Harnessing Human Nature for the Reduction of Poverty Nava Ashraf
International Forum on Reduction of Extreme Poverty | July 2014
Health
Education
Development
Development is Co-Produced
Development is Co-Produced
Resources and Supply is Not Enough
More than 13 million needless deaths every year from conditions for which safe, effective and affordable prevention and treatment exist Insecticide treated nets prevent malaria Condoms to prevent HIV/AIDs Water purification to prevent waterborne illness
Resources and Supply is Not Enough
More than 13 million needless deaths every year from conditions for which safe, effective and affordable prevention and treatment exist Insecticide treated nets prevent malaria Condoms to prevent HIV/AIDs Water purification to prevent waterborne illness
Families remain trapped in poverty, even when simple yield-improving agricultural technologies and savings instruments are available.
The Co-Producer
The Co Producer
How We (All) Make Decisions: Universal Principles Exacerbated under Stress & Poverty Obstacles —>Levers
The Co-Producer
How We (All) Make Decisions: Universal Principles Present-Bias Limited Bandwidth Social Influencers
Fast vs Slow Thinking “Fast” Mammalian brain: involved more in decisions for now (when wants are preferred) than for decisions for later. “Slow”Neocortex: involved in both types of decisions.
Choosing Fruit vs. Chocolate: Read and van Leeuwen (1998) Choosing(Today(
If(you(were( deciding(today,( would(you(choose( fruit(or(chocolate( for(next(week?(
Ea.ng(Next(Week(
Time(
Patient Choices for the Future
Choosing(Today(
Today,(74%(of( subjects(choose( fruit(for(next( week.(
Ea.ng(Next(Week(
Time(
Impatient Choices for Today Choosing(&(Ea,ng(Simultaneously(
If(you(were( deciding(today,( would(you(choose( fruit(or(chocolate( for(today?(
Time(
Time Inconsistent Preferences
Choosing(&(Ea,ng(Simultaneously(
Today,(70%(of( subjects(choose( chocolate(for( today.(
Time(
We want to do the right thing
We want to do the right thing
...we just find it difficult.
Cognitive Load 80 students brought into a laboratory Told to memorize a number 50% memorize a 2-digit number (low cognitive load) 50% memorize a 7-digit number (high cognitive load)
Given snack choice: fruit salad or chocolate cake
Shiv and Fedorikhin (1999)
Results
(Ashraf et al, 2006)
Average increase in bank account savings: after 6 months, 46%; after 12 months, 80% Increase for those who took up: after 6 months, 192%; after 12 months, 337% Similar product subsequently used by the Bank to help clients keep commitment to stop smoking
A word on methods: Field experiments
Need to know what works and why
A word on methods: Field experiments
Need to know what works and why But in evaluation, there is always the fundamental problem of identification Randomized Control Trials (RCTs) allow for causal inference through randomization into treatment and large sample sizes
A word on methods: Field experiments
Need to know what works and why But in evaluation, there is always the fundamental problem of identification Randomized Control Trials (RCTs) allow for causal inference through randomization into treatment and large sample sizes
Particularly helpful in demonstrating value of psychological & sociological factors in development
Incentives against Procrastination Immunization rates of just 5% in rural Udaipur (India) Small incentive (1 kg raw lentils per vaccine) raised full immunization to 39% Children who were offered immunization without lentil incentive: 16% Banerjee, A., Duflo, E., Glennerster, R., & Kothari, D. (2010).
(Banerjee et al., 2010)
(Banerjee et al., 2010)
Fast vs Slow Thinking: Limited Bandwidth
The Power of Defaults: Organ Donation (Johnson and Goldstein 2003)
Defaults and 401k Participation
Fortune 500 company 401(k) started in 1985 Check box to contribute In April-1998 key change Check box not to contribute Does opt-in vs. opt-out affect retirement savings?
% of New Employees Enrolling
(Madrian and Shea 2001)
Status Quo Effect vs. Company Tenure
It takes 20 years to overcome the cost of filling a form!
Just Assistance with Forms Makes Significant Difference in:
Access to Banking Services Among people given a referral letter to a bank and instructions on how to open an account, 90 percent had thought they would follow through — but only 50 percent did A bank representative assisting people with the forms had a large positive effect on take-up (Mullainathan and Shafir, 2009)
Applying to College: Individuals receiving tax preparation assistance were also offered help with the FAFSA & aid estimates compared against tuition costs Combined assistance & information increased FAFSA submissions High school seniors whose parents received the treatment went from 28%-36% more likely to have completed 2 years of college (Bettinger et al, 2012)
Making it Easy:
Cost-Effectiveness
Social Identity
The drive for social inclusion is fundamental, sometimes trumping the drive for physical sustenance. In his landmark studies, Harry Harlow showed that infant monkeys choose to starve in the arms of a soft, cloth “mother” over having access to milk from a wire “mother.” .
Social Identity Social Identity – Perception of oneness with a group of people – self concept extends to include social group.
