@article{bakhtiar_guiteras_levinsohn_mobarak_2023, title={Social and financial incentives for overcoming a collective action problem}, volume={162}, ISSN={["1872-6089"]}, url={http://dx.doi.org/10.1016/j.jdeveco.2023.103072}, DOI={10.1016/j.jdeveco.2023.103072}, abstractNote={Addressing public health externalities often requires community-level collective action. Due to social norms, each person's sanitation investment decisions may depend on the decisions of neighbors. We report on a cluster randomized controlled trial conducted with 19,000 households in rural Bangladesh where we grouped neighboring households and introduced (either financial or social recognition) rewards with a joint liability component for the group, or asked each group member to make a private or public pledge to maintain a hygienic latrine. The group financial reward has the strongest impact in the short term (3 months), inducing a 7.5-12.5 percentage point increase in hygienic latrine ownership, but this effect dissipates in the medium term (15 months). In contrast, the public commitment induced a 4.2-6.3 percentage point increase in hygienic latrine ownership in the short term, but this effect persists in the medium term. Non-financial social recognition or a private pledge has no detectable effect on sanitation investments.}, journal={JOURNAL OF DEVELOPMENT ECONOMICS}, publisher={Elsevier BV}, author={Bakhtiar, M. Mehrab and Guiteras, Raymond P. and Levinsohn, James and Mobarak, Ahmed Mushfiq}, year={2023}, month={May} } @article{guiteras_quistorff_kim_shumway_2023, title={statacons: An SCons-based build tool for Stata}, volume={23}, ISSN={["1536-8734"]}, DOI={10.1177/1536867X231162032}, abstractNote={ In this article, we present statacons, an SCons-based build tool for Stata. Because of the integration of Stata and Python in recent versions of Stata, we are able to adapt SCons for Stata workflows without the use of an external shell or extensive configuration. We discuss the usefulness of build tools generally, provide examples of the use of statacons in Stata workflows, present key elements of the syntax of statacons, and discuss extensions, alternatives, and limitations. We provide recommendations for collaborative workflows and, at the end of the article, installation instructions. }, number={1}, journal={STATA JOURNAL}, author={Guiteras, Raymond P. and Quistorff, Brian and Kim, Ahnjeong and Shumway, Clayson}, year={2023}, month={Mar}, pages={148–196} } @article{guiteras_kim_quistorff_shumway_2022, title={statacons: An SCons-Based Build Tool for Stata}, url={https://doi.org/10.31222/osf.io/qesx6}, DOI={10.31222/osf.io/qesx6}, abstractNote={This paper presents statacons, an SCons-based build tool for Stata. Because of the integration of Stata and Python in recent versions of Stata, we are able to adapt SCons for Stata workflows without the use of an external shell or extensive configuration. We discuss the usefulness of build tools generally, provide examples of the use of statacons in Stata workflows, present key elements of the syntax of statacons, and discuss extensions, alternatives, and limitations. Appendices provide installation instructions and recommendations for collaborative workflows.}, author={Guiteras, Raymond and Kim, Ahnjeong and Quistorff, Brian and Shumway, Clayson}, year={2022}, month={Jan} } @article{ercumen_guiteras_spears_2021, title={Biology, behavior and policy, or, Dr. Fauci, Sen. Paul and Prof. Lucas walk into a pandemic}, volume={31}, ISSN={2589-5370}, url={http://dx.doi.org/10.1016/j.eclinm.2020.100719}, DOI={10.1016/j.eclinm.2020.100719}, abstractNote={In a highly-publicized recent exchange in the U.S. Senate, Dr. Anthony Fauci and Sen. Rand Paul expressed radically different views on the level of herd immunity needed to contain the coronavirus epidemic. Sen. Paul noted that transmission rates in New York City appeared low, despite the virus's high inherent infectiousness, proposing that this was evidence that the share of the population already infected was sufficient to have reached herd immunity. Dr. Fauci memorably responded, “If you believe 22% is herd immunity, I believe you're alone in that” [[1]U.S. Senate. Committee on health, education, labor & pensions COVID-19: an update on the federal response. https://www.help.senate.gov/hearings/covid-19-an-update-on-the-federal-response. Accessed online 10 Dec 2020.Google Scholar]. For Sen. Paul, the implication of a low threshold for herd immunity is that restrictions on activity can be reduced without risking runaway disease transmission. If correct, this would be welcome, since such restrictions have immense economic, health and emotional costs. Unfortunately, his policy recommendation suffers from a crucial flaw in logic: it ignores the Lucas critique. Prof. Robert Lucas's Nobel-prize-winning insight, developed in the study of the unemployment-inflation tradeoff in macroeconomics, was that empirical relationships observed under one policy regime cannot necessarily be used to argue for a change in policy [[2]Lucas R.E. Econometric policy evaluation: a critique.Carnegie Rochester Conf Ser Public Policy. 