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Impact of caregiver incentives on child health: evidence from an experiment with Anganwadi workers in India

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  • Prakarsh Singh
  • William A. Masters

Abstract

This paper provides evidence for the effectiveness of performance pay among government caregivers to improve child health in India. In a controlled study of 160 daycare centers serving over 4000 children, we randomly assign workers to receive performance pay or fixed bonuses of roughly similar expected value, and test for differences in malnutrition among the children in their care. We find that performance pay reduces the prevalence of weight-for-age malnutrition by about 5 percentage points in 3 months. This effect is sustained in the medium term with a renewal of incentives but the differential growth rate fades away once the scheme is discontinued. Fixed bonuses lead to smaller-sized effects and only in the medium-term. Both treatments appear to improve worker effort and communication with mothers, who in turn feed a more calorific diet to their children at home.

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  • Prakarsh Singh & William A. Masters, 2016. "Impact of caregiver incentives on child health: evidence from an experiment with Anganwadi workers in India," NCID Working Papers 01/2016, Navarra Center for International Development, University of Navarra.
    • Handle: RePEc:nva:unnvaa:wp01-2016
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    1. Natalia Montinari & Antonio Nicolò & Regine Oexl, 2016. "The gift of being chosen," Experimental Economics, Springer;Economic Science Association, vol. 19(2), pages 460-479, June.
    2. Powell-Jackson, Timothy & Mazumdar, Sumit & Mills, Anne, 2015. "Financial incentives in health: New evidence from India's Janani Suraksha Yojana," Journal of Health Economics, Elsevier, vol. 43(C), pages 154-169.
    3. Zahid Hasnain & Nick Manning & Jan Henryk Pierskalla, 2014. "The Promise of Performance Pay? Reasons for Caution in Policy Prescriptions in the Core Civil Service," The World Bank Research Observer, World Bank, vol. 29(2), pages 235-264.
    4. Singh, Prakarsh, 2016. "Learning and Behavioral Spillovers of Nutritional Information," IZA Discussion Papers 10085, Institute of Labor Economics (IZA).
    5. Gertler, Paul & Vermeersch, Christel, 2012. "Using performance incentives to improve health outcomes," Policy Research Working Paper Series 6100, The World Bank.
    6. Ernst Fehr & Georg Kirchsteiger & Arno Riedl, 1993. "Does Fairness Prevent Market Clearing? An Experimental Investigation," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 108(2), pages 437-459.
    7. Edward P. Lazear, 2000. "The Power of Incentives," American Economic Review, American Economic Association, vol. 90(2), pages 410-414, May.
    8. Jean Tirole & Roland Bénabou, 2006. "Incentives and Prosocial Behavior," American Economic Review, American Economic Association, vol. 96(5), pages 1652-1678, December.
    9. Uri Gneezy & Stephan Meier & Pedro Rey-Biel, 2011. "When and Why Incentives (Don't) Work to Modify Behavior," Journal of Economic Perspectives, American Economic Association, vol. 25(4), pages 191-210, Fall.
    10. Cason, Timothy N. & Masters, William A. & Sheremeta, Roman M., 2010. "Entry into winner-take-all and proportional-prize contests: An experimental study," Journal of Public Economics, Elsevier, vol. 94(9-10), pages 604-611, October.
    11. Simon Burgess & Carol Propper & Marisa Ratto & Emma Tominey, 2017. "Incentives in the Public Sector: Evidence from a Government Agency," Economic Journal, Royal Economic Society, vol. 127(605), pages 117-141, October.
    12. Singh, Prakarsh & Mitra, Sandip, 2017. "Incentives, information and malnutrition: Evidence from an experiment in India," European Economic Review, Elsevier, vol. 93(C), pages 24-46.
