Monday, November 8, 2010

What on earth we're doing

In case I've been giving you the impression that Colin and I moved the family to Western Kenya to give Caleb superstar status in a small town, I'll set the record straight.  Colin (and soon I) are working at an NGO called Innovations for Poverty Action (IPA).  My elevator speech to someone unfamiliar with international development is that "IPA does research on development projects -- anything from health to education to agriculture -- to see if the programs are actually accomplishing what they set out to do." 

If someone seems interested for more (though this is rare, maybe I need to spice up my elevator speech...), I'll explain that it's run by a bunch of hot shot economists (the kind who win MacArthur Genius grants) who run "randomized control trials," in which randomly selected participants get the interverntion (like a subsidy for fertilizer or a HIV education class) and another group does not. This way, whatever positive outcomes accrue to the treatment group and not to the control group one can attribute to the intervention and not some other external event. Kind of like drug trials. The actual studies are inevitably more complicated than this, but that's the basic idea.

If this sounds too wonky for you, the greater context is that international donors have become increasingly cynical about funding development projects and one of the reasons is because decades of aid have shown such poor results (for a host of complicated reasons).  Add to that the fact that rigorous evaluations are relatively new to the development field and almost no one is doing randomized controls to test which strategies are working best - or even at all. 

So, enter IPA.  Using incredibly rigorous research methodology they isolate what's working well and what's most cost effective and then use the information to sway policy makers and to also scale up successful interventions themselves. 

Their research has also helped to put some theoretical international development debates to rest. 

Here's one example: Thanks in large part to Harvard economist Jeffrey Sachs, inexpensive treated bed nets have been heralded as the most cost effective way of reducing malaria - one of the main causes of infant mortality and also major drain on productivity in Africa.  Lots of enthusiasm was generated for the idea that if a bed net were provided for everyone, we'd see child mortality drop and also a development boon.
But the devil is always in the details.  This enthusiasm led to a glutt of bed nets in some places that were, in one notrious example, used as fodder for wedding dresses instead of their intended purpose.  So, economists came in wagging their fingers talking about market distortions and inefficiencies of free distribution and recommended setting a price for bed nets so that those who needed them most would signal so by paying for them.  And those that paid for them would also be most likely to use them most consistently and thus most effectively. 

But others argued that for a public good such as malaria prevention, where reducing the liklihood of contracting the disedase for one person has spillover effects for their neighbors, the most important thing is to maximize coverage and, just as importantly, that even modest cost sharing would prevent some of the most vulnerable from getting protection.

Both sides make some sense in theory, but IPA did the research.

IPA researchers gave bed nets to pregnant women in Kenya, some for free and some for a range of subsidized prices and looked at what happened.  They found that cost-sharing did not necessarily increase how consistently or well the nets were used nor did in increase use by those most vulnerable to infection, as compared to free distribution.  They did a good old cost-effectiveness analysis and showed empirically that cost-sharing is at best marginally more cost-effective than free distribution, but free distribution leads to many more lives saved. 

So, while the work IPA does is soemtimes hard to explain and not as immediately "feel good-y" as providing health care or education or micro-loans, their work is crucial to ensure that the "do gooder" stuff is actually doing good and that the work doing the most good reaches the most people.


  1. Very touching but i feel its a little long, to make this more intresting to read i think you should add more pictures to get more feels while reading it. Other than that thanks for the information.

  2. We are destroying our earth with our actions. The whole world is running towards technology race and thus destroyed the natural image of the earth.