Mainsha Shah is a development economist whose primary research and teaching interests lie at the intersection of applied microeconomics, health, and development. She originally received her Ph.D. from UC Berkeley. She has written several papers on the economics of sex markets in order to learn how more effective policies and programs can be deployed to slow the spread of HIV/AIDS and other sexually transmitted infections. She also works in the area of child health and education. Shah has been the PI on various impact evaluations and randomized controlled trials and is currently leading projects in Tanzania, Indonesia, and India. She has also worked extensively in Ecuador and Mexico. Her research has been supported by Bill and Melinda Gates Foundation, William and Flora Hewlett Foundation, the World Bank, and the National Science Foundation, among others. She is an editor at Journal of Health Economics and an Associate Editor at The Review of Economics and Statistics. Follow Shah on Twitter @Manisha_econ.
Contact
About
Areas of Expertise
- Applied Microeconomics
- International Development
- Global Health
Curriculum Vitae
Research
Selected Publications
Improving Mental Health of Adolescent Girls in Low- and Middle-Income Countries: Causal Evidence from Life Skills Programming
with S. Baird, J. Seager, B. Avuwadah, J. Hamory, S. Sabarwal, and A. Vyas, in the Journal of Human Resources.
This study provides causal evidence on the impact of life skills programming on the mental health of adolescent girls aged 10-19 in three distinct low- and middle-income countries: Tanzania, Bangladesh, and Ethiopia. Life skills interventions significantly improved a component of mental health in all three contexts, with reductions in depression in Tanzania, and improvements in socio-emotional development in Bangladesh and Ethiopia. However, findings suggest substantial heterogeneity in impact. Programs that target both adolescent boys and girls appear more effective than those that target girls alone, and existing supportive environments are a necessary condition for programs to improve mental health.
Reminders, but not Monetary Incentives, Increase COVID-19 Booster Uptake
with T. Chang, M. Jacobson, M. Kopetsky, R. Pramanik, and S. Shah, Proceedings of the National Academy of Sciences, July 2023, 120(31).
Despite substantially decreasing the risk of hospitalization and death from COVID-19, COVID-19 booster vaccination rates remain low around the world. A key question for public health agencies is how to increase booster vaccination rates, particularly among high-risk groups. We conducted a large preregistered randomized controlled trial (with 57,893 study subjects) in a county health system in northern California to test the impact of personal reminder messages and small financial incentives of $25 on booster vaccination rates. We found that reminders increased booster vaccination rates within 2 wk by 0.86 percentage points (P = 0.000) or nearly 33% off the control mean of 2.65%. Monetary incentives had no additional impact on vaccination rates. The results highlight the potential of low-cost targeted messages, but not small financial incentives, to increase booster vaccination rates.
Unintended Consequences of Lockdowns: COVID-19 and the Shadow Pandemic
with S. Ravindran, Nature Human Behaviour. March 2023, 7(3).
Violence against women is a problem worldwide, with economic costs ranging from 1% to 4% of global gross domestic product. During the coronavirus disease 2019 lockdowns, the United Nations coined the term the Shadow Pandemic to describe the increase in global violence against women. Here, using variation in the intensity of government-mandated lockdowns in India, we show that domestic violence complaints increase significantly in districts with the strictest lockdown rules. We find similarly large increases in cybercrime complaints. However, rape and sexual assault complaints decrease in districts with the strictest lockdowns, consistent with decreased female mobility in public spaces, public transport and workplaces where they might be at greater risk for rape and sexual assault. Medium-term analysis shows that increases in domestic violence complaints persist 1 year later, while other complaints related to rape, sexual assault and cybercrimes return to pre-lockdown levels.
The Dirty Business of Eliminating Open Defecation: The Effect of Village Sanitation on Child Height from Field Experiments in Four Countries
(with P. Gertler, M. Alzua, L. Cameron, S. Martinez, and S. Patil) Journal of Development Economics. November 2022, 159.
We examine the impacts of a sanitation program designed to eliminate open defecation in at-scale randomized field experiments in four countries: India, Indonesia, Mali, and Tanzania. The programs – all variants of the widely-used Community-Led Total Sanitation (CLTS) approach - increase village private sanitation coverage in all four locations by 7–39 percentage points. We use the experimentally-induced variation in access to sanitation to identify the causal relationship between village sanitation coverage and child height. We find evidence of threshold effects where increases in child health of 0.3 standard deviations are realized once village sanitation coverage reaches 50–75%. There do not appear to be further gains beyond this threshold. These results suggest that there are large health benefits to achieving coverage levels well below the 100% coverage pushed by the CLTS movement. Open defecation decreased in all countries through improved access to private sanitation facilities, and additionally through increased use of sanitation facilities in Mali who implemented the most intensive behavior change intervention.
Aggregate Effects from Public Works: Evidence from India
with J. Cook, The Review of Economics and Statistics. July 2022, 104(4).
