Cost-benefit Calculations Research Articles

To work or to study? Postmigration educational investments of adult refugees in Germany – Evidence from a choice experiment

In this article, we analyze individual factors and situational conditions under which immigrants are more or less likely to invest in host country-specific human capital. Theoretically, we root our expectations in a strand of the immigrant human capital investment model combined with a basic model of educational decisions. Using a choice experiment, we simulate a decision process among refugees in Germany and examine the determinants of investment preferences into host country-specific credentials, such as vocational education, as an alternative to an immediately available job offer. The choice experiment was introduced in the IAB-BAMF-SOEP Survey of Refugees, a representative longitudinal survey of recently arrived refugees in Germany. We find that refugees’ intentions of investing in vocational education are guided by the transferability of foreign human capital, the time horizon to reap investments, and rational cost–benefit calculations. The probability of success is influential on its own but also bolsters the relevance of costs and benefits in educational choices.

Pharmacoeconomic analysis of pertuzumab in treatment of HER2-positive breast cancer in Ukraine

Background. The incidence of breast cancer tends to be increasing worldwide in recent years. It is characterized by various clinical manifestations and potential treatment approaches. The choice of treatment strategy, its sequence as well as the efficiency of administered chemotherapy is quite relevant these days.
 Purpose – assessing economic feasibility of targeted therapy with pertuzumab (Perjeta®) in patients with metastatic HER2+ BC from the perspective of the health care system of Ukraine.
 Materials and methods. The treatment outcomes as well as related costs were determined by means of Markov analytical modelling based on a randomized multicenter open clinical study of CLEOPATRA phase III [2]. The model time horizon was 20 years. The alternative schemes of frontline therapy of metastatic HER2+ breast cancer were compared: PTD regimen pertuzumab + trastuzumab + docetaxel and TD regimen trastuzumab + docetaxel. Based on Markov modelling, pharmacoeconomic analysis by means of cost-effectiveness and cost-utility methods was carried out. As an efficiency criterion, LYG amount was used, as a utility criterion − QALY indicator. Direct medical costs were counted, the structure of which had been determined according to the current Protocol. The cost of drugs was calculated in accordance with the Register of wholesale prices for pharmaceuticals of the Ministry of Health of Ukraine; the cost of treatment procedures was determined in accordance with the available price lists of paid medical services provided by licensed medical institutions. Discounting at the level of 3 % per year was applied. Sensitivity analysis of the outcomes was carried out before pertuzumab price changed.
 Results. According to the modelling, the average life expectancy of patients with HER2+ BC, receiving PTD scheme is 15.69 years compared to 13.95 years in the TD group. Along with prolonging life, associated with PTD scheme, its quality increases. Patients in the TD group gain 7.8 QALY on average, while in the PTD group it is 9.24. The total expenses for the simulated (involved into modeling) study period in the PTD group averaged UAH 1 970 369.6 per patient, in the TD group − UAH 732 517.7. ICER (cost of 1 additional life year) and ICUR (cost of 1 additional qualityadjusted life year) incremental coefficients amounted to UAH 710924.6 and UAH 861175.4 respectively.
 Conclusions. 1. Pertuzumab target drug is an effective pharmaceutical when administered to patients with metastatic HER2 + breast cancer. 2. The frontline therapy regimen for patients with metastatic HER2 + breast cancer with pertuzumab being included is more expensive in comparison with trastuzumab + docetaxel regimen; at the same time it makes it possible to achieve better results, i. e. to provide on average extra 1.74 life years and 1.44 QALY in 20-year perspective. 3. Pharmacoeconomic analysis based on Markov model and cost-effectiveness and cost-benefit calculations make it possible to consider pertuzumab (Perjeta®), included into frontline targeted therapy regimen of trastuzumab + docetaxel in patients with metastatic HER2+ breast cancer, as an economically feasible medical technology under current health care conditions in Ukraine.

