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This research aims to better understand the impact of the Matlab health interventions by using panel data to control for unobservables and understand the dynamics and long-term effects of these programs. Heterogeneity in the fertility response to the family planning program is analyzed, using sequential fertility to isolate the family planning program from other interventions and examine heterogeneity based on time-varying characteristics. The link between childhood measles vaccination and school enrollment is examined using instrumental variables, and is motivated by the hypothesis that by avoiding the long-term health effects of a disease, vaccinated children are higher-achieving. Both analyses generate interesting findings that are not captured using the traditional methodologies and outcomes of program evaluation.

Julia Driessen, PhD, is an assistant professor of health policy and management in the Graduate School of Public Health at the University of Pittsburgh. She has a secondary appointment in the Department of Economics. In 2011 Dr. Driessen received her PhD in Economics from Johns Hopkins University. Her research interests include program evaluation and the links between health interventions and socioeconomic status, with an emphasis on heterogeneity of program effects as well as long-term outcomes. Recent research has analyzed the schooling effects of childhood measles vaccination and variation in the fertility response to a family planning program in Bangladesh. Her primary new interest since arriving at Pitt is the clinical and financial effects of electronic medical records in developing countries.

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Julia R. Driessen Assistant Professor of Health Policy and Management in the Graduate School of Public Health Speaker the University of Pittsburgh
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From Argentina to Zimbabwe, the 2012 Draper Hills Summer Fellows are working on the front lines of democracy, development, and the rule of law —often under threat— to improve their respective societies and defend the principles of justice and freedom.

Twenty-five leaders from 23 countries compose this year's class. More than half are women championing and inspiring new democratic models by leading pro-democracy movements in Ethiopia, empowering female entrepreneurs in Bangladesh, and reforming the criminal justice system in Georgia. They are joined by Arab Spring activists from Libya and Syria who have been jailed and persecuted for their work upholding human rights principles.

Across Africa, this year's fellows are bolstering good governance, combating corruption, increasing access to justice, and regulating natural resources. The fellows also include judges, national representatives, and police commissioners from Asia and Latin America who are enhancing transparency in government, strengthening civil service administration, and promoting electoral transparency.

Selected from a pool of 460 applicants, the 2012 class will arrive at Stanford on July 22 to begin a three-week training program at Stanford’s Center on Democracy, Development, and the Rule of Law. Fellows live together on the university’s campus where they will connect with peers, exchange experiences, and receive academic training from a team of interdisciplinary faculty.

One of the few programs of its kind in academia, the Draper Hills Summer Fellows Program combines the rich experiences of practitioners with academic training to maximize the impact of their work advancing political, economic, and social change.

Academic sessions are delivered by a team of Stanford political scientists, lawyers, and economists who are pioneering innovative research in the field of democratic development. Faculty engage the fellows to test their theories, exchange ideas, and learn more about the situations they study from afar. Guest speakers from private foundations, think tanks, government agencies, and the U.S. justice system provide a practitioner’s perspective on pressing issues. Site visits to Silicon Valley firms round out the experience, allowing fellows to explore how technology tools and social media platforms are being used to catalyze democratic practices.

Entering its eighth year, the Draper Hills Summer Fellows program includes a network of 200 alumni from 57 developing democracies. The program is funded by the generous support from Bill and Phyllis Draper and Ingrid von Mangoldt Hills.

To learn more about the 2012 Draper Hills Summer Fellows and their innovative work, please click here.  

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Preparing a meal in some of the world’s poorest rural areas can turn an ordinary activity into a deadly chore. Animal dung and crop scraps often fuel the indoor fires used for cooking. And before any food fills a hungry belly, thick black smoke fills a family’s lungs.

Pneumonia and other acute respiratory infections kill about 1 million people a year in low-income countries, making them the top cause of death in the developing world and the greatest threat to children’s lives. Makeshift stoves belch much of the polluted air leading to those illnesses. About 75 percent of South Asians and nearly half the world’s population use open-fire stoves inside their homes.

“The smoke is asphyxiating,” said Grant Miller, an associate professor of medicine at Stanford working on ways to get people to buy – and use – cleaner, safer stoves. “It burns your eyes and you can’t stop coughing.”

Governments and humanitarian organizations have urged people to trade their traditional stoves for safer models, many of which have chimneys that funnel smoke out of a home. But the switch from dangerous stoves has been slow to come, even though most people using them know they’re harmful.

Miller and his colleagues are studying what’s behind the reluctance and what can be done about it. They suspect much of the problem rests with the widespread approach to clean cookstove conversion, which focuses on educating people about the appliances’ health hazards and offering new models at a low cost.

Their most recent findings, published in the Proceedings of the National Academy of Sciences, boil down to this: Clean and modern cookstoves don’t have features people want. And until they’re redesigned, people are unlikely to bother with them.