    13. Strauss, John, 1986. "Does Better Nutrition Raise Farm Productivity?," Journal of Political Economy, University of Chicago Press, vol. 94(2), pages 297-320, April.
    14. Joppe de Ree & Karthik Muralidharan & Menno Pradhan & Halsey Rogers, 2015. "Double for Nothing? Experimental Evidence on the Impact of an Unconditional Teacher Salary Increase on Student Performance in Indonesia," NBER Working Papers 21806, National Bureau of Economic Research, Inc.
    15. de Walque, Damien & Gertler, Paul J. & Bautista-Arredondo, Sergio & Kwan, Ada & Vermeersch, Christel & de Dieu Bizimana, Jean & Binagwaho, Agnès & Condo, Jeanine, 2015. "Using provider performance incentives to increase HIV testing and counseling services in Rwanda," Journal of Health Economics, Elsevier, vol. 40(C), pages 1-9.
    16. Karthik Muralidharan & Venkatesh Sundararaman, 2013. "Contract Teachers: Experimental Evidence from India," NBER Working Papers 19440, National Bureau of Economic Research, Inc.
    17. Akerlof, George A, 1984. "Gift Exchange and Efficiency-Wage Theory: Four Views," American Economic Review, American Economic Association, vol. 74(2), pages 79-83, May.
    18. Hillman, A.L. & Ripley, K. & Goldfarb, N. & Nuamah, I. & Weiner, J. & Lusk, E., 1998. "Physician financial incentives and feedback: Failure to increase cancer screening in Medicaid managed care," American Journal of Public Health, American Public Health Association, vol. 88(11), pages 1699-1701.
    19. George A. Akerlof, 1982. "Labor Contracts as Partial Gift Exchange," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 97(4), pages 543-569.
    20. Singh, Prakarsh, 2011. "Performance Pay and Information: Reducing Child Malnutrition in Urban Slums," MPRA Paper 29403, University Library of Munich, Germany.
    21. Jain, Monica, 2015. "India’s Struggle Against Malnutrition—Is the ICDS Program the Answer?," World Development, Elsevier, vol. 67(C), pages 72-89.
    22. David S. Lee, 2009. "Training, Wages, and Sample Selection: Estimating Sharp Bounds on Treatment Effects," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 76(3), pages 1071-1102.
    23. repec:cep:stieop:42 is not listed on IDEAS
    24. Moulton, Brent R., 1986. "Random group effects and the precision of regression estimates," Journal of Econometrics, Elsevier, vol. 32(3), pages 385-397, August.
    25. Ashraf, Nava & Bandiera, Oriana & Jack, B. Kelsey, 2014. "No margin, no mission? A field experiment on incentives for public service delivery," Journal of Public Economics, Elsevier, vol. 120(C), pages 1-17.
    26. Hammer, Jeffrey & Spears, Dean, 2016. "Village sanitation and child health: Effects and external validity in a randomized field experiment in rural India," Journal of Health Economics, Elsevier, vol. 48(C), pages 135-148.
    27. Jere R. Behrman & Susan W. Parker & Petra E. Todd & Kenneth I. Wolpin, 2015. "Aligning Learning Incentives of Students and Teachers: Results from a Social Experiment in Mexican High Schools," Journal of Political Economy, University of Chicago Press, vol. 123(2), pages 325-364.
    28. Akresh, Richard & de Walque, Damien & Kazianga, Harounan, 2013. "Cash transfers and child schooling : evidence from a randomized evaluation of the role of conditionality," Policy Research Working Paper Series 6340, The World Bank.
    29. Gary Charness & Guillaume R. Frechette & John H. Kagel, 2004. "How Robust is Laboratory Gift Exchange?," Experimental Economics, Springer;Economic Science Association, vol. 7(2), pages 189-205, June.
    30. Jacob, Brian A., 2005. "Accountability, incentives and behavior: the impact of high-stakes testing in the Chicago Public Schools," Journal of Public Economics, Elsevier, vol. 89(5-6), pages 761-796, June.
    31. Miller, Grant & Luo, Renfu & Zhang, Linxiu & Sylvia, Sean & Shi, Yaojiang & Foo, Patricia & Zhao, Qiran & Martorell, Reynaldo & Medina, Alexis & Rozelle, Scott, 2012. "Effectiveness of provider incentives for anaemia reduction in rural China: a cluster randomised trial," EconStor Open Access Articles and Book Chapters, ZBW - Leibniz Information Centre for Economics, vol. 345, pages 1-10.