1976; 1: 19-46Crossref Scopus (1933) Google Scholar]. The logic is simple, but profound: the relationships we observe in the data depend on behavior, and behavior responds to and is affected by policy, so when policy changes we should expect behavior to change as well. As a result, we cannot expect the empirical relationships observed under the previous policy regime to continue under the new policy regime, nor can we claim that our new policy will have the effects we would anticipate if behavior were fixed. How does this insight from macroeconomics apply to coronavirus and herd immunity? Suppose we grant Sen. Paul's claim that, in previously hard-hit areas such as New York City, relatively low shares of the population previously infected have contributed in important ways to slowing the spread of disease. Even so, his policy conclusion—that distancing, masking and restrictions on activity can safely end—does not follow. The Lucas Critique reminds us that by changing policy, we change behavior, which in turn will affect the relationships on which we based our policy change. A little math can help. In a standard, simple epidemiological model, the population threshold for herd immunity, commonly denoted p, is given by the formulap=1−(1/R0),where R0 is the basic reproduction number and refers to the expected number of secondary cases that result from one infected case. For an extremely contagious disease like measles, R0 might be about 10, leading to a p of about 0.9, which is why attaining high rates of immunization is so important. For a much less contagious disease, the threshold is lower. For example, if R0 = 1.2, then p = 0.17. Once more than 17% of the population is immune, whether through infection or from vaccination, we expect the disease to die out. The details change in more complex models, for example if different sub-populations spread the disease at different rates, or if acquired immunity is only partial, but the basic insight is the same: the less infectious a disease is, the lower the herd immunity threshold. While this insight is correct, it is easy to make two conceptual mistakes. The first mistake would be to assume that R0 is a fixed, intrinsic biological property of a disease. While some diseases are inherently more contagious than others, R0 is a result of both biology (i.e., duration of being contagious, risk of infection for a given level of exposure) but also of environment and behavior (i.e., contact rate between susceptible and infected individuals, amount of exposure when a contact occurs) [[3]Delamater P.L. Street E.J. Leslie T.F. Yang Y.T. Jacobsen K.H. Complexity of the basic reproduction number (R).Emerg Infect Dis. 2019; 25: 1-4Crossref PubMed Scopus (284) Google Scholar]. This is why we should wear masks, maintain physical distance, meet other people outdoors rather than indoors whenever feasible, and so on: even if we cannot change the inherent infectiousness of the disease, we can still reduce R0. The second mistake would be to forget the Lucas critique: even if we concede that the low share of previously infected people exceeded a herd immunity threshold, it does not follow that we can use this observation to argue for fewer restrictions on activity, or to tell the public that fewer precautions are needed. If indeed the herd immunity threshold was low, it is likely that this was in large part because public policy and private behavior contributed to keeping R0 low. Policies such as shelter-in-place orders have successfully reduced mobility and COVID-19 transmission across the US [[4]Dave D. Friedson A.I. Matsuzawa K. Sabia J.J. When do shelter-in-place orders fight COVID-19 best? Policy heterogeneity across states and adoption time.Econ Inq. 2020; https://doi.org/10.1111/ecin.12944Crossref PubMed Scopus (50) Google Scholar]. If we were to change policy or encourage less cautious private behavior, R0 would likely increase, and the herd immunity threshold would increase as well. Why does this matter for the future? Going forward, understanding how interactions among biology, behavior and policy affect outcomes will continue to be crucial for good policy design, while neglecting to consider how behavior may change in response to new interventions and policies may undermine progress. For example, recent weeks have brought positive news on vaccine development, including the approval and initial distribution of vaccines in several countries. In addition to saving many lives, the arrival of these vaccines will allow less restrictive policies, and vaccinated individuals will naturally and rationally increase their levels of activity as vaccination reduces risks to their health. On balance, this increase in activity will be welcome and beneficial. However, it will likely dampen some of the benefits of the vaccine, because increased activity will push R0 back up among those who are unlucky enough not to be protected by the vaccine. Since we will not know in advance who will have this bad luck, policy should continue to encourage low-cost mitigation, such as masking, ventilation of indoor spaces, and modest physical distancing, and policymakers should be cautious about lifting restrictions on large gatherings, especially indoors. On an even more basic level, the change in behavior could even undermine the level of protection the vaccine provides. In the double-blind placebo-controlled field trials of these vaccines, vaccine recipients still had a strong incentive to protect themselves and limit their own exposure, for two reasons. First, they did not know whether they had received the vaccine rather than the placebo. Second, at the time, it was not yet known that the vaccine would be effective. In contrast, an individual who knows she has received an approved, effective vaccine may reasonably and rationally take fewer precautions. The result is that early individuals to receive a vaccine may