Mylene Lagarde
Biographic Data
| ID | 1262641 |
|---|---|
| NAME | Mylene Lagarde |
| GIVEN NAMES | Mylene |
| FAMILY NAME | Lagarde |
| SIGNATURE | LAGARDE M |
| AFFILIATIONS | London School of Economics and Political Science |
| ORCID | 0000-0002-5713-2659 |
| VERIFIED | Yes |
| TOTAL WORKS | 23 |
| TOTAL CITATIONS | 22 |
| WORKS AS AUTHOR | 23 |
| WORKS AS EDITOR | 0 |
| FIRST PUBLICATION YEAR | 2007 |
| LATEST PUBLICATION YEAR | 2026 |
| H-INDEX | 3 |
Dynamic and heterogeneous impacts of granting and revoking elective c-section rights in São Paulo
Elective caesarean sections (c-sections) present a significant public health challenge due to associated health risks and increased costs. This study examines the causal impacts of a unique natural experiment in São Paulo, Brazil: Law 17,137/2019, which temporarily allowed pregnant women to opt for c-sections in public healthcare facilities. Using a difference-in-differences estimator, we analyse the Law's effects on c-section rates across variou…
Framing of sensitive topics in surveys measuring corruption in healthcare
Corruption is a costly, consequential and complex phenomenon facing healthcare systems globally. Measuring the prevalence of petty corruption, such as bribery and informal payments, is challenging due to the hidden and sensitive nature of these exchanges. This paper explores how question framing influences estimates of informal payment prevalence in doctor-patient relationships in two steps. We analyze the responses from the Eurobarometer survey …
Better together? Group incentives and the demand for prevention
In a field experiment with 400 groups of informal entrepreneurs in El Salvador, we compare the impact of group incentives (linked to compliance of all members) to equivalent individual ones to encourage cardiovascular check-ups. We test two incentive designs: small rewards and lotteries. Group incentives are as effective as individual ones at increasing demand for prevention, but, unlike individual incentives, they fail to target those with poten…
The demand for private telehealth services in low- and middle-income countries
In low- and middle-income countries, many believe that telehealth services could significantly expand access to doctors by offering remote access at low cost. Yet, despite its convenience, telehealth care is limited by the absence of physical examination, point-of-care testing, or immediate treatment. Hence it is unclear how individuals value such options compared to standard face-to-face care. We study this issue in South Africa with general pra…
Levels and determinants of overprescribing of antibiotics in the public and private primary care sectors in South Africa
Although overprovision of antibiotics in primary care is a key driver of antibiotic resistance, little is known about its determinants in low-income and middle-income countries. Patient demand and financial incentives for providers are often held responsible for overprovision. Yet, inadequate provision exists in their absence and could be fuelled by quality of care issues and incorrect beliefs of providers regarding patients’ expectations. We exp…
The long-term effects of free care on birth outcomes
As women in many countries still fail to give birth in facilities due to financial barriers, many see the abolition of user fees as a key step on the path towards universal coverage. We exploited the staggered removal of user charges in Zambia from 2006 to estimate the effect of user fee removal up to five years after the policy change. We used data from the birth histories of two nationally representative Demographic and Health Surveys to implem…
Overtreatment and benevolent provider moral hazard
Overtreatment is widespread in health, with potentially dire consequences for patients, health systems and public health. It may be fueled by providers when they do not bear the cost of treatment (moral hazard), even they do not profit financially from it (i.e. benevolent providers). We test this hypothesis by creating an exogeneous change in the incentives faced by private doctors in South Africa. We find that provider moral hazard has no effect…
Can patients improve the quality of care they receive? Experimental evidence from Senegal
Providers in many low and middle-income countries (LMICs) often fail to correctly diagnose and treat their patients, even though they have the clinical knowledge to do so. Against the backdrop of many failed attempts to increase provider effort, this study examines whether quality of care can be improved by encouraging patients to be more active during consultations. We design a simple experiment with undercover standardised patients who randomly…
Overconfident health workers provide lower quality healthcare
Narratives of Promise, Narratives of Caution
Social Impact Bonds (SIBs) are a new mechanism for delivering public services. This article reviews the emerging SIB literature in high‐income settings. It identifies three distinct narratives: a public sector reform narrative; a financial sector reform narrative; and a cautionary narrative. These are analyzed relative to three themes: public versus private values; outcomes contracting; and risk allocation. The first two narratives are complement…