Anterior Cingulate Cortex Lesions Abolish Budget Effects on Effort-Based Decision-Making in Rat Consumers.

Demand theory can be applied to analyze how animal consumers change their selection of commodities in response to changes in commodity prices, given budget constraints. Previous work has shown that demand elasticities in rats differed between uncompensated budget conditions in which the budget available to be spent on the commodities (e.g., the finite number of discrete operants to "purchase" rewards in two-alternative fixed-ratio schedules) was kept constant, and compensated budget conditions in which the budget was adjusted so that consumers could potentially continue to obtain the original reward bundles. Here, we hypothesized that rat anterior cingulate cortex (ACC) was necessary to produce this budget effect on demand elasticities. We applied excitotoxic or sham lesions to ACC in rats performing an effort task in which the prices of liquid vanilla or chocolate rewards (the effort required to obtain rewards) and the budget (the total number of operants) was manipulated. When reward prices changed, and the budget was compensated, all rats adjusted their demand for chocolate and vanilla accordingly. In sham-lesioned rats, changes in demand were even more pronounced when the budget was not compensated for the price changes. By contrast, ACC-lesioned animals did not show this additional budget effect. An in-depth comparison of the rats' choice patterns showed that, unlike sham rats, ACC-lesioned animals failed to maximize session-bundle utility after price/budget changes, revealing deficits in higher-order choice-strategy adaptations. Our results suggest a novel role of ACC in considering purchasing power during complex cost-benefit value computations.SIGNIFICANCE STATEMENT Anterior cingulate cortex (ACC) is important for allocating effort in cost-benefit calculations in animals and humans. Economic theory prescribes that the value of the costs in cost-benefit analyses not only depends on the net nominal costs required to purchase a reward, but also on the available budget resources, i.e., on the budget's "purchasing value." We asked whether ACC, a region implicated in effort-based decision-making and reward comparisons, is required for computing the value of effort relative to a budget constraint. Applying demand theory to describe rat choices in a rodent effort allocation task with varying effort prices and budgets, we show that ACC integrity was necessary for computing purchasing power, a core variable in economic choice theory.

Analyzing Mass Attitudes Toward the International Court of Justice

AbstractThis paper analyzes public attitudes about the International Court of Justice (ICJ). We explore two questions: (1) Why are some people in favor of submitting their country's disputes to the ICJ while others are opposed? (2) How can we explain variations in public support for compliance with a costly ICJ ruling? We argue that individual-level attitudes about both issues are driven by different psychological dynamics. While we expect that cost–benefit calculations and cosmopolitan social identity will affect attitudes in both contexts, people's views on compliance should also be shaped by their level of social dominance orientation (SDO). Our statistical analysis is based on original survey data, collected in Belize in April 2019. We obtain three main findings. First, people's ex ante beliefs about the costs of an ICJ ruling have tangible effects on attitudes toward ICJ adjudication. As predicted, higher expected costs lead to decreased support for adjudication. Second, cosmopolitanism is positively associated with support for adjudication, but it has no effect on attitudes about compliance with international court rulings. Third, high-SDO respondents are less likely to favor the implementation of a costly ICJ verdict. However, SDO only reduces support for compliance in individuals with narrow social identity attachments.

Analytical Framework for Homeowner-Focused Computational Cost-Benefit Mitigation Decision Making