actually face higher levels of viral exposure than the experimental population did, since their behavior may change while, at least at early stages of vaccination, the overall level of infection in the community has not yet been reduced. We do not know how the vaccine will perform in this new context, and the growing evidence that higher intensity of exposure is associated with more severe illness should make us cautious [[5]Gandhi M. Beyrer C. Goosby E. Masks do more than protect others during COVID-19: reducing the inoculum of SARS-CoV-2 to protect the wearer.J Gen Intern Med. 2020; 35: 3063-3066Crossref PubMed Scopus (83) Google Scholar]. Again, public communication and policy should continue to encourage basic, low-cost protections to the extent possible, and will need to balance encouraging vaccine takeup with reminders not to abandon basic precautions. In particular, we suggest it will be useful to emphasize the “layers” mental model: [[6]Reason J. The contribution of latent human failures to the breakdown of complex systems.Philos Trans R Soc Lond B Biol Sci. 1990; 327: 475-484Crossref PubMed Scopus (380) Google Scholar] vaccines add an additional layer of protection. This additional layer may allow us to remove some existing layers that are especially burdensome, but should not lead us to remove all other layers, especially those which are low cost. This caution is especially necessary in these early stages because it is not yet clear that these vaccines provide sterilizing immunity. That is, even though the results of major trials have shown that the vaccines reduce illness, it is not known whether, or to what extent, they prevent infection and ongoing transmission [[7]Peiris M. Leung G.M. What can we expect from first-generation COVID-19 vaccines?.Lancet. 2020; 396: 1467-1469Summary Full Text Full Text PDF PubMed Scopus (45) Google Scholar]. Some data suggest a reduction in infection from at least one of the vaccines [[8]ModernaTX Inc. mRNA-1273 sponsor briefing document addendum. https://www.fda.gov/media/144453/download. Accessed online 18 Dec 2020.Google Scholar], which is positive news, but these are preliminary results and need further data and study before we can be confident. If the vaccine does not provide significant sterilizing immunity, then individuals or sub-groups who a vaccine does not protect, or who choose not to be vaccinated, will still be at serious risk. In fact, the risk to these groups may be even greater than it is without a vaccine, since the less cautious behavior of others may accelerate transmission [[9]The LancetCOVID-19 vaccines: no time for complacency.Lancet. 2020; 396: 1607Summary Full Text Full Text PDF PubMed Scopus (23) Google Scholar]. That is, to the extent that a vaccine prevents infection and onward transmission, it produces a positive externality: by vaccinating yourself, you make others safer. However, to the extent that it induces less cautious behavior, it may create a negative externality. On balance, of course, vaccines are overwhelmingly beneficial, but we can guard against the possibility of this negative unintended consequence by maintaining basic protections. This question of whether, and to what extent, these vaccines provide immunity – as opposed to just protection – is vitally important. Careful monitoring of those who have been vaccinated in trials, as well as a sample of those who receive early vaccines, is urgently needed to provide data on this crucial question. In addition to continuing to collect infection rates among trial participants [[8]ModernaTX Inc. mRNA-1273 sponsor briefing document addendum. https://www.fda.gov/media/144453/download. Accessed online 18 Dec 2020.Google Scholar], data on non-participating members of their households can inform the question of whether vaccination prevents transmission within households [[10]Ali M. Emch M. von Seidlein L. et al.Herd immunity conferred by killed oral cholera vaccines in Bangladesh: a reanalysis.Lancet. 2005; 366: 44-49Summary Full Text Full Text PDF PubMed Scopus (245) Google Scholar]. While it is reasonable to lift the highest-cost restrictions, such as school closures, before this question is resolved, policy and communication should continue to encourage low-cost protections like mask-wearing, and medium-cost interventions like improved ventilation and air filtration, especially in schools. This cautious approach will likely delay the safe return of valued services like indoor dining. Compensating affected workers and business owners will soften the economic impact of this caution and may reduce political resistance. Dr. Ercumen reports grants from Bill & Melinda Gates Foundation, outside the submitted work. All other authors report nothing.}, journal={EClinicalMedicine}, publisher={Elsevier BV}, author={Ercumen, Ayse and Guiteras, Raymond and Spears, Dean}, year={2021}, month={Jan}, pages={100719} } @article{amebelu_ban_bhagwan_brown_chandler_chilengi_colford_cumming_curtis_evans_et al._2021, title={The Lancet Commission on water, sanitation and hygiene, and health}, volume={398}, ISSN={["1474-547X"]}, DOI={10.1016/S0140-6736(21)02005-5}, abstractNote={In 2010, access to water and sanitation was recognised as a human right and, in 2015, an ambitious Sustainable Development Goal (SDG) of achieving universal access to safely managed water, sanitation, and hygiene (WASH) services by 2030 was agreed. Half a decade later, SDG 6 is off-track,1WHOUNICEFProgress on household drinking water, sanitation and hygiene, 2000–2020: five years into the SDGs. World Health Organization, Geneva2021Google Scholar and the COVID-19 pandemic has highlighted how limited access to WASH services undermines public health efforts2Brewer TF Zhang M Gordon D et al.Housing, sanitation and living conditions affecting SARS-CoV-2 prevention interventions in 54 African countries.Epidemiol Infect. 