Crowd-out in school-based health interventions: Evidence from India’s midday meals program
Journal of Public Economics · 2021 · James N. Berry、Saurabh Mehta、Priya Mukherjee、Hannah Ruebeck、Gauri Kartini Shastry
中文摘要
政府常常依赖学校来实施多项以儿童结果为目标的项目。如何改善这些项目的实施是一个重要的、尚未解决的问题。作为在印度奥里萨邦进行的一项随机对照试验的一部分，我们测量了一项营养项目和一项监督干预对一项既有的以学校为基础的营养项目实施的影响，具体为印度政府的铁和叶酸补充（IFA）项目。新的营养干预分配了一种添加到学校餐食中的微量营养素混合物（MNM），而监督干预则改变了监督活动的强度。我们发现，高强度监督改善了政府 IFA 项目的实施，而 MNM 干预则对其产生了挤出效应。净效应是，高强度监督改善了儿童健康，而 MNM 干预则没有。对 IFA 项目的挤出效应以及对监督的敏感性主要存在于资源或能力受限的学校中。
Abstract
Governments often rely on schools to implement multiple programs targeting child outcomes. How to improve the implementation of these programs is an important, open question. As part of a randomized controlled trial in Odisha, India, we measured the impacts of a nutrition program and a monitoring intervention on the implementation of a pre-existing school-based nutrition program, specifically the Indian government’s iron and folic acid supplementation (IFA) program. The new nutrition intervention distributed a micronutrient mix (MNM) to be added to school meals while the monitoring intervention varied the intensity of monitoring activities. We find that high intensity monitoring improved implementation of the government’s IFA program, while the MNM intervention crowded it out. The net effect is that high intensity monitoring improved child health, while the MNM intervention did not. Both crowd-out of the IFA program and sensitivity to monitoring were predominantly found among schools that were resource or capacity constrained.