Social scientists should adopt higher transparency standards to improve the quality and credibility of research.

BackgroundRelatively few programmes have attempted to actively engage the private sector in national malaria control efforts. This paper evaluates the health impact of a large-scale distribution of insecticide-treated nets (ITNs) conducted in partnership with a Zambian agribusiness, and its cost-effectiveness from the perspective of the National Malaria Control Programme (NMCP).MethodsThe study was designed as a cluster-randomized controlled trial. A list of 81,597 cotton farmers was obtained from Dunavant, a contract farming company in Zambia’s cotton sector, in December 2010. 39,963 (49%) were randomly selected to obtain one ITN each. Follow-up interviews were conducted with 438 farmers in the treatment and 458 farmers in the control group in June and July 2011. Treatment and control households were compared with respect to bed net ownership, bed net usage, self-reported fever, and self-reported confirmed malaria. Cost data was collected throughout the programme.ResultsThe distribution effectively reached target beneficiaries, with approximately 95% of households in the treatment group reporting that they had received an ITN through the programme. The average increase in the fraction of household members sleeping under an ITN the night prior to the interview was 14.6 percentage points (p-value <0.001). Treatment was associated with a 42 percent reduction in the odds of self-reported fever (p-value <0.001) and with a 49 percent reduction in the odds of self-reported malaria (p-value 0.002). This was accomplished at a cost of approximately five US$ per ITN to Zambia’s NMCP.ConclusionsThe results illustrate that existing private sector networks can efficiently control malaria in remote rural regions. The intra-household allocation of ITNs distributed through this channel was comparable to that of ITNs received from other sources, and the health impact remained substantial.

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We motivate, describe, and discuss a funding strategy that commits outcome-based payments to the scaleup of a poverty alleviation program in the face of doubts about the external validity of available evidence.Keywords: results-based financing, outcome funding, external validity, aid effectiveness Author Affiliation: ⸸ Blavatnik School of Government and St Antony's College, University of Oxford. richard.sedlmayr@sant.ox.ac.uk.Transparency Statement: Supplementary materials, data, and code are accessible on the Open Science Framework (osf.io/mp5ns). Disclosures: My involvement in project design and donor advisory could have affected the neutrality of my assessments.Acknowledgments: This work was prepared in the context of an ongoing project involving multiple parties. It could not have emerged without the thought partnership of Avnish Gungadurdoss, Douglas Emeott, and Juan Camilo Villalobos of Instiglio, a nonprofit organization that promotes results-based financing in development and has the overall responsibility for the management of the project. I thank Dianne Calvi, Celeste Brubaker, and Caroline Bernadi at Village Enterprise; Jessica Cartwright and Radana Crhova at the UK Department for International Development; Duc Tran and Joaquin Carbonell at the US Agency for International Development; and Wesley Panek and Alice Gugelev at Global Development Incubator. I also benefitted from relevant interactions with Stefan Dercon, Mushfiq Mobarak, Jan Witt, Bill Savedoff, Owen Barder, James Snowden, Celeste Brubaker, Stefan Dercon, Mara Arioldi, and Julien Labonne. Any errors are mine. 2 INTRODUCTIONPayment-by-Results (PbR) involves pledges by funders to pay implementers of social and development programs as a function of yet-unachieved outcomes. Skeptics warn that this is not an evidence-based approach because it appears to defy empirical insights on the effects of extrinsic performance incentives on intrinsic motivation (Frey, 2017). But the objective of linking payments to evidence of impact must not be limited to the creation of performance incentives. It could be to give demonstrably impactful approaches the upper hand in the struggle for resources and thereby alter the constituency of the social and development sector in favor of cost-effective ones. Viewed through this lens, PbR is the very definition of evidencebased policy. This does not negate that PbR -like other grantmaking approaches -can have diverse pitfalls.We explore an application that involves the expansion of so-called ultra-poor graduation programs. These have been studied extensively and a substantial body of evidence exists. However, their cost-effectiveness relative to other poverty alleviation approaches is not easily established because few other approaches have been evaluated with equal rigor. Further, because of their complexity and associated uncertainty about their critical success factors, it remains difficult to make confident projections of impact at large scale: in other words, the external validity of available evidence is in doubt....

Despite persistent and widespread enthusiasm, pay-for-success has been slow to materialize – especially in international development assistance. This concept note argues that the availability of credible outcome funding is the most important bottleneck to the development of the sector; hypothesizes that once credible outcome funding is made available, markets should be able to solve most other coordination challenges, including input financing; and proposes a testable solution: a ‘clearinghouse’ that settles outcome-based contracts between funders and the rest of the social sector.