2021; 149: e183Crossref Scopus (1) Google Scholar and exacerbates health and social inequalities.3Ekumah B Armah FA Yawson DO et al.Disparate on-site access to water, sanitation, and food storage heighten the risk of COVID-19 spread in Sub-Saharan Africa.Environment Res. 2020; 189109936Crossref PubMed Scopus (26) Google Scholar Important inter-related trends, including climate change, rapid urbanisation, increasing humanitarian crises, and persistent gender and income inequalities, compound this challenge. The deficit is huge—almost half the world's population did not have access to safely managed sanitation services in 2020.1WHOUNICEFProgress on household drinking water, sanitation and hygiene, 2000–2020: five years into the SDGs. World Health Organization, Geneva2021Google Scholar But achieving this ambitious SDG must not be dismissed as beyond reach. For diverse reasons, including public health, gender equality, and social and environmental justice, achieving this goal is imperative. Yet the reality is that many national systems have inadequate plans, financing, and capacity to deliver on the promise of the SDG. The public health case for investing in WASH services is clear and increasingly urgent in the context of climate change, antimicrobial resistance, and rapid urban growth. Effective WASH services prevent various infectious diseases and their sequelae,4Pruss-Ustun A Wolf J Bartram J et al.Burden of disease from inadequate water, sanitation and hygiene for selected adverse health outcomes: an updated analysis with a focus on low- and middle-income countries.Int J Hyg Environ Health. 2019; 222: 765-777Crossref PubMed Scopus (151) Google Scholar reduce exposure to naturally occurring and synthetic toxic chemicals,5Landrigan PJ Fuller R Acosta NJR et al.The Lancet Commission on pollution and health.Lancet. 2018; 391: 462-512Summary Full Text Full Text PDF PubMed Scopus (1492) Google Scholar and reduce pressure on health-care services. Beyond public health, WASH shapes people's living conditions and their opportunities, particularly for women and girls.6Caruso BA Sevilimedu V Fung IC Patkar A Baker KK Gender disparities in water, sanitation, and global health.Lancet. 2015; 386: 650-651Summary Full Text Full Text PDF PubMed Scopus (35) Google Scholar Many WASH investments do not realise these potential returns. Results from large trials of low-cost WASH interventions report little or no health impact, even when delivered with high fidelity and sustained compliance.7Luby SP Rahman M Arnold BF et al.Effects of water quality, sanitation, handwashing, and nutritional interventions on diarrhoea and child growth in rural Bangladesh: a cluster randomised controlled trial.Lancet Glob Health. 2018; 6: e302-e315Summary Full Text Full Text PDF PubMed Scopus (297) Google Scholar, 8Null C Stewart CP Pickering AJ et al.Effects of water quality, sanitation, handwashing, and nutritional interventions on diarrhoea and child growth in rural Kenya: a cluster-randomised controlled trial.Lancet Glob Health. 2018; 6: e316-e329Summary Full Text Full Text PDF PubMed Scopus (274) Google Scholar, 9Humphrey JH Mbuya MNN Ntozini R et al.Independent and combined effects of improved water, sanitation, and hygiene, and improved complementary feeding, on child stunting and anaemia in rural Zimbabwe: a cluster-randomised trial.Lancet Glob Health. 2019; 7: e132-e147Summary Full Text Full Text PDF PubMed Scopus (185) Google Scholar, 10Knee J Sumner T Adriano Z et al.Effects of an urban sanitation intervention on childhood enteric infection and diarrhea in Maputo, Mozambique: a controlled before-and-after trial.Elife. 2021; 10e62278Crossref PubMed Google Scholar Other research has revealed the early onset of asymptomatic enteropathogen carriage in communities without safe WASH services11Platts-Mills JA Liu J Rogawski ET et al.Use of quantitative molecular diagnostic methods to assess the aetiology, burden, and clinical characteristics of diarrhoea in children in low-resource settings: a reanalysis of the MAL-ED cohort study.Lancet Glob Health. 2018; 6: e1309-e1318Summary Full Text Full Text PDF PubMed Scopus (103) Google Scholar and its longer-term consequences, including childhood stunting.12Rogawski ET Liu J Platts-Mills JA et al.Use of quantitative molecular diagnostic methods to investigate the effect of enteropathogen infections on linear growth in children in low-resource settings: longitudinal analysis of results from the MAL-ED cohort study.Lancet Glob Health. 2018; 6: e1319-e1328Summary Full Text Full Text PDF PubMed Scopus (117) Google Scholar This situation has led to calls for “radically more effective” WASH interventions.13Pickering AJ Null C Winch PJ et al.The WASH Benefits and SHINE trials: interpretation of WASH intervention effects on linear growth and diarrhoea.Lancet Glob Health. 