As a result of increasing windstorm losses in the United States over the past 50 years, a variety of residential wind hazard mitigation strategies have been recommended. Wind hazard mitigation undoubtedly reduces windstorm losses; however, little customized information is available to support the economic decision-making process for individual stakeholders, especially at the consumer level. Therefore, there is a need for decision support tools to calculate, evaluate, and present the economic benefits of mitigation over variable decision-making time horizons for unique building characteristics in specific geographical locations. This paper presents a cost-benefit computational decision-making recommendation framework that evaluates and presents the cost effectiveness of mitigation, customized based on location, years of interest, and building characteristics. The decision-making framework consists of two cores. The user-independent core and user-dependent core which consists of eight steps, divided into four subprocesses: (1) data acquisition, (2) data evaluation, (3) cost-benefit calculation, and (4) results comparison and decision making. To demonstrate the framework, a wood-framed single-family home in light suburban terrain in Golden Meadow, Louisiana, is used as a case study, considering retrofit mitigation with a $15,000 budget and a decision-making time horizon of 30 years. The case study provides six mitigation options, with cost ranging between approximately $2,000 and $15,000 and net benefit/cost ratios ranging from 2.4 to 13. Once fully implemented in a decision making information tool, the developed mitigation recommendation framework will provide valuable information that can be used by home designers, builders, owners, and other stakeholders to better understand the economic facets of wind hazard mitigation, providing critical information as part of the overall decision-making process.

Anti-Modalities

Constitutional argument runs on the rails of “modalities.” These are the accepted categories of reasoning used to make claims about the content of supreme law. Some of the modalities, such as ethical and prudential arguments, seem strikingly open ended at first sight. Their contours come into clearer view, however, when we attend to the kinds of claims that are not made by constitutional interpreters—the analytical and rhetorical moves that are familiar in debates over public policy and political morality but are considered out of bounds in debates over constitutional meaning. In this Article, we seek to identify the “anti-modalities” of constitutional law and to investigate their implications. The anti-modalities both stabilize and undermine the modalities. On the one hand, they work in tandem to ensure that constitutional interpretation remains a distinctive legal enterprise. The two argument bundles are in this sense mutually reinforcing, even co-constitutive. On the other hand, by ruling out various important categories of reasoning—from general moral theory to emotional judgment to many cost-benefit calculations—the anti-modalities put continuous pressure on the modalities to accommodate such reasoning in adulterated forms, or else insist on a long distance between the inputs into supreme law and the concerns that most people care about. We call this distance constitutional law’s “resonance gap.” Such a gap arises in all areas of law, but it is especially pronounced in the constitutional realm. Although the anti-modalities play a critical role in preserving the law/politics distinction, they have deleterious consequences for each side of that line. The best response, this Article suggests, is not necessarily to narrow the resonance gap but rather to narrow the domain of constitutional law. If constitutional argument must exclude (or purport to exclude) vital modes of reasoning, we might worry less about refining its grammar and more about restricting its reach.

Emergency room and major trauma treatment is a"loss-making business" : ASwiss trauma center experience with current DRG reimbursement

HintergrundEs galt herauszufinden, wie kostendeckend die Versorgung potenziell Schwerverletzter in einem Schweizer Traumazentrum ist, und inwieweit Spitalgewinne bzw. -verluste mit patientenbezogenen Unfall‑, Behandlungs- oder Outcome-Daten korrelieren.MethodikAnalyse aller 2018 im Schockraum (SR) bzw. mit Verletzungsschwere New Injury Severity Score (NISS) ≥8 notfallmäßig stationär behandelter Patienten eines Schwerverletztenzentrums der Schweiz (uni- und multivariate Analyse; p < 0,05).ErgebnisseFür das Studienkollektiv (n = 513; Ø NISS = 18) resultierte gemäß Spitalkostenträgerrechnung ein Defizit von 1,8 Mio. CHF. Bei einem Gesamtdeckungsgrad von 86 % waren 66 % aller Fälle defizitär (71 % der Allgemein- vs. 42 % der Zusatzversicherten; p < 0,001). Im Mittel betrug das Defizit 3493.- pro Patient (allg. Versicherte, Verlust 4545.-, Zusatzversicherte, Gewinn 1318.-; p < 0,001). Auch „in“- und „underlier“ waren in 63 % defizitär. SR-Fälle machten häufiger Verlust als Nicht-SR-Fälle (73 vs. 58 %; p = 0,002) wie auch Traumatologie- vs. Neurochirurgiefälle (72 vs. 55 %; p < 0,001). In der multivariaten Analyse ließen sich 43 % der Varianz erhaltener Erlöse mit den untersuchten Variablen erklären. Hingegen war der ermittelte Deckungsgrad nur zu 11 % (korr. R2) durch die Variablen SR, chirurgisches Fachgebiet, Intensivaufenthalt, Thoraxverletzungsstärke und Spitalletalität zu beschreiben. Case-Mix-Index gemäß aktuellen Diagnosis Related Groups (DRG) und Versicherungsklasse addierten weitere 13 % zu insgesamt 24 % erklärter Varianz.DiskussionDie notfallmäßige Versorgung potenziell Schwerverletzter an einem Schweizer Traumazentrum erweist sich nur in einem Drittel der Fälle als zumindest kostendeckend, dies v. a. bei Zusatzversicherten, Patienten mit einem hohen Case-Mix-Index oder einer IPS- bzw. kombinierten Polytrauma- und Schädel-Hirn-Trauma-DRG-Abrechnungsmöglichkeit.Zusatzmaterial onlineDie Online-Version dieses Beitrags (10.1007/s00113-020-00937-w) enthält weitere Tabellen und Abbildungen (s. Verweise „Zusatzmaterial online: Abb.“ bzw. „Zusatzmaterial online: Tab.“ im Text). Beitrag und Zusatzmaterial stehen Ihnen auf www.springermedizin.de zur Verfügung. Bitte geben Sie dort den Beitragstitel in die Suche ein, das Zusatzmaterial finden Sie beim Beitrag unter „Ergänzende Inhalte“.

