TED and Burning Man

July 18, 2010

I spent last week in Oxford at my first TEDGlobal conference.  I was unexpectedly struck by the parallels between this prestigious gathering of global intelligentsia and an event ostensibly as far away at the other side of the spectrum as possible – Burning Man. 

Burning Man is near impossible to explain to the uninitiated, let alone succinctly.  It’s like dropping yourself on another planet with an entirely different species of human being.  You’re on a dusty dried lakebed that looks like the moon (known as the playa), without money and branding, wearing some ridiculous costume, surrounded by creativity at every turn.  One's first impression is often of some absurd hippy drugfest in the desert, but I assure you there is much more to it than that.  This link or this link will give you more information. 


Here are the parallels I observed between the Burning Man and TED:

1) People step outside of the confines of their everyday routine and realize how much they’re missing.  At TED, it’s about stepping back and pondering a bigger picture to inform your work.  At Burning Man, it’s about recognizing how differently humans can organize themselves, even if only for a week. 

2) People are much more open to each other than almost everywhere else.  A TED badge or presence on the playa translates into a willingness to engage with whoever stumbles upon your path.  An hour into meeting someone last week, deep in conversation, he began talking about something deeply personal. He said to me, “We’re in TED space, so I’m going to be very open about this.”

3) There are infinitely more fascinating things to do with your time than possible, so it’s futile to attempt to allocate it.  At TED, every person is passionate about what he or she does and is utterly fascinating.  You can attempt to engage with the speakers but the person sitting right next to you is just as incredible.  At Burning Man creative things to explore are literally ubiquitous.  So in both instances, you may as well give up on the planning and stumble.  For a type A like me, this alone is liberating.

4) You’re intensely over-stimulated.  There’s so much to do and see and it’s temporary, so you don’t want to miss a thing.  You go and go and go and go and by the time it comes to and end, you’re utterly exhausted. 

5) When it’s over, you crash.  As Chris Anderson warned us on Friday, “there’s so much dopamine running through your brains, you’ll probably be a bit sad for the next few days”.  In my case, my brain is still so turned on, the crash hasn’t hit.  Yet.  


Both events will change you.  If there is any way you can to to either, I encourage you to make it happen.
 

 

One of the more exciting things happening in access to finance

July 18, 2010

Imagine you are a bank.  What information would you need to determine the creditworthiness of an entrepreneur or a small business?  If the business is at an early stage, financial statements may not be very valuable.  If the business has little physical capital to be used as collateral, it might be too risky.  If the entrepreneur has no credit history, it might be game over.  Microfinance gets around this with the group-lending model, because while it is costly for a lender to assess the creditworthiness of an entrepreneur with no collateral, others in her social network can.  Furthermore the lending group's assessment is credible because its members have something to lose if the entrepreneur defaults on her loan.  Microfinance as well as banks, however, do not reach many small and medium enterprises in developing countries.

The work at the Entrepreneurial Finance Lab (EFL) at Harvard's Center for International Development has devised an innovative approach to reaching this segment.  Outlined in a recent Business Week article, EFL has been researching the use of a psychometric test to evaluate the creditworthiness of entrepreneurs.  It asks questions such as "Do you enjoy going to parties?" to assess business skills, integrity, intelligence, and motivation.  Three years of pilots in Kenya, South Africa, Rwanda, Colombia, and Peru have shown that banks using the test can realize equivalent or better results than traditional credit assessment models.  Some banks saw default rates drop from 40% to 25%.  From here the EFL will roll out a even bigger test in Kenya and South Africa in August, with the largest bank on the African Continent, Standard Bank of South Africa.

Some are skeptical that researchers from Harvard can determine the creditworthiness of entrepreneurs in developing countries.  It isn't the researchers who are making the decisions but algorithms based on the data the test gathers that determines it.  At it's core the approach is implying that this sort of algorithm using data glean directly from entrepreneurs may be better at determining creditworthiness than humans collecting and processing information themselves (see point number one of "what turns me on lately" below).  The bottom line is that the banking system as currently structured isn't reaching many entrepreneurs in developing countries.  By relying instead on a radically different set of information and process to make lending decisions, we can potentially bring credit to entrepreneurs who currently do not have access.  I haven't seen the study in detail but considering who's driving the work, I doubt it would be easy to poke holes in the evidence.  

