Program evaluations and policy proposals are only as good as the data upon which they are based. Although we all know this to be true, discussions about the reliability of data, especially self-reported data, have only recently emerged in the field of development economics. The other week, I highlighted two papers from the Journal of Development Economics’ Symposium on Measurement and Survey Design which discussed how recall bias might undermine the reliability of self-reported data. Even when recall bias is not at play though, self-reported data might be threatened by respondents’ desire to misreport their activities so as to portray their behaviors in a more positive light.
Sarah Baird and Berk Özler explore this phenomenon as it relates to education in their study, “Examining the Reliability of Self-Reported Data on School Participation.” Many Conditional Cash Transfer (CCT) programs are evaluated based on self-reported data about school enrollment and attendance rates. However, the desire to give socially desirable answers or the belief that program funding is linked to evaluation results might lead survey participants to over-report their level of school participation. Baird and Özler test the extent to which self-reported data of school enrollment rates can be considered reliable in CCT evaluations of this nature . . . Read More
In a recent post, Tim Ogden and I discussed the importance of having solid, reliable data on which to base program evaluations and policy decisions. The Journal of Development Economics explored this theme in last year’s Symposium on Measurement and Survey Design which featured more than a dozen papers on improving data quality in development research (Hat tip to Berk Ozler of the World Bank’s Development Impact blog for pointing us to it).
An important discussion at the symposium was the extent to which self-reported data can be considered accurate and reliable. Because study participants are usually asked to report information after significant time has elapsed, self-reported data are often subject to recall bias and can be inaccurate or misleading. This post is the first in a three-part series that will explore the reliability of self-reported data through a discussion of papers featured at the symposium . . . Read More
Focusing on financial access can sometimes obscure the rationale for doing so. We don’t really care about access to finance for its own sake. The point of providing quality financial services to poor households is to give them an easier, more stable path to prosperity. But what are the pitfalls and slippery spots on that path that we hope to ameliorate?
It seems that financing health care is one of the biggest obstacles that poor households face. Take Joseph, a farmer from the Kenyan Rift Valley Province. When his three-year old daughter inhaled a piece of corn she began struggling to breathe. Joseph had no cash at the time, so he waited before visiting a doctor, hoping she would get better. But after three days, symptoms became so serious that Joseph had to take his daughter to the hospital for emergency care. The only way Joseph could accumulate the sums necessary to pay the bill was to sell his land. When I met him two years later, it seemed unlikely that Joseph would ever be able to buy it back. Selling the land had pushed the household into extreme poverty . . . Read More
If you live in the U.S. or another developed country, chances are the life you lead is very different from that of a poor villager in India—but the way you make important choices may not be. Recent findings from a study by the Robert Wood Johnson Foundation and the Harvard School of Public Health demonstrate that in the U.S., familiarity trumps data when it comes to picking a hospital. In other words, Americans are more likely to frequent a hospital they or someone they know had an experience with, than a hospital formally recognized for better quality. Interestingly, FAI research in India shows similar results. The study “Can Insurers Improve Healthcare Quality?” reveals that when provided with information on who is the best quality care provider by their MFI or microinsurer, clients still supplement this information with information from informal sources.
Another interesting parallel: Based on evidence demonstrating that the uninsured have worse health and higher mortality than the insured population in the U.S, you might be surprised to learn that the uninsured do not necessarily receive worse quality of healthcare (see page 9). FAI research found the same to be true in our India study—that healthcare insurance status is not significantly associated with better quality care for patients . . . Read More
There’s a new report out from our friends over at Freedom from Hunger that’s worth paying attention to. The report, “Integrating microfinance and health strategies: examining the evidence to inform policy and practice,” takes a look at the small but growing number of studies that attempt to show that MFIs are capable of contributing to health improvement by increasing knowledge that leads to behavioral changes, and by enhancing access to health services through addressing financial, geographic and other barriers. It concludes that while “more rigorous research is needed to inform policy and guide program implementation to integrate microfinance and health interventions…the microfinance sector offers an underutilized opportunity for delivery of health-related services to many hard-to-reach populations.” I couldn’t agree more.
Too often we find ourselves operating in development “silos,” with health advocates talking mainly to other health advocates, and conversations about financial inclusion conversations happening only in finance circles. But the fact is that for poor households, access to the right financial services at the right moment is often the key to solving other problems, like paying for health care or sending children to school . . . Read More
The organizers of this year’s 5th International Microinsurance Conference, held last week in Dakar, wisely included “Providing health insurance to the poor” as one of the main themes. Health events - whether they are unanticipated emergencies, or even foreseeable events like giving birth - are among the main financing challenges for poor households. When you’re living on $1 or $2 a day, better health financing mechanisms have the potential to make a huge difference. Too often, they’re literally life and death issues. Read More
A new video on global health features BRAC USA CEO Susan Davis and Partners in Health founder Paul Farmer. BRAC has been a pioneer in taking a holistic approach to reducing poverty, and their healthcare programs reach more than 92 million people in Asia and Africa. Farmer recently spoke as part of NYU’s “Social Entrepreneurship in the 21st Century” speaker series about his success with Partners In Health in providing healthcare services for the poor in Latin America, Africa and Russia... Read More
The Microinsurance Network and ILO's Microinsurance Innovation Facility and STEPprogramme are conducting a survey on Third-Party Payment Mechanisms in Health Microinsurance in Developing Countries.
Payment mechanisms form an integral component of insurance schemes because they not only affect the financial flexibility available to customers, but also afect the quality of care delivered by the health provider... Read More