The micro-politics of corporate responsibility: How companies shape protest in communities affected by mining

Abstract This article analyzes how corporate social responsibility (CSR) affects individual incentives to engage in protest against mining companies. The study finds that CSR practices provide selective incentives to individuals that increase the perceived costs and reduce the benefits of engaging in collective action against the firm. This individual cost-benefit calculation is affected through discursive, institutional and distributive mechanisms. When CSR practices function to reduce perceptions of uncertainty and risk associated with the mining project, channel public participation through legitimate institutional forums, and distribute material benefits broadly, they increase individual perceptions of the costs of protest against companies. The study is based on a comparative analysis of eight cases of firm-community relationships in Argentina and Chile, and provides strong empirical evidence for the role of CSR in the everyday depression of incentives to protest in mining communities. The article offers a novel framework for understanding corporate social responsibility that theorizes the social practices of companies in terms of their effects on individual incentives to engage in collective action, which is fully compatible with the contentious politics approach, and adds analytical power and nuance to existing efforts to understand social conflicts.

Selection of IoT-based technology for electric smart meter on PLN Disjaya

With so many platforms or protocols developed by several organizations or institutions, such as LoRa, NB-IoT and SigFox that have their own advantages and limitations. While it takes a large and long-term investment to deliver IoT technology. Apart from that, losses caused by the use of conventional meters on electricity customers cause a decrease in income by electricity supply companies. In this study aims to choose the internet-based technology of things for electricity smart meters in the PLN Disjaya region between three LoRa, NB-IoT and Sigfox technologies. This research is doing network design, coverage analysis, capacity analysis and network utilization, cost benefit calculation and analysis, data rate speed and proprietary. From the analysis results obtained SigFox superior in terms of coverage, capacity and network utilization, cost benefits (NPV, IRR, Payback Period, BCR, ROI), LoRa superior in terms of proprietary and NB-IoT superior in terms of data rate speed.

Land Trafficking and the Fertile Spaces of Legality

AbstractLand trafficking, responsible for the unprecedented rate of urbanization in many Latin American cities, is often conceptualized through corruption as ‘abuses of public office for private gain’. While those involved in the practice rely at times on violence and illegality, their repertoire is sophisticated, allowing them to move in and out of legality as part of their cost–benefit calculations. In this article I argue that land trafficking is based on legalized corruption. I use an ethnographic approach to observe the strategic conduits that are technically embedded in, and opportunistically related to, different municipal processes to legalize illegality. I demonstrate how land traffickers use morphing possibilities between land tenure types (communal, private and government) and mimic development typologies that have gained legitimacy over time. I also show how conflicting, competing and humanitarian rationalities that characterize the state play a crucial role in promoting land trafficking, by grafting illegality and violations onto ‘formal’ practices.

