Research

Study Overview

This project studies how physician incentives, oversight, and enforcement affect the use of physician-certified paid sick leave in Chile. Using large-scale administrative records linking medical leave certificates to physicians and patients, the research examines how doctors respond to regulatory scrutiny and sanctions, and how these responses affect patients’ subsequent use of sick leave. More broadly, the project studies the role of physician discretion in social insurance programs in which access to benefits depends on medical certification. It examines whether enforcement changes certification behavior, whether patients substitute toward other physicians when access to leave becomes more restrictive, and how these responses shape the effectiveness of policies intended to control inappropriate use while preserving access to medically justified leave. The project combines population-level administrative data with quasi-experimental research designs to provide evidence on provider behavