Projects

Cash as Housing Support: The Causal Impact of an Uncondtional Cash Transfer on Housing and Neighborhood Conditions of Low-Income, U.S. Children

This is joint work with the Baby’s First Years study PIs: Lisa Gennetian, Katherine Magnuson, Kimberly Noble, Greg Duncan, Nathan Fox, Sarah Halpern-Meekin, and Hirokazu Yoshikawa

Abstract: A long-standing debate in housing policy centers on whether direct cash transfers can achieve the goals of housing assistance programs while avoiding unintended consequences such as reductions in employment and earnings, landlord discrimination, and rent inflation in response to vouchers. To inform this debate, we examine the causal impact of a monthly unconditional cash transfer on housing and neighborhood conditions among families with low-income and young children—a key population of policy importance for housing assistance programs—using data from a randomized controlled trial called Baby’s First Years, in which 1,000 mothers received either $333 (“high-cash gift”; n=400) or $20 (“low-cash gift”, n=600) for the first 76 months of their child’s life. We find that the cash gift reduced housing cost burdens and increased consumption of non-housing goods, with no detectable impacts on neighborhood characteristics, rent levels, or employment and earnings. The cash gift also impacted other dimensions of housing: families were less likely to live in multigenerational households and less likely to move within the child’s first three years. Reported housing assistance receipt declined over the first three years, a pattern that appears to reflect household choices rather than changes in income eligibility.

Interactive Mobile Support for Lady Health Workers Promoting Breastfeeding

with Erica Field, Nicola Singletary, and Kate Vyborny

Abstract: Breastfeeding is critical for infant health, particularly in poor settings, as it ensures infants receive key nutrients and protects infants from lethal water-borne infections such as diarrheal disease and pneumonia. Worldwide, adoption of WHO-recommended breastfeeding practices could avert over 820,000 infant deaths annually, which include: (1) early initiation (< 1 hour after birth), (2) exclusive breastfeeding for the first 6 months, and (3) continued breastfeeding with appropriate complementary foods for > 2 years. Collaborating with UNICEF and the Government of Punjab, we will conduct a randomized evaluation of an innovative mobile health app designed to support the promotion of WHO-recommended breastfeeding practices by Pakistan’s Lady Health Workers. Using variation in breastfeeding behavior induced by the intervention, we will quantify the causal effect of breastfeeding on infant and maternal health outcomes. Innovative sub-experiments will also allow us to estimate the impact of measurement error on the relationship between breastfeeding and health outcomes.

This project is being implemented by the Centre for Economic Research in Pakistan (CERP) and has been funded by USAID DIV, The Weiss Fund, and the Fund for Innovation in Development (FID).

Evaluating the impact of community health workers on maternal and child health outcomes: Evidence from a natural experiment

with Erica Field and Kate Vyborny

Abstract: Community Health Workers (CHWs) are uniquely positioned to reduce maternal and child health disparities in developing countries. Over 4 million CHWs worldwide provide health services to millions of households, with many programs focusing specifically on maternal and child health (Schneider et al. 2016; WHO, 2023). However, despite the wide reach of these programs, there exists little, high-quality evidence on the causal impact of CHWs on maternal and child health outcomes (Lewin et al., 2010). We propose to leverage detailed micro-data from over 100,000 households in Punjab, Pakistan in combination with a quasi-experimental change in CHW coverage. Punjab’s CHW program focuses on child and maternal health and has a wide reach in rural areas where access to other health care is limited. By exploiting the quasi-experimental change in coverage, we aim to address the following research questions: (1) How does CHW coverage affect health beliefs, behaviors, and maternal and child health outcomes?; (2) What are the medium-term effects on health outcomes for children exposed to CHW support in utero / in infancy?; and (3) How do effects evolve over time after a community loses access to a CHW? This project will provide robust evidence on the impact of Punjab’s CHW program and lay a strong foundation for future collaborations with the government to study the CHW program. More broadly, this study will provide critical evidence on the causal impact of CHWs on child and maternal well-being and their role in promoting global health equity.