    32. Behrman, Jere R & Deolalikar, Anil B, 1987. "Will Developing Country Nutrition Improve with Income? A Case Study for Rural South India," Journal of Political Economy, University of Chicago Press, vol. 95(3), pages 492-507, June.
    33. Meenakshi J V, 2015. "Utilization of ICDS Services and their Impact on Child Health Outcomes Evidence from Three East Indian States," Working Papers id:7646, eSocialSciences.
    34. Laishram Ladusingh & Manoj Alagarajan & Konsam Dinachandra Singh, 2015. "What Explains Child Malnutrition of Indigenous People of Northeast India?," Working Papers id:7539, eSocialSciences.
    35. Simon Burgess & Marisa Ratto, 2003. "The Role of Incentives in the Public Sector: Issues and Evidence," Oxford Review of Economic Policy, Oxford University Press and Oxford Review of Economic Policy Limited, vol. 19(2), pages 285-300, Summer.
    36. Singh, Prakarsh, 2015. "Performance pay and information: Reducing child undernutrition in India," Journal of Economic Behavior & Organization, Elsevier, vol. 112(C), pages 141-163.
    37. Derek Neal & Diane Whitmore Schanzenbach, 2010. "Left Behind by Design: Proficiency Counts and Test-Based Accountability," The Review of Economics and Statistics, MIT Press, vol. 92(2), pages 263-283, May.
    38. Ernst Fehr & Simon Gaechter, "undated". "Do Incentive Contracts Crowd out Voluntary Cooperation?," IEW - Working Papers 034, Institute for Empirical Research in Economics - University of Zurich.
    39. Karthik Muralidharan & Venkatesh Sundararaman, 2011. "Teacher Performance Pay: Experimental Evidence from India," Journal of Political Economy, University of Chicago Press, vol. 119(1), pages 39-77.
    40. Kandpal, Eeshani, 2011. "Beyond Average Treatment Effects: Distribution of Child Nutrition Outcomes and Program Placement in India's ICDS," World Development, Elsevier, vol. 39(8), pages 1410-1421, August.
    41. Prakarsh Singh & Sandip Mitra, 2015. "Performance Pay and Malnutrition: Evidence from an Experiment targeting Child Malnutrition in West Bengal," NCID Working Papers 05/2015, Navarra Center for International Development, University of Navarra.
    42. Fairbrother, G. & Hanson, K.L. & Friedman, S. & Butts, G.C., 1999. "The impact of physician bonuses, enhanced fees, and feedback on childhood immunization coverage rates," American Journal of Public Health, American Public Health Association, vol. 89(2), pages 171-175.
    43. Gustavo J. Bobonis & Edward Miguel & Charu Puri-Sharma, 2006. "Anemia and School Participation," Journal of Human Resources, University of Wisconsin Press, vol. 41(4).
    44. Erlend Berg & Maitreesh Ghatak & R Manjula & D Rajasekhar & Sanchari Roy, 2019. "Motivating Knowledge Agents: Can Incentive Pay Overcome Social Distance?," The Economic Journal, Royal Economic Society, vol. 129(617), pages 110-142.
    45. Jere R. Behrman & Mark R. Rosenzweig, 2004. "Returns to Birthweight," The Review of Economics and Statistics, MIT Press, vol. 86(2), pages 586-601, May.
    46. Renfu Luo & Grant Miller & Scott Rozelle & Sean Sylvia & Marcos Vera-Hernández, 2015. "Can Bureaucrats Really Be Paid Like CEOs? School Administrator Incentives for Anemia Reduction in Rural China," NBER Working Papers 21302, National Bureau of Economic Research, Inc.
    47. Roland Bénabou & Jean Tirole, 2003. "Intrinsic and Extrinsic Motivation," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 70(3), pages 489-520.
    48. Prakarsh Singh, 2016. "Learning and Behavioral Spillovers of Nutritional Information," Working Papers id:11268, eSocialSciences.
    49. Simon Burgess & Marisa Ratto, 2003. "The Role of Incentives in the Public Sector: Issues and Evidence," The Centre for Market and Public Organisation 03/071, The Centre for Market and Public Organisation, University of Bristol, UK.
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    Cited by:

