Sebastian Martinez

Employment Generation in Rural Africa: Mid-Term Results from an Experimental Evaluation of the Youth Opportunities Program in Northern Uganda

This brief summarizes the results of a gender impact evaluation study, entitled Employment generation in rural Africa : mid-term results from an experimental evaluation of the youth opportunities program in Northern Uganda, conducted in the year 2008, in Uganda. The study observed that mid-term results after two years suggest four main findings. First, despite a lack of central monitoring and accountability, most youth invest the transfer in vocational skills and tools. Second, the economic impacts of the transfer are large. Third, the evidence suggests that poor access to credit is a major reason youth cannot start these vocations in the absence of aid. Finally, these economic gains result in modest improvements in social stability. The outcomes are split into three themes: Economic, Alienation, and Subjective Well-being. For each theme, the results are summed and presented as a z-score. The economic impacts are large with an increase in .28 standard deviations. The male and female economic impacts are similar. Funding for the study derives from Gender Action Plan, Uganda Social Action Fund, Spanish Impact Evaluation Fund.

Effects of Ethnic Attributes on the Quality of Family Planning Services in Lima, Peru: A Randomized Crossover Trial

Most studies reporting ethnic disparities in the quality of healthcare come from developed countries and rely on observational methods. We conducted the first experimental study to evaluate whether health providers in Peru provide differential quality of care for family planning services, based on the indigenous or mestizo (mixed ethnoracial ancestry) profile of the patient. In a crossover randomized controlled trial conducted in 2012, a sample of 351 out of the 408 public health establishments in Metropolitan Lima, Peru were randomly assigned to receive unannounced simulated patients enacting indigenous and mestizo profiles (sequence-1) or mestizo and then indigenous profiles (sequence-2), with a five week wash-out period. Both ethnic profiles used the same scripted scenario for seeking contraceptive advice but had distinctive cultural attributes such as clothing, styling of hair, make-up, accessories, posture and patterns of movement and speech. Our primary outcome measure of quality of care is the proportion of technical tasks performed by providers, as established by Peruvian family planning clinical guidelines. Providers and data analysts were kept blinded to the allocation. We found a non-significant mean difference of -0·7% (p = 0·23) between ethnic profiles in the percentage of technical tasks performed by providers. However we report large deficiencies in the compliance with quality standards of care for both profiles. Differential provider behaviour based on the patients ethnic profiles compared in the study did not contribute to deficiencies in family planning outcomes observed. The study highlights the need to explore other determinants for poor compliance with quality standards, including demand and supply side factors, and calls for interventions to improve the quality of care for family planning services in Metropolitan Lima.

Effects of ethnicity on the quality of family planning services in Lima, Peru

Materials and methods In a crossover randomized controlled trial conducted in 2012, a sample of 351 out of the 408 public health establishments in Metropolitan Lima, Peru were randomly assigned to receive unannounced simulated patients enacting indigenous and mestizo (mixed ethnoracial ancestry) profiles (sequence-1) or mestizo and then indigenous profiles (sequence-2), with a five week wash-out period. Both ethnic profiles used the same scripted scenario for seeking contraceptive advice but had distinctive cultural attributes such as clothing, styling of hair, make-up, accessories, posture and patterns of movement and speech. Our primary outcome measure of quality of care is the proportion of technical tasks performed by providers, as established by Peruvian FP clinical guidelines. Providers and data analysts were kept blinded to the allocation. The trial was registered with ClinicalTrials.gov NCT01885858.

Supplementary Materials for: Is Results-Based Aid More Effective than Conventional Aid?: Evidence from the Health Sector in El Salvador

This document contains the appendices to Is Results-Based Aid More Effective than Conventional Aid? Evidence from the Health Sector in El Salvador.

Is Results-Based Aid More Effective than Conventional Aid?: Evidence from the Health Sector in El Salvador

Results-based aid (RBA) models link funds to outcomes, rather than paying for inputs. Despite their theoretical appeal and recent adoption by donors and multilateral development banks, there is limited empirical evidence supporting this form of aid for national governments. We estimate the effects of a RBA model using a natural experiment in El Salvador, where the same community health intervention was implemented in 98 municipalities using one of three financing models. The Salud Mesoamerica Initiative funded fourteen municipalities with a RBA model that partially conditions funds on the attainment of externally measured maternal and child health targets. Fifty-four municipalities funded inputs using conventional aid and thirty had national funds. Using a difference-in-difference approach and national health systems data we find that preventive health services increased by 19.8% in conventional aid municipalities and by 42% in RBA municipalities compared to national funds, suggesting that the results-based conditionality roughly doubled aid effectiveness. Effects are driven by increases in maternal and child preventive services incentivized by the RBA model. Rather than diverting resources from other populations, we find that the expansion of health services under RBA also benefited men and the elderly, not explicitly incentivized by the results model. While data on final health outcomes are not available, our results on proxy measures point to potential improvements in population health. The effects appear to have been driven by a more rapid expansion of health infrastructure and qualified personnel by motivated national authorities.

