Paul Gertler

University of California, Berkeley | UCB · Haas School of Business

We examined the impact of sugar exposure within 1000 days since conception on diabetes and hypertension, leveraging quasi-experimental variation from the end of the United Kingdom’s sugar rationing in September 1953. Rationing restricted sugar intake to levels within current dietary guidelines, yet consumption nearly doubled immediately post-ration...

We test two ways to improve revenue collection efficiency for water and sanitation utilities: (i) face-to-face engagement between utility staff and customers and (ii) contract enforcement for service disconnection due to nonpayment in the form of transparent and credible disconnection notices. Engagement has no effect, while enforcement significant...

As global temperatures go up and incomes rise, air conditioner sales are poised to increase dramatically. Recent studies explore the potential economic and environmental impacts of this growth, but relatively little attention has been paid to the implications for inequality. In this paper we use household-level microdata from 16 countries to charac...

We use a multi-country field experiment that combines random variation at the treatment level with exogenous variation in the length of exposure to treatment to test the effect of a slum housing intervention on the evolution of the housing aspirations of untreated co-resident neighbors. Initially after the intervention, we observe a large housing g...

Air conditioning adoption is increasing dramatically worldwide as incomes rise and average temperatures go up. Using daily temperature data from 14,500 weather stations, we rank 219 countries and 1,692 cities based on a widely used measure of cooling demand called total cooling degree day exposure. India, China, Indonesia, Nigeria, Pakistan, Brazil...

Subjective well-being may not improve in step with increases in material well-being due to hedonic adaptation, a psychological process that attenuates the long-term emotional impact of a favorable or unfavorable change in circumstances. As a result, people’s degree of happiness eventually returns to a stable reference level. We use a multicountry f...

This paper analyzes a randomized experiment that uses novel strategies to promote handwashing with soap at critical points in time in Peru. It evaluates a large-scale comprehensive initiative that involved both community and school activities in addition to communication campaigns. The analysis indicates that the initiative was successful in reachi...

This paper provides empirical evidence regarding the causal effects that upgrading slum dwellings has on the living conditions of the extremely poor. In particular, we study the impact of providing better houses in situ to slum dwellers in El Salvador, Mexico and Uruguay. We experimentally evaluate the impact of a housing project run by the NGO TEC...

Building on long-term benefits of early intervention (Paper 2 of this Series) and increasing commitment to early childhood development (Paper 1 of this Series), scaled up support for the youngest children is essential to improving health, human capital, and wellbeing across the life course. In this third paper, new analyses show that the burden of...

When physicians own complementary medical service facilities such as laboratories and imaging centers, they gain financially by referring patients to these entities. This creates an incentive for the physician to exploit patients' trust by recommending more services than necessary. Using data from Taiwan, which introduced a “separating” policy, tha...

This paper provides empirical evidence regarding the causal effects that upgrading slum dwellings has on the living conditions of the extremely poor. In particular, we study the impact of providing better houses in situ to slum dwellers in El Salvador, Mexico and Uruguay. We experimentally evaluate the impact of a housing project run by the NGO TEC...

The second edition of the Impact Evaluation in Practice handbook is a comprehensive and accessible introduction to impact evaluation for policy makers and development practitioners. First published in 2011, it has been used widely across the development and academic communities. The book incorporates real-world examples to present practical guideli...

We study household decisions to acquire energy-using assets in the presence of rising incomes. We develop a theoretical framework to characterize the effect of income growth on asset purchases when consumers face credit constraints. We use large and plausibly exogenous shocks to household income generated by the conditional-cash-transfer program in...

Technological innovation is an essential driver of human and economic development. It can improve the functioning of markets (Jensen, 2007), promote government accountability (Callen and Long, 2014), build human capital (Foster and Rosenzweig, 1996), and reduce the risks we face from global environmental change (Dar et al., 2013). Yet designing tec...

The creation of non-contributory pension schemes is becoming increasingly common as countries struggle to reduce poverty. Drawing on data from Mexico's Adultos Mayores Program (Older Adults Program) - a cash transfer scheme aimed at rural adults over 70 years of age - we evaluate the effects of this program on the well-being of the beneficiary popu...

The adoption of new clinical practice patterns by medical care providers is often challenging, even when the patterns are believed to be efficacious and profitable. This paper uses a randomized field experiment to examine the effects of temporary financial incentives paid to medical care clinics for the initiation of prenatal care in the first trim...

Significance The use of air conditioning is poised to increase dramatically over the next several decades as global temperatures go up and incomes rise around the world. In this paper, we use high-quality microdata from Mexico to characterize empirically the relationship between temperature, income, and air conditioning. We describe both how electr...

A fundamental question in economics is whether happiness increases pari passu with improvements in material conditions or whether humans grow accustomed to better conditions over time. We rely on a large-scale experiment to examine what kind of impact the provision of housing to extremely poor populations in Latin America has on subjective measures...

This paper evaluates a large-scale appliance replacement program in Mexico that from 2009 to 2012 helped 1.9 million households replace their old refrigerators and air conditioners with energy-efficient models. Using household-level billing records from the universe of Mexican residential customers, we find that refrigerator replacement reduces ele...

Background Poor sanitation is thought to be a major cause of enteric infections among young children. However, there are no previously published randomized trials to measure the health impacts of large-scale sanitation programs. India's Total Sanitation Campaign (TSC) is one such program that seeks to end the practice of open defecation by changing...