This effort happens to be led by Asim Khwaja, one of my favorite professors from Harvard.  He is not just a brilliant analytical mind who has studied firms and financial markets in developing countries extensively, but he is also an out of the box thinker.  So while this may sound like a crazy idea relative to the status quo, it's actually an innovation on par with microfinance. 

If this works, it has the potential to be revolutionary.  All of us concerned about access to finance in developing countries should most certainly stay tuned.

 
 

Things that turn me on lately

July 18, 2010

A few things have been on my mind for awhile.  Topics I'm particularly fascinated by, and that I think are important for development.  They are the following:

How people access and process information, and what the deficiencies in that process mean for the challenges we face in international development.  I actually think this is very relevant for a long list of issues, especially aid and access to capital.

Prospect theory and the implications for development.  In sum, prospect theory argues that we value things not absolutely, but relative to other things.  This implies we're basically hamsters on a wheel, always trying to keep up with the Joneses.

The evolutionary role of fairness and how it shapes our behavior today (see recent posting from one of Sendhil's papers).

Where the right equilibrium is when it comes to measuring effectiveness and creating accountability in development.  In short, I think we have more to learn from the private sector than from academia (i.e. I have quite a few criticisms of the randomista camp).

How early stage investors access and process information to make investment decisions.  I'm very interested in fostering innovation and access to capital is an important part of it.  I wrote a paper on this for Asim Khwaja's class.  I thought he would throw up all over it because I argued that there are very significant behavioral elements.  He didn't.

The role of proximity in early stage venture capital, for the same reasons as mentioned above.  I wrote my final paper on this in Asim's class.  He actually liked it (he's unimaginably critical, which is part of why I love him so much).  He also thought I should push on the issue more, so I will post a cliff notes version soon.

* * *

My little vacation from blogging came to a screeching halt this past week at TED, and many of the talks touched on these topics.  My mind is bursting at the seams and I have to get my thoughts in writing to alleviate my excitement, so a deluge of posts are coming your way.
 

Is this really what we're striving for?

July 18, 2010
 

I'm in the middle of biggest transition state of my life.  Not only am I just about to embark in a new direction with my career, but I'm also just about to transition from a girlfriend to a wife, and motherhood looms on the horizon.  As I move on to these significantly different phases of my professional and personal life, I'm doing a considerable amount of thinking about my priorities and how I want to live.  In doing so, I'm reminded of a real problem with the society I exist in. 

We're brought up to strive to get the best grades, to get into the best university, to get the best job.  What is it that's most widely lauded for these best and brightest of my generation's college graduates?  The highest paying, of course: investment banking and management consulting.  These are jobs where we work 100 hours a week, sometimes living out of a suitcase five days a week.  And once we have those jobs, we're applauded when we earn a raise or a promotion.  Competition for such recognition and income leads us to work even harder and compromise more and more of our personal interests.  We may live in big houses and drive BMWs, but what are we sacrificing for it?  One of the partners I worked with at Accenture once told me he was leaving one day for yet another business trip and his daughter said to him, "Daddy, when are you coming to visit us again?" 


So as I ask myself the questions I outlined in my previous post, and as I look at the norms in American society, I can't help but wonder -- is this what we're striving for?  As a society we're valuing money, a vehicle for consumption and symbol of status, above all else.  We outsource parenting to nannies, our personal interests become a to do list that collects dust for decades, our family understands that we can't find the time to send a birthday card or a present because we're just so very busy.  (There are fascinating psychological and economical explanations for why we've landed here, but those will have to wait for later posts.)  We spend so much time talking about the environmental problems with development, but what about the cultural ones?

My first experience traveling to a developing country back when I was 19 resulted in an unexpected reaction.  I didn't think, as Sheryl WuDunn told us to at TED this past week, "Wow, I've won the lottery.  My life is so much better than these Egyptian people's.  It's my responsibility to help make their lives better."  Instead I thought to myself, "Wow, these people seem a hell of a lot closer to the things that ultimately matter most in life."  

At the end of the day it's hard to argue that I'd trade my current state for living on less than a dollar a day, but I think it's important to recognize that for all we've gained with economic development, there's also a lot we've lost.  As our professional lives become more competitive, which ultimately leads to pre-school becoming competitive, we should recognize that this societal problem is only going to get worse.  
 

Asking myself, "What's the goal again?"