Measuring inequalities in the distribution of the Fiji Health Workforce
While populations with lower mortality tend to have a slightly greater share of health workers, the overall distribution of health workers on the basis of need is more equitable in Fiji than for many other LMICs. The overall shortage of health workers could be addressed by creating new cadres of health workers; employing increasing numbers of foreign doctors, including specialists; and increasing funding for health worker training, as already dem…
Physicians’ responses to financial and social incentives
Because compensation policies have critical implications for the provision of health care, and evidence of their effects is limited and difficult to study in the real world, laboratory experiments may be a valuable methodology to study the behavioural responses of health care providers. With this experiment undertaken in 2013, we add to this new literature by designing a new medically framed real effort task to test the effects of different remun…
Specialty training for the retention of Malawian doctors
One year of campaigns in Cameroon
BACKGROUND: Targeted campaigns have been reported to disrupt routine health services in low- and middle-income countries. The objective of this study was to evaluate the average effect of public health campaigns over 1 year on routine services such as antenatal care, routine vaccination and outpatient services. METHOD: We collected daily activity data in 60 health facilities in two regions of Cameroon that traditionally undergo different intensit…
The use of specialty training to retain doctors in Malawi
Emigration has contributed to a shortage of doctors in many sub-Saharan African countries. Specialty training is highly valued by doctors and a potential tool for retention. Yet not all types of training may be valued equally. In the first study to examine preferences for postgraduate training in depth, we carried out a discrete choice experiment as part of a cross-sectional survey of all Malawian doctors within seven years of graduation and not …
Equity in the allocation of public sector financial resources in low- and middle-income countries
Going beyond horizontal equity
Using decision mapping to inform the development of a stated choice survey to elicit youth preferences for sexual and reproductive health and HIV services in rural Malawi
Promoting healthy behaviours and improving health outcomes in low and middle income countries
How to do (or not to do) … Assessing the impact of a policy change with routine longitudinal data
A lack of good quality evidence on the effect of alternative social policies in low- and middle-income countries has been recently underlined and the value of randomized trials increasingly advocated. However, it is also acknowledged that randomization is not always feasible or politically acceptable. Analyses using longitudinal data series before and after an intervention can also deliver robust results and such data are often reasonably easy to…
PS47 Could Improved Training Opportunities Reduce Health Workforce Migration From Sub-Saharan Africa? Evidence From A Discrete Choice Experiment Among Pharmacists
Background Sub-Saharan Africa (SSA) suffers from acute shortages of all types of health workers, partly due to high rates of health workforce migration (HWM) to high-income countries. The role of non-financial incentives in HWM is inadequately defined and their potential as policy levers is overlooked. This study examined the hypothesis that improved local education opportunities could alter the relative uptakes of local and foreign training, ult…
Cost-effectiveness analysis of human resources policy interventions to address the shortage of nurses in rural South Africa
Conditional Cash Transfers for Improving Uptake of Health Interventions in Low- and Middle-Income Countries
CONTEXT: Cash transfers conditional on certain behaviors, intended to provide access to social services, have been introduced in several developing countries. The effectiveness of these strategies in different contexts has not previously been the subject of a systematic review. OBJECTIVE: To assess the effectiveness of conditional monetary transfers in improving access to and use of health services, as well as improving health outcomes, in low- a…
Physicians’ responses to financial and social incentives
Because compensation policies have critical implications for the provision of health care, and evidence of their effects is limited and difficult to study in the real world, laboratory experiments may be a valuable methodology to study the behavioural responses of health care providers. With this experiment undertaken in 2013, we add to this new literature by designing a new medically framed real effort task to test the effects of different remun…
The use of specialty training to retain doctors in Malawi
Emigration has contributed to a shortage of doctors in many sub-Saharan African countries. Specialty training is highly valued by doctors and a potential tool for retention. Yet not all types of training may be valued equally. In the first study to examine preferences for postgraduate training in depth, we carried out a discrete choice experiment as part of a cross-sectional survey of all Malawian doctors within seven years of graduation and not …