2019; 7: e1139-e1146Summary Full Text Full Text PDF PubMed Scopus (116) Google Scholar Low-cost household interventions focusing on individual behaviours also risk shifting responsibility for public goods from the state to the individual. Such interventions often demand a large investment of time and financial resources from those least able to bear the costs, and underestimate or overlook the structural challenges faced by people living in poverty. Moreover, the true costs of these so-called low-cost approaches are often born by women as the de-facto water managers or caregivers who are tasked with additional responsibilities, reinforcing gender inequalities.14Ray I Smith KR Towards safe drinking water and clean cooking for all.Lancet Glob Health. 2021; 9: e361-e365Summary Full Text Full Text PDF PubMed Scopus (9) Google Scholar International attention focuses almost exclusively on low-income and middle-income countries (LMICs), suggesting WASH is no longer a truly global concern. This focus neglects the challenges faced by many disadvantaged groups in high-income countries (HICs), such as populations in rural15Allaire M Wu H Lall U National trends in drinking water quality violations.Proc Natl Acad Sci USA. 2018; 115: 2078-2083Crossref PubMed Scopus (100) Google Scholar and urban16Bellinger DC Lead contamination in Flint—an abject failure to protect public health.N Engl J Med. 2016; 374: 1101-1103Crossref PubMed Scopus (108) Google Scholar settings in the USA. The near exclusive focus of the global WASH sector on LMICs reinforces an international architecture and outlook still shaped by colonial legacies.17Abimbola S Pai M Will global health survive its decolonisation?.Lancet. 2020; 396: 1627-1628Summary Full Text Full Text PDF PubMed Scopus (53) Google Scholar Against this backdrop, The Lancet announces a new Commission on water, sanitation and hygiene, and health. The aim of the Commission is to reimagine and reconstitute WASH not only as a central pillar of public health, but also as a pathway to gender equality and social and environmental justice. The work of the Commission will be informed by the latest evidence but will also be grounded in critical reflection on the evolution and priorities of this global sector. The Commissioners are diverse across research disciplines, geography, and career stages, gender balanced, and are supported by a wider global network of scientists undertaking supporting research. The UK Foreign, Commonwealth and Development Office and the Bill & Melinda Gates Foundation have provided funding for research that will inform the work of this Commission. At the first Commission meeting, three priority areas for its work were agreed. First, the necessity of achieving universal access to at least safely managed WASH services must be clearly argued. The continued pursuit of narrow, low-cost household interventions in the face of growing evidence of their insufficiency distracts from the central challenge of building national systems capable of delivering universal access to safely managed services. The Commission will assess the health, social, and environmental consequences of slow progress towards universal access to safely managed WASH services, and delineate the scale and distribution of these deficits. Second, the cost of achieving universal access to at least safely managed WASH services will be immense but so too are the potential benefits. The Commission will assess the financial costs of achieving universal access to at least safely managed services, as well as other barriers to progress. But we will also provide a comprehensive assessment of the potential benefits of such an achievement, encompassing public health gains, financial returns through improvements in human capital and productivity, and other benefits relating to social and environmental justice and gender equality. Third, the Commission will make concrete recommendations for reform focused on the establishment of national systems that are capable of both professionalised delivery of WASH services for all and responding to key challenges such as climate change and rapid urbanisation. Public health, gender equality, and broader social and environmental justice will be at the heart of our recommendations. The focus will be global, recognising that WASH-related inequalities exist in HICs and LMICs, as does the potential for further health and social gains. As our work progresses, we will engage policy and practice actors and post interim updates on the Commission's website. The current pandemic shows we cannot afford to slide further on our international goals of improving access to WASH, and renewed action is needed now. RB is employed by the Water, Sanitation, and Hygiene programme at the Bill & Melinda Gates Foundation and is contributing to this Lancet Commission in his independent capacity as an economist and WASH expert. JBr reports a grant from the Bill & Melinda Gates Foundation unrelated to the Commission. OC reports grants from the Bill & Melinda Gates Foundation and UK Foreign, Commonwealth and Development Office related to the Commission. MCF reports grants from the Bill & Melinda Gates Foundation both related to, and unrelated to, the Commission. AJP reports a grant from the Bill & Melinda Gates Foundation related to the Commission. All the other authors declare no competing interests. The Commissioners of the Lancet Commission on Water, Sanitation and Hygiene, and Health are: Argaw Amebelu, Radu Ban, Jay Bhagwan, Joe Brown, Clare Chandler, Roma Chilengi, John M Colford, Jr, *Oliver Cumming, †Valerie Curtis, Barbara E Evans, Matthew C Freeman, Raymond Guiteras, Guy Howard, Jean Humphrey, Gagandeep Kang, Robinah Kulabako, Claudio F Lanata, Maggie A Montgomery, Clair Null, Amy J Pickering, Jennyfer Wolf, supported by Jocalyn Clark and Ana Mateus from The