Pascaline Dupas

All Publications

• The effects of India's COVID-19 lockdown on critical non-COVID health care and outcomes: Evidence from dialysis patients. Social science & medicine (1982) Jain, R., Dupas, P. 2022; 296: 114762

  Abstract

  India's COVID-19 lockdown, one of the most severe in the world, is widely believed to have disrupted critical non-COVID health services. However, linking these disruptions to effects on health outcomes has been difficult due to the lack of reliable, up-to-date health outcomes data. We identified all dialysis patients under a statewide health insurance program in Rajasthan, India (N = 2110), and conducted surveys to examine the effects of the lockdown on non-COVID care access and health outcomes. Post-lockdown mortality was our primary outcome and morbidity and hospitalization were secondary outcomes. 63% of patients experienced a disruption to their care. Transport barriers, hospital service disruptions, and difficulty obtaining medicines were the most common causes. We compared monthly mortality in the four months after the lockdown with pre-lockdown mortality trends, as well as with mortality trends for a similar cohort in the previous year. Mortality in May 2020, after a month of exposure to the lockdown, was 1.70 percentage points (95% CI 0.01-0.03) or 64% higher than in March 2020 and total excess mortality between April and July was estimated to be 22%. A 1SD increase in an index of care disruptions was associated with a 0.17SD (95% CI 0.13-0.22) increase in a morbidity index, a 3.1 percentage point (95% CI 0.012-0.051) increase in hospitalization, and a 2.1 percentage point (95% CI 0.00-0.04) increase in probability of death between May and July. Females, socioeconomically disadvantaged groups, and patients living far from the health system faced worse outcomes. The results highlight the unintended consequences of the lockdown on critical, life-saving non-COVID health services that must be taken into account in the implementation of future policy efforts to control the spread of pandemics.

  View details for DOI 10.1016/j.socscimed.2022.114762

  View details for PubMedID 35151150

• COVID-19 related immunization disruptions in Rajasthan, India: A retrospective observational study. Vaccine Jain, R., Chopra, A., Falezan, C., Patel, M., Dupas, P. 2021

  Abstract

  INTRODUCTION: Governments around the world suspended immunization outreach to control COVID-19 spread. Many have since resumed services with an emphasis on catch-up vaccinations. This paper evaluated immunization disruptions during India's March-May 2020 lockdown and the extent to which subsequent catch-up efforts reversed them in Rajasthan, India.METHODS: In this retrospective observational study, we conducted phone surveys to collect immunization details for 2,144 children that turned one year old between January and October 2020. We used logistic regressions to compare differences in immunization timeliness and completed first-year immunization status among children that were due immunizations just before (unexposed), during (heavily exposed), and after (post-exposure) the lockdown.RESULTS: Relative to unexposed children, heavily exposed children were significantly less likely to be immunized at or before 9months (OR 0.550; 95% CI 0.367-0.824; p=0.004), but more likely to be immunized at 10-12months (OR 1.761; 95% CI 1.196-2.591; p=0.004). They were also less likely to have completed their key first-year immunizations (OR 0.624; 95% CI 0.478-0.816; p=0.001) by the time of survey. In contrast, post-exposure children showed no difference in timeliness or completed first-year immunizations relative to unexposed children, despite their younger age. First-year immunization coverage among heavily exposed children decreased by 6.9pp to 10.4pp (9.7% to 14.0%). Declines in immunization coverage were larger among children in households that were poorer, less educated, lower caste, and residing in COVID red zones, although subgroup comparisons were not statistically significant.CONCLUSION: Disruptions to immunization services resulted in children missing immunization during the lockdown, but catch-up efforts after it was eased ensured many children were reached at later ages. Nevertheless, catch-up was incomplete and children due their immunizations during the lockdown remained less likely to be fully immunized 4-5months after it lifted, even as younger cohorts due immunizations in June or later returned to pre-lockdown schedules.

