Welcome to my website!
I'm a UK-US Fulbright Visiting Scholar at the Economic Growth Centre, Department of Economics, Yale University.
I'm joining the Institute for Fiscal Studies (IFS) as a Senior Research Economist in January 2023, when I'm also becoming a Research Associate at University College London (UCL), Department of Economics. I'm also an IZA Research Affiliate.
I'm an applied microeconomist and my research sits at the intersection of Development, Public and Health Economics. I use applied econometrics and field experiments to understand the principles underlying effective public good/service delivery in low- and middle-income countries. I also explore ways to induce people to adopt welfare-improving technologies and behaviours.
I hold a PhD and MPA from the London School of Economics and Political Science (LSE), and a BSc in Economics from Universidad del Pacifico.
An ounce of prevention for a pound of cure: Efficiency of community-based healthcare
(with P. Bernal, P. Celhay, S. Martinez and D. Sanchez)
We study the efficiency of community health teams, a common strategy in low- and middle-income countries for primary healthcare delivery. Our empirical strategy exploits the roll-out of a nation-wide expansion of coverage to this preventive healthcare model in El Salvador. Using a panel dataset of municipalities spanning 2005-2018 from consultation and hospital records of almost 5 million episodes, we show that investing in community-based healthcare led to a more efficient allocation of care. Preventive care increased and curative care and hospitalizations from preventable conditions decreased, while coverage in curative care for previously unattended chronic diseases increased.
Countering misinformation with targeted messages: Experimental evidence using mobile phones
(with A. Armand, B. Augsburg and K. Kumar)
There remains limited evidence on the instruments that facilitate or counteract misinformation, especially in lower-income contexts. We study microtargeting, an approach used by political parties throughout the world to influence voters. The development of the COVID-19 pandemic in India provides a unique setting as the surge in misinformation was accompanied by the prevalence of misconceptions based on religious identity, a politically-salient dimension. We implement a field experiment in a population at high risk of misinformation – slum residents – by randomly allocating participants to receive on their mobile phones messages introduced by a local citizen, the messenger, and in which doctors debunk misconceptions. We randomly vary the signaled religious identity of the messenger into either Muslim or Hindu, guaranteeing exogenous variation in religion concordance with the recipient. Doctor messages are effective at increasing citizens’ knowledge, but misconceptions are affected only in presence of religion concordance and for religious-salient misconceptions.
When Nature Calls Back: Sustaining Behavioural Change in Rural Pakistan
(with B. Augsburg, Z. Durrani, M. Vaidyanathan and Z. White)
Journal of Development Economics (2022)
We implement a randomized controlled trial and a qualitative study to assess whether, and if so how, behavioral change can be sustained. We do so in the context of Pakistan’s national sanitation strategy to combat open defecation, Community-Led Total Sanitation. Our findings demonstrate that continued follow-up activities that build on the original intervention lead to only modest reductions in reversal to unsafe sanitation on average, but gain in importance where initial conditions are unfavorable, i.e. poor public infrastructure and sanitation facilities. Promotion efforts are hence best targeted towards those who face larger difficulties in constructing and maintaining high-quality sanitation. The effects were sustained at least one year after the implementation of activities.
COVID-19 vaccine acceptance and hesitancy in LMICs, and implications for messaging
(with D. Karlan, M. Callen, M. Teachout, M. Humphreys, SB Omer, A M Mobarak et al.)
Nature Medicine (2021)
As vaccination campaigns are deployed worldwide, addressing vaccine hesitancy is of critical importance to ensure sufficient immunization coverage. We analyzed COVID-19 vaccine acceptance across 15 samples covering ten low- and middle- income countries (LMICs) in Asia, Africa, and South America, and two higher income countries (Russia and the United States). Methods Standardized survey responses were collected from 45,928 individuals between June 2020 and January 2021. We estimate vaccine acceptance with robust standard errors clustered at the study level. We analyze stated reasons for vaccine acceptance and hesitancy, and the most trusted sources for advice on vaccination, and we disaggregate acceptance rates by gender, age, and education level. Findings We document willingness to take a COVID-19 vaccine across LMIC samples, ranging from 67% (Burkina Faso) to 97% (Nepal). Willingness was considerably higher in LMICs (80%) than in the United States (65%) and Russia (30%). Vaccine acceptance was primarily explained by an interest in personal protection against the disease (91%). Concern about side effects (40%) was the most common reason for reluctance. Health workers were considered the most trusted sources of information about COVID-19 vaccines. Interpretation Given high levels of stated willingness to accept a COVID-19 vaccine across LMIC samples, our study suggests that prioritizing efficient and equitable vaccine distribution to LMICs will yield high returns in promoting immunization on a global scale.
Public Service Delivery and Free Riding: Experimental Evidence from India
(with A. Armand, B. Augsburg and M. Ghatak)
This paper provides novel evidence on the trade-off between public service delivery and free riding in low- and middle-income countries. We implement a field experiment in the slums of two major Indian cities, where inadequate access to sanitation restricts residents to either free ride, by disposing human waste in common-property areas, or use a fee-funded public service provided by community toilets. Using original survey, behavioral and objective measurements, we show that top-down incentives for the quality of service provision improves delivery and reduces non-payment of fees, but excludes a share of residents from using the service, forcing them into free riding. Willingness to pay for the service is unaffected, but demand for public intervention in the quality of delivery increases, replacing the demand to address free riding. Adding a campaign sensitizing the consequences of free riding among residents raises awareness, but does not induce any behavioral change. Supplementing reduced form estimates with structural estimates, we show that eliminating free riding requires subsidizing use beyond free basic services.
Can White Elephants Kill?
The Unintended Consequences of Infrastructure Development in Peru
I provide evidence of the severe social costs imposed by infrastructure projects that are being implemented (i.e., projects started but not yet completed) in the context of sewerage in Peru. Using a counterfactual implementation predicted from geography-based cost considerations as an instrument, I show that implemented projects increase infant and under-five mortality. These results are driven by hazards, poor hygienic conditions and unsafe behavior, which increase deaths by waterborne diseases and accidents. Delays and mid-construction halting are common, and exacerbate the lethal effects of projects. Failing to take the implementation phase into account could severely bias the welfare evaluation of infrastructure.
Work in Progress
Resource windfalls and local labor markets: Evidence from Peru
The political economy of public works: Evidence from a reform in term limits
Financing health providers:
The case of universal health insurance in Peru
(with Juan Pablo Rud)
(with Claudio Ferraz and Gabriel Granato)
(with Gabriela Smarrelli and Marcos Vera-Hernandez )
Media and Blogs
University of St Andrews
MSc in Economics Dissertation supervision
University of Edinburgh
MSc in Economics Dissertation supervision
London School of Economics and Political Science
Social Economics and Policy - LSE Teaching Excellence Award 2019