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Impact of Caregiver Incentives on Child Health: Evidence from an Experiment with Anganwadi Workers in India

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  • William A. Masters

  • Prakarsh Singh

Abstract

This paper provides evidence of effectiveness for performance pay among government caregivers to improve child health in India. In a controlled study of 160 daycare centers serving over 4,000 children, we randomly assign individual workers to receive either fixed bonuses or incentive payments based on the weight-for-age nutritional status of children in their care, and also collect data from a control group receiving only their standard salary. Mothers of children in all three study arms receive nutrition information. We find that performance pay reduces the prevalence of underweight by about 5 percentage points over 3 months, and height improves by about one centimeter. Impacts are sustained in the medium term when incentives are renewed but fade when they are discontinued. Fixed bonuses lead to smaller effects. Both treatments appear to improve worker effort and communication with mothers, who in turn feed a more calorific diet to their children at home.

Suggested Citation

  • William A. Masters & Prakarsh Singh, 2016. "Impact of Caregiver Incentives on Child Health: Evidence from an Experiment with Anganwadi Workers in India," Working Papers id:11258, eSocialSciences.
    • Handle: RePEc:ess:wpaper:id:11258
    Note: Institutional Papers
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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. 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).
    3. 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.
    4. 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.
    5. 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.
    6. 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).
    7. 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.
    8. 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.
    9. 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).
    10. Nandan Jha & Neena Banerjee, 2025. "Effects of diffusion and education on women’s fertility in India," Journal of Population Research, Springer, vol. 42(2), pages 1-48, June.
    11. 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.
    12. 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.
    13. Seoyeon Chang & Sonoko Ishikawa & Naoki Miyamoto & Ryo Takahashi, 2025. "Misperception or Discrimination? Gender Bias in Health Communication on Anemia Prevention," Working Papers 2501, Waseda University, Faculty of Political Science and Economics.
    14. 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).
    15. Sayli Javadekar & Kritika Saxena, 2025. "The seen and unseen: the unintended impact of a conditional cash transfer program on prenatal sex selection," Journal of Population Economics, Springer;European Society for Population Economics, vol. 38(1), pages 1-34, March.

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    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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