In a collective effort bringing together 15 studies, researchers from over 30 institutions surveyed over 20,000 individuals between June 2020 and January 2021 on questions regarding respondents’ vaccine acceptance and hesitancy and their most trusted sources for vaccination advice. During some surveys, results from COVID-19 vaccine clinical trials had yet to be announced, and during later surveys, governments had started approving vaccines for use. The fast-moving nature of COVID-19 information may change people’s perceptions about vaccines by the time they are widely available in low- and middle-income countries (LMICs). Over the past six months, the body of evidence demonstrating the safety and efficacy of available COVID-19 vaccines, which have been given to millions of people, has become clearer. At the same time, severe, but rare, side effects may have undermined public confidence.
Widespread acceptance of COVID-19 vaccines is crucial for achieving sufficient immunization coverage to end the global pandemic, yet few studies have investigated COVID-19 vaccination attitudes in lower-income countries, where large-scale vaccination is just beginning. We analyze COVID-19 vaccine acceptance across 15 survey samples covering 10 low- and middle-income countries (LMICs) in Asia, Africa and South America, Russia (an upper-middle-income country) and the United States, including a total of 44,260 individuals. We find considerably higher willingness to take a COVID-19 vaccine in our LMIC samples (mean 80.3%; median 78%; range 30.1 percentage points) compared with the United States (mean 64.6%) and Russia (mean 30.4%). Vaccine acceptance in LMICs is primarily explained by an interest in personal protection against COVID-19, while concern about side effects is the most common reason for hesitancy. Health workers are the most trusted sources of guidance about COVID-19 vaccines. Evidence from this sample of LMICs suggests that prioritizing vaccine distribution to the Global South should yield high returns in advancing global immunization coverage. Vaccination campaigns should focus on translating the high levels of stated acceptance into actual uptake. Messages highlighting vaccine efficacy and safety, delivered by healthcare workers, could be effective for addressing any remaining hesitancy in the analyzed LMICs.
In this paper we investigate whether access to savings accounts affects risk attitudes and intertemporal choices. We exploit a field experiment that randomized access to savings accounts among a largely unbanked population of Nepalese villagers. One year after the accounts were introduced, we administered lottery-choice and intertemporal-choice tasks to the treatment and control groups. We find that the treatment is more willing to take risks in the lottery-choice task and is more responsive to changes in experimental interest rates in the intertemporalchoice task. The results on time discounting are less conclusive, but suggest that the treatment group is more willing to delay receiving money. These results suggest that access to formal savings devices has a positive feedback loop for poor families by increasing their willingness to take risks and to delay gratification.
The majority of the poor lack access to bank accounts and have to use costly informal savings mechanisms. Using a field experiment, I randomly gave access to simple bank accounts with no fees at local bank branches to a large sample of female household heads in Nepal. Results show that there is untapped demand for savings accounts and that the poor do save. Access to the savings accounts increased monetary assets and total assets without crowding out other kinds of assets or savings institutions. Finally, financial access strongly increased households’ investments in health and education.
Increasing education for girls is an important policy priority in many developing countries, where secondary school enrollment often remains lower for girls than for boys.
Some researchers and policymakers have argued that menstruation may be causing girls to miss a significant number of school days. At the maximum, some have estimated that girls might be missing as much as 10 to 20 percent of school days due to menstruation. Anecdotal evidence seems to support this. Girls report missing school during their periods and lacking access to modern sanitary products.
In response, NGOs and sanitary product manufacturers have conducted campaigns to distribute sanitary products in the hope that this will remove a barrier to female education (CH Deutsch. 2007. “A Not-So- Simple Plan to Keep African Girls in School.” NYT Nov. 12). However, there has been little or no rigorous evidence on how much school girls miss due to their periods and the impact of providing sanitary products.
Emily Oster and J-PAL affiliate Rebecca Thornton introduced a convenient and hygienic sanitary product, reusable menstrual cups, to Nepalese girls in the seventh and eighth grades. Their evaluation addressed several questions: Is menstruation as large a barrier to education as many believe? Does switching to modern sanitary products increase attendance and school performance among girls?
- Girls miss fewer school days because of menstruation than previously believed. Even though 47 percent of the girls in this study reported missing some school due to menstruation in the past year, attendance data found that girls missed only about half a day of school per year because of their periods.
- While the menstrual cups were used by many girls in the treatment group, they did not reduce the (very small) amount of school missed due to menstruation. The study found no significant impact on attendance, even though 60 percent of the girls in the treatment group chose to use the menstrual cup.
- Although the new sanitary product did not have a direct educational benefit, girls liked the product. When offered the menstrual cup, most girls chose to use it, often switching away from traditional cloth rags.