Human Rights-inspired Governmentality: COVID-19 through a Human Dignity Perspective

The paper aims to reconstruct the debate over the pandemic in Italy to highlight the logic of the discourse that guided the various voices. The two governmentalities that have monopolized the public and political debate are biomedical and economic. The former brought the defense of biological life ( zoé) as the ultimate element of truth and legitimacy of the government’s action. The latter, based the “true” justification upon a careful cost–benefit calculation and the protection of the interests of homo oeconomicus. The debate lacked a “social” perspective capable of placing dignity and human rights as a compass for intervention. What has been lost by limiting the question to a choice between defending bare life or defending economic interests? Behind an apparent impartial universalism that would drive both biomedical and economic logic, there emerges a form of discrimination and lack of protection for specific sectors of society, in particular the marginal ones.

How involved are involved fathers in Hungary? Exploring caring masculinities in a post-socialist context

This study examines what can enable or constrain Hungarian fathers to be actively involved in care through analysing interviews by applying Hanlon’s approach to caring masculinities as valued identities for men and Dermott’s concept of intimate fathering. The empirical base of this qualitative study – the first of its kind in Hungary – is a collection of 55 semi-structured in-depth interviews. Several interrelated factors were shown as potentially enabling or constraining men’s active engagement in their paternal role, including work- and work–life balance-related factors, practical cost-benefit calculations, quality of life concerns, childhood socialisation patterns and attitudes towards the gendered parenting models of one’s own parents.

Feasibility Assessment of Converting Forest Into Palm Oil Plantation and Its Implication for Forest Policy and Palm Oil Sustainability Challenges: A Case Study in Melawi Regency of West Kalimantan Province, Indonesia

The massive development of oil palm plantations puts significant pressure on forest converting in Melawi Regency, West Kalimantan Province. This is supported by the target of opening 200,000 ha of new oil palm plantations in West Kalimantan Province until 2034. Meanwhile, deforestation is the most critical climate change issue in tropical countries including Indonesia. This research examines the feasibility of clearing forest areas to be converted to palm oil plantations. This research employs the insurance approach to assess the benefits of forest ecosystems. Based on the calculation of the cost-benefits of financial and environmental feasibility, it is found that the protection of forest ecosystems is more feasible than opening palm oil plantations. However, based on the socio-economic cost-benefit calculation results, it is found that opening palm oil plantations is more feasible to implement than ecosystem protection activities. Finally, from the calculation of the total benefits-cost financial, environmental, and socio-economic feasibility, it is found that forest ecosystem protection activities are more feasible to implement than opening palm oil plantations. Another finding stated that an opening of 10,000 ha forest area for palm oil plantations would cause 6.4401 times more damage than the benefits that might be obtained if 10,000 ha of forest area ecosystem is not converted into a palm oil plantation area.

New Directions in Macroeconomics

The glaring failure of modern macroeconomics to predict the Global Financial Crisis, and to provide remedies for the Great Recession which followed, has led to renewed interest in alternative approaches to Macroeconomics. There is huge amount of ongoing work aimed at creating a Macroeconomics for the 21st Century. The task is of the highest priority, as failures of economic theory have led to misery for millions. Wrong measures of GDP, and cost-benefit calculation which fail to account for environmental costs, and prioritize private profits over social welfare, have created a climate catastrophe which threatens to destroy the planet. In accordance with the importance of this task, we are expanding the scope of this journal, to cover all new approaches to economics, which fall outside of the boxes of conventional macro, micro, and econometrics of the 20th Century. This article outlines seven broad categories of research directions, and four different methodological principles which fall outside the boundaries of the conventional approach, and offer promise for building a Macroeconomics for the 21st Century. We hope to invite contributions in these areas for future issues.