Stems from: Cognitive factors: categorization of individuals into groups; and salience of outgroups Motivational factors: distinctiveness and/or prestige of the group; survival
Identifying barriers to adoption of new contraception technologies
Modern contraception provides unprecedented degree of choice for women in developed countries, but adoption rates lag in developing world Unmet need estimated at 25% in sub-Saharan Africa
Identifying barriers to adoption of new contraception technologies
Modern contraception provides unprecedented degree of choice for women in developed countries, but adoption rates lag in developing world Unmet need estimated at 25% in sub-Saharan Africa
Open question: What is driving the rates of excess fertility? Assumed to be lack of “access� (availability, suitability, misinformation)
Field Experiment Design Primary driver of Excess Fertility assumed to be access; study offers voucher lowering barriers to access
Field Experiment Design
Field Experiment Design
Results Women given voucher alone: 23% more likely to visit a family planning nurse 38% more likely to take up a concealable form of contraception 57% reduction in unwanted births
Results Women given voucher alone: 23% more likely to visit a family planning nurse 38% more likely to take up a concealable form of contraception 57% reduction in unwanted births ...than when they were given the voucher with their husband.
Results Women given voucher alone: 23% more likely to visit a family planning nurse 38% more likely to take up a concealable form of contraception 57% reduction in unwanted births ...than when they were given the voucher with their husband. Only when women have greated autonomy to adopt contraception does it lead to a decrease in unwanted births.
Results Women given voucher alone: 23% more likely to visit a family planning nurse 38% more likely to take up a concealable form of contraception 57% reduction in unwanted births ...than when they were given the voucher with their husband. Only when women have greated autonomy to adopt contraception does it lead to a decrease in unwanted births. ...but is that the whole story?
Maternal mortality
1 woman in 27
Maternal mortality
Maternal mortality
Maternal mortality
Pilot Results
What other relationships exist within the household...
Curriculum
Threats to the Social Identity
Proinflammatory cytokine activity and cortisol (i.e., stress) and that these changes occur in concert with shame. Chronic social self threats and persistent experience of shame-related cognitive and affective states predict disease-relevant immunological and health outcomes in HIV. And. . .
Neurologically, Social Exclusion = Physical Pain (Eisengerger, Liberman, & Williams, 2003, Science)
(A) Increased activity in anterior cingulate cortex during exclusion relative to inclusion. (B) Increased activity in right ventral prefrontal cortex during exclusion relative to inclusion. Both areas are active during physical pain.
Prosocial Motivations
In repeated economic experiments, people show a propensity to give up money in order to meet other needs.
Leveraging Pro-Social Motivation in the Provider
Harnessing innovative distribution mechanisms Female condoms: new technology that can prevent HIV/AIDS transmission and increase women’s contraceptive options – but a difficult technology to learn, need innovative distribution method
Field experiment context
Ashraf, Bandiera and Jack: “No Margin, No Mission? A Field Experiment on Incentives for Public Service Delivery.� May 2013.
Design and implement a field experiment with SFH Zambia, a public health organization
Ashraf, Bandiera and Jack: “No Margin, No Mission? A Field Experiment on Incentives for Public Service Delivery.� May 2013.
Design and implement a field experiment with SFH Zambia, a public health organization 1. Census: Survey all salons in Lusaka (~2500) 2. Randomly assign 1200 salons to four treatments 3. Invite to training, learn about incentives 4. Sales and monitoring: collect monthly data on hairdressers for one year.
Field experiment design
Alternative rewards
Tie reward (stars) to sales effort (# of stars proportional to social value)
Results
Results
Stars (non-financial rewards) are much more effective than financial incentives in this setting Seems to be driven by warm glow effect and social comparison
Community Health Workers
Shortages of health workers across sub-Saharan Africa undermine national health systems 3% of health work force in Africa, which has 11% of world’s population and 24% of disease burden
In Zambia, 12 million people but only 646 doctors CHWs a potentially innovative solution to this problem What are the optimal recruitment and compensation strategies
Ashraf, Bandiera & Lee: “Recruiting and Motivating Health Workers: A Field Experiment in Zambia. (Ongoing)
CHW Recruitment Posters
Community oriented poster
Career oriented poster
Conclusions
Getting inside the head and heart of the human being reveals the Universal Principles of : Present-Bias Limited Bandwidth Social Influencers for Belonging
Conclusions
Getting inside the head and heart of the human being reveals the Universal Principles of : Present-Bias Limited Bandwidth Social Influencers for Belonging
These can be incorporated into Smart Design of Programs, Services and Products and leveraged, to maximize impact
Conclusions
Getting inside the head and heart of the human being reveals the Universal Principles of : Present-Bias Limited Bandwidth Social Influencers for Belonging
These can be incorporated into Smart Design of Programs, Services and Products and leveraged, to maximize impact Just as development, health, education is co-produced, so is Knowledge: Becoming Co-Generators of Knowledge