Lancet. †Valerie Curtis died on Oct 19, 2020. Jimma University, Jimma, Ethiopia (AA); Bill & Melinda Gates Foundation, Seattle, WA, USA (RB); Water Research Commission, Pretoria, South Africa (JBh); University of North Carolina, Chapel Hill, NC, USA (JBr); Centre for Infectious Disease Research in Zambia, Lusaka, Zambia (RC); London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK (CC, OC); University of California, Berkeley, CA, USA (JMC, AJP); University of Leeds, Leeds, UK (BEE); Emory University, Atlanta, GA, USA (MCF); North Carolina State University, Raleigh, NC, USA; (RG); University of Bristol, Bristol, UK (GH); Johns Hopkins University, Baltimore, MD, USA (JH); Christian Medical College, Vellore, India (GK); Makerere University, Kampala, Uganda (RK); Nutritional Research Institute, Lima, Peru (CFL); World Health Organization, Geneva, Switzerland (MAM, JW); Mathematica, Washington, DC, USA (CN)}, number={10310}, journal={LANCET}, author={Amebelu, Argaw and Ban, Radu and Bhagwan, Jay and Brown, Joe and Chandler, Clare and Chilengi, Roma and Colford, John M. and Cumming, Oliver and Curtis, Valerie and Evans, Barbara E. and et al.}, year={2021}, month={Oct}, pages={1469–1470} } @article{berry_fischer_guiteras_2020, title={Eliciting and Utilizing Willingness to Pay: Evidence from Field Trials in Northern Ghana}, volume={128}, ISSN={0022-3808 1537-534X}, url={http://dx.doi.org/10.1086/705374}, DOI={10.1086/705374}, abstractNote={We use the Becker-DeGroot-Marschak (BDM) mechanism to estimate willingness to pay (WTP) for and heterogeneous impacts of clean water technology through a field experiment in Ghana. Although WTP is low relative to cost, demand is inelastic at low prices. Short-run treatment effects are positive throughout the WTP distribution. After 1 year, use and benefits are both increasing in WTP, with negative effects on low-WTP households. Combining estimated treatment effects with households’ WTP implies valuations of health benefits much smaller than typically used by policy makers. We explore differences between BDM and take-it-or-leave-it valuations and make recommendations for implementing BDM in the field.}, number={4}, journal={Journal of Political Economy}, publisher={University of Chicago Press}, author={Berry, James and Fischer, Greg and Guiteras, Raymond}, year={2020}, month={Apr}, pages={1436–1473} } @article{ercumen_prottas_harris_dioguardi_dowd_guiteras_2020, title={Poultry Ownership Associated with Increased Risk of Child Diarrhea: Cross-Sectional Evidence from Uganda}, volume={102}, ISSN={0002-9637 1476-1645}, url={http://dx.doi.org/10.4269/ajtmh.19-0012}, DOI={10.4269/ajtmh.19-0012}, abstractNote={Abstract. Domestic animals have been associated with enteric infections in young children and can also be carriers of respiratory viruses. We conducted a cross-sectional assessment of health outcomes in children aged < 5 years associated with animal presence among 793 rural households in Uganda. We recorded the 2-week prevalence of diarrhea and respiratory infections in children, and the number of cows, poultry, sheep/goats, and pigs in the household. We used generalized linear models with robust standard errors to estimate the prevalence ratio (PR) for diarrhea and respiratory infections associated with households owning the above- versus below-median number of animals. We conducted unadjusted and adjusted analyses controlling for socioeconomic, water, sanitation, and hygiene indicators. Children in households with the above-median number (> 5) of poultry had 83% higher diarrhea prevalence than those with ≤ 5 poultry (adjusted PR = 1.83 [1.04, 3.23], P = 0.04). Children in households with the above-median number (> 2) of cows had 48% lower prevalence of respiratory infection than those with ≤ 2 cows (adjusted PR = 0.52 [0.35, 0.76], P < 0.005). There were no other significant associations between domestic animals and child health. Studies should assess if barring chickens from indoor living quarters and sanitary disposal of chicken and other animal feces can reduce childhood zoonotic infections.}, number={3}, journal={The American Journal of Tropical Medicine and Hygiene}, publisher={American Society of Tropical Medicine and Hygiene}, author={Ercumen, Ayse and Prottas, Chris and Harris, Angela and Dioguardi, Angelique and Dowd, Greg and Guiteras, Raymond}, year={2020}, month={Mar}, pages={526–533} } @book{guiteras_levinsohn_mobarak_2019, title={Demand Estimation with Strategic Complementarities: Sanitation in Bangladesh}, ISSN={1936-4016}, number={553}, author={Guiteras, R. and Levinsohn, J. and Mobarak, A.M.}, year={2019}, month={Jan} } @article{cumming_arnold_ban_clasen_esteves mills_freeman_gordon_guiteras_howard_hunter_et al._2019, title={The implications of three major new trials for the effect of water, sanitation and hygiene on childhood diarrhea and stunting: a consensus statement}, volume={17}, ISSN={1741-7015}, url={http://dx.doi.org/10.1186/s12916-019-1410-x}, DOI={10.1186/s12916-019-1410-x}, abstractNote={Three large new trials of unprecedented scale and cost, which included novel factorial designs, have found no effect of basic water, sanitation and hygiene (WASH) interventions on childhood stunting, and only mixed effects on childhood diarrhea. Arriving at the inception of the United Nations’ Sustainable Development Goals, and the bold new target of safely managed water, sanitation and hygiene for all by 2030, these results warrant the attention of researchers, policy-makers and practitioners. Here