Going beyond horizontal equity
Using decision mapping to inform the development of a stated choice survey to elicit youth preferences for sexual and reproductive health and HIV services in rural Malawi
Specialty training for the retention of Malawian doctors
Cost-effectiveness analysis of human resources policy interventions to address the shortage of nurses in rural South Africa
Can patients improve the quality of care they receive? Experimental evidence from Senegal
Providers in many low and middle-income countries (LMICs) often fail to correctly diagnose and treat their patients, even though they have the clinical knowledge to do so. Against the backdrop of many failed attempts to increase provider effort, this study examines whether quality of care can be improved by encouraging patients to be more active during consultations. We design a simple experiment with undercover standardised patients who randomly…
Overconfident health workers provide lower quality healthcare
Conditional Cash Transfers for Improving Uptake of Health Interventions in Low- and Middle-Income Countries
CONTEXT: Cash transfers conditional on certain behaviors, intended to provide access to social services, have been introduced in several developing countries. The effectiveness of these strategies in different contexts has not previously been the subject of a systematic review. OBJECTIVE: To assess the effectiveness of conditional monetary transfers in improving access to and use of health services, as well as improving health outcomes, in low- a…
Promoting healthy behaviours and improving health outcomes in low and middle income countries
How to do (or not to do) … Assessing the impact of a policy change with routine longitudinal data
A lack of good quality evidence on the effect of alternative social policies in low- and middle-income countries has been recently underlined and the value of randomized trials increasingly advocated. However, it is also acknowledged that randomization is not always feasible or politically acceptable. Analyses using longitudinal data series before and after an intervention can also deliver robust results and such data are often reasonably easy to…
PS47 Could Improved Training Opportunities Reduce Health Workforce Migration From Sub-Saharan Africa? Evidence From A Discrete Choice Experiment Among Pharmacists
Background Sub-Saharan Africa (SSA) suffers from acute shortages of all types of health workers, partly due to high rates of health workforce migration (HWM) to high-income countries. The role of non-financial incentives in HWM is inadequately defined and their potential as policy levers is overlooked. This study examined the hypothesis that improved local education opportunities could alter the relative uptakes of local and foreign training, ult…
Cost-effectiveness analysis of human resources policy interventions to address the shortage of nurses in rural South Africa
Using decision mapping to inform the development of a stated choice survey to elicit youth preferences for sexual and reproductive health and HIV services in rural Malawi
Equity in the allocation of public sector financial resources in low- and middle-income countries
Going beyond horizontal equity
One year of campaigns in Cameroon
BACKGROUND: Targeted campaigns have been reported to disrupt routine health services in low- and middle-income countries. The objective of this study was to evaluate the average effect of public health campaigns over 1 year on routine services such as antenatal care, routine vaccination and outpatient services. METHOD: We collected daily activity data in 60 health facilities in two regions of Cameroon that traditionally undergo different intensit…
The use of specialty training to retain doctors in Malawi
Emigration has contributed to a shortage of doctors in many sub-Saharan African countries. Specialty training is highly valued by doctors and a potential tool for retention. Yet not all types of training may be valued equally. In the first study to examine preferences for postgraduate training in depth, we carried out a discrete choice experiment as part of a cross-sectional survey of all Malawian doctors within seven years of graduation and not …
Measuring inequalities in the distribution of the Fiji Health Workforce
While populations with lower mortality tend to have a slightly greater share of health workers, the overall distribution of health workers on the basis of need is more equitable in Fiji than for many other LMICs. The overall shortage of health workers could be addressed by creating new cadres of health workers; employing increasing numbers of foreign doctors, including specialists; and increasing funding for health worker training, as already dem…
Physicians’ responses to financial and social incentives
Because compensation policies have critical implications for the provision of health care, and evidence of their effects is limited and difficult to study in the real world, laboratory experiments may be a valuable methodology to study the behavioural responses of health care providers. With this experiment undertaken in 2013, we add to this new literature by designing a new medically framed real effort task to test the effects of different remun…
