Person:
de Walque, Damien
Author Name Variants
Fields of Specialization
Education,
Macroeconomic and Structural Policies,
Health
Degrees
ORCID
External Links
Departments
Development Research Group
Externally Hosted Work
Contact Information
Last updated
January 31, 2023
Biography
Damien de Walque received his Ph.D.in Economics from the University of Chicago in 2003. His research interests include health and education and the interactions between them. His current work is focused on evaluating the impact of financial incentives on health and education outcomes. He is currently evaluating the education and health outcomes of conditional cash transfers linked to school attendance and health center visits in Burkina Faso. He is also working on evaluating the impact of HIV/AIDS interventions and policies in several African countries. He is leading two evaluations of the impact of short-term financial incentives on the prevention of HIV/AIDS and other sexually transmitted infections (STIs): individuals who test negatively for a set of STIs receive regular cash payment in Tanzania, while in Lesotho they receive lottery tickets. On the supply side of health services, he is managing a large portfolio of impact evaluations of results-based financing in the health sector. He has also edited a book on risky behaviors for health (smoking, drugs, alcohol, obesity, risky sex) in the developing world.
Publication Search Results
1 - 10 of 13
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Publication
Cash Transfers and Child Schooling : Evidence from a Randomized Evaluation of the Role of Conditionality
(World Bank, Washington, DC, 2013-01)The authors conduct a randomized experiment in rural Burkina Faso to estimate the impact of alternative cash transfer delivery mechanisms on education. The two-year pilot program randomly distributed cash transfers that were either conditional or unconditional. Families under the conditional schemes were required to have their children ages 7-15 enrolled in school and attending classes regularly. There were no such requirements under the unconditional programs. The results indicate that unconditional and conditional cash transfer programs have a similar impact increasing the enrollment of children who are traditionally favored by parents for school participation, including boys, older children, and higher ability children. However, the conditional transfers are significantly more effective than the unconditional transfers in improving the enrollment of "marginal children" who are initially less likely to go to school, such as girls, younger children, and lower ability children. Thus, conditionality plays a critical role in benefiting children who are less likely to receive investments from their parents. -
Publication
Using Provider Performance Incentives to Increase HIV Testing and Counseling Services in Rwanda
(World Bank, Washington, DC, 2013-02)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
Armed Conflict and Schooling : Evidence from the 1994 Rwandan Genocide
(World Bank, Washington, DC, 2008-04)Civil war, and genocide in particular, are among the most destructive of social phenomena, especially for children of school-going age. In Rwanda school enrollment trends suggest that the school system recovered quickly after 1994, but these numbers do not tell the full story. Two cross-sectional household surveys collected before and after the genocide are used to compare children in the same age group who were and were not exposed to the genocide - and their educational outcomes are substantially different. Children exposed to the genocide experienced a drop in educational achievement of almost one-half year of completed schooling, and are 15 percentage points less likely to complete third or fourth grade. Sustained effort is needed to reinforce educational institutions and offer a "second chance" to those youth most affected by the conflict. -
Publication
Parental Education and Children’s Schooling Outcomes : Is the Effect Nature, Nurture, or Both? Evidence from Recomposed Families in Rwanda
(World Bank, Washington, DC, 2005-01)Educated parents tend to have educated children. But is intergenerational transmission of human capital more nature, more nurture, or both? The author uses household survey data from Rwanda that contains a large proportion of children living in households without their biological parents. The data allows him to separate genetic from environmental parental influences. The nonrandom placement of children is controlled by including the educational attainment of the absent biological parents and the type of relationship that links the children to their "adoptive" families. The results of the analysis suggest that the nurture component of the intergenerational transmission of human capital is important for both parents, contrary to recent evidence proposed by Behrman and Rosenzweig (2002) and Plug (2004). The author concludes that mothers education had no environmental impact on children s schooling. Interestingly, mothers education matters more for girls, while fathers education is more important for boys. Finally, an important policy recommendation in the African context emerges from the analysis: the risk for orphans or abandoned children to lose ground in their schooling achievements is minimized if they are placed with relatives. -
Publication
Evidence from a Randomized Evaluation of the Household Welfare Impacts of Conditional and Unconditional Cash Transfers Given to Mothers or Fathers
(World Bank, Washington, DC, 2016-06)This study conducted a randomized control trial in rural Burkina Faso to estimate the impact of alternative cash transfer delivery mechanisms on education, health, and household welfare outcomes. The two-year pilot program randomly distributed cash transfers that were either conditional or unconditional and were given to either mothers or fathers. Conditionality was linked to older children enrolling in school and attending regularly and younger children receiving preventive health check-ups. Compared with the control group, cash transfers improve children's education and health and household socioeconomic conditions. For school enrollment and most child health outcomes, conditional cash transfers outperform unconditional cash transfers. Giving cash to mothers does not lead to significantly better child health or education outcomes, and there is evidence that money given to fathers improves young children's health, particularly during years of poor rainfall. Cash transfers to fathers also yield relatively more household investment in livestock, cash crops, and improved housing. -