July 18, 2010
 

One of the things I'm doing with my time off between graduation and working full time is taking a massive step back when it comes to my thinking about development.  I'm asking myself the following questions:

What do I believe should be the societal goals of "development"?  Is there some level of overall well being (or freedom as Sen would define it) that we consider a right of everyone that inhabits this planet?  If so, upon what basis are those rights determined?  Or is it that, given the human desire to "give back", there will always be a role for development so long as there is inequality? 

Answering these questions has led me to political philosophy and theories of justice.  It's an ocean that is more often than not obtuse, but I look forward to engaging on this topic in the coming months.  I think it's an important one, and it doesn't seem like we talk about it enough.  

 

Social Preferences and Corruption

April 8, 2010
 
I recently read Sendhil Mullainathan's paper, "Psychology and Development Economics," for a class I'm taking with him. It's a fantastic read and very accessible -- I highly recommend it.  One section, however, is so thought provoking that I felt it worth replicating in full on my blog.  It's about the psychology of fairness and its role in corrupt behavior.  I have become extremely interested fairness in human behavior, and its evolutionary roots.  I think it has a lot to teach us about development.  

This passage a long one but trust me, it's worth it.  Read on.

 
* * *

In many important development contexts, self-interested behavior is very deleterious. Bureaucrats in many countries are corrupt. They enforce regulations sporadically or take bribes. Another stark example is teacher absenteeism. Numerous studies have found that teacher absenteeism is one of the primary problems of education in developing countries.  Teachers simply do not show up to school, and as a result, little education can take place.  This blatantly selfish behavior stands in contrast to some evidence on social preferences that individuals may value the utility of others. I will review this literature and describe how social preferences may be contributing to the problem and may serve as part of the solution. 

A very simple game called the ultimatum game has become an excellent tool for studying social preferences (Guth, Schmittberger and Schwarze 1982, Thaler 1988).  In this game, one player (call him the Proposer) makes the first move and offers a split of a certain amount, say $10.  The second player (Responder) decides whether to accept or reject this split. If it is accepted, P and R get the proposed split. If rejected, then both get zero.  This game has been run in many, many countries and for stakes that range from a few dollars in the US to a few months of income in many countries. Yet the pattern of findings is relatively constant.  First, responders often reject unfair offers (i.e. away from 50-50 splits).  Second, proposers often make very fair offers, close to 50-50 or 60- 40.  Moreover, proposers fair offers are not just driven by fear of rejection. They tend to make offers larger than what a simple (risk-neutral) fear of rejection implies. The ultimatum game illustrates two facts about interpersonal preferences: (i) people care about others and are willing to give up resources to help others and (ii) people react negatively to perceived unfair behavior and are willing to give up resources to punish it.  The second fact illustrates part of the “dark side” of interpersonal preferences. In simple altruistic models, interpersonal preferences are only a good thing: having one person care in a positive way about another only makes it easier to deal with externalities and so on. The Responders possible punishment behavior shows, however, the way in which interpersonal preferences could potentially cause inefficiencies and conflicts.  

This possibility is clearest in a classic experiment by Messick and Sentis (1979).  They ask subjects to imagine they have completed a job with a partner. They are asked to decide what fair pay for their work is.  They divide the subjects into two groups however. One group is told to imagine that they had worked 7 hours on the task while the partner had worked 10. The other group is told to imagine that they had worked 10 hours while the partner had worked 7. Both groups were told that the person who had worked 7 hours had been paid $25 and were asked what the 10 hour person should be paid.  Those who were told that they had worked 7 hours (and paid $25) tended to feel that the 10-hour subject should be paid $30.29.  In contrast, those who were told that they had worked 10 hours felt they should be paid $35.24.  The source of the bias can be seen in the bimodality of the distribution of perceived fair wages. One mode was at equal pay($25 for both) while the other mode was at equal hourly wage (so the 10 hour worker gets paid approximately $35.70).  Interestingly, the difference between the two treatments was mainly in the proportion at each mode.  Those who had worked 7 hours showed more subjects at the equal pay level mode while those who had been told theyd worked 10 hours showed more subjects at the equal hourly pay mode.  In other words, both groups recognized two compelling norms: equal pay for equal work and equal pay for equal output.  Yet their roles determined (in part) which norm they picked.  Such conflicts could easily arise even if theres disagreement about measuring input levels (which often are not fully observed). More broadly, when there is not universal agreement about what is fair division, individuals trying to act fair may produce even more conflict than individuals acting in a self-interested manner.