The Long Term Impacts of Grants on Poverty: 9-Year Evidence from Uganda's Youth Opportunities Program

In 2008, Uganda granted hundreds of small groups

Piloto de cambio de receptor de becas en educación media superior

400/person to help members start individual skilled trades. Four years on, an experimental evaluation found grants raised earnings by 38% (Blattman, Fiala, Martinez 2014). We return after 9 years to find these start-up grants acted more as a kick-start than a lift out of poverty. Grantees investment leveled off; controls eventually increased their incomes through business and casual labor; and so both groups converged in employment, earnings, and consumption. Grants had lasting impacts on assets, skilled work, and possibly child health, but had little effect on mortality, fertility, health or education.

Do Larger School Grants Improve Educational Attainment? : Evidence from Urban Mexico

Con el objetivo de reducir las tasas de abandono escolar y aumentar la graduacion del bachillerato, PROSPERA implemento un piloto en el cual el apoyo educativo de la trasferencia monetaria condicionada se pagaba directamente al becario en lugar de a la beneficiaria titular. El piloto fue evaluado experimentalmente. Mas de mil escuelas fueron asignadas de manera aleatoria a un grupo de tratamiento y a uno de control. En este estudio se presentan los resultados del primer seguimiento, realizado 8 a 11 meses despues de iniciarse este cambio. El efecto promedio del cambio de receptor del apoyo educativo (intencion de tratamiento) es una reduccion en la desercion escolar de 1.6 puntos porcentuales, respecto a una media de 13.1 para el grupo de control. Este efecto representa una reduccion relativa del 12.2 por ciento en la tasa de desercion escolar. Entre los becarios que declaran recibir personalmente la transferencia (tratamiento sobre los tratados), el impacto es del 19.8 por ciento. Los receptores de la beca tienen un incremento real en sus ingresos y adquieren mayor conocimiento sobre la transferencia. Estos podrian ser dos mecanismos importantes que conducen a la reduccion del abandono escolar. Estos primeros resultados sugieren que el cambio de receptor tiene el potencial de convertirse en una medida efectiva para reducir la desercion escolar entre los becarios de PROSPERA en los tres grados del bachillerato.

Effects of a home-based participatory play intervention on infant and young child nutrition: a randomised evaluation among low-income households in El Alto, Bolivia

Estudiamos los efectos de incrementar las becas educativas en la escolaridad de los estudiantes de educacion secundaria y bachillerato de ingresos bajos y medios en Mexico. Desde 2009, el programa Oportunidades de transferencias monetarias condicionadas (TMC) incremento las becas educativas para los estudiantes en niveles secundario y de bachillerato, en promedio, en 27 por ciento para las mujeres y 30 por ciento para los hombres. Este cambio se hizo en 263 de las 630 localidades urbanas del pais. Utilizando bases de datos administrativos y una estrategia de identificacion “diferencias-en-diferencias” (DD por sus siglas en ingles), encontramos que los estudiantes cuyas familias recibieron becas mayores, exhiben tasas de desercion mas bajas en la educacion secundaria y aumentan la graduacion del bachillerato hasta en 33,5 por ciento. El tamano de los efectos no varia sustancialmente por sexo o habilidad academica, medida a traves de una prueba estandarizada, en linea de base. El ingreso futuro esperado por la mayor escolaridad compensa el costo de las becas educativas en una proporcion de mas de dos a uno. Los patrones que observamos guardan coherencia con una demanda elastica de escolaridad, lo que sugiere que incrementar el componente escolar de las transferencias monetarias condicionadas puede ser un modo eficiente de aumentar la escolaridad entre los estudiantes de bajos ingresos.

Study Proposal: Do Larger School Grants Improve Educational Attainment?: Evidence from Urban Mexico

Background Stunting affects child survival and is a key indicator of child well-being. Therefore, reducing stunting is a global goal. Improving infant and young child feeding (IYCF) practices is a recommended approach to reduce the risk of mortality and ameliorate nutritional status. Behavioural change interventions have the potential to improve IYCF practices. Methods We evaluated the effectiveness of an innovative behavioural change strategy on caregiver’s knowledge, IYCF practices and nutritional status of children from low-income households in El Alto, Bolivia. Home visits used culturally adapted participatory play strategies to promote recommended IYCF practices. A total of 2014 households with children younger than 12 months at baseline were randomly assigned to treatment and control groups. Findings Caregiver knowledge and IYCF practices improved by 0.2 SD, as did food expenditures on recommended foods and dietary diversity. No significant effects were detected on anthropometric indicators or anaemia. Treatment compliance was 88% of households at enrolment and 66% at completion. Interpretation Participatory play-based behavioural change strategies are a promising delivery model to improve recommended IYCF practices. After 30u2009months of intervention, we found sustained positive effects on caregiver’s knowledge and IYCF practices but no effect on nutritional status. Despite the lack of effect on linear growth and anaemia, our results highlight the relevance of implementing interventions that improve IYCF practices due to their importance for early development and prevention of obesity. Other contextual variables, apart from diet, that could be limiting children’s growth potential in this population need to be identified to design holistic approaches that improve child well-being and human capital.