Publication
The use of video vignettes to measure health worker knowledge: Evidence from Burkina Faso
(Elsevier, 2018-09)The quality of care is a crucial determinant of good health outcomes, but is difficult to measure. Survey vignettes are a standard approach to measuring medical knowledge among health care providers. Given that written vignettes or knowledge tests may be too removed from clinical practice, particularly where “learning by doing” may be an important form of training, we developed a new type of provider vignette. It uses videos presenting a patient visiting the clinic with maternal/early childhood symptoms. We tested these video vignettes with current and future (students) health professionals in Burkina Faso. Participants indicated that the cases used were interesting, understandable and common. Their performance was consistent with expectations. Participants with greater training (medical doctors vs. nurses and midwives) and experience (health professionals vs. students) performed better. The video vignettes can easily be embedded in computers, tablets and smart phones; they are a convenient tool to measure provider knowledge; and they are cost-effective instruction and testing tools. -
Publication
Child Ability and Household Human Capital Investment Decisions in Burkina Faso
( 2010-07-01)Using data they collected in rural Burkina Faso, the authors examine how children's cognitive abilities influence resource constrained households' decisions to invest in their education. This paper uses a direct measure of child ability for all primary school-aged children, regardless of current school enrollment. The analysis explicitly incorporates direct measures of the ability of each child s siblings (both absolute and relative measures) to show how sibling rivalry exerts an impact on the parents decision of whether and how much to invest in their child s education. The findings indicate that children with one standard deviation higher own ability are 16 percent more likely to be currently enrolled, while having a higher ability sibling lowers current enrollment by 16 percent and having two higher ability siblings lowers enrollment by 30 percent. The results are robust to addressing the potential reverse causality of schooling influencing child ability measures and using alternative cognitive tests to measure ability. -
Publication
Antiretroviral Therapy Awareness and Risky Sexual Behaviors : Evidence from Mozambique
( 2010-11-01)This paper studies the effect of increased access to antiretroviral therapy on risky sexual behavior, using data collected in Mozambique in 2007 and 2008. The survey sampled both households of randomly selected HIV positive individuals and households from the general population. Controlling for unobserved individual characteristics, the findings support the hypothesis of disinhibition behaviors, whereby risky sexual behaviors increase in response to the perceived changes in risk associated with increased access to antiretroviral therapy. Furthermore, men and women respond differently to the perceived changes in risk. In particular, risky behaviors increase for men who believe, wrongly, that AIDS can be cured, while risky behaviors increase for women who believe, correctly, that antiretroviral therapy can treat AIDS but cannot cure it. The findings suggest that scaling up access to antiretroviral therapy without prevention programs may not be optimal if the objective is to contain the disease, since people would adjust their sexual behavior in response to the perceived changes in risk. Therefore, prevention programs need to include educational messages about antiretroviral therapy, and address the changing beliefs about HIV in the era of increasing antiretroviral therapy availability. -
Publication
The Demographic and Socio-economic Distribution of Excess Mortality during the 1994 Genocide in Rwanda
( 2009-03-01)There is an extensive literature on violent conflicts such as the 1994 Rwandan genocide, but few papers examine the profiles of victims and perpetrators, or more broadly the micro-level dynamics of widespread violence. This paper studies the demographic consequences of the Rwandan genocide and how the excess mortality due to the conflict was distributed in the population. Data collected by the 2000 Demographic and Health Survey indicate that although there were more deaths across the entire population, adult males were the most likely to die. Using the characteristics of the survey respondent as a proxy for the socio-economic status of the family dead, the results also show that individuals with an urban or more educated background were more likely to die. Over and above the human tragedies, a long-term cost of the genocide is the country's loss of productive skills. -
Publication
Educational and Health Impacts of Two School Feeding Schemes : Evidence from a Randomized Trial in Rural Burkina Faso
( 2009-06-01)This paper uses a prospective randomized trial to assess the impact of two school feeding schemes on health and education outcomes for children from low-income households in northern rural Burkina Faso. The two school feeding programs under consideration are, on the one hand, school meals where students are provided with lunch each school day, and, on the other hand, take-home rations that provide girls with 10 kg of cereal flour each month, conditional on 90 percent attendance rate. After running for one academic year, both programs increased girls enrollment by 5 to 6 percentage points. While there was no observable significant impact on raw scores in mathematics, the time-adjusted scores in mathematics improved slightly for girls. The interventions caused absenteeism to increase in households that were low in child labor supply while absenteeism decreased for households that had a relatively large child labor supply, consistent with the labor constraints. Finally, for younger siblings of beneficiaries, aged between 12 and 60 months, take-home rations have increased weight-for-age by .38 standard deviations and weight-for-height by .33 standard deviations. In contrast, school meals did not have any significant impact on the nutrition of younger children.