Senior Associate Dean for Faculty
Sanford School of Public Policy, Duke University
I'm a Professor at Sanford School of Public Policy at Duke University. I also hold secondary appointments in the Department of Economics and the Global Health Institute.
As an applied microeconomist working in health policy / global health, my research focuses on topics including: performance based contracts, measurement of provider quality and performance, social franchising, and social accountability / monitoring. I also study the role of subjective expectations / beliefs in healthcare behavior.
Several of these projects feature field experiments and policy interventions / evaluations. Much of my current field work is in India.
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Research highlights ....
COVID-19 Research in India.
a collaborative effort with IDFC Institute and several colleagues including Anu Acharya (mapmygenome) & Anup Malani (Chicago)
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As part of our efforts to assist COVID response strategies in India, we have embarked on a number of projects that aims to assess the severity of the epidemic in India and inform policy options. These efforts include:
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Prevalence of COVID in Karnataka (JAMA )
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Seroprevalence in Mumbai (Lancet Global Health )
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Random testing of returning workers to Bihar ( medRxiv draft )
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Several more projects related to this effort are ongoing. Please email me for details if you would like to know more.
Accountability / Community Monitoring for Service Delivery. ERID WP 295
Using a village level randomized trial design, we investigate two key mechanisms through which accountability interventions are hypothesized to improve healthcare delivery and health outcomes: information provision about health service entitlements and facilitation of collective action for community monitoring. We find large improvements in immunization rates, treatment of childhood diarrhea, and institutional delivery rates, modest improvements in child nutritional outcomes, and no effects on child mortality. Overall, the effects of information combined with facilitation are larger and statistically significant more often than that of providing information alone.
Input and Output based Performance Contracts.
(American Economic Journal - Applied Economics, forthcoming)
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One of the first papers to dig deeper into performance incentives to study how the structure of contracts (whether agents are paid on inputs or outputs). We find significant effects of both, but higher human capital providers, as theory predicts, might perform better with output contracts that provide opportunities to innovate.
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Effect of Social Franchising and Telemedicine (Health Affairs, October 2016 and Bulletin of World Health Organization, May 2017)
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Our research project evaluates a large scale social franchising program that aimed to improve care for childhood diarrhea and pneumonia. The WHP-Sky program, which won many global awards for social entrepreneurship and several million dollars in funding support, did not improve outcomes or quality of care.
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Selected Media: NPR (Goats&Soda), IndiaSpend, Telegraph India
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The "know-do" gap in quality JAMA Pediatrics (2015)
One of the first papers to document the gap between what healthcare providers know and the care they provide to patients.
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Selected Media: Financial Times, Deutsche Welle, Hindu, Economic Times, Indiaspend and others.