A substantial literature shows that U.S. early childhood interventions have important long-term economic benefits. However, there is little evidence on this question for developing countries. We report substantial effects on the earnings of participants in a randomized intervention conducted in 1986–1987 that gave psychosocial stimulation to growth...

We examine how the productivity of different industries changes over the course of a financial crisis by exploiting cross-firm, within-industry differences in productivity resulting from the Asian financial crisis of 1997. We show that the crisis coincided with dramatic changes in productivity and that many of these changes were sustained in the lo...

This paper analyzes a randomized experiment that uses novel strategies to promote handwashing with soap at critical points in time in Peru. It evaluates a large-scale comprehensive initiative that involved both community and school activities in addition to communication campaigns. The analysis indicates that the initiative was successful in reachi...

The decentralization of public services is a major feature of institutional innovation. The main argument in support of decentralization is that it brings decisions closer to the people, thereby alleviating information asymmetries and improving accountability. However, decentralization can also degrade service provision in poor communities that lac...

We nested a large-scale field experiment into the national rollout of the introduction of performance pay for medical care providers in Rwanda to study the effect of incentives for health care providers. In order to identify the effect of incentives separately from higher compensation, we held constant compensation across treatment and comparison g...

Most of the future growth in energy use is forecast to come from the developing world. Understanding the likely pace and specific location of this growth is essential to inform decisions about energy infrastructure investments and to improve greenhouse gas emissions forecasts. We argue that countries with pro-poor economic growth will experience la...

Pay for performance (P4P) is generating interest in Africa. This chapter is an early look at Sub-Saharan Africa’s experience with this approach. To date more than 20 African countries have pilots or programs providing some elements of P4P to their health workers. The chapter proposes a framework to analyze how P4P affects the number, distribution a...

The objective of this study was to measure willingness-to-accept (WTA) reductions in risks for HIV and other sexually transmitted infections (STI) using conditional economic incentives (CEI) among men who have sex with men (MSM), including male sex workers (MSW) in Mexico City. A survey experiment was conducted with 1,745 MSM and MSW (18-25 years o...

Many community-based studies of acute child illness rely on cases reported by caregivers. In prior investigations, researchers noted a reporting bias when longer illness recall periods were used. The use of recall periods longer than 2–3 days has been discouraged to minimize this reporting bias. In the present study, we sought to determine the opti...

There is a growing concern that food or cash transfer programs may contribute to overweight and obesity in adults. We studied the impact of Mexico's Programa de Apoyo Alimentario (PAL), which provided very poor rural households with cash or in-kind transfers, on women's body weight. A random sample of 208 rural communities in southern Mexico was ra...

This paper provides empirical evidence on the causal effects that upgrading slum dwellings has on the living conditions of the extremely poor. In particular, we study the impact of providing better houses in situ to slum dwellers in El Salvador, Mexico and Uruguay. We experimentally evaluate the impact of a housing project run by the NGO TECHO whic...

The creation of non-contributory pension schemes is becoming increasingly common as countries struggle to reduce poverty. Drawing on data from Mexico’s Adultos Mayores Program (Older Adults Program) -- a cash transfer scheme aimed at rural adults over 70 years of age -- we evaluate the effects of this program on the well-being of the beneficiary po...

This paper analyzes a randomized experiment that uses novel strategies to promote handwashing with soap at critical times in Peru. It evaluates a large-scale intervention that includes a mass media provincial campaign and a district-level community component. The analysis finds that the mass media intervention alone had no significant effect on exp...

Gradients across socio-economic position exist for many measures of children's health and development in higher-income countries. These associations may not be consistent, however, among the millions of children living in lower- and middle-income countries. Our objective was to examine child development and growth in young children across socio-eco...

Conditional cash transfer (CCT) programs operate by giving cash payments to families only if they comply with a set of certain requirements relating to the health and education of family members. In this paper we discuss why and how CCTs could affect children's outcomes, and review evidence from CCT programs throughout the world that focus on the e...

This study examines the effect of performance incentives for health care providers to provide more and higher quality care in Rwanda on child health outcomes. The authors find that the incentives had a large and significant effect on the weight-for-age of children 0-11 months and on the height-for-age of children 24-49 months. They attribute this i...

This paper examines a large-scale appliance replacement program in Mexico that since 2009 has helped 1.5 million households replace their old refrigerators and air-conditioners with energy-efficient models. Using household-level electric billing records from the population of Mexican residential customers we find that refrigerator replacement reduc...

Over the next 25 to 30 years, nearly all of the growth in energy demand, fossil fuel use, associated local pollution, and greenhouse gas emissions is forecast to come from the developing world. This paper argues that the world's poor and near-poor will play a major role in driving medium-run growth in energy consumption. As the world economy expand...

Recent studies have linked transfers from Mexican conditional cash transfer program Oportunidades (formerly PROGRESA) to improvements in child development (Fernald, Gertler, and Neufeld 2008, 2009) but this work has been crit icized as failing to account for endogeneity of the transfers. We create an exogenous instrume nt for the amount of tran sfe...

Siblings can slow child development, but distinguishing intrinsic from economic circumstances has been more difficult. The grants of the Oportunidades Mexican welfare program allo w us to test this linkage. We investigate whether transfers increase firstborn characteristics faster than other children’s characteristics, and whether the observed nega...

A number of countries are pursuing the regulation of sex work to decrease the spread of sexually transmitted infections (STIs) and to reduce the probability of a generalized human immunodeficiency virus/acquired immunodeficiency syndrome epidemic. We study the effects of enforcing licensing regulation laws on sex worker STI rates, using nationally...

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