This paper explores the aggregate economic effects from India’s National Rural Employment Guarantee Scheme (NREGS), which provides up to 100 days of labor to rural laborers at the mandated minimum wage. We examine the within-district change to night-time lights and banking deposits using the staggered program rollout for identification. We find consistent and robust evidence that NREGS increased aggregate economic output by 1-2% per capita measured by night-time lights. This effect, however, is not equal across districts. We observe no positive effect of the program in poorer districts, illuminating an important source of heterogeneity.
Working Papers
“Sex, Power, and Adolescence: Intimate Partner Violence and Sexual Behaviors,” with J. Seager, J. Montalvao, and M. Goldstein, 2023.
Working Paper (August 2023)
Adolescents in Sub-Saharan Africa have some of the highest rates of intimate partner violence across the globe. This paper evaluates the impact of a randomized controlled trial that offers females a goal setting activity to improve their sexual and reproductive health outcomes and offers their male partners a soccer intervention, which educates and inspires young men to make better sexual and reproductive health choices. Both interventions reduce female reports of intimate partner violence. Impacts are larger among females who were already sexually active at baseline. We develop a model to understand the mechanisms at play. The soccer intervention improves male attitudes around violence and risky sexual behaviors. Females in the goal setting arm take more control of their sexual and reproductive health by exiting violent relationships. Both of these mechanisms drive reductions in IPV.
“Violent Discipline and Parental Behavior: Short- and Medium-term Effects of Virtual Parenting Support to Caregivers,” (with L Dinarte-Diaz, S. Ravindran, S Powers, and H Baker-Henningham) 2023.
Working Paper (June 2023)
Approximately 75% of children aged 2 to 4 worldwide are regularly subjected to violent discipline across the globe. We study the impact of a virtually-delivered intervention on positive parenting practices in Jamaica. We find the intervention improves caregiver knowledge (0.52 SD) and attitudes around violence (0.2 SD) and leads to meaningful changes in caregiver disciplining behaviors, with a 0.12 SD reduction in violence against children. Treatment children also experience fewer emotional problems (0.17 SD). When we return nine months later, we also find reductions in caregiver depression (0.12 SD), anxiety (0.16 SD), and parental stress (0.16 SD) for treatment caregivers. The virtual delivery has important scalable policy implications which could help decrease violence against children across the globe.
“Reducing bias among health care providers: Experimental evidence from Tanzania, Burkina Faso, and Pakistan,” (with Z. Wagner, C. Moucheraud, A. Wollum, W. Friedman, and W. Dow), 2023.
Working Paper (May 2023)
Bias among health care providers can lead to poor-quality care and poor health outcomes, and it can exacerbate disparities. We use a randomized controlled trial to evaluate an intervention to reduce family planning provider bias towards young women in 227 clinics in Tanzania, Burkina Faso, and Pakistan. The intervention educated providers about bias towards young women, facilitated communication about bias with other providers, and offered non-financial public awards to clinics with the least biased care. After 12 months, the intervention led to less-biased attitudes and beliefs among providers and more comprehensive counseling. Clients also perceived better treatment at intervention clinics compared to control clinics. Despite reductions in reported bias, we find mixed evidence regarding changes in method dispensing
Human Capital Investment in the Presence of Child Labor (with N. Bau, M. Rotemberg, and B. Steinberg), 2020. NBER Working Paper 27241.
Working Paper (March 2021)
Policies that improve early life human capital are a promising tool to alter disadvantaged children's lifelong trajectories. Yet, in many low-income countries, children and their parents face tradeoffs between schooling and productive work. If there are positive returns to human capital in child labor, then children who receive greater early life investments may attend less school. Exploiting early life rainfall shocks in India as a source of exogenous variation in early life investment, we show that increased early life investment reduces schooling in districts with high child labor. These effects persist and are intergenerational, affecting adult household consumption, and lead to a divergence in the next generations' educational outcomes. Our results are robust to instrumenting for child labor prevalence with crop-mix and to the inclusion of a rich set of district-level characteristics. We provide evidence that reductions in educational investment in response to positive early life shocks are total welfare-reducing.
Policy Reports
Information and Illegal Market Mechanisms with T. Logan. VoxEU.org April 2009.
(April 2009)
Scaling Up Rural Sanitation: Findings from the Impact Evaluation Baseline Survey in Indonesia with L. Cameron, Water and Sanitation Project Technical Paper, November 2010.
(November 2010)
Impact Evaluation of a Large-Scale Rural Sanitation Project in Indonesia with L. Cameron and S. Olivia, World Bank Policy Research Paper 6360, February 2013.
(February 2013)
The Effect of Workfare Programmes on Educational Attainment: Evidence from India with B. Steinberg. voxdev.org. May 2015.
(May 2015)
Behavioral Economics and Reproductive Health Decision-Making with A. Sellman and T. Madon. Behavioral Economics.com. April 2016.
(April 2016)
Last updated on 08/16/2023