Community Toilet Use in Slums: Willingness-to-Pay and the Role of Informational and Supply-Side Constraints in India (with A. Armand and B. Augsburg).
Pre-Analysis Plan: American Economic Association’s RCT Registry 3087
Abstract: The rapid pace of urbanization in most cities of the developing world can create enormous challenges for the quality of life of people living in informal settlements. We focus on understanding the role of supply-side and informational constraints in the quality of urban sanitation. We implement a cluster-randomized experiment in 110 slums in the cities of Lucknow and Kanpur, India. Community Toilets (CTs) and their catchment areas are randomly allocated to either a supply-side intervention on its own or combined with information provision. Data from both slum dwellers and CT caretakers’ behaviour is obtained using a wide range of methods, including surveys, observational data and incentive-compatible behavioural measurements.
Sustainability of Sanitation Behaviour: Evidence from Pakistan (with B. Augsburg)
Abstract: Slippage back to unsafe sanitation behaviour when uptake had been achieved explains why sanitation interventions may not achieve improvements in public health. In this study we report the results of a randomized controlled trial and accompanying qualitative research evaluating the effectiveness of follow-up visits on sustained sanitation and hygiene behaviour in rural Pakistan. These visits consisted on participatory activities to mobilise villages to build toilets and eliminate open defecation after a community-led total sanitation (CLTS) campaign. We find that follow-up activities are effective at reducing open defecation and increasing usage of private latrines in households prone to slippage –those that built toilets of bad quality and in villages with worse public infrastructure (i.e. limited outside option).
Effectiveness of Community Health Teams: Evidence from El Salvador (with P. Bernal, P. Celhay and S. Martinez).
Abstract: Access to high-quality preventive health care can deter mortality. Community health teams have emerged as a supply alternative to deficient formal health care provision in low- and middle-income countries, but the empirical evidence on their effectiveness is inconclusive. We analyze the effects of a nation-wide health reform in El Salvador on access and quality of primary health care as well as health outcomes. Using a difference-in-difference approach and unique administrative data from the national health system, we find that the reform increased preventive health services and decreased ambulatory care sensitive hospitalizations and amenable mortality. The reform increased institutional delivery as well as pre-natal and puerperal visits. Although the reform targeted mainly maternal and child health care, we find that men and the elderly also benefited from the expansion and improvement of health services.