  View details for DOI 10.1016/j.vaccine.2021.06.022

  View details for PubMedID 34154863

• Sex, lies, and measurement: Consistency tests for indirect response survey methods JOURNAL OF DEVELOPMENT ECONOMICS Chuang, E., Dupas, P., Huillery, E., Seban, J. 2021; 148

  View details for DOI 10.1016/j.jdeveco.2020.102582

  View details for Web of Science ID 000598176900014

• The daily grind: Cash needs and labor supply JOURNAL OF ECONOMIC BEHAVIOR & ORGANIZATION Dupas, P., Robinson, J., Saavedra, S. 2020; 177: 399–414

  View details for DOI 10.1016/j.jebo.2020.06.017

  View details for Web of Science ID 000567780800019

• Decentralization and efficiency of subsidy targeting: Evidence from chiefs in rural Malawi JOURNAL OF PUBLIC ECONOMICS Pia Basurto, M., Dupas, P., Robinson, J. 2020; 185

  View details for DOI 10.1016/j.jpubeco.2019.07.006

  View details for Web of Science ID 000531026900004

• Decentralization and efficiency of subsidy targeting: Evidence from chiefs in rural Malawi. Journal of public economics Basurto, M. P., Dupas, P., Robinson, J. 2020; 185: 104047

  Abstract

  Lower-income countries spend vast sums on subsidies. Beneficiaries are typically selected via either a proxy-means test (PMT) or through a decentralized identification process led by local leaders. A decentralized allocation may offer informational advantages, but may be prone to elite capture. We study this trade-off in the context of two large-scale subsidy programs in Malawi (for agricultural inputs and food) decentralized to traditional leaders ("chiefs") who are asked to target the needy. Using household panel data, we find that nepotism exists but has only limited mistargeting consequences. Importantly, we find that chiefs target households with higher returns to farm inputs, generating an allocation that is more productively efficient than what could be achieved through strict poverty-targeting. This could be welfare improving, since within-village redistribution is common. Productive efficiency targeting is concentrated in villages with above-median levels of redistribution.

  View details for DOI 10.1016/j.jpubeco.2019.07.006

  View details for PubMedID 32435073

  View details for PubMedCentralID PMC7224518

• HIV prevention among youth: A randomized controlled trial of voluntary counseling and testing for HIV and male condom distribution in rural Kenya. PloS one Duflo, E. n., Dupas, P. n., Ginn, T. n., Barasa, G. M., Baraza, M. n., Pouliquen, V. n., Sharma, V. n. 2019; 14 (7): e0219535

  Abstract

  Voluntary Counseling and Testing for HIV (VCT) and increasing access to male condoms are common strategies to respond to the HIV/AIDS pandemic. Using biological and behavioral outcomes, we compared programs to increase access to VCT, male condoms or both among youth in Western Kenya with the standard available HIV prevention services within this setting.A four arm, unblinded randomized controlled trial.The sample includes 10,245 youth aged 17 to 24 randomly assigned to receive community-based VCT, 150 male condoms, both VCT and condoms, or neither program. All had access to standard HIV services available within their communities. Surveys and blood samples for HSV-2 testing were collected at baseline (2009-2010) and at follow up (2011-2013). VCT was offered to all participants at follow up. HSV-2 prevalence, the primary outcome, was assessed using weighted logistic regressions in an intention-to-treat analysis.For the 7,565 respondents surveyed at follow up, (effective tracking rate = 91%), the weighted HSV-2 prevalence was similar across groups (control group = 10.8%, condoms only group = 9.1%, VCT only group = 10.2%, VCT and condoms group = 11.5%). None of the interventions significantly reduced HSV-2 prevalence; the adjusted odds ratios were 0.87 (95% CI: 0.61-1.25) for condoms only, 0.94 (95% CI: 0.64-1.38) for VCT only, and 1.12 (95% CI: 0.79-1.58) for both interventions. The VCT intervention significantly increased HIV testing (adj OR: 3.54, 95% CI: 2.32-5.41 for VCT only, and adj OR: 5.52, 95% CI: 3.90-7.81 for condoms and VCT group). There were no statistically significant effects on risk of HIV, or on other behavioral or knowledge outcomes including self-reported pregnancy rates.This study suggests that systematic community-based VCT campaigns (in addition to VCT availability at local health clinics) and condom distribution are unlikely on their own to significantly reduce the prevalence of HSV-2 among youth.

