Research
Research
Social Image and the Social Multiplier: Experimental Evidence from Community Deworming in Kenya with Edward Jee and Karim Naguib
Moving services farther typically reduces take‑up of preventive care. Yet when take-up is observable, requiring greater effort can raise the social image return to participation, dampening the distance penalty. We study this interaction in a community deworming campaign across 144 Kenyan communities. We randomly vary distance to treatment sites—close or far—and cross‑randomize public signals that increase the observability of deworming. Reduced form results show that, without signals, moving from close to far lowers take‑up by 16 percentage points; with signals, the close--far gap is 7 percentage points smaller. We estimate a structural model that separates the private cost and social image channels and accounts for the fact that, absent signals, observability falls with distance. The estimates imply that, as distance increases and participation falls, being seen deworming becomes more informative about motivation. With signals, social image returns rise with distance and partly offset private costs, so take-up declines only 80–90% as much as it would if social image played no role. Without signals, declining observability reduces social image returns and take-up declines 10–30% more. These dynamics matter for optimal site placement: a policymaker who accounts for social image can achieve the same deworming coverage with 6% fewer sites when actions are highly observable.
The Impact of Incentive Removal: Experimental Evidence from Childhood Immunization with Juliette Finetti and Zachary Kuloszewski
We investigate the impact of incentives and their removal on parents’ decisions to vaccinate subsequent children. We follow up with parents three years after exposure to a bracelet incentive for timely vaccination in Sierra Leone, leveraging the random assignment of clinics to implement the incentive. Since only parents with a newborn at the time of the experiment were eligible for the incentive, we exploit within-clinic variation in exposure. First, we find that parents who received an incentive for an earlier child are 5 to 11% less likely to vaccinate their subsequent child on time compared to parents in the control group. There are no effects on vaccination rates by 15 months of age, suggesting that parents delay vaccination rather than abstaining altogether. Second, parents living in communities where incentives were implemented but who were ineligible for them exhibit no changes in vaccination behavior, ruling out changes in community norms or clinic as explanations. Third, incentives that were valued as signals of vaccination completion do not result in adverse effects after their removal. Our causal forest analysis suggests that parents with higher vaccination costs are most affected by these negative effects. Taken together, our findings suggest that experience of incentives can reduce parents’ intrinsic motivation. These findings have important implications: while policy makers commonly focus on moving individuals to adopt a desirable behavior, we show that incentives may significantly impact the motivation of those already performing the desired action.
Social Signaling and Childhood Immunization: A Field Experiment in Sierra Leone The Quarterly Journal of Economics, Volume 139, Issue 4, November 2024, Pages 2083–2133, https://doi.org/10.1093/qje/qjae025
Recipient of the 2020 Distinguished CESifo Affiliate Award in Behavioral Economics.
Awarded $2.37 million by USAID DIV, the Weiss Asset Management Foundation and a generous private donor to scale up Social Incentives for Childhood Immunization in collaboration with the Government of Sierra Leone.
Government Trust and Covid-19 Vaccination: The Role of Supply Disruptions and Political Allegiances in Sierra Leone with Anbar Aizenman, Fatu E. Conteh, Rachel Glennerster, Samantha Horn, Desmond M. Kangbai and Sarah Shaukat. American Economic Review, Papers & Proceedings, 113: 647-52, 2023
Health Knowledge and Non-Pharmaceutical Interventions During the COVID-19 Pandemic in Africa with Anne Fitzpatrick, Sabrin Beg, Laura Derksen, Jason Kerwin, Adrienne Lucas, Natalia Ordaz Reynoso and Munir Squires. Journal of Economic Behavior & Organization, 190, 2021
Knowledge versus Skills: Evidence from a Field Study on Health Information in Sierra Leone with Fatu E. Conteh, Rachel Glennerster and Samantha Horn (Analysis in progress) (AEA registry)
Relying on Unregulated Firms to Achieve Public Health Goals: Evidence from Pharmacies in Kenya with Michael Dinerstein, Emma Yan and Younggeun Yoo (Analysis in progress) (AEA registry)
The Role of Informal Markets for Medicines: Experimental Evidence from Sierra Leone with Fatu E. Conteh, Michael Dinerstein, Sofia Gallo and Aaron Leonard (Pilot in progress)
Scaling Social Image Incentives: Experimental Evidence from the Malaria Vaccine with Juliette Finetti and Shana Warren (In the field) (AEA registry)