de Walque, Damien
Development Research Group
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Education, Macroeconomic and Structural Policies, Health
Development Research Group
Externally Hosted Work
Last updated January 31, 2023
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.
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Now showing 1 - 7 of 7
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) Akresh, Richard ; de Walque, Damien ; Kazianga, HarounanThis 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.
Female Sex Workers Use Power Over Their Day-to-Day Lives to Meet the Condition of a Conditional Cash Transfer Intervention to Incentivize Safe Sex(Elsevier, 2017-05) Cooper, Jan E. ; Dow, William H. ; de Walque, Damien ; Keller, Ann C. ; McCoy, Sandra I. ; Fernald, Lia C.H. ; Balampama, Marianna P. ; Kalolella, Admirabilis ; Packel, Laura J. ; Wechsberg, Wendee M. ; Ozer, Emily J.Female Sex Workers are a core population in the HIV epidemic, and interventions such as conditional cash transfers (CCTs), effective in other health domains, are a promising new approach to reduce the spread of HIV. Here we investigate how a population of Tanzanian female sex workers, though constrained in many ways, experience and use their power in the context of a CCT intervention that incentivizes safe sex. We analyzed 20 qualitative in-depth interviews with female sex workers enrolled in a randomized-controlled CCT program, the RESPECT II pilot, and found that while such women have limited choices, they do have substantial power over their work logistics that they leveraged to meet the conditions of the CCT and receive the cash award. It was through these decisions over work logistics, such as reducing the number of workdays and clients, that the CCT intervention had its greatest impact on modifying female sex workers’ behavior.
The Use of Financial Incentives to Prevent Undesirable Behaviors(World Bank, Washington, DC, 2018-05) de Walque, DamienBehaviors that are putting people's health and well-being at risk are widespread in the developing world and some of them, like smoking and unhealthy diets, are on the rise. Some of these behaviors can be prohibited or prevented by taxation. But financial incentives such as conditional cash transfers are also increasingly proposed and tested to discourage such behaviors, in domains as varied as HIV/AIDS, drugs, alcohol, smoking, obesity, or early marriage prevention. This paper presents the theoretical justification for using such incentives, distinguishing between the price, income effects, and the nudge effects. The growing literature about the effectiveness of financial incentives to prevent undesirable behaviors is reviewed in detail for each type of harmful behavior. Finally, the paper discusses the long-term sustainability of such incentives, a key issue if they are to be scaled up beyond pilot programs and research projects. The current evidence on whether such incentives have an impact after they are discontinued is mixed. Some design features, like lotteries or commitment devices, could induce savings as well as increase effectiveness, therefore improving sustainability.
Incentivizing School Attendance in the Presence of Parent-Child Information Frictions(World Bank, Washington, DC, 2018-06) de Walque, Damien ; Valente, ChristineEducation conditional cash transfer programs may increase school attendance in part due to the information they transmit to parents about their child's attendance. This paper presents experimental evidence that the information content of an education conditional cash transfer program, when given to parents independently of any transfer, can have a substantial effect on school attendance. The effect is as large as 75 percent of the effect of a conditional cash transfer incentivizing parents, and not significantly different from it. In contrast, a conditional transfer program incentivizing children instead of parents is nearly twice as effective as an "information only" treatment providing the same information to parents about their child's attendance. Taken together, these results suggest that children have substantial agency in their schooling decisions. The paper replicates the findings from most evaluations of conditional cash transfers that gains in attendance achieved by incentivizing parents financially do not translate into gains in test scores. But it finds that both the information only treatment and the alternative intervention incentivizing children substantially improve math test scores.
The Intergenerational Mortality Tradeoff of COVID-19 Lockdown Policies(World Bank, Washington, DC, 2021-05) Ma, Lin ; Shapira, Gil ; de Walque, Damien ; Do, Quy-Toan ; Friedman, Jed ; Levchenko, Andrei A.In lower-income countries, the economic contractions that accompany lockdowns to contain the spread of COVID-19 can increase child mortality, counteracting the mortality reductions achieved by the lockdown. To formalize and quantify this effect, this paper builds a macro-susceptible-infected-recovered model that features heterogeneous agents and a country-group-specific relationship between economic downturns and child mortality, and calibrate it to data for 85 countries across all income levels. The findings show that in low-income countries, a lockdown can potentially lead to 1.76 children’s lives lost due to the economic contraction per COVID-19 fatality averted. The ratio stands at 0.59 and 0.06 in lower-middle and upper-middle income countries, respectively. As a result, in some countries lockdowns can actually produce net increases in mortality. In contrast, the optimal lockdown that maximizes the present value of aggregate social welfare is shorter and milder in poorer countries than in rich ones, and never produces a net mortality increase.
Invitations and Incentives: A Qualitative Study of Behavioral Nudges for Primary Care Screenings in Armenia(Springer Nature, 2020-12) Gong, Estelle ; Chukwuma, Adanna ; Ghazaryan, Emma ; de Walque, DamienNon-communicable diseases account for a growing proportion of deaths in Armenia, which require early detection to achieve disease control and prevent complications. To increase rates of screening, demand-side interventions of personalized invitations, descriptive social norms, labeled cash transfers, and conditional cash transfers were tested in a field experiment. Our complementary qualitative study explores factors leading to the decision to attend screening and following through with that decision, and experiences with different intervention components. An individual’s decision to screen depends on 1) the perceived need for screening based on how they value their own health and perceive hypertension and diabetes as a harmful but manageable condition, and 2) the perceived utility of a facility-based screening, and whether screening will provide useful information on disease status or care management and is socially acceptable. Following through with the decision to screen depends on their knowledge of and ability to attend screenings, as well as any external motivators such as an invitation or financial incentive. Personalized invitations from physicians can prompt individuals to reconsider their need for screening and can, along with financial incentives, motivate individuals to follow through with the decision to screen. The effect of descriptive social norms in invitations should be further studied. Efforts to increase preventive screenings as an entry point into primary care in Armenia may benefit from implementation of tailored messages and financial incentives.
Early Education, Preferences, and Decision-Making Abilities(World Bank, Washington, DC, 2022-09) Cardim, Joana ; Carneiro, Pedro ; Carvalho, Leandro S. ; de Walque, DamienOne way to advance understanding of individual differences in decision making is to study the development of children’s decision making. This paper studies the causal effects of daycare attendance on children’s economic preferences and decision-making abilities, exploiting a lottery system that randomized admissions into oversubscribed daycare centers in Rio de Janeiro. Overall, daycare attendance had no effect on economic preferences or decision-making abilities. However, it did increase aversion to disadvantageous inequality (having less than one’s peer). This increase is driven mostly by girls, a result that reproduces in a different study that randomized admissions into preschool education.