Let us return to the case of teacher absenteeism. The PROBE report surveyed teachers extensively in many areas of India and noted high absenteeism levels. Its in-depth interviews are illuminating about their attitudes and highlights how teachers often feel unmotivated. Some of this discouragement can be viewed as a perceived failure of reciprocity. As noted earlier, individuals strongly adhere to the norm of reciprocity.  Failures of reciprocity (or perceived failures) can result in punitive or self-interested behavior in response.  Teachers may feel a strong social preference early on and be motivated to teach and give much more than they need to.  After all, from a pure self- interest motive, they know they can get away with very little teaching.  Yet they may be initially motivated to do more, to come to school, to struggle with tougher students and so on.  They may view these contributions as a "gift" in large part due to the initial framing of the job (as a plum job, with good salaries, secure employment and plenty of other time for other activities).  Thus, a young teacher may think, I am giving a lot to the school. As with any giving, however, the teacher may expect strong reciprocity and see (perhaps in a self-interested way) many outcomes as a lack of reciprocity. For example, the Probe report notes that many schools have terrible infrastructure; accordingly, teachers may feel that the government is not reciprocating their "gifts". This may be especially exaggerated by the transfer system in India, which moves teachers to various areas, disrupting the lives of teachers. Thus both the benign neglect of schooling and the active transfers could easily drive teachers to feel that the government does not reciprocate their efforts. They may also come to feel similarly vis a vis parents, who they may feel do not care about their children's education. 

Even an initially motivated teacher may very quickly feel justified in their growing apathy.  They gave it their best and think that their efforts were not reciprocated. Are these inferences justified?  Perhaps not. As in the Messick and Sentis study teachers may very well be making such inferences in a self-interested way. The failure of the context may very well be in it allowing teachers to make such biased attributions of fairness. Alternatively, teachers may very well be justified in these attributions. We simply cannot tell. 

At a deeper level, these studies of fairness suggest that the problem of corruption may have interesting social preference wrinkles.  People may be more willing to avoid taxes if they feel they are not "fair".  This judgment of unfairness could be the result of getting very few government services or having to bribe corrupt middleman in order to procure government services. Economic models of corruption, by assuming blatant self-interest, ignore the tension corruption generates. If most people, as the evidence suggests, have strong social preferences, then corrupt acts will require self-justification.  This resembles anecdotal evidence on corruption experiences. It is very rare that an official simply asks for a bribe. The request is often couched with an explanation for the reason for the bribe. Even though the bribe is clearly a violation of the law, there is usually a story that serves to justify it in the context of the law.  For example, a customs officer may point to improper packaging as a reason for an extra payment. These kinds of insights may one day help to better understand the nature of corruption and anti-corruption policies.  

 

My Classmates' Letter to the Harvard Kennedy Citizen

April 7, 2010
 
Needless to say, I am fortunate to be surrounded by extremely brilliant and passionate people here at Harvard.  I should have included contributions from them at the onset of this blog, but late is better than never.  A few of the first year MPAIDs wrote the letter below to our school paper in response to the Harvard's response to the earthquake in Haiti.   

This is one of several guest contributions I will be adding over the next few days.

* * * 

Dear Editors of the Harvard Kennedy Citizen,

The earthquake in Haiti has shocked and saddened us all. We have been inspired, though, by the outpouring of support from the Harvard Community. At the same time, relief and reconstruction are currently entering a critical stage: while concerned actors must continue to mobilize support, the challenge becomes to utilize donations and efforts in the most efficacious ways. The task is not as easy as simply giving money: experiences during natural disasters have taught harsh lessons, namely that financial donations that are forthcoming in the immediate aftermath of a disaster often pour in and overwhelm local systems; and yet, after the initial deluge, monies are not sustained long enough to address longer-term challenges (including critical infrastructure, security, social services, and institutional capacity building) that can allow a country to rebuild itself. The 2004 Tsunami is an iconic example of the ill-effects of having funds pour in in ways that are disconnected with capacity and needs assessment; we should now be concerned aid will even more acutely inundate relief organizations in Haiti.

