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Begin New Search Publishing Institution The John F. Kennedy School of Government at Harvard University Author Dan Levy

1. Can Transparency and Accountability Programs Improve Health? Experimental Evidence from Indonesia and Tanzania

Author:
Jean Arkedis, Jessica Creighton, Archon Fung, Stephen Kosack, Dan Levy, and Courtney Tolmie
Publication Date:
05-2019
Content Type:
Working Paper
Institution:
The John F. Kennedy School of Government at Harvard University
Abstract:
We assess the impact of a transparency and accountability program designed to improve maternal and newborn health (MNH) outcomes in Indonesia and Tanzania. Co-designed with local partner organizations to be community-led and non-prescriptive, the program sought to encourage community participation to address local barriers in access to high quality care for pregnant women and infants. We evaluate the impact of this program through randomized controlled trials (RCTs), involving 100 treatment and 100 control communities in each country. We find that on average, this program did not have a statistically significant impact on the use or content of maternal and newborn health services, nor the sense of civic efficacy or civic participation among recent mothers in the communities who were offered it. These findings hold in both countries and in a set of prespecified subgroups. To identify reasons for the lack of impacts, we use a mixed-method approach combining interviews, observations, surveys, focus groups, and ethnographic studies that together provide an in-depth assessment of the complex causal paths linking participation in the program to improvements in MNH outcomes. Although participation in program meetings was substantial and sustained in most communities, and most attempted at least some of what they had planned, only a minority achieved tangible improvements and fewer still saw more than one such success. Our assessment is that the main explanation for the lack of impact is that few communities were able to traverse the complex causal paths from planning actions to accomplishing tangible improvements in their access to quality health care.
Topic:
Health, Health Care Policy, Children, and Randomized Controlled Trials
Political Geography:
Africa, Indonesia, Tanzania, and Southeast Asia

2. Two-Stage Examinations: Can Examinations Be More Formative Experiences?

Author:
Dan Levy, Mae Klinger, and Theodore Svoronos
Publication Date:
09-2018
Content Type:
Working Paper
Institution:
The John F. Kennedy School of Government at Harvard University
Abstract:
Two-stage examinations consist of a first stage in which students work individually as they typically do in examinations (stage 1), followed by a second stage in which they work in groups to complete another examination (stage 2), which typically consists of a subset of the questions from the first examination. Data from two-stage midterm and final examinations are used to assess the extent to which individuals improve their performance when collaborating with other students. On average, the group (stage 2) score was about one standard deviation above the individual (stage 1) score. While this difference cannot be interpreted as the causal effect of two-stage examinations on learning, it suggests that individuals experienced substantial performance gains when working in groups in an examination. This average performance gain was comparable with the average difference between the top performer of the group in stage 1 and the group’s stage 1 average, and was equivalent to about two-thirds of the difference between the “super student” score (i.e. the sum of the maximum score for each question in stage 1) and the group’s stage 1 average. This last result suggests that group collaboration takes substantial (albeit partial) advantage of the aggregate knowledge and skills of the group’s individual members. Student feedback about their experience with two-stage examinations reveal that that these types of examinations are generally perceived to be more helpful for learning and are less stressful than traditional examinations. Finally, using data on group gender compositions, we investigate the potential role of gender dynamics on group efficiency.
Topic:
Education, Gender Issues, Collaborative Learning, and Collaborative Efficiency
Political Geography:
Global Focus and United States of America

3. Why is Chiapas Poor?

Author:
Dan Levy, Ricardo Hausmann, Miguel Angel Santos, Luis Espinoza, and Miguel Flores
Publication Date:
07-2015
Content Type:
Working Paper
Institution:
The John F. Kennedy School of Government at Harvard University
Abstract:
No matter which way you look at it, Chiapas is the most backward of any state in Mexico. Its per capita income is the lowest of the 32 federal entities, at barely 40% of the national median (Figure 1). Its growth rate for the decade 2003-2013 was also the lowest (0.2%),1 causing the income gap separating Chiapas from the national average to increase from 53% to 60%. That is to say that today the average income for a worker in Mexico is two and a half times greater than the average in Chiapas. The two next poorest states, Oaxaca and Guerrero, are 25% and 30% above Chiapas.2 According to the Instituto Nacional de Estadística y Geografía de México (INEGI, National Institute of Statistics and Geography), Chiapas is also the state with the highest poverty rate (74.7%) as well as extreme poverty (46.7%).3 These major differences in income levels among Mexican federal entities are reproduced as in a fractal within Chiapas. In fact, while the wealthiest entity (Mexico City) is wealthier than the poorest (Chiapas) by a factor of six, the difference within Chiapas between the wealthiest municipality (Tuxtla Gutiérrez) and the poorest (Aldama and Mitontic) is by a factor greater than eight.4 As there are different "Mexicos" within Mexico,5 in Chiapas there are also different sorts of Chiapas (Figure 2). Income per capita in Tuxtla Gutiérrez, to the right of the distribution, is five standard deviations above the state average. Next comes a series of intermediate cities, San Cristóbal de las Casas, Comitán de Domínguez, Tapachula, and Reforma, between two and a half to four standard deviations above the average. The remaining municipalities of Chiapas follow (122 in all), clustered to the far left of the distribution. In addition, both the statistics available at the town level and our visits to various municipalities in Chiapas seem to indicate that significant differences also exist within these municipalities. From this vantage point, questions as to why Chiapas is poor, or what explains its significant backwardness compared to other areas of Mexico, become much more complex. Why do some regions in Chiapas have high income levels, while other regions remain stagnant, fully dependent on federal transfers and deprived from the benefits of modern life?
Topic:
Development, Poverty, Governance, and Economic Inequality
Political Geography:
Central America, Mexico, and Chiapas