Health systems play a central role in economic growth by supporting productivity, human capital development, and resilience in the face of natural disasters. Although some health indicators have significantly improved in the last two decades, most developing countries continue to face persistent challenges—from health worker shortages and stock-outs of essential medicines, to lack of sanitation and water infrastructure.
CEGA’s researchers test economic and behavioral strategies to improve health outcomes for low-income families. The network has discovered several promising interventions, including cash transfers to school-age girls in Malawi (which dramatically reduces HIV infection), social incentives and commitment devices to reduce smoking in the Philippines, and pay-for-performance schemes to improve clinic outcomes in Rwanda. These approaches focus on health service providers as well as individuals and communities.
CEGA's research in health is advanced, in part, through an initiative focused on reproductive health. Although services for family planning and sexual health are available in most developing countries, low-income and marginalized individuals often face behavioral barriers that affect reproductive health. This can include procrastination, intra-household bargaining problems, and biases among health care providers. BERI supports teams of researchers from economics, psychology and public health working to improve decision-making related to reproductive health.
Recognizing that the application of behavioral economics to global health challenges could greatly improve welfare outcomes in developing countries, CEGA has helped coordinate a Behavioral Economics in Health Working Group at UC Berkeley. In 2014, in collaboration with other centers on campus, CEGA hosted the first conference in a series of Behavioral Health Economics events. The day included presentations of ongoing or completed research at the nexus of behavioral economics and health, both in developing and developed countries.
CEGA researchers conducted one of the first evaluations of PROGRESA, a landmark conditional cash transfer program designed to improve the health of young children and families in Mexico. PROGRESA participants received a monthly transfer of 90 pesos (approximately US$7) conditional on the completion of required health checks. The transfers led to a 60 percent increase in clinic visits relative to non-PROGRESA areas. Among children, there were also significant reductions in the incidence of illness and anemia, as well as an increase in height.
A primary school deworming program in Kenya lowered rates of severe anemia and showed substantial height gains, averaging 0.5 centimeters. Pupils that received treatment reported being sick significantly less often, had lower rates of severe anemia, and showed substantial height gains, averaging 0.5 centimeters. The results of this study helped inspire Deworm the World, which served 35 million children last year.
An innovative trial in Kenya tested the effectiveness of “labeled” health savings programs that help women invest in preventive health products like bednets or micronutrient supplements. The program was implemented through Rotating Saving and Credit Associations (ROSCAs), which are clubs of women who pool small amounts of money through regular contributions. The women then take turns withdrawing a lump sum from the pool. By creating a “health pot” in each ROSCA, separate from the existing rotating fund, women were able to invest nearly 120 percent more in health products than those in a control group.
Photo: Kenya Life Panel Survey (KLPS), 1998