we report the conclusions of an expert meeting convened by the World Health Organization and the Bill and Melinda Gates Foundation to discuss these findings, and present five key consensus messages as a basis for wider discussion and debate in the WASH and nutrition sectors. We judge these trials to have high internal validity, constituting good evidence that these specific interventions had no effect on childhood linear growth, and mixed effects on childhood diarrhea. These results suggest that, in settings such as these, more comprehensive or ambitious WASH interventions may be needed to achieve a major impact on child health. These results are important because such basic interventions are often deployed in low-income rural settings with the expectation of improving child health, although this is rarely the sole justification. Our view is that these three new trials do not show that WASH in general cannot influence child linear growth, but they do demonstrate that these specific interventions had no influence in settings where stunting remains an important public health challenge. We support a call for transformative WASH, in so much as it encapsulates the guiding principle that – in any context – a comprehensive package of WASH interventions is needed that is tailored to address the local exposure landscape and enteric disease burden.}, number={1}, journal={BMC Medicine}, publisher={Springer Science and Business Media LLC}, author={Cumming, Oliver and Arnold, Benjamin F. and Ban, Radu and Clasen, Thomas and Esteves Mills, Joanna and Freeman, Matthew C. and Gordon, Bruce and Guiteras, Raymond and Howard, Guy and Hunter, Paul R. and et al.}, year={2019}, month={Aug}, pages={173} } @article{guiteras_jack_2018, title={Productivity in piece-rate labor markets: Evidence from rural Malawi}, volume={131}, ISSN={0304-3878}, url={http://dx.doi.org/10.1016/j.jdeveco.2017.11.002}, DOI={10.1016/j.jdeveco.2017.11.002}, abstractNote={Piece-rate compensation is a common feature of developing country labor markets, but little is known about how piece-rate workers respond to incentives, or the tradeoffs that an employer faces when setting the terms of the contract. In a field experiment in rural Malawi, we hired casual day laborers at piece rates and collected detailed data on the quantity and quality of their output. Specifically, we use a simplified Becker-DeGroot-Marschak mechanism, which provides random variation in piece rates conditional on revealed reservation rates, to separately identify the effects of worker selection and incentives on output. We find a positive relationship between output quantity and the piece rate, and show that this is solely the result of the incentive effect, not selection. In addition, we randomized whether workers were subject to stringent quality monitoring. Monitoring led to higher quality output, at some cost to the quantity produced. However, workers do not demand higher compensation when monitored, and monitoring has no measurable effect on the quality of workers willing to work under a given piece rate. Together, the set of worker responses that we document lead the employer to prefer a contract that offers little surplus to the worker, consistent with an equilibrium in which workers have little bargaining power.}, journal={Journal of Development Economics}, publisher={Elsevier BV}, author={Guiteras, Raymond P. and Jack, B. Kelsey}, year={2018}, month={Mar}, pages={42–61} } @book{guiteras_aglasan_palloni_2017, title={A Practitioner’s Guide to Randomization Inference, Preliminary and Incomplete Draft}, author={Guiteras, R. and Aglasan, S. and Palloni, G.}, year={2017}, month={Mar} } @article{ben yishay_fraker_guiteras_palloni_shah_shirrell_wang_2017, title={Microcredit and willingness to pay for environmental quality: Evidence from a randomized-controlled trial of finance for sanitation in rural Cambodia}, volume={86}, ISSN={0095-0696}, url={http://dx.doi.org/10.1016/j.jeem.2016.11.004}, DOI={10.1016/j.jeem.2016.11.004}, abstractNote={Low willingness to pay (WTP) for environmental quality in developing countries is a key research question in environmental economics. One explanation is that missing credit markets may suppress WTP for environmental improvements that require large up-front investments. We test the impact of microloans on WTP for hygienic latrines via a randomized controlled trial in 30 villages in rural Cambodia. We find that microcredit dramatically raises WTP for improved latrines, with 60% of households in the Financing arm willing to purchase at an unsubsidized price, relative to 25% in the Non-financing arm. Effects on latrine installation are positive but muted by several factors, including a negative peer effect: randomly induced purchases by neighbors reduce a household's probability of installing its own latrine. On methodological grounds, this paper shows that a "decision-focused evaluation" can be integrated into academic analysis to provide insight into questions of general interest.