Luuk van Kempen

Subjective Well-Being in Rural India: The Curse of Conspicuous Consumption.

Using data on 697 individuals from 375 rural low income households in India, we test expectations on the effects of relative income and conspicuous consumption on subjective well-being. The results of the multi-level regression analyses show that individuals who spent more on conspicuous consumption report lower levels of subjective well-being. Surprisingly an individual’s relative income position does not affect feelings of well-being. Motivated by positional concerns, people do not passively accept their relative rank but instead consume conspicuous goods to keep up with the Joneses. Conspicuous consumption always comes at the account of the consumption of basic needs. Our analyses point at a positional treadmill effect of the consumption of status goods.

A perverse 'net' effect? Health insurance and ex-ante moral hazard in Ghana

Incentive problems in insurance markets are well-established in economic theory. One of these incentive problems is related to reduced prevention efforts following insurance coverage (ex-ante moral hazard). This prediction is yet to be tested empirically with regard to health insurance, as the health domain is often considered relatively immune to perverse incentives, despite its validation in other insurance markets that entail adverse shocks. This paper tests for the presence of ex-ante moral hazard with reference to malaria prevention in Ghana. We investigate whether enrollment in the countrys National Health Insurance Scheme (NHIS) negatively affects ownership and use of insecticide-treated bed nets (ITNs). We use a panel of 400 households in the Brong Ahafo region for this purpose and employ a propensity-adjusted household fixed effects model. Our results suggest that ex-ante moral hazard is present, especially when the level of effort and cost required for prevention is high. Implications of perverse incentive effects for the NHIS are briefly outlined.

Factors impeding the acceptability and use of malaria preventive measures: implications for malaria elimination in eastern Rwanda

BackgroundLong-lasting insecticidal nets (LLIN), indoor residual spraying (IRS) and malaria case treatment with artemisinin-based combination therapy (ACT) have been proven to significantly reduce malaria, but may not necessarily lead to malaria elimination. This study explored factors hindering the acceptability and use of available malaria preventive measures to better inform area specific strategies that can lead to malaria elimination.MethodsNine focus group discussions (FGD) covering a cross-section of 81 lay community members and local leaders were conducted in Ruhuha, Southern Eastern Rwanda in December 2013 to determine: community perceptions on malaria disease, acceptability of LLIN and IRS, health care-seeking behaviours and other malaria elimination strategies deployed at household and environmental levels. Discussions were recorded in Kinyarwanda, transcribed into English and coded using Nvivo 10 software.ResultsParticipants ranked malaria as the top among five common diseases in the Ruhuha sector. Participants expressed comprehensive knowledge and understanding of malaria transmission and symptoms. The concept of malaria elimination was acknowledged, but challenges were reported. Sleeping under a bed net was negatively affected by increase of bedbugs (and the associated irritability) as well as discomfortable warmness particularly during the dry season. These two factors were reported as common hindrances of the use of LLIN. Also, widespread use of LLIN in constructing chicken pens or as fences around vegetable gardens was reported.Participants also reported that IRS appeared to lead to an increase in number of mosquitoes and other household bugs rather than kill them. Prompt health centre utilization among participants with presumed malaria was reported to be common particularly among subscribers to the subsidized community-based health insurance (CBHI) scheme. In contrast, the lack of CBHI and/or perceptions that health centre visits were time consuming were common reasons for the use of over-the-counter medicines for malaria management.ConclusionIn this study, identification of behavioural determinants in relation to LLIN use, IRS acceptability and health care seeking is a critical step in the development of effective, targeted interventions aiming to further reduce malaria transmission and elimination in the area.

The ‘Downside’ of Women Empowerment in India: An Experimental Inquiry into the Role of Expectations

The paper reports on a field experiment conducted among poor women organized in self-help groups in the north-east of India. The experiment tests in a simple game whether overly optimistic expectations with respect to the benefits of exercising agency reduces one’s appreciation of remaining with agency in the future. If so, unrealistic expectations may trigger behaviour that jeopardizes empowerment processes. It is hypothesized that negative emotions, such as disappointment, bring about such risks. We find that overstretched expectations may indeed work against empowerment if the gap between achieved and expected outcomes following increased agency is sufficiently wide. However, modest expectation gaps have the opposite effect and tend to promote attitudes conducive to empowerment. A tentative explanation for this result is offered by combining insights from recent work on the role of aspirations.

Women's autonomy and subjective well-being: How gender norms shape the impact of self-help groups in Odisha, India

This paper presents impact estimates of womens self-help group (SHG) membership on subjective well-being in Odisha, India, using 2008 survey data in a quasi-experimental design. It finds that, while there is evidence of a positive impact of SHG membership on womens autonomy, on average, SHG membership does not affect subjective well-being. However, results also reveal that for members living in communities with relatively conservative gender norms among nonmembers, subjective well-being is notably lower. The authors interpret this finding as evidence that these SHG members feel a loss of identity – a problem that looms larger when womens enhanced autonomy implies a stronger violation of gender norms at the community level. In these communities, social-sanctioning mechanisms contribute to a negative impact of womens SHGs on subjective well-being, as evidenced by qualitative accounts of womens empowerment trajectories in the research area.

Do Cash Transfers Crowd Out Community Investment in Public Goods? Lessons from a Field Experiment on Health Education

This article discusses voluntary contributions to health education in Peru, using a new experimental setup to identify voluntary contributions to local public goods. The experiment enables individuals to contribute to a health education meeting facilitated by an NGO, which they know will only be organized if the cumulative investment level exceeds a certain threshold value. In contrast to expectations of aid distributors, individuals contributed a substantial amount of money, despite the supposed long-term nature of the benefits. The result suggests that donor paternalism, undermining the agency of beneficiaries to exercise control over funds, is not always necessary to guarantee investment in local public goods. We explore multiple interpretations, suggesting that “unaccounted for” short-term benefits from participation as well as liquidity and paternalistic altruism add to explaining the relatively high investment. More in general, the article shows the potential for using experimental research methods in the area of nonprofit management.

National dialogues as an interruption of civil war – the case of Yemen

ABSTRACT Yemeni tribes have traditionally used dialogues to prevent clashes. At national level this tradition has been applied to prevent civil wars. This article discusses whether national dialogues are suitable instruments for setting disputes at national level, looking at the circumstances under which these dialogues could lead to successful results. Several criteria are considered, of which building an environment of trust and ownership of external interventions seem to be the most significant. Trust-building before entering into formal negotiations is important, but it is unclear whether this should be a separate phase, or can be part of a reconciliation stage, which the literature on dialogues singles out as highly conducive for success. Local ownership is an important precondition for success in the theoretical discourse, but (direct) international and regional involvement is required, as external bodies are often the cause of internal conflicts in Yemen.