It is with this in mind that we raise the following issues based on our respective experiences assisting in crises in Somalia, Burma, Lebanon, many places affected by the Tsunami, Katrina, etc., arguing that citizen donors are ultimately responsible for maximizing the impact of their donations:

1. Money is often not the limiting factor: Coordination (interagency and with governments), logistics, human resources/capacity, and security are often larger constraints; excessive funds often exacerbate these problems;

2. High-Impact Short-term Funds: Therefore, donated funds should be used optimally, allocated to NGOs only based on their absorption capacity. Even organizations with such capacity may be legally constrained from carrying over funding from one fiscal year to another and may be compelled to disburse funding hastily on endeavors of limited impact. The donor community should emphasize transparency in aid monies received, so that funds can be allocated in the most effective ways.

3. Sustained Long-term Funding: Funding that exceeds current absorptive capacity can be better utilized by:

a. Disbursing funds to organizations that have the legal and administrative capabilities to manage and spend the funds over a longer time period, as well as the competency and experience to engage in post-natural disaster redevelopment work;

b. Placing funds with organizations that will have the long-term scope, organizational reach, and capacity to disburse funds to viable but capacity-constrained NGOs on the ground;

c. Build on previous models (in Pakistan, for instance [ii]) that encourage donors to make long-term incremental pledges rather than one-off donations.

Finally, we would also encourage all members of the Harvard Community to go beyond disaster relief support to consider the deep and enduring problem of Haiti's underdevelopment. Some, such as columnist David Brooks of the New York Times ("The Underlying Tragedy" Jan 14, 2010 [iii]), have simplified and distorted the issue by advancing an argument that it is Haiti's 'culture' that has determined its poverty. Harvard Professor Paul Farmer, someone who knows Haiti better than Mr. Brooks, reminds us that "systemic studies of extreme suffering suggest that the concept of culture should enjoy only an exceedingly limited role in explaining the distribution of misery...'Culture' does not explain suffering; it may at worst furnish an alibi" (Pathologies of Power (2003), pp 48-49). Here that alibi - Brooks' idea that one should blame voodoo for Haiti's underdevelopment (also demeaning a value system, while apotheosizing Judeo-Christian ethics as the standard bearer) - encourages an elision of the far more relevant political and economic causes of Haiti's underdevelopment. To wit, Haiti's 20th century has been characterized by direct and indirect U.S. military occupation and domination. In the 1910s, the US invaded and occupied directly, at which point it literally rewrote the Haitian Constitution to allow ownership and exploitation of Haitian resources by foreign capital, and where it refashioned the police in order to put down peasant resistance to these policies (an operation where 50,000 peasants may have died).  Throughout the rest of the century the US supported Haitian military coups and presided over unsustainable extraction of natural resources by transnational corporations. It was no accident that the agriculture sector collapsed, massive out-migration resulted, and diseases like AIDS run rampant. These are not accidents of history, but clear results of geopolitical and global economic machinations (see Farmer's AIDS and Accusation: Haiti and the Geography of Blame, 1992: pp 178-190).

Therefore, fighting reactionary and opportunistic discourses such as Brooks', both in our Harvard Community and beyond, is the responsibility of those here committed to justice. Indeed, speaking back to the Brooks's is a critical aspect of "what we can do to help, " provided that it duly leads to a deeper interrogation into the ways in which we are complicit in the political-economic foundations that exacerbate disasters like these, and to the extent that such an interrogation spurs a commitment to work to alter systems and structures that allow such exploitation to endure. By participating in this kind of justice project we seek to prevent similar degrees of suffering in the future, for Haitians and for millions of others across the underdeveloped world alike.

Sincerely,

Elliott Prasse-Freeman, Dalia Al Kadi, Marcos Ferreriro


[i] The Economist describes the negative effects of an overflow of funds during the Tsunami, and outlines the potential relevance now for Haiti

[ii] http://www.developpakistan.org/Default.aspx?tabid=149

[iii] New York Times, January 14, 2010

 

Executive Summary: Second Year Policy Analysis

April 6, 2010
Below is the executive summary of my Second Year Policy Analysis, entitled "Domestic Broadband Infrastructure Policy: Laying the Foundation for the Future of ICT in Tanzania."  It examines the Tanzanian government's policy regarding national backbone infrastructure.  Email me if you'd like to read the full paper.
 
* * *

With the recent launch of its submarine fiber-optic cable, SEACOM removed the most significant historical constraint to East African broadband connectivity.  Nonetheless, lack of adequate domestic infrastructure still prevents widespread broadband adoption and the Tanzanian government has enacted very proactive policies in response.  Determined to catalyze investment, the government recently began building a national fiber-optic backbone.  Because the substantial fixed costs of fiber networks are largely capacity independent, aggregating traffic in a single backbone can significantly lower the cost of broadband service provision.  By encouraging private companies to utilize the government-owned backbone, Tanzania’s policy seeks to maximize cost efficiency and to enable the private sector to focus on last mile infrastructure, content, and application services.