}, journal={Journal of Environmental Economics and Management}, publisher={Elsevier BV}, author={Ben Yishay, Ariel and Fraker, Andrew and Guiteras, Raymond and Palloni, Giordano and Shah, Neil Buddy and Shirrell, Stuart and Wang, Paul}, year={2017}, month={Nov}, pages={121–140} } @article{guiteras_mobarak_levinsohn_bakhtiar_2017, title={Social and Financial Incentives for Overcoming Collective Action Problems}, volume={5}, url={http://dx.doi.org/10.1257/rct.2227-2.0}, DOI={10.1257/rct.2227-2.0}, journal={AEA Randomized Controlled Trials}, publisher={American Economic Association}, author={Guiteras, Raymond and Mobarak, A. Mushfiq and Levinsohn, James and Bakhtiar, Mehrab}, year={2017}, month={May} } @book{guiteras_levine_polley_quistorff_2016, title={Credit Constraints, Discounting and Investment in Health: Evidence from Micropayments for Clean Water in Dhaka}, url={http://www.google.com/url?q=http%3A%2F%2Fgo.ncsu.edu%2Frpguiter.dhaka-water-wtp.pdf&sa=D&sntz=1&usg=AFQjCNFuwI6Srmg2EgQEcC2CZSXyn9kPcw}, author={Guiteras, R. and Levine, D.I. and Polley, T. and Quistorff, B.}, year={2016}, month={Feb} } @article{guiteras_levine_luby_polley_khatun-e-jannat_unicomb_2016, title={Disgust, Shame, and Soapy Water: Tests of Novel Interventions to Promote Safe Water and Hygiene}, volume={3}, ISSN={2333-5955 2333-5963}, url={http://dx.doi.org/10.1086/684161}, DOI={10.1086/684161}, abstractNote={Lack of access to clean water is among the most pressing environmental problems in developing countries, where diarrheal disease kills nearly 700,000 children per year. While inexpensive and effective practices such as chlorination and hand washing with soap exist, efforts to motivate their use by emphasizing health benefits have seen only limited success. This paper measures the effect of messages appealing to negative emotions (disgust at consumption of human feces) and social pressure (shame at being seen consuming human feces) on hand-washing behavior and use of and willingness to pay for water chlorination among residents of slum compounds in Dhaka, Bangladesh. Neither the traditional, health-based message nor the new disgust-and-shame message led to high levels of chlorination during a free trial, nor to high willingness to pay for the chlorine at the end of the free trial. Provision of low-cost hand-washing facilities did increase hand washing, although the effect size is modest.}, number={2}, journal={Journal of the Association of Environmental and Resource Economists}, publisher={University of Chicago Press}, author={Guiteras, Raymond P. and Levine, David I. and Luby, Stephen P. and Polley, Thomas H. and Khatun-e-Jannat, Kaniz and Unicomb, Leanne}, year={2016}, month={Jun}, pages={321–359} } @book{guiteras_mobarak_2016, place={United Kingdom}, title={Does Development Aid Undermine Political Accountability? Leader and Constituent Responses to a Large-Scale Intervention}, url={http://ibread.org/bread/working/489}, number={489}, institution={The Bureau for Research and Economic Analysis of Development}, author={Guiteras, R. and Mobarak, A.M.}, year={2016}, month={Aug} } @article{guiteras_levine_polley_2016, title={The pursuit of balance in sequential randomized trials}, volume={1}, url={http://www.scopus.com/inward/record.url?eid=2-s2.0-84963706927&partnerID=MN8TOARS}, DOI={10.1016/j.deveng.2015.11.001}, abstractNote={In many randomized trials, subjects enter the sample sequentially. Because the covariates for all units are not known in advance, standard methods of stratification do not apply. We describe and assess the method of DA-optimal sequential allocation (Atkinson, 1982) for balancing stratification covariates across treatment arms. We provide simulation evidence that the method can provide substantial improvements in precision over commonly employed alternatives. We also describe our experience implementing the method in a field trial of a clean water and handwashing intervention in Dhaka, Bangladesh, the first time the method has been used. We provide advice and software for future researchers.}, journal={Development Engineering}, author={Guiteras, R.P. and Levine, D.I. and Polley, T.H.}, year={2016}, pages={12–25} } @article{guiteras_levinsohn_mobarak_2015, title={Encouraging sanitation investment in the developing world: A cluster-randomized trial}, volume={348}, ISSN={0036-8075 1095-9203}, url={http://dx.doi.org/10.1126/science.aaa0491}, DOI={10.1126/science.aaa0491}, abstractNote={Helping the poor invest in sanitation}, number={6237}, journal={Science}, publisher={American Association for the Advancement of Science (AAAS)}, author={Guiteras, R. and Levinsohn, J. and Mobarak, A. M.}, year={2015}, month={Apr}, pages={903–906} } @book{guiteras_jina_mobarak_2015, place={Working paper}, title={Routine Disasters: Floods, Human Capital and Adaptation in Bangladesh}, author={Guiteras, R. and Jina, A. and Mobarak, A.M.}, year={2015}, month={Apr} } @article{guiteras_jina_mobarak_2015, title={Satellites, Self-reports, and Submersion: Exposure to Floods in Bangladesh}, volume={105}, ISSN={0002-8282}, url={http://dx.doi.org/10.1257/aer.p20151095}, DOI={10.1257/aer.p20151095}, abstractNote={ A burgeoning “Climate-Economy” literature has uncovered many effects of changes in temperature and precipitation on economic activity, but has made considerably less progress in modeling the effects of other associated phenomena, like natural disasters. We develop new, objective data on floods, focusing on Bangladesh. We show that rainfall and self-reported exposure are weak proxies for true flood exposure. These data allow us to study adaptation, giving accurate measures of both long-term averages and short term variation in exposure. This is important in studying climate change impacts, as people will not only experience new exposures, but also experience them differently. }, number={5}, journal={American Economic Review}, publisher={American Economic Association}, author={Guiteras, Raymond and Jina, Amir and Mobarak, A. Mushfiq}, year={2015}, month={May}, pages={232–236} }