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所经历的不良健康结果已经众所周知，但实际的、全社会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状况的项目，本研究计划寻求确定四种这样的解决方案。这些项目的共同点不仅在于它们的目标，还在于它们严格的方法：社会项目的受控实验。项目一审查了孟加拉国保健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项目的长期影响，追踪教育、结婚年龄和妇女对资源的控制对妇女和儿童结局的因果影响，该项目主要包括三个部分：推迟结婚的激励措施、教育支持和生计培训。项目二评估村一级的激励能否促进集体行动，以改善对保健服务的需求和获得。它审查了印度尼西亚Generasi政府方案的影响，根据该方案，村庄每年获得一笔整体赠款，条件是该村在12个目标卫生和教育指标中的每一个指标上的表现。项目三考察在需求低的情况下，如何在补贴保健产品时控制腐败。它将评估价格对免费杀虫剂处理过的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，它将评估减少这种腐败的三种干预措施：审计；市场竞争和社区赋权。项目四考察了一家小额信贷组织向其印度客户提供的灾难性健康保险计划的影响，该计划涵盖了住院分娩。该项目将研究该方案对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。它将把这一项目的影响与一项政府项目的影响进行比较，该项目为妇女在机构分娩时提供财政激励。

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.