Rather than provide development assistance indefinitely, foreign aid donors increasingly seek to help communities sustainably provide local public goods themselves. We examine various strategies for sustainably fighting intestinal worms through voluntary local mobilization. Intestinal worms affect one in four people worldwide, but can be controlled by taking medicine twice annually. Since much of the resulting treatment benefit comes through reduced disease transmission, standard public finance analysis provides a rationale for subsidized treatment. Randomized evaluations suggest several efforts to replace subsidies with sustainable worm control measures were ineffective. A drug cost recovery program reduced take-up by 80%. A mobilization intervention designed to boost drug take up failed. Health education did not affect behavior. People were less likely to take drugs if randomly exposed to more information through their social network. In this context, using external interventions to promote sustainable voluntary provision of local public goods (like worm control) appears unrealistic.

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Improved health in low-income countries could considerably improve wellbeing and possibly promote economic growth. The last decade has seen a surge in field experiments designed to understand the barriers that households and governments face in investing in health and how these barriers can be overcome, and to assess the impacts of subsequent health gains. This chapter first discusses the methodological pitfalls that field experiments in the health sector are particularly susceptible to, then reviews the evidence that rigorous field experiments have generated so far. While the link from in utero and child health to later outcomes has increasingly been established, few experiments have estimated the impacts of health on contemporaneous productivity among adults, and few experiments have explored the potential for infrastructural programs to impact health outcomes. Many more studies have examined the determinants of individual health behavior, on the side of consumers as well as among providers of health products and services.