  View details for DOI 10.1371/journal.pone.0219535

  View details for PubMedID 31361767

• THE EFFECT OF SAVINGS ACCOUNTS ON INTERPERSONAL FINANCIAL RELATIONSHIPS: EVIDENCE FROM A FIELD EXPERIMENT IN RURAL KENYA ECONOMIC JOURNAL Dupas, P., Keats, A., Robinson, J. 2019; 129 (617): 273–310

  View details for DOI 10.1111/ecoj.12553

  View details for Web of Science ID 000514633100009

• Banking the Unbanked? Evidence from Three Countries AMERICAN ECONOMIC JOURNAL-APPLIED ECONOMICS Dupas, P., Karlan, D., Robinson, J., Ubfal, D. 2018; 10 (2): 257–97

  View details for DOI 10.1257/app.20160597

  View details for Web of Science ID 000429600800009

• Infrastructure Quality Assessment in Africa using Satellite Imagery and Deep Learning Oshri, B., Hu, A., Adelson, P., Chen, X., Dupas, P., Weinstein, J., Burke, M., Lobell, D., Ermon, S., ACM ASSOC COMPUTING MACHINERY. 2018: 616–25

  View details for DOI 10.1145/3219819.3219924

  View details for Web of Science ID 000455346400065

• Risk information, risk salience, and adolescent sexual behavior: Experimental evidence from Cameroon JOURNAL OF ECONOMIC BEHAVIOR & ORGANIZATION Dupas, P., Huillery, E., Seban, J. 2018; 145: 151–75

  View details for DOI 10.1016/j.jebo.2017.10.007

  View details for Web of Science ID 000423649900010

• Governance and the effectiveness of public health subsidies: Evidence from Ghana, Kenya and Uganda JOURNAL OF PUBLIC ECONOMICS Dizon-Ross, R., Dupas, P., Robinson, J. 2017; 156: 150–69

  Abstract

  Distributing subsidized health products through existing health infrastructure could substantially and cost-effectively improve health in sub-Saharan Africa. There is, however, widespread concern that poor governance - in particular, limited health worker accountability - seriously undermines the effectiveness of subsidy programs. We audit targeted bednet distribution programs to quantify the extent of agency problems. We find that around 80% of the eligible receive the subsidy as intended, and up to 15% of subsidies are leaked to ineligible people. Supplementing the program with simple financial or monitoring incentives for health workers does not improve performance further and is thus not cost-effective in this context.

  View details for PubMedID 29576663

• Supply and Demand for Improved Sanitation: Results from Randomized Pricing Experiments in Rural Tanzania ENVIRONMENTAL SCIENCE & TECHNOLOGY Peletz, R., Cock-Esteb, A., Ysenburg, D., Haji, S., Khush, R., Dupas, P. 2017; 51 (12): 7138–47

  Abstract

  Improving access to sanitation is a global public health priority. Sufficient consumer demand is required for sanitation coverage to expand through private provision. To measure consumer demand for hygienic latrine platform products in rural Tanzania, we conducted a randomized, voucher-based real-money sales trial with 1638 households with unimproved latrines. We also evaluated multiple supply chain options to determine the costs of supplying latrine platform products to rural households. For concrete latrine SanPlats, 60% of households were willing to pay US$0.48 and 10% of households were willing to pay US$4.05, yet the average cost of supplying the SanPlat to households was US$7.51. Similarly, for plastic sanitary platforms, willingness-to-pay (WTP) dropped from almost 60% at a price of US$1.43 to 5% at a price of US$12.29, compared to an average supply cost of US$23.28. WTP was not significantly different between villages that had participated in the National Sanitation Campaign and those that had not. Randomized informational interventions, including hygiene data-sharing and peer-based exposure to latrine platform products, had minimal effects on WTP. In conclusion, current household demand for latrine platform products is too low to achieve national goals for improved sanitation coverage through fully commercial distribution.

  View details for PubMedID 28562018

• Targeting health subsidies through a nonprice mechanism: A randomized controlled trial in Kenya. Science Dupas, P., Hoffmann, V., Kremer, M., Zwane, A. P. 2016; 353 (6302): 889-895

  Abstract

  Free provision of preventive health products can markedly increase access in low-income countries. A cost concern about free provision is that some recipients may not use the product, wasting resources (overinclusion). Yet, charging a price to screen out nonusers may screen out poor people who need and would use the product (overexclusion). We report on a randomized controlled trial of a screening mechanism that combines the free provision of chlorine solution for water treatment with a small nonmonetary cost (household vouchers that need to be redeemed monthly in order). Relative to a nonvoucher free distribution program, this mechanism reduces the quantity of chlorine procured by 60 percentage points, but reduces the share of households whose stored water tests positive for chlorine residual by only one percentage point, substantially improving the trade-off between overinclusion and overexclusion.