Homeless without benefits: the non-take-up problem

Despite the extensive literature on non-take-up of rights in welfare states, the problem has been little studied in relation to homelessness specifically. Part of a larger research project on homelessness services, the present study examined the issue in Israel. The review of the literature points to methodological problems in assessing non-take-up, which may be reduced by using administrative data. Based on questionnaire responses of 107 participants working with people experiencing homelessness, 13 interviews, grey literature and quantitative administrative data, the findings suggest that in 2016, only 38% and 48% of people experiencing homelessness in Israel have taken up income and rent support, respectively, due to structural and bureaucratic barriers and cost-benefit calculations that factor in social stigmas. Ways of reducing bureaucratic barriers and ensuring welfare provision to prevent and end homelessness are discussed, as is the possibility of institutional compassion as a way of increasing take-up.

Prediction of trust propensity from intrinsic brain morphology and functional connectome.

Trust forms the basis of virtually all interpersonal relationships. Although significant individual differences characterize trust, the driving neuropsychological signatures behind its heterogeneity remain obscure. Here, we applied a prediction framework in two independent samples of healthy participants to examine the relationship between trust propensity and multimodal brain measures. Our multivariate prediction analyses revealed that trust propensity was predicted by gray matter volume and node strength across multiple regions. The gray matter volume of identified regions further enabled the classification of individuals from an independent sample with the propensity to trust or distrust. Our modular and functional decoding analyses showed that the contributing regions were part of three large‐scale networks implicated in calculus‐based trust strategy, cost–benefit calculation, and trustworthiness inference. These findings do not only deepen our neuropsychological understanding of individual differences in trust propensity, but also provide potential biomarkers in predicting trust impairment in neuropsychiatric disorders.

Working Paper 33: A worm’s-eye view of wildlife trafficking in Uganda

This Working Paper is a key output of the Basel Institute's Green Corruption programme, a multi-disciplinary engagement that targets environmental degradation through tested anti-corruption, asset recovery and governance methods. The research is funded by PMI Impact as part of a wider project on intelligence-led on financial crime in illegal wildlife trade (IWT).&#x0D; The fight against wildlife trafficking is a global one. Wildlife trafficking constitutes the fourth-largest form of illicit trade flow in the world. Its prevalence is often explained in economic terms: it is a “low-risk, high-profit” trade. Global efforts are therefore directed at increasing the “costs” of wildlife trafficking and reducing the rewards.&#x0D; However, rational cost-benefit calculations by individuals seeking personal economic gain do not fully explain why wildlife trafficking is so prevalent. Nor, therefore, will it be solved by passing new laws and strengthening law enforcement alone. Scholars as well as development and law enforcement practitioners increasingly recognise the importance of considering the way in which the local context and socio-cultural structures (so-called behavioural drivers) influence the behaviours of individuals and their propensity to engage in wildlife trafficking.&#x0D; This social context is not only an anchor for decision-making but also influences the strategies through which wildlife trafficking is organised. Individuals are part of informal networks. Social connections in and between the networks facilitate the transportation of wildlife products from poachers to buyers across vast geographical spaces. Public officials can be part of such networks too. In such cases those individuals, rather than enforcing the law, use their position to cover up the trafficking of wildlife products out of parks, cities and ports in East Africa.&#x0D; This approach of emphasising context-sensitive behavioural drivers anchors the research activities that the Public Governance division is leading in Uganda as part of the wider programme of work of the Institute. Uganda is a hub for wildlife trafficking in East Africa. High volumes of wild animal products are transported into, through and out of Uganda using various methods and strategies. Taking a worm’s-eye perspective, the research aims to provide further understanding on:&#x0D; &#x0D; Why wildlife trafficking happens, by focusing on the economic and behavioural drivers of wildlife trafficking and the role of the broader governance environment in generating increased corruption risks in public offices mandated to prevent and combat wildlife trafficking.&#x0D; How wildlife trafficking happens, by focusing on the role and strategies employed by informal networks of poachers, middlemen and buyers to transport high volumes of wildlife products into, through and out of Uganda.&#x0D; &#x0D; The findings are based on 47 interviews with Ugandan-based and international anti-IWT experts (IGOs, NGOs, academics and public officials) and 8 focus group discussions with wildlife conservation and anti-corruption experts in Kampala, members of reformed poachers’ networks in Western Uganda, and individuals living around a wildlife habitat in Northern Uganda. Together, these provide context-specific insights on the drivers and facilitators of wildlife trafficking in Uganda. The present report synthesises their observations and aims to contribute to the development of evidence-informed approaches to curbing the trade.