Of concern, in the two years since Tanzania’s backbone policy was first put in place, the market has shifted rapidly.  Currently the private sector is eager to invest in national backbone infrastructure on a cost effective basis, which implies public investment at the scale of the existing policy is no longer required.  Additionally, the current policy carries substantial risks that remain unmitigated in implementation to date: 1) the government’s ownership of a single national backbone may bias policy decisions; 2) a public monopoly limits incentives for efficiency and current costs for the national backbone are higher than industry norm; 3) the government’s participation in the retail market through the government-owned Tanzania Telecommunications Company Limited (TTCL) compromises neutral management of the backbone and exacerbates the concerns outlined above.  As a consequence of these issues, the current policy risks undermining the very objectives it was formulated to achieve.

Recommendations for policy improvements must consider the substantial government investment to date.  Furthermore, the government must take care to foster private investment and competition without creating market inefficiencies.  By selling conditional indefeasible rights of use (IRUs) and dark fiber across the government-owned national backbone, Tanzania can enable competition in the wholesale broadband market alongside a consolidated infrastructure.  Offering IRUs and dark fiber will shift capital away from duplicative investments in new networks and allow the government to quickly recover a substantial portion of its investment.  This approach will achieve scale in the national backbone and foster competition in the last mile, updating the current policy in light of the changes that have occurred in the market since its inception.  Furthermore, these policies do not carry the significant implementation risks currently observed.

 

When Life (and School) Gets in the Way

April 6, 2010
Apologies for the long respite from postings.  Responsibility largely lies with my Second Year Policy Analysis paper (i.e. my thesis), which commanded every ounce of bandwidth I had to give (and then some).  Then for a few weeks, life got in the way.

But I am back, and I have a long list of things to say...

 
 

Random Evaluation in the Real World

February 19, 2010
 
Ken Bank's recent post "Social Mobile and the Missing Metrics" really started my wheels turning. Among many other things, it started me thinking about how we could be smarter in implementation so as to facilitate true impact evaluation.

The first thing that came to mind is Oportunidades, formerly known as Progressa, the famous social assistance program in Mexico that made cash transfers contingent on school attendance and visits to health clinics.  When Opportunidades rolled out, they couldn't scale immediately due to limited resources.  So what they brilliantly did was randomized recipients, which enabled rigorous evaluation of the program's impact.  And so I thought, why can't we scale up mobile technologies (and other interventions for that matter) in the same way?

Surely we can, but as soon as I put more thought into it, I realized there are inherent limitations.  Any well run organization will put some serious thought into how it scales up its efforts.  The decision of where to go next will likely be based on criteria such as where the problem it is addressing is most acute, where partner organizations are operating to ease implementation, where donors want them to go, where talent is available, etc etc etc.  The greater the resource constraints, the more important it becomes to be strategic in expansion decisions.  That's smart management.  

Unfortunately, it also creates a real problem for rigorous evaluation.  Since the "treatment" areas are chosen based on systematic criteria, this creates selection bias.  If you wanted to understand how microfinance effects a typical rural village you'd have to randomly assign microfinance access to a set of typical rural villages.  But MFIs don't expand by dropping pins on the map, they'd choose villages based on criteria such as income level.  So what's the way out? How can we think about evaluations in a world that for very good reason does not target the average of its expansion opportunities?

It doesn't make sense that organizations would randomize expansion in order to facilitate evaluation, especially where resources are limited.  What does make sense though, it that they could randomize expansion in some way among the subset that does meet the criteria.  For example, when FrontlineSMS:Medic expands to a new partner, they could roll out the technology to a subset of clinics and wait 6-12 months to roll it out fully, evaluating its impact in the interim.  This wouldn't give us an answer to how the technology effects health in the developing world at large, but it would give us an answer to the technology's impact in places where partners showed interest in utilizing SMS to improve rural healthcare. 

Bottom line being that if we're going to get smarter about random evaluation in the real world, it's going to be constrained by the way the real world actually operates.  We might not find answers to how our interventions impact the world at large, but at least we'll start to have answers to how our interventions impact the world we focus on.

 
 
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