One of the greatest behavioral nudges of all time is the week of different-colored placebo pills in a package of birth control to allow you to just keep taking pills and always be on the right schedule.
Please adopt this innovation. It cannot alter costs that much.
Sincerely, spending too much time scheduling on google calendar now that my US birth control pills have run out.
Working my way through “Demand for and supply of evaluations in selected Sub-Saharan African countries,” which is a good read. there are several great points to note and consider but just one that i want to highlight here:
In no country was there a comprehensive library of evaluations that had been undertaken [there].
This seems like something that should change, as an important public good and source of information for national planning departments. I wonder if ethics review / institutional review bodies that work to register and approve studies may be able to take on some of this function.
I am starting to re-read the Anti-Politics Machine after some time… and, of course, started with the epilogue — the closest Ferguson comes to giving advice from his vivisection. here’s a gem that remains relevant ten-plus years later, in spite of major political changes in southern Africa:
Certainly, national and international ‘development’ agencies do constitute a large and ready market for advice and prescriptions, and it is the promise of real ‘input’ that makes the ‘development’ form of engagement such a tempting one for many intellectuals. These agencies seem hungry for good advice, and ready to act on it. Why not give it?
But as I have tried to show, they only seek the kind of advice they can take. One ‘developer’ asked my advice on what his country could do to ‘help these people.’ When I suggested that his government might contemplate sanctions against apartheid, he replied, with predictable irritation, ‘No, no! I mean development!‘
The only ‘advice’ that is in question here is advice about how to ‘do development’ better. There is a ready ear for criticisms of ‘bad development projects,’ so long as these are followed up with calls for ‘good development projects.’
Just finished Salmaan‘s Blind Spot: How Neoliberalism Infiltrated Global Health. Below, a few tidbits of his weaving of the local and personal with the global, ideological, and ideal. everything below represents a direct quote and the page numbers are marked in parentheses.
This book is intended to add to the conversation about how to more effectively bring the fruits of technology and innovation to those for whom it is a matter of life and death; how social, political, and economic forces have shaped practices in global health; and how ideological blind spots are traps along the path of achieving some of our most humane and important societal goals (xxxii).
In truth, I was confused. I was in my mid-twenties and had been convinced by seasoned development experts that this approach [a revolving drug fund in badakhshan, tajikistan] was an integral part of the transition from “humanitarian assistance” to “long term development.” Of course, as a graduate student somewhat versed in development theory, I knew that something was not right about planning a strategy with people from France and Switzerland, whose medicines were paid for by health insurance, to convince the Canadians, whose medicines were paid for by health insurance, that the Bangladeshis, whose entire life-world had collapsed, who had no access to pooled-risk insurance schemes, and who were now living in poverty, should finance medicines from their destitute communities; that they should “participate in their own health” by joining committees that defined what doctors could prescribe for them; and that their system of curative care – with hospitals, clinics, and experts trained over 70 years of soviet rule – should move towards a more “preventative” medical system in the midst of epidemic disease and hunger. But I participated in moving the strategy forward because i saw it as a means of protecting the most vulnerable (82).
The rise of NGOs as recipients of aid dollars closely followed the ascendancy of neoliberal thinking in washington and london. in their studies of the ngo sector, David Hulme and Michael Edwards described the 1980s and 1990s as a period dominated by a “new policy agenda,” which placed a premium on the untested belief that the private sector was a better mechanism for delivering services and that NGOs are more efficient than the government, especially in providing services to poor people… NGOs became a powerful global political force explicitly identified as a meeting place for economic and political aid (106).
As Ahmed and I were to see, these assumptions did not stop with the revolving drug fund. Instead, it appeared to us that the idea that privatization was the only logical path forward – an assumption made without critical assessment of the potential consequences – was manifesting itself in other ways. It was as if the aspirations of Hayek and his colleagues at the Mont Pèlerin Society were being realized in real time: ideology was operating as common sense. as to other important outcomes – reduced mortality or morbidity, or ensuring justice and dignity – they fell into what I refer to as realms of neoliberal programmatic blindness: areas of programs that are eclipsed by ideological aims (114).
I have come to the conclusion that the way out of the amber is both complex and simple. At its most complex, it will require the re-calibration of our goals as a society and the type of world we wish to create… at its most simple, this will require re-calibrating our focus in global health and development from “sustainability” and “local ownership” to an approach that puts equity and patient outcomes first… a re-calibration of focus towards equity of access and equity of outcome will allow NGOs to again take up the mantle as a vanguard of a moral order that finds poverty and structural violence unacceptable (142).
Sometimes I re-read a paper and remember how nice a sentence or paragraph was (especially when thinking that a benevolent or benign dictator might make research so much easier, as though easy was the main goal of research).
So it is with the paper by Gary King and colleagues (2007) on “a ‘politically robust’ experimental design for public policy evaluation, with application to the mexican universal health insurance program”.
Scholars need to remember that responsive political behavior by political elites is an integral and essential feature of democratic political systems and should not be treated with disdain or as an inconvenience. Instead, the reality of democratic politics needs to be built into evaluation designs from the start — or else researchers risk their plans being doomed to an unpleasant demise. thus, although not always fully recognized, all public policy evaluations are projects in both political science and political science.
What would be nice is if researchers would share more of their experiences and lessons learned not just in robust research design (though this is critical) but also in working to (and failing to) persuade local political leaders to go along with randomization schemes and to potentially hold off any kind of scale-up until the results are in… and only if they are promising!
[on phone, while in auto on the way to work]
<e: “Hi dry cleaner. I had to leave home for office, so I left one dress hanging on my door. Can you please pick it up?”
Dry Cleaner: “Sure, I will send a boy to pick it up.”
– 10 minutes later –
Dry Cleaner: “The boy is standing outside your door and says no one is answering.”
Me: “Yes, I had to leave for office, so I left one dress hanging on my door. Can he please take it?”
Dry Cleaner: “Yes madam.”
– 3 minutes later –
Dry Cleaner: “The boy says there is only one dress.”
Me: “Yes, there is one dress hanging on the door. Can he please take it to clean?”
Dry Cleaner: “Yes madam.”
Service and perseverance and convenience, yes.