    1. Singh, Prakarsh & Mitra, Sandip, 2017. "Incentives, information and malnutrition: Evidence from an experiment in India," European Economic Review, Elsevier, vol. 93(C), pages 24-46.
    2. Cason, Timothy N. & Masters, William A. & Sheremeta, Roman M., 2020. "Winner-take-all and proportional-prize contests: Theory and experimental results," Journal of Economic Behavior & Organization, Elsevier, vol. 175(C), pages 314-327.
    3. Dasgupta, Utteeyo & Mani, Subha & Singh, Prakarsh, 2016. "Searching for Religious Discrimination among Anganwadi Workers in India: An Experimental Investigation," IZA Discussion Papers 10048, Institute of Labor Economics (IZA).
    4. Peng Nie & Anu Rammohan & Wencke Gwozdz & Alfonso Sousa-Poza, 2019. "Changes in Child Nutrition in India: A Decomposition Approach," IJERPH, MDPI, vol. 16(10), pages 1-22, May.
    5. Asadi-Aliabadi, Mehran & Karimi, Seyed M & Tehrani-Banihashemi, Arash & Mirbaha-Hashemi, Fariba & Janani, Leila & Babaee, Ebrahim & Nojomi, Marzieh & Moradi-Lakeh, Maziar, 2022. "Effectiveness of pay for performance to non-physician health care providers: A systematic review," Health Policy, Elsevier, vol. 126(7), pages 592-602.
    6. Singh, Prakarsh & Masters, William A., 2020. "Performance bonuses in the public sector: Winner-take-all prizes versus proportional payments to reduce child malnutrition in India," Journal of Development Economics, Elsevier, vol. 146(C).
    7. Travova, Ekaterina, 2023. "Under pressure? Performance evaluation of police officers as an incentive to cheat," Journal of Economic Behavior & Organization, Elsevier, vol. 212(C), pages 1143-1172.
    8. Jagatabandhu Mohapatra & Ranjit Kumar Dehury & Parthsaratathi Dehury & Ranjan Pattnaik, 2021. "The Functions of Integrated Child Development Services (ICDS): An Assessment of Existing Policy and Practice in Odisha," Journal of Development Policy and Practice, , vol. 6(2), pages 231-251, July.
    9. Singh, Neha S. & Kovacs, Roxanne J. & Cassidy, Rachel & Kristensen, Søren R. & Borghi, Josephine & Brown, Garrett W., 2021. "A realist review to assess for whom, under what conditions and how pay for performance programmes work in low- and middle-income countries," Social Science & Medicine, Elsevier, vol. 270(C).
    10. Dasgupta, Utteeyo & Mani, Subha & Singh, Prakarsh, 2016. "Searching for Religious Discrimination among Anganwadi Workers in India: An Experimental Investigation," IZA Discussion Papers 10048, Institute of Labor Economics (IZA).
    11. Utteeyo Dasgupta & Subha Mani & Prakarsh Singh, 2020. "Searching for religious discrimination among childcare workers," Review of Development Economics, Wiley Blackwell, vol. 24(2), pages 362-382, May.
    12. Khemani,Stuti & Chaudhary,Sarang & Scot,Thiago, 2020. "Strengthening Public Health Systems : Policy Ideas from a Governance Perspective," Policy Research Working Paper Series 9220, The World Bank.

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    More about this item

    Keywords

    Performance pay; public health information; child malnutrition;
    All these keywords.

    JEL classification:

    • O1 - Economic Development, Innovation, Technological Change, and Growth - - Economic Development
    • I1 - Health, Education, and Welfare - - Health
    • M5 - Business Administration and Business Economics; Marketing; Accounting; Personnel Economics - - Personnel Economics

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