Specialty training for the retention of Malawian doctors
Narratives of Promise, Narratives of Caution
Social Impact Bonds (SIBs) are a new mechanism for delivering public services. This article reviews the emerging SIB literature in high‐income settings. It identifies three distinct narratives: a public sector reform narrative; a financial sector reform narrative; and a cautionary narrative. These are analyzed relative to three themes: public versus private values; outcomes contracting; and risk allocation. The first two narratives are complement…
Overconfident health workers provide lower quality healthcare
Can patients improve the quality of care they receive? Experimental evidence from Senegal
Providers in many low and middle-income countries (LMICs) often fail to correctly diagnose and treat their patients, even though they have the clinical knowledge to do so. Against the backdrop of many failed attempts to increase provider effort, this study examines whether quality of care can be improved by encouraging patients to be more active during consultations. We design a simple experiment with undercover standardised patients who randomly…
The long-term effects of free care on birth outcomes
As women in many countries still fail to give birth in facilities due to financial barriers, many see the abolition of user fees as a key step on the path towards universal coverage. We exploited the staggered removal of user charges in Zambia from 2006 to estimate the effect of user fee removal up to five years after the policy change. We used data from the birth histories of two nationally representative Demographic and Health Surveys to implem…
Overtreatment and benevolent provider moral hazard
Overtreatment is widespread in health, with potentially dire consequences for patients, health systems and public health. It may be fueled by providers when they do not bear the cost of treatment (moral hazard), even they do not profit financially from it (i.e. benevolent providers). We test this hypothesis by creating an exogeneous change in the incentives faced by private doctors in South Africa. We find that provider moral hazard has no effect…
Levels and determinants of overprescribing of antibiotics in the public and private primary care sectors in South Africa
Although overprovision of antibiotics in primary care is a key driver of antibiotic resistance, little is known about its determinants in low-income and middle-income countries. Patient demand and financial incentives for providers are often held responsible for overprovision. Yet, inadequate provision exists in their absence and could be fuelled by quality of care issues and incorrect beliefs of providers regarding patients’ expectations. We exp…
Better together? Group incentives and the demand for prevention
In a field experiment with 400 groups of informal entrepreneurs in El Salvador, we compare the impact of group incentives (linked to compliance of all members) to equivalent individual ones to encourage cardiovascular check-ups. We test two incentive designs: small rewards and lotteries. Group incentives are as effective as individual ones at increasing demand for prevention, but, unlike individual incentives, they fail to target those with poten…
The demand for private telehealth services in low- and middle-income countries
In low- and middle-income countries, many believe that telehealth services could significantly expand access to doctors by offering remote access at low cost. Yet, despite its convenience, telehealth care is limited by the absence of physical examination, point-of-care testing, or immediate treatment. Hence it is unclear how individuals value such options compared to standard face-to-face care. We study this issue in South Africa with general pra…
Framing of sensitive topics in surveys measuring corruption in healthcare
Corruption is a costly, consequential and complex phenomenon facing healthcare systems globally. Measuring the prevalence of petty corruption, such as bribery and informal payments, is challenging due to the hidden and sensitive nature of these exchanges. This paper explores how question framing influences estimates of informal payment prevalence in doctor-patient relationships in two steps. We analyze the responses from the Eurobarometer survey …
Dynamic and heterogeneous impacts of granting and revoking elective c-section rights in São Paulo
Elective caesarean sections (c-sections) present a significant public health challenge due to associated health risks and increased costs. This study examines the causal impacts of a unique natural experiment in São Paulo, Brazil: Law 17,137/2019, which temporarily allowed pregnant women to opt for c-sections in public healthcare facilities. Using a difference-in-differences estimator, we analyse the Law's effects on c-section rates across variou…
Medicine (17 works) · Economics (16 works) · Economic growth (15 works) · Global Maternal and Child Health (14 works) · Business (13 works) · Health care (13 works) · Incentive (8 works) · Environmental health (7 works) · Political science (7 works) · Public economics (7 works)