Maternal and Child Health in Poor Countries: Evidence from Randomized Evaluations

描述(由申请人提供)：几十年来，发展中国家的母亲和儿童经历的健康状况不佳已经是众所周知的，但实际的、全社会范围的解决方案仍然难以捉摸。通过评估在不同背景下通过不同渠道改善健康的项目，该研究计划试图确定四种这样的解决方案。这些项目不仅因为它们的目标而团结在一起，而且在它们严格的方法上也是如此：社会项目的受控实验。项目I审查了孟加拉国卫生服务需求的基本驱动因素的因果关系。该项目将通过研究一个由三个主要部分组成的计划的长期影响，追踪教育、结婚年龄和妇女对资源的控制对妇女和儿童结果的因果影响：延迟结婚的激励、教育支持和生计培训。项目二评估村级奖励是否能够促进集体行动，以改善对保健服务的需求和获得保健服务的机会。它考察了印度尼西亚政府项目Generasi的影响，根据该项目，村庄每年获得一笔整体补助金，条件是村庄在12个目标健康和教育指标中的每一个指标上的表现。项目三审查了在需求较低的情况下补贴保健品时如何控制腐败。它将评估价格对免费驱虫蚊帐和净水包的接受和使用的影响，并审查价格对腐败的影响。然后，它将评估三种减少腐败的干预措施：审计、市场竞争和社区赋权。项目四审查了一家小额信贷组织向其印度客户提供的一项灾难性医疗保险计划的影响，该计划涵盖了医院提供的服务。该项目将研究这一方案对接受机构提供服务的影响，以及健康冲击对家庭经济福利的影响。它将比较这一计划与政府为机构分娩提供财政激励的计划的影响。 公共卫生相关性：这项研究计划试图通过四项严格的评估来确定改善母婴健康的经济有效的方法。第一个项目衡量晚婚对年轻妇女的影响，第二个项目评估改善当地保健服务提供情况的新办法，第三个项目确定提供救生产品的最佳方式，第四个项目衡量保险对机构提供服务的影响。

DESCRIPTION (provided by applicant): The poor health outcomes experienced by mothers and children in the developing world have been well known for decades, but practical, society-wide solutions remain elusive. By evaluating projects that seek to improve health through different channels in diverse contexts, this research program seeks to identify four such solutions. These projects are united not only by their goals, but in their rigorous methodology: controlled experiments of social programs. Project I examines the causal effect of fundamental drivers of demand for health services in Bangladesh. This project will trace the causal impact of education, age at marriage, and women's control over resources on women and children's outcomes by studying the long run implications of a program with three main parts: incentives to delay marriage, education support, and livelihood training. Project II assesses whether village-level incentive can foster collective action to improve demand for and access to health services. It examines the impact of a government program in Indonesia, Generasi, under which villages receive an annual block grant conditional on the village's performance on each of the 12 targeted health and education indicators. Project III examines how corruption can be controlled when subsidizing health product in a context of low demand. It will evaluate the impact of prices on the take up and usage of free insecticide treated bed nets and water purification kits and examine the impact of prices on corruption. It will then evaluate three interventions to reduce this corruption: auditing; market competition, and community empowerment. Project IV examines the impact of a catastrophic health insurance scheme offered by a microfinance organization to its clients in India, which covers hospital delivery. The project will study the impact of this program on the take up of institutional delivery, and on the impact of health shocks on household economic welfare. It will compare the impact of this program with that of a government program that gives women financial incentives for institutional delivery. PUBLIC HEALTH RELEVANCE: This research program seeks to identify cost-effective ways to improve maternal and child health through four rigorous evaluations. The first project measures the impact of delayed marriage for young women, the second evaluates a new approach to improve local health service delivery, the third identifies the best ways to deliver life-saving products, and the fourth measures the effect of insurance for institutional delivery.