methods to reduce the incidence of child diarrhea (including providing free chlorine dispensers at water sources); unveiled the big potential of small incentives (see, for example, “Incentives for Immunizations”); explored the sensitivity of demand to small changes in the price of health products (“The Price is Wrong”); and more. Yet many questions remain untested: for example, what are effective solutions to the challenges of health service delivery in urban areas? Current evaluations are seeking to answer this and other important questions.

J-PAL’s Health Program seeks to promote the important contributions that randomized evaluations can make in understanding how improvements in health services and delivery can reduce poverty. Each year, significant resources are allocated to global health and development initiatives. However, despite substantial investment, improvements in global health indicators have been uneven. For example, according to the World Health Organization’s (WHO) latest data, encouraging declines in child mortality rates have occurred globally, while improvements in maternal mortality, TB, and HIV/AIDS have been slower (World Health Statistics Report 2010). Moreover, the WHO reports worsening of certain key indicators such as prevalence of undernutrition in a number of countries.

This uneven progress highlights the importance of directing limited resources to the most effective strategies and programs. Randomized evaluations conducted by J-PAL’s affiliates measure the impact and cost-effectiveness of different approaches to improving health outcomes. The Health Program works in conjunction with J-PAL’s Policy Group to disseminate these findings to governments, stakeholders, and development organizations, and conducts comparative cost-effectiveness analyses to help identify which health interventions have the largest impact per dollar spent.

Concurrently, the Health Program is conducting a broad regional assessment of health and development to identify knowledge gaps and priority areas for impact evaluation. This comprehensive review will ultimately inform the Health Program’s long-term research agenda.

Policy Lessons

Charging even very small user fees sharply limits access to preventive health care. Though charging small fees is promoted for many reasons, several experiments in different countries found very little support for these views.

Impersonally administered and direct incentives for attendance are the most effective at increasing service provider attendance. However, in settings where supervisors were given discretion over administering incentives, these programs became ineffective.

The most cost-effective methods of reducing diarrhea focus on cleaning water to break the transmission of diarrheal disease.