Managing Global Health: Applying Behavioral Economics to Create Impact
Course Number 2230
Associate Professor Nava Ashraf
Winter; Q3Q4; 3 credits
Managing Global Health (MGH) trains students to see through the lens of the end-user and to use the levers of behavior change to generate impact in health and social programs. Although most of the applications are in global health, it is appropriate for students who anticipate working in health, education, or international development sectors, as well as those with a general interest in learning how behavioral economics can be effectively applied.
Health, and development more broadly, is not something we give to people: it is something they co-produce together with supply-side and institutional factors. In this course, students learn how to design products and services from the perspective of the patient/customer and the provider/supplier. Students will also learn to utilize the most cutting-edge and gold standard research and evaluation methods in this design. Through exposure to major practitioner challenges and innovative solutions from HBS Case discussions, protagonists from the field, expert guest faculty from across Harvard, and engagement with research in public health, public policy, psychology, and economics, students will learn to bridge the worlds of research and action to creatively, and skillfully, make an impact in global health.
Course Content and Organization
The insight of the course consists of four modules 1) putting the end user first; 2) designing solutions; 3) measuring success; and 4) execution.
1. Putting the End User First
The course begins by placing the customer - not the donor - at the center of public health services. Many of the remaining barriers to improving health outcomes lie within the patient. For example, condoms can prevent the transmission of HIV/AIDS and other STIs, but are not routinely used. How do we encourage individuals to adopt such health products that essentially guarantee a positive health outcome, are cheap, and are easy to use? We approach this problem by recognizing co-production and identifying the end user. Putting the end user first requires the consideration of actual behavior (including biases), rather than theoretical behavior. Behavioral economics emphasizes that humans are imperfect and can act irrationally, suffering from time-inconsistency, loss aversion, limited attention and many more biases, many of which are amplified by stress and cognitive overload.
2. Designing Solutions
The second module is based on the knowledge of behavioral tendencies and associated levers learned in the first module. Students learn how to impact behavior change and health outcomes in both consumers and providers. We focus on how to influence the consumer take-up a product by effectively setting price. While the focus of this course is the end user, the providers must be incentivized to ultimately put their needs first. We explore various methods of incentivizing workers, beyond typical financial schemes, to effectively to promote better health service delivery.
3. Measuring Success
While the skill of putting the end user first is what allows students to learn how to execute all other aspects of global health delivery, much of the energy put into this work is lost if measurement is done poorly. This module shows students how to evaluate the impact of the solutions they design. Evaluation is particularly important in non-profit service delivery because market mechanisms, which traditionally give feedback in the for-profit sector, do not exist in the global health sector, and because in the absence of ordinary market feedback (sales, earnings), mission-driven organizations often turn to their cherished beliefs for motivation. Students will be inspired to adopt a culture of experimentation and inquiry, rather than rely on self-generated beliefs, which may or may not be valid. Key skills are 1) learning how to determine the right measures for designing the most effective solutions-and 2) how to evaluate and adjust the programs and measures as needed through iterative testing.
The first three modules of this course can be taken together as an iterated diagnose, design, and test cycle. At the end of this cycle, the manager will have a product that has been designed to address the specific nature of the problem and tested rigorously to measure impact. The principal motivation for this final, mini, module is to begin to address the challenge of turning good, tested ideas into large-scale action and policy. This module looks specifically at the large, upstream players responsible for making and executing most high-level decisions related to funding, policy, and programs, and how to coordinate these actors by leveraging commitment and fostering accompaniment.