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Thursday, July 23, 2020

Randomised Control Trials and the Alleviation of Poverty in India

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Sattva Vasavada
Sattva Vasavada
South Asia

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Sattva Vasavada

Article Title

Randomised Control Trials and the Alleviation of Poverty in India

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Global Views 360

Publication Date

July 23, 2020

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Poverty in India — A Representative Image

Poverty in India — A Representative Image | Source: Atul Kumar via Unsplash

Abhijit Banerjee and Esther Duflo won the 2019 Nobel Prize in Economics for their “experimental approach in alleviating global poverty”. Their experimental approach encompassed a variety of novel methods to understand and analyse interventions and Randomised Control Trials (RCTs). Their research has been used by policy makers to make informed policy decisions to best help the marginalised.

What are RCTs?

To understand the effect of a policy, intervention, or medicine, decision makers try to measure the efficacy of the treatment. Do deworming pills given to children improve test scores? Does providing chlorinated water improve the health and economic outcomes of villages? These are some causal (read causal, i.e. caused by, not casual) questions researchers are interested in. The best way to analyse causal effects is to randomise the selection of people in the treatment and the control group (for example: children who are given deworming pills versus children who are not given the pills). This random selection of the two groups removes many statistical biases that might affect the results.

RCTs in India:

Many of the RCTs performed by Banerjee and Duflo were in India. They involved short- and long-term impact assessments of various interventions, policies, models, and treatments. We look at a few RCTs implemented in India:

Teacher absenteeism rates:

Troubled by the low attendance rates (or high absence rates) of public-school teachers in India, Duflo assessed the impact of financial incentives on the absence rates of teachers in Rajasthan. The study monitored teacher attendance by cameras, which was tied to a financial incentive if the attendance was high. From a baseline absence rate of 44%, teacher absenteeism in the treatment group fell by 21%, relative to the control group. High teacher attendance caused child test scores to improve too.

COVID-19 and health-seeking behaviour:

In the context of COVID-19, Banerjee tested the effect of sending messages via SMS that promoted health preserving behaviour. The results were very positive. By sending a short, 2.5-minute clip to 25 million randomly selected individuals in West Bengal, the intervention i) found a two-fold increase in symptom reporting to village health workers, ii) increased hand washing rates by 7%, and iii) increased mask-wearing by 2%. While mask-wearing rates increased only marginally, the spillover effects (wearing a mask stops the virus from infecting more people) were moderately high and positive.

Asset Transfers and the Notion of Poverty:

An RCT by Banerjee in West Bengal involving a productive asset transfer accompanied with training found large and persistent effects on monthly consumption and other variables. The treatment group reported 25% higher consumption levels relative to the control group, who did not receive the asset transfer and training. Implications of such RCTs are huge. The notion that the poor are lazy and unwilling to perform strenuous labour is falsified by this RCT. Often, what the poor lack are opportunities that are hard to come by, given their financial status. A small nudge, like the asset transfer, can cause large and positive effects on their well-being.  

Salt fortification to reduce anaemia:

RCTs also help rule out less cost-effective interventions. Duflo and Banerjee evaluated an RCT which distributed fortified salt in 400 villages of Bihar, to reduce the prevalence of anaemia. However, this intervention found no statistically significant impact on health outcomes like anaemia, hemoglobin, etc.  Thus, while RCTs help introduce novel methods of impacting the lives of the poor, they also help in ruling out in-effective measures. A policy maker might try other alternatives to reduce the prevalence of anaemia.

Are RCTs the gold standard?

Maybe. Extrapolating results from a regional RCT to national policies could present problems. Contextuality matters. A study that indicates positive gains for one region might present different, and rather adverse effects for another region. Nation wide effects might not be as prominent as regional results of a single RCT. The good part is that Banerjee and Duflo have a solution. Just perform more RCTs!

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February 4, 2021 4:45 PM

COVID-19 and Hungary’s steep slide towards Authoritarianism

The Hungarian Prime Minister, Viktor Orban, has used the pandemic of coronavirus to turn Hungary into an authoritarian system. This undermines the fundamental principles of democracy and rule of law in a way that is hard to reconcile as necessary for public health. On 30th March 2020, the Hungarian government passed a bill in the parliament which approved granting his government emergency powers.

Critics have said that the emergency of the coronavirus pandemic has turned Hungarian democracy into a dictatorship. This bill, which turned into a law, diminishes the Parliament’s check on the executive power. This means that elections and referendums will be delayed indefinitely.

Political commentator Zoltan Cegledi told BIRN, “Hungary’s already run as an illiberal democracy, the government’s will to destroy, limit and exhaust democracy is permanent. Its future victims will be the remnants of autonomy. Even before the pandemic threat, they [the government] tried to besiege cultural institutions and representatives while attacking judicial independence.”

The legislation under the law also allows up to five years of imprisonment for anyone who publishes false or misleading information that alarm or agitate the public or undermine the government’s “successful protection”. This also means that it is easy for the executive powers to jail the journalists for doing their job. Political Capital Institute, a Budapest-based think tank also wrote “The remaining checks and balances in Hungary will cease to exist and the country will likely witness a new wave of attacks against the free press,” while analysing the bill.

Crucially, the Bill on Protection Against Coronavirus, now a law, does not have any sunset clause. This means the law allows the government to decide when (or if) to end the state of emergency. Hungary’s democratic opposition said that even though they had concerns over a number of elements in the bill, they were willing to overlook it in the emergency situation as long as the sunset clause was introduced. However, the ruling party had made it clear that it was not willing to back down over the sunset clause.

Lydia Gall, a senior researcher at the Human Rights Watch said that Orban had already “weaponized coronavirus to stoke xenophobia” after claiming that coronavirus was imported to Hungary by Iranian students.

The question now arises is why Orban is doing this? There are two reasons. One, this labels the opposition as the “supporters of the coronavirus”, instead of supporters of the people, which will win his government the political debate in advance. Two, Orban sees this as the perfect time for a power grab. Every country is dealing with how to save the lives of its citizens and avoid a total economic collapse- this makes the country more inward-looking, which means that the foreign policy, in general, becomes less important and human rights and the rule of law in other countries become issues of less importance for most politicians and citizens, even though that should not be the case. When there is a death threat, the citizens of a country have a more narrow view. This is how Orban’s strategy of a power grab would work perfectly in the time of an emergency like a pandemic. Rights groups and government critics have said that while it is clear that coronavirus brings extraordinary challenges, there need to be checks and balances in place for the government, especially given Orban trying to challenge the democracy of Hungary since the past ten years since he has been in power.

Orban is not alone in seeing the pandemic as an opportunity to invoke emergency powers and turn a democratic state into an authoritarian one. But this enabling act represents his latest step along the autocratic path he embarked on a decade ago.

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