  View details for DOI 10.1126/science.aaf6288

  View details for PubMedID 27563091

  View details for PubMedCentralID PMC5003414

• Education, HIV, and Early Fertility: Experimental Evidence from Kenya AMERICAN ECONOMIC REVIEW Duflo, E., Dupas, P., Kremer, M. 2015; 105 (9): 2757-2797

  View details for DOI 10.1257/aer.20121607

  View details for Web of Science ID 000363884300002

• Turning a Shove into a Nudge? A "Labeled Cash Transfer" for Education AMERICAN ECONOMIC JOURNAL-ECONOMIC POLICY Benhassine, N., Devoto, F., Duflo, E., Dupas, P., Pouliquen, V. 2015; 7 (3): 86-125

  View details for DOI 10.1257/pol.20130225

  View details for Web of Science ID 000358662600004

• School governance, teacher incentives, and pupil-teacher ratios: Experimental evidence from Kenyan primary schools JOURNAL OF PUBLIC ECONOMICS Duflo, E., Dupas, P., Kremer, M. 2015; 123: 92-110

  View details for DOI 10.1016/j.jpubeco.2014.11.008

  View details for Web of Science ID 000353083100007

• Price Subsidies, Diagnostic Tests, and Targeting of Malaria Treatment: Evidence from a Randomized Controlled Trial AMERICAN ECONOMIC REVIEW Cohen, J., Dupas, P., Schaner, S. 2015; 105 (2): 609-645

  View details for DOI 10.1257/aer.20130267

  View details for Web of Science ID 000349335100005

• Getting essential health products to their end users: Subsidize, but how much? SCIENCE Dupas, P. 2014; 345 (6202): 1279-1281

  Abstract

  Although coverage rates and health outcomes are improving, many poor people around the world still do not benefit from essential health products. An estimated two-thirds of child deaths could be prevented with increased coverage of products such as vaccines, point-of-use water treatment, iron fortification, and insecticide-treated bednets. What limits the flow of products from the producer's laboratory bench to the end users, and what can be done about it? Recent empirical research suggests a crucial role for heavy subsidies.

  View details for DOI 10.1126/science.1256973

  View details for Web of Science ID 000341483800044

  View details for PubMedID 25214612

• SHORT-RUN SUBSIDIES AND LONG-RUN ADOPTION OF NEW HEALTH PRODUCTS: EVIDENCE FROM A FIELD EXPERIMENT ECONOMETRICA Dupas, P. 2014; 82 (1): 197-228

  View details for DOI 10.3982/ECTA9508

  View details for Web of Science ID 000331276700005

• SHORT-RUN SUBSIDIES AND LONG-RUN ADOPTION OF NEW HEALTH PRODUCTS: EVIDENCE FROM A FIELD EXPERIMENT. Econometrica : journal of the Econometric Society Dupas, P. 2014; 82 (1): 197-228

  Abstract

  Short-run subsidies for health products are common in poor countries. How do they affect long-run adoption? A common fear among development practitioners is that one-off subsidies may negatively affect long-run adoption through reference-dependence: People might anchor around the subsidized price and be unwilling to pay more for the product later. But for experience goods, one-off subsidies could also boost long-run adoption through learning. This paper uses data from a two-stage randomized pricing experiment in Kenya to estimate the relative importance of these effects for a new, improved antimalarial bed net. Reduced form estimates show that a one-time subsidy has a positive impact on willingness to pay a year later inherit. To separately identify the learning and anchoring effects, we estimate a parsimonious experience-good model. Estimation results show a large, positive learning effect but no anchoring. We black then discuss the types of products and the contexts inherit for which these results may apply.