An exploratory examination of organizational insiders’ descriptive and normative perceptions of cyber-relevant rights and responsibilities

Within the field of organizational cybersecurity, much attention has been given to insider compliance and non-compliance with the information security policies (ISPs) set forth by their organizations. Most of these efforts apply theoretical foundations based on self-interest, personal incentive, and cost-benefit calculations to explain compliance and non-compliance motives. We take a different approach to understand insiders’ ISP compliance by exploring how insiders view their rights and responsibilities related to security-relevant behaviors. Relying on Deonance Theory, we assess the extent to which insiders categorize a wide variety of behaviors that are or can be implemented in corporate ISPs according to several deontic conditional operators (e.g., nature of perceived requiredness). These operators form the basis for a rights and responsibility framework. We find that out of 38 unique security-relevant behaviors, 22 exhibit one or more forms of potential moral “gray area” patterns. Among these patterns, significant differences between insiders’ descriptive (i.e., “is”) and normative (i.e., “should be”) assessments of rights and responsibilities perceptions are particularly interesting. Our findings shed additional light on insiders’ compliance with organizational ISPs when those ISPs place increased restrictions on what the insider must or must not do.

The ABCs of Covid-19 prevention in Malawi: Authority, benefits, and costs of compliance.

A wide array of authorities-from religious leaders to government ministers-call upon citizens to take preventative measures against Covid-19. Which authorities can most effectively gain public compliance, and which measures will the public take up? Moreover, do people comply with authorities out of respect for their legitimacy, due to their expertise, or for fear of sanctioning? Answers to these questions are important for development practitioners, who need to understand how different partnerships might affect health behavior, and for scholars interested in understanding authority, legitimacy, and compliance. We explore these questions using a conjoint experiment embedded in a telephone survey of 641 Malawians. Individuals in our sample are more likely to say that they will comply with precautionary measures when the costs are low and expected benefits are high. Respondents view both traditional authorities and hospital heads as legitimately issuing directives and having the ability to monitor and sanction non-compliance, but appear to comply more with hospital heads and to do so out of respect for their expertise. These results emphasize how who issues directives affects whether individuals comply and provides insights as to why they do so. The findings also reflect individuals' cost-benefit calculations when considering precautionary measures, highlighting the importance of steps that can reduce costs (e.g., food security or income measures) or accurately reflect risks (e.g., information signaling the prevalence of Covid-19). The study not only helps to address the Coronavirus crisis but also has important implications for broader questions of authority and compliance.

Revisiting Economic Costs of Arsenicosis

The present paper uses the propensity score matching (PSM) method to calculate the economic loss of arsenicosis-affected households. In contrast to prior studies, whose estimates of income loss were limited to labour-market sources, the PSM method controls for labour market and other sources of income, as well as demographic and educational factors, to identify losses from social discrimination. It first establishes that arsenicosis-affected households are subject to social discrimination, and then shows that this leads to a significant loss of expenditure. Second, it proves that overlooking social discrimination leads to an underestimation of income loss. The results have important implications, both for understanding the plight of arsenicosis-affected households and for cost–benefit calculations in the adoption of policies for fighting arsenic contamination.