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For young adults living in countries with AIDS epidemics, getting an HIV test may influence near-term decisions, such as when to leave school, when to marry, and when to have a first child. These behaviors, which define the transition from adolescence to adulthood, have long-term implications on well-being and directly affect a person's risk of contracting HIV. Using an experimental design embedded in a panel survey from Malawi, this study assesses the impact of voluntary counseling and testing of young adults for HIV on these decisions. The results show negligible intent-to-treat effect of HIV testing on behaviors. There is some suggestive evidence on differential response by wealth and by prior beliefs about one's status.

Adolescent Health --- Adulthood --- Disease Control & Prevention --- Gender --- Gender & Health --- Health, Nutrition and Population --- HIV/AIDS --- Population & Development --- Population Policies --- Risk Behavior

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Armenia experienced dramatic demographic changes in the past three decades: the share of adults age 65 and over nearly doubled, the total fertility rate reduced by more than 30 percent, and the male-to-female sex ratio at birth increased to one of the world's highest. Like other middle-income countries concerned with the implications of an aging population for long-term growth and fiscal sustainability, Armenia introduced financial incentives to promote fertility. This paper estimates the effect of the 2009 reform of the universal Childbirth Benefit Program, which increased the amounts of lump sum transfers conditional on birth. The analysis relies on a quasi-experimental strategy exploiting the timing of the policy change and eligibility rule-women get a larger transfer for third and higher-order births. The findings show that the annual probability of an additional birth among women with at least two other children increased between 1.4 and 1.6 percentage points in the five years following the policy change. These effects are equivalent to 58 and 64 percent of the pre-reform birth probability for women who had at least two children. Given the previously demonstrated relationship between fertility level and sex ratio in societies with strong son preference, the reform may potentially alleviate the sex imbalance without directly targeting it. Parents who already have at least one son and are less likely to engage in sex selection and more likely to have additional births; however, the findings do not indicate a significant increase in the likelihood of having daughters.

Demographics --- Fertility --- Gender --- Gender and Development --- Gender and Social Policy --- Gender Discrimination --- Health, Nutrition and Population --- Prenatal Care --- Pronatalist Incentive --- Reproductive Health --- Son Preference

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In lower-income countries, the economic contractions that accompany lockdowns to contain the spread of COVID-19 can increase child mortality, counteracting the mortality reductions achieved by the lockdown. To formalize and quantify this effect, this paper builds a macro-susceptible-infected-recovered model that features heterogeneous agents and a country-group-specific relationship between economic downturns and child mortality. The model is calibrated to data for 85 countries across all income levels. The findings show that in low-income countries, a lockdown can potentially lead to 1.76 children's lives lost due to the economic contraction per COVID-19 fatality averted. The figure stands at 0.59 and 0.06 in lower-middle-income and upper-middle-income countries, respectively. As a result, in some countries, lockdowns can produce net increases in mortality. The optimal lockdowns are shorter and milder in poorer countries than in rich ones and never produce a net mortality increase.

Business Cycle --- Business Cycles and Stabilization Policies --- Child Mortality --- Coronavirus --- COVID-19 --- Disease Control and Prevention --- Early Child and Children's Health --- Economic Downturn --- Health, Nutrition and Population --- Inequality --- Labor Markets --- Lockdown --- Macroeconomics and Economic Growth --- Pandemic Impact --- Pandemic Response --- Poverty and Health --- Poverty Reduction --- Sir-Macro

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This paper presents the results of a randomized controlled trial set to evaluate the effects of a pay-for-performance scheme that rewarded community health worker cooperatives for the utilization of five targeted maternal and child health services by their communities. The experiment took place in 19 districts in Rwanda between 2010 and 2014. The analysis finds no impact of the performance payments on coverage of the targeted services, attitudes and behaviors of community health workers, or outcomes at the cooperative level. No synergies are found between the scheme and a demand-side, in-kind transfer intervention that was independently effective in increasing coverage rates of targeted services.

Child Health --- Health Cooperatives --- Health Workers --- Maternal Health --- Performance Incentives

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In lower-income countries, the economic contractions that accompany lockdowns to contain the spread of COVID-19 can increase child mortality, counteracting the mortality reductions achieved by the lockdown. To formalize and quantify this effect, we build a macro-susceptible-infected-recovered model that features heterogeneous agents and a country-group-specific relationship between economic downturns and child mortality, and calibrate it to data for 85 countries across all income levels. We find that in low-income countries, a lockdown can potentially lead to 1.76 children's lives lost due to the economic contraction per COVID-19 fatality averted. The ratio stands at 0.59 and 0.06 in lower-middle and upper-middle income countries, respectively. As a result, in some countries lockdowns can actually produce net increases in mortality. In contrast, the optimal lockdown that maximizes the present value of aggregate social welfare is shorter and milder in poorer countries than in rich ones, and never produces a net mortality increase.