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IFPRI3; ISI; B Promoting healthy food systems ; MTID ; PR

Informal health providers ranging from drug vendors to traditional healers account for a large fraction of health care provision in developing countries. They are, however, largely unlicensed and unregulated leading to concern that they provide ineffective and, in some cases, even harmful care. A new and controversial policy tool that has been proposed to alter household health seeking behavior is an outright ban on these informal providers. The theoretical effects of such a ban are ambiguous. In this paper, we study the effect of a ban on informal (traditional) birth attendants imposed by the Malawi government in 2007. To measure the effect of the ban, we use a difference-in-difference strategy exploiting variation across time and space in the intensity of exposure to the ban. Our most conservative estimates suggest that the ban decreased use of traditional attendants by about 15 percentage points. Approximately three quarters of this decline can be attributed to an increase in use of the formal sector and the remainder is accounted for by an increase in relative/friend-attended births. Despite the rather large shift from the informal to the formal sector, we do not find any evidence of a statistically significant reduction in newborn mortality on average. The results are robust to a triple difference specification using young children as a control group. We examine several explanations for this result and find evidence consistent with quality of formal care acting as a constraint on improvements in newborn health.

An individual who takes an HIV test can be informed about their own status and risk. Similarly, when friends, family or neighbors learn of a person's HIV status, they may update their beliefs about HIV infection among people they know. Using an experiment conducted in rural Malawi which randomly assigned incentives to learn HIV results, we find that as people in the community learn their HIV results, individuals revise their beliefs downward about deaths attributable to HIV/AIDS. We find corresponding behavioral responses with a significant decrease in condom use and no significant increase in multiple partnerships among those who are HIV-negative.

IFPRI3; C.3 Labor Markets; CRP2; C Improving markets and trade ; MTID; PIM ; PR ; CGIAR Research Program on Policies, Institutions, and Markets (PIM)