  View details for DOI 10.3982/ECTA9508

  View details for PubMedID 25308977

  View details for PubMedCentralID PMC4193678

• Global Health Systems: Pricing and User Fees Encyclopedia of Health Economics Dupas, P. edited by Culyer, A. J. Elsevier, San Diego. 2014: 136–141
• Why Don't the Poor Save More? Evidence from Health Savings Experiments AMERICAN ECONOMIC REVIEW Dupas, P., Robinson, J. 2013; 103 (4): 1138-1171

  View details for DOI 10.1257/aer.103.4.1138

  View details for Web of Science ID 000322877700002

• Why Don’t the Poor Save More? Evidence from Health Savings Experiments. The American economic review Dupas, P., Robinson, J. 2013; 103 (4): 1138-71

  Abstract

  Using data from a field experiment in Kenya, we document that providing individuals with simple informal savings technologies can substantially increase investment in preventative health and reduce vulnerability to health shocks. Simply providing a safe place to keep money was sufficient to increase health savings by 66 percent. Adding an earmarking feature was only helpful when funds were put toward emergencies, or for individuals that are frequently taxed by friends and relatives. Group-based savings and credit schemes had very large effects.

  View details for PubMedID 29533047

• Savings Constraints and Microenterprise Development: Evidence from a Field Experiment in Kenya AMERICAN ECONOMIC JOURNAL-APPLIED ECONOMICS Dupas, P., Robinson, J. 2013; 5 (1): 163-192

  View details for DOI 10.1257/app.5.1.163

  View details for Web of Science ID 000313044600006

• Happiness on Tap: Piped Water Adoption in Urban Morocco AMERICAN ECONOMIC JOURNAL-ECONOMIC POLICY Devoto, F., Duflo, E., Dupas, P., Pariente, W., Pons, V. 2012; 4 (4): 68-99

  View details for DOI 10.1257/pol.4.4.68

  View details for Web of Science ID 000310565800003

• The (hidden) costs of political instability: Evidence from Kenya's 2007 election crisis JOURNAL OF DEVELOPMENT ECONOMICS Dupas, P., Robinson, J. 2012; 99 (2): 314-329

  View details for DOI 10.1016/j.jdeveco.2012.03.003

  View details for Web of Science ID 000309092400011

• Inferring welfare maximizing treatment assignment under budget constraints JOURNAL OF ECONOMETRICS Bhattacharya, D., Dupas, P. 2012; 167 (1): 168-196

  View details for DOI 10.1016/j.jeconom.2011.11.007

  View details for Web of Science ID 000300863300011

• Health Behavior in Developing Countries ANNUAL REVIEW OF ECONOMICS, VOL 3 Dupas, P. 2011; 3: 425-449

  View details for DOI 10.1146/annurev-economics-111809-125029

  View details for Web of Science ID 000295144200017

• Challenges in Banking the Rural Poor: Evidence from Kenya's Western Province NBER Africa Conference Volume Dupas, P. 2011
• Do Teenagers Respond to HIV Risk Information? Evidence from a Field Experiment in Kenya AMERICAN ECONOMIC JOURNAL-APPLIED ECONOMICS Dupas, P. 2011; 3 (1): 1-34

  View details for DOI 10.1257/app.3.1.1

  View details for Web of Science ID 000287105100001

• Peer Effects and the Impact of Tracking: Evidence from a Randomized Evaluation in Kenya Ametican Economic Review Duflo, E., Dupas, P., Kremer, M. 2011; 101 (5): 1739-74
• Coping with Political Instability: Micro Evidence from Kenya's 2007 Election Crisis 122nd Annual Meeting of the American-Economics-Association Dupas, P., Robinson, J. AMER ECONOMIC ASSOC. 2010: 120–24

  View details for DOI 10.1257/aer.100.2.120

  View details for Web of Science ID 000278389300025

• FREE DISTRIBUTION OR COST-SHARING? EVIDENCE FROM A RANDOMIZED MALARIA PREVENTION EXPERIMENT QUARTERLY JOURNAL OF ECONOMICS Cohen, J., Dupas, P. 2010; 125 (1): 1-45

  View details for Web of Science ID 000274626700001

• What Matters (and What Does Not) in Households' Decision to Invest in Malaria Prevention? 121st Annual Meeting of the American-Economic-Association Dupas, P. AMER ECONOMIC ASSOC. 2009: 224–30

  View details for DOI 10.1257/aer.99.2.224

  View details for Web of Science ID 000266458300038

• Can Tracking Improve Learning? Evidence from Kenya Education Next Duflo, E., Dupas, P., Kremer, M. 2009; 9 (3): 64-70
• Comparing the Paths of the Unemployed in France and the United States Economie et Statistique Cohen, D., Dupas, P. 2000; 332-333: 17-36