With Jake Robyn* and Gaston Sorgho**
Randomization might- at first – sound like a scary word for health policy makers and professionals. They read medical journals and know from their training that randomized trials are scientifically rigorous designs to evaluate the impact of a program. But their first inclination might be to prefer to have the randomized trial in somebody else’s backyard. Randomization seems politically difficult. How to explain it to the people who will have to wait for the new intervention? Will it not create a backlash with the people who are randomly assigned to the control group? How will the population be convinced that the random allocation was fair and that there were no back room deals?
Our experience in many countries is that public randomization ceremonies are an excellent platform to build support for randomization and for the entire impact evaluation process. In Cameroon, we organized public randomization ceremonies in three Regions to assign health facilities to four study groups in an impact evaluation of performance-based financing (PBF) in the health sector. Held in the regional capitals and combined with the official launching of the project in each Region, we invited representatives of each facility, district health management teams, and local government, who all took part themselves in the randomization. Each of the randomization ceremonies received close oversight from the central and regional levels of the Ministry of Public Health. This made the randomization process completely fair and transparent to all health facilities participating in the study.
- On the IDB First steps blog, evidence from CCT programs that the long-term impacts are greater when kids get this in the womb and in their first two years of life versus even when aged 2 to 5: children who were exposed to the CCT while in-utero and during the first two years of life score 0.15 standard deviations higher in the cognitive development assessment than those boys who were exposed to the program when they were 2 to 5 years old.
- Call for papers – NEUDC conference November 2-3 at Harvard. This is a fun conference which allows you to see lots of new work in development .