EASST Returns to Kampala: Highlights from the 2018 Evidence Summit

Maya Ranganath heads CEGA’s Global Networks portfolio, which equips researchers with the skills to become leaders in rigorous policy research and dissemination.

Every summer, leading early-career East African researchers come together for an “Evidence Summit” organized by the East Africa Social Science Translation (EASST) Collaborative. The Summit has multiple goals: it’s an opportunity to share rigorous research with East African policy makers, addressing a range of pressing social and economic challenges. It links African academics across disciplines and sectors, promoting vital intellectual exchange. And it draws a critical mass of CEGA researchers each year, deepening the ties between East African and U.S. academics.

Participants in the 2018 EASST Summit in Uganda. Photo Credit: Mouris Privet

The Summit is also the annual “community gathering” for EASST, a network of nearly 25 economists, statisticians, and social scientists based at East African universities and think tanks. EASST grew out of a 2009 meeting in Kampala, attended by a small vanguard of African academics committed to randomized policy evaluation. The network’s public launch came in 2012, at an Evidence Summit hosted by Makerere University. Since then, the annual Summit has been hosted in partnership with universities and think tanks across Tanzania, Rwanda, Kenya, and Ethiopia.

And in July 2018, the network finally returned home to Uganda, for its 7th annual convening.

This year’s event engaged more than 120 participants to discuss evidence-driven policy ideas for the environment, health, financial inclusion, education, and women’s empowerment. For the audience, it was a rare opportunity to hear the latest findings from both East African and American social scientists. It also featured a forum for policy makers to share their priorities (and discuss some of the challenges of working with academics).

Here, we highlight some of the exciting findings presented at this year’s conference. In a future post, we’ll report on the Summit’s policy panel, which offered some fascinating insights about how evidence is used in the “real world”.

Session 1: Agriculture and the Environment

• Climate change and rising temperatures are likely to increase violence and conflict globally, although the drivers are unknown. Ted Miguel (CEGA Faculty Director) discussed results from a series of 12 lab experiments in Kenya and California, exploring how temperature affects people’s emotions and psychological responses. Higher temperatures did not affect economic preferences or pro-social behavior among Kenyan or California study participants. However in one experiment, higher temperatures resulted in more destructive behavior among Kenyan participants (as measured through a ‘Joy of Destruction’ game that elicits aggressive anti-social behavior). The effect was particularly strong for marginalized groups, consistent with evidence that people experiencing stress react more strongly to additional stressors. Email Ted for more information (emiguel@berkeley.edu).

Ted Miguel presents on “Economic Decision-Making, Judgement, and Destructive Behavior Under Thermal Stress.” Photo Credit: Mouris Privet.

• Uganda has accepted over 50,000 refugees from South Sudan since early 2017. Annet Adong (EASST Fellow, 2013) examined data on informal land arrangements among refugees and host communities, which can rely heavily on social and behavioral preferences. Through a series of lab-in-the-field experiments, she finds that host communities expect refugees to be more trustworthy than members of their own communities; this is consistent with the finding that nearly 50 percent of host community members have provided refugees with informal access to private lands. See slides here.

Session 2: Health

• The prevalence of non-communicable diseases (NCDs) is increasing throughout Sub-Saharan Africa; in Tanzania, 26% of adults aged 25–64 years have hypertension and 9% have diabetes. Fred Manang (EASST Fellow, 2015) shared results from an EASST-funded pilot RCT testing low-cost, scalable ways to increase screening for NCDs. The pilot examined two approaches: sending information about screenings via SMS, and providing an additional cash incentive to cover patients’ transportation and opportunity costs. The financial incentive was more effective than SMS messages alone. The pilot also revealed major spillovers (with large numbers of untreated patients appearing for screening), suggesting a strong social network effect. This ongoing work is joint with Zachary Olson (UC Berkeley). Email Fred for more information (fmanang@gmail.com)

(L) Fred Manang presents on “Leveraging Networks and Financial Incentives to Increase Non Communicable Disease Screening Rates in Tanzania.” (R) Audience members engage with the summit. Photo Credit: Mouris Privet.

• In Mali, public sector physicians routinely over-prescribe antimalarial drugs, providing medication even when the treatment is inappropriate. Simone Schaner (CEGA affiliate) presented results from an RCT testing whether this is driven by doctors intentionally overtreating, or by patients pressuring their doctors to prescribe. The study finds that over-medication is driven largely by doctors “giving in” to patient demands, against their own preferences. This implies that helping doctors with negotiation skills, combined with cost sharing, could reduce the risks of misuse. See slides here.

(L) Simone Schaner presents on “The Contribution of Patients and Providers to the Overuse of Prescription Drugs.” (R) Audience member reads the summit agenda. Photo Credit: Mouris Privet

Session 3: Financial Inclusion

• In Kenya’s informal sector, which comprises 85% of the country’s labor force, fewer than 1% of workers save for retirement. Amos Njuguna (EASST fellow, 2013) discussed results from an EASST-funded RCT evaluating the effects of SMS reminders on pension savings among informal workers. In the short term, SMS reminders did increase savings in an existing pensions program, but the effect did not persist. Follow-up interviews with study participants suggest that the results may be driven by the inefficiency of saving mechanisms. Njuguna is coordinating with Kenyan pension authorities and service providers to explore more formal investment avenues, including automatic enrollment, access to micro-loans, and easy exit. This work was joint with Will Dow (UC Berkeley) and Justin White (UCSF). See slides here.
• Microfinance programs often fail to reach the poorest households, and programs that specifically target “ultra-poor” households are often expensive to implement. Ethan Ligon (CEGA affiliate) presented a study comparing BRAC’s “Targeting the Ultra Poor” (TUP) program in South Sudan, which provides livestock and training to ultra-poor households, with an equivalent-cost cash transfer program. Outcomes were mixed: the TUP group reported significant gains in assets and savings in the short-term, with shifts of labor from farming to livestock. However, there were no long-term improvements in consumption. The cash group reported higher long-term consumption, but experienced no short-term gain in assets and no growth in the share of households with savings. This work was joint with Elliot Collins (Kiva), Reajul Chowdhury and Munshi Sulaiman (BRAC). See slides here.

As always, the presentations at this year’s Evidence Summit evoked lively debate and sparked new collaborations and partnerships. But the 2018 event was particularly exciting, because it marked the start of a new initiative: the Network of Impact Evaluation Researchers in Africa (NIERA). This nascent body, led by EASST fellows, aims to become a leading policy research network in Africa, integrating rigorous evaluations with training and policy outreach. Stay tuned for a future blog post by NIERA’s leaders.