“People don’t think of cookstoves as health technologies,” said Miller, an associate professor of medicine and a Stanford Health Policy faculty member at the university’s Freeman Spogli Institute for International Studies. Miller is the senior author of the PNAS paper, which published online June 11.

“They don’t think respiratory illness is the biggest health problem that they have,” he said. “And when you ask them what they want from a stove, they talk about saving time and having better fuel efficiency. They’re not talking about smoke emissions.”

In the first of two studies, Miller – joined by Yale researchers and Lynn Hildemann, a Stanford engineering professor affiliated with the Stanford Woods Institute for the Environment – surveyed about 2,500 women who cook for their families in rural Bangladesh. 

Nearly all of the women use traditional stoves, and 94 percent of them said they know the smoke from their stoves can make them sick. But 76 percent said the smoke is less harmful than polluted water, and 66 percent said it wasn’t as dangerous as rotten food.

“People know their cookstoves are bad, but they don’t think cookstoves are the most important problem they face,” Miller said. “They’d rather spend their money fixing those things and getting their kids into a good school than buying a new cookstove.”

When asked what features are most important in a stove, the women talked about things that could save fuel costs, cooking time and the hassle that goes into collecting fuel.

“A very small percent said reducing pollution was important,” Miller said.

The researchers then tried to assess more directly how Bangladeshis value new stoves. They offered 2,200 customers across 42 rural villages the opportunity to buy one of two models – one boasted improved fuel efficiency; the other had a chimney to reduce exposure to indoor smoke.

At the market prices of $5.80 for an efficient stove and $10.90 for the chimney stove, less than a third of customers ordered either model. And when the stoves were delivered a few weeks after the orders were taken, a very small number of families actually went through with the purchase of either model.  Large randomized discounts increased customer interest in fuel-efficient stoves, but did little to raise purchase rates of chimney stoves.

“A big implication is that the health education and social marketing approaches aren’t going to work,” Miller said. “You need to get inside the heads of the users and figure out what they really want and value – even if unrelated to smoke and health – and then give it to them.”

The lead author of the PNAS paper was Ahmed Mushfiq Mobarak, an economist at Yale. It was co-authored by Yale researchers Puneet Dwivedi and Robert Bailis. Their work was supported by the Freeman Spogli Institute’s Walter H. Shorenstein Asia-Pacific Research Center, Stanford’s Woods Institute for the Environment, and the International Growth Centre.

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Jean Enriquez is the Executive Director of the Coalition Against Trafficking Women-Asia-Pacific. Ms. Enriquez is an experienced person and trainer for various international and national fora on trafficking and prostitution, sexuality, health and reproductive rights, women’s political participation, women and development. She has worked on women’s issues in many of the poor countries of South Asia and the Mekong Region, such as Bangladesh and Cambodia. She has counseled victims of incestuous rape; has rescued women from prostitution; and has had her team of social workers threatened by abusers.Ms. Enriquez is a recipient of  The Outstanding Women in the Nation's Service award in 2010, and was named as one of the 7 Modern-Day Heroes by Yahoo! Philippines in 2011.

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Jean Enriquez Executive Director of the Coalition Against Trafficking of Women-Asia Pacific Speaker
Helen Stacy Director Moderator Program on Human Rights
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It is now widely recognized that a rigorous, policy-relevant impact evaluation embeds the counterfactual analysis of impact in a wider analysis of the underlying program theory (theory of change) of the intervention, also referred to as causal chain analysis. Unpacking the causal chain requires a combination of factual and counterfactual analysis. The seminar will present examples of causal chains. The types of data collection and analysis – both quantitative and qualitative – to analyze the different links in the chain will be discussed. A major challenge in mixed methods is to truly integrate quantitative and qualitative approaches.

About the speaker

Howard White formerly led the impact evaluation program of the Independent Evaluation Group of the World Bank, where he was responsible for impact studies on basic education in Ghana, health and nutrition in Bangladesh, rural electrification, rural development in Andhra Pradesh and a review of impact studies of water supply and sanitation.

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Howard White Executive Director Speaker International Initiative for Impact Evaluation (3ieimpact.org)
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Philip Keefer is a Lead Research Economist in the Development Research Group of the World Bank. Since receiving his PhD in Economics from Washington University at St. Louis, he has worked continuously on the interaction of institutions, political economy and economic development. His research has included investigations of the impact of insecure property rights on economic growth; the effect of political credibility on the policy choices of governments; and the sources of political credibility in democracies and autocracies. It has appeared in journals that span economics and political science, ranging from the Quarterly Journal of Economics to the American Review of Political Science, and has been influenced by his work in a wide range of countries, including Bangladesh, Brazil, the Dominican Republic, Indonesia, México, Perú, Pakistan and the Philippines.

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Philip Keefer Lead Research Economist Speaker World Bank
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