Antonella Bancalari

Antonella Bancalari
Research

Can White Elephants Kill?

The Unintended Consequences of Infrastructure Development in Peru

Submitted

It has long been accepted that investing in public infrastructure promotes economic development. However, there is little awareness of the prevalence of "white elephants" and their consequences. In this paper, I study the effect of unfinished sewerage infrastructure on early-life mortality in Peru. I compile several sources of administrative panel data for 1,400 districts spanning 2005--2015, and I rely on the budgetary plans and timing of expenditure for 6,000 projects to measure unfinished projects and those completed in a given district. I document that mid-construction abandonment and delays are highly prevalent. I exploit geographical features and partisan alignment to instrument for project implementation. Surprisingly, unfinished sewerage projects increased early-life mortality, driven by lack of water availability, water-borne diseases and accidents. While unfinished projects pose hazards to the population, completed sewerage projects decrease early-life mortality, in line with studies in advanced economies during the previous centuries.

Runner up for Best JMP - Royal Economic Society Junior Symposium

Winner of "Nada es Gratis" JMP in Economics

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Coordination and the Poor Maintenance Trap: an Experiment on Public Infrastructure in India

(with A. Armand and B. Augsburg)

Submitted

Poorly maintained public infrastructure is common in low- and middle-income countries, with consequences for service delivery and public health. By experimentally identifying the impact of incentives for local maintenance for both providers and potential users, this paper provides one of the first economic analyses of providerâ??user dynamics in the presence of local coordination failure. Focusing on shared sanitation facilities for slum residents in two major Indian cities, we randomly allocate facilities to either a control or two treatments. The first treatment incentivizes maintenance of the facility among providers, while the second treatment adds a sensitization campaign about the returns of a well-maintained facility among potential users. Using surveys, behavioral and objective measurements for both providers and potential users, we show that incentivizing maintenance does not favor collective action. The treatments raise the quality of facilities and reduce free riding, but at the cost of user selection. Providers improve routine maintenance, but also respond strategically to the newly-introduced incentives. While slum residents' private willingness to pay and cooperation are unaffected, their demand for public intervention increases. The second treatment raises awareness, but does not affect behavior.

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.)

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.

When Nature Calls Back: Sustaining Behavioural Change in Rural Pakistan (with B. Augsburg, Z. Durrani, M. Vaidyanathan and Z. White)

We assess if behavioural change can be sustained through continued follow-up. We implement a field experiment in rural villages of Pakistan that had previously undergone a campaign that forms part of the national sanitation strategy, Community-Led Total Sanitation (CLTS). Implementing agencies continued to conduct engagement activities in randomly selected villages on a regular basis during the following two years. Within this period, 30\% of households in control villages stopped using functional latrines and slipped back to open defecation. Follow-up improved sustainability of sanitation behavioural change, by decreasing slippage back to open defecation and increasing the continued use of functioning latrines. We find suggestive evidence that the effectiveness of follow-up activities was not only sustained but intensified over time. Continued follow-up was primarily effective at sustaining sanitation behavioural change where initial conditions are unfavourable ---i.e. poor public infrastructure and low-quality sanitation facilities. Promotion efforts are hence best targeted towards those that are most likely to slip back into unsafe behaviour.

COVID-19, Fake News and Religious Tensions in Slums of India (with A. Armand, B. Augsburg and K. Kumar)

One of the most, if not the most, at-risk groups of COVID-19 is the urban poor, living in overcrowded conditions with very limited access to public (health) infrastructure. We conduct phone surveys to analyse to what extent slum dwellers can and do respond to COVID-19 advise. We further run a field experiment to analyse whether social media can be successfully used to counter the spread of misinformation and fake news, as well as exploring religion bias in processing new information.

Effectiveness of Community Health Teams: Evidence from El Salvador
(with P. Bernal, P. Celhay and S. Martinez)

Access to high-quality preventive health care can deter mortality. Community health teams have emerged as an alternative to deficient formal health care provision in low- and middle-income countries, but the evidence on their effectiveness is inconclusive. Using quasi-experimental techniques and a fine-grain panel dataset of health records, we evaluate the effectiveness of a nation-wide reform in El Salvador that mobilized communities to access preventive healthcare. We find that the reform improved preventive behavior and reduced hospitalizations and deaths caused by diseases amenable to health access and quality.

Work in Progress

Municipal revenues and public employment:
The role of royalties from natural resources

The political economy of `white elephants':
Re-election incentives and completion of infrastructure projects

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 )

Teaching

University of St Andrews

Development Economics

Health Economics 

Microeconomics

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London School of Economics and Political Science

Social Economics and Policy - LSE Teaching Excellence Award 2019