Gertler, Paul Jerome

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Impact evaluation, Health economics
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Last updated: January 31, 2023
Paul Gertler is the Li Ka Shing Professor of Economics at the University of California, Berkeley where he holds appointments in the Haas School of Business and the School of Public Health. He is also the Scientific Director of the UC Center for Effective Global Action. Dr. Gertler is an internationally recognized expert in impact evaluation. Dr. Gertler was Chief Economist of the Human Development Network of the World Bank from 2004-2007 and the Founding Chair of the Board of Directors of the International Initiative for Impact Evaluation (3ie) from 2009-2012.  At the World Bank he led an effort to institutionalize and scale up impact evaluation for learning what works in human development. He is the author of the bestselling textbook Applied Impact Evaluation published by the World Bank Press. He has been a Principal Investigator on a large number of at-scale multi-site impact evaluations including Mexico’s CCT program, PROGRESA/OPORTUNIDADES, and Rwanda’s Health Care Pay-for-Performance scheme. He holds a PhD in economics from the University of Wisconsin and prior to UC Berkeley has held academic appointments at Harvard, RAND, and SUNY Stony Brook.
Citations 490 Scopus

Publication Search Results

Now showing 1 - 10 of 21
  • Publication
    Using Provider Performance Incentives to Increase HIV Testing and Counseling Services in Rwanda
    (World Bank, Washington, DC, 2013-02) de Walque, Damien; Gertler, Paul J.; de Dieu Bizimana, Jean; Vermeersch, Christel; Condo, Jeanine
    Paying for performance provides financial rewards to medical care providers for improvements in performance measured by specific utilization and quality of care indicators. In 2006, Rwanda began a paying for performance scheme to improve health services delivery, including HIV/AIDS services. This study examines the scheme's impact on individual and couples HIV testing and counseling and using data from a prospective quasi-experimental design. The study finds a positive impact of paying for performance with an increase of 6.1 percentage points in the probability of individuals having ever been tested. This positive impact is stronger for married individuals: 10.2 percentage points. The results also indicate larger impacts of paying for performance on the likelihood that the respondent reports both partners have ever been tested, especially among discordant couples (14.7 percentage point increase) in which only one of the partners is HIV positive.
  • Publication
    Impact Evaluation in Practice, First Edition
    (World Bank, 2011) Gertler, Paul J.; Martinez, Sebastian; Premand, Patrick; Rawlings, Laura B.; Vermeersch, Christel M. J.
    The Impact Evaluation in Practice handbook is a comprehensive and accessible introduction to impact evaluation for policymakers and development practitioners. The book incorporates real-world examples to present practical guidelines for designing and implementing evaluations. Readers will gain an understanding of the uses of impact evaluation and the best ways to use evaluations to design policies and programs that are based on evidence of what works most effectively. The handbook is divided into three sections: Part One discusses what to evaluate and why; Part Two outlines the theoretical underpinnings of impact evaluation; and Part Three examines how to implement an evaluation. Case studies illustrate different methods for carrying out impact evaluations.
  • Publication
    Effect of the Jamaica Early Childhood Stimulation Intervention on Labor Market Outcomes at Age 31
    (World Bank, Washington, DC, 2021-09) Gertler, Paul; Pinto, Rodrigo; Chang-Lopez, Susan M.; Grantham-McGregor, Sally; Vermeersch, Christel; Wright, Amika S.
    This paper reports the labor market effects of the Jamaica Early Childhood Stimulation intervention at age 31. The study is a small-sample randomized early childhood education stimulation intervention targeting stunted children living in the poor neighborhoods of Kingston, Jamaica. Implemented in 1987–89, treatment consisted of a two-year, home-based intervention designed to improve nutrition and the quality of mother-child interactions to foster cognitive, language, and psycho-social skills. The original sample was 127 stunted children between ages 9 and 24 months. The study was able to track and interview 75 percent of the original sample 30 years after the intervention, both still living in Jamaica and migrated abroad. The findings reveal large and statistically significant effects on income and schooling; the treatment group had 43 percent higher hourly wages and 37 percent higher earnings than the control group. This is a substantial increase over the treatment effect estimated for age 22, when a 25 percent increase in earnings was observed.
  • Publication
    Using Provider Performance Incentives to Increase HIV Testing and Counseling Services in Rwanda
    (Elsevier, 2014-12-12) de Walque, Damien; Gertler, Paul J.; de Dieu Bizimana, Jean; Vermeersch, Christel; Condo, Jeanine
    Paying for performance provides financial rewards to medical care providers for improvements in performance measured by utilization and quality of care indicators. In 2006, Rwanda began a pay for performance scheme to improve health services delivery, including HIV/AIDS services. Using a prospective quasi-experimental design, this study examines the scheme's impact on individual and couples HIV testing. We find a positive impact of pay for performance on HIV testing among married individuals (10.2 percentage points increase). Paying for performance also increased testing by both partners by 14.7 percentage point among discordant couples in which only one of the partners is an AIDS patient.
  • Publication
    Long-Run Effects of Temporary Incentives on Medical Care Productivity
    (World Bank, Washington, DC, 2015-06) Celhay, Pablo; Gertler, Paul; Giovagnoli, Paula; Vermeersch, Christel
    The adoption of new clinical practice patterns by medical care providers is often challenging, even when the patterns are believed to be efficacious and profitable. This paper uses a randomized field experiment to examine the effects of temporary financial incentives paid to medical care clinics for the initiation of prenatal care in the first trimester of pregnancy. The rate of early initiation of prenatal care was 34 percent higher in the treatment group than in the control group while the incentives were being paid, and this effect persisted at least 15 months and likely 24 months or more after the incentives ended. These results are consistent with a model where the incentives enable providers to address the fixed costs of overcoming organizational inertia in innovation, and suggest that temporary incentives may be effective at motivating improvements in long-run provider performance at a substantially lower cost than permanent incentives.
  • Publication
    Housing, Health, and Happiness
    (World Bank, Washington, DC, 2007-04) Cattaneo, Matias D.; Galiano, Sebastian; Gertler, Paul J.; Martinez, Sebastian; Titiunik, Rocio
    Despite the importance of housing for people's well-being, there has been little work done to assess the causal impact of housing and housing improvement programs on health and welfare. In this paper the authors help fill this gap by investigating the impact of a large-scale effort by the Mexican government to replace dirt floors with cement floors on child health and adult happiness. They find that replacing dirt floors with cement floors significantly reduces parasitic infestations in young children, reduces diarrhea, reduces anemia, and improves cognitive development. Finally, they also find that this program leave adults substantially better off, as measured by satisfaction with their housing and quality of life and by their significantly lower rates of depression and perceived stress.
  • Publication
    School-Based Management and Learning Outcomes: Experimental Evidence from Colima, Mexico
    (World Bank, Washington, DC, 2019-06) Garcia-Moreno, Vicente; Gertler, Paul; Patrinos, Harry Anthony
    A school-based management program was implemented Mexico in 2001 and continued until 2014. This national program, Programa Escuelas de Calidad, was considered a key intervention to improve learning outcomes. In 2006, the national program was evaluated in the Mexican state of Colima, being the first experimental evaluation of the national program. All schools were invited to participate in the program; a random selection was performed to select the treatment and control groups among all the applicants. An intent-to-treat approach did not detect any impact on learning outcomes; a formal school-based management intervention plus a monetary grant was not enough to improve learning outcomes. First, the schools in the evaluation sample, control and treatment, were schools with high learning outcomes. Second, these schools had experienced some years of regular school-based management practices before the evaluation. A difference-in-difference design is used to identify heterogeneous effects of the program on learning outcomes. The difference-in-difference approach shows that the intensity of treatment increased test scores during the first year of the intervention.
  • Publication
    Paying Primary Health Care Centers for Performance in Rwanda
    (World Bank, Washington, DC, 2010-01) Basinga, Paulin; Gertler, Paul J.; Soucat, Agnes L.B.; Binagwaho, Agnes; Soucat, Agnes L.B.; Sturdy, Jennifer R.; Vermeersch, Christel M.J.
    Paying for performance (P4P) provides financial incentives for providers to increase the use and quality of care. P4P can affect health care by providing incentives for providers to put more effort into specific activities, and by increasing the amount of resources available to finance the delivery of services. This paper evaluates the impact of P4P on the use and quality of prenatal, institutional delivery, and child preventive care using data produced from a prospective quasi-experimental evaluation nested into the national rollout of P4P in Rwanda. Treatment facilities were enrolled in the P4P scheme in 2006 and comparison facilities were enrolled two years later. The incentive effect is isolated from the resource effect by increasing comparison facilities' input-based budgets by the average P4P payments to the treatment facilities. The data were collected from 166 facilities and a random sample of 2158 households. P4P had a large and significant positive impact on institutional deliveries and preventive care visits by young children, and improved quality of prenatal care. The authors find no effect on the number of prenatal care visits or on immunization rates. P4P had the greatest effect on those services that had the highest payment rates and needed the lowest provider effort. P4P financial performance incentives can improve both the use of and the quality of health services. Because the analysis isolates the incentive effect from the resource effect in P4P, the results indicate that an equal amount of financial resources without the incentives would not have achieved the same gain in outcomes.
  • Publication
    Using Performance Incentives to Improve Health Outcomes
    (World Bank, Washington, DC, 2012-06) Gertler, Paul; Vermeersch, Christel
    This study examines the effect of performance incentives for health care providers to provide more and higher quality care in Rwanda on child health outcomes. The authors find that the incentives had a large and significant effect on the weight-for-age of children 0-11 months and on the height-for-age of children 24-49 months. They attribute this improvement to increases in the use and quality of prenatal and postnatal care. Consistent with theory, They find larger effects of incentives on services where monetary rewards and the marginal return to effort are higher. The also find that incentives reduced the gap between provider knowledge and practice of appropriate clinical procedures by 20 percent, implying a large gain in efficiency. Finally, they find evidence of a strong complementarity between performance incentives and provider skill.
  • Publication
    The Effect of India’s Total Sanitation Campaign on Defecation Behaviors and Child Health in Rural Madhya Pradesh: A Cluster Randomized Controlled Trial
    (Public Library of Science, 2014-08-26) Patil, Sumeet R.; Arnold, Benjamin F.; Salvatore, Alicia L.; Briceno, Bertha; Ganguly, Sandipan; Colford Jr., John M.; Gertler, Paul J.
    Poor sanitation is thought to be a major cause of enteric infections among young children. However, there are no previously published randomized trials to measure the health impacts of large-scale sanitation programs. India's Total Sanitation Campaign (TSC) is one such program that seeks to end the practice of open defecation by changing social norms and behaviors, and providing technical support and financial subsidies. The objective of this study was to measure the effect of the TSC implemented with capacity building support from the World Bank's Water and Sanitation Program in Madhya Pradesh on availability of individual household latrines (IHLs), defecation behaviors, and child health (diarrhea, highly credible gastrointestinal illness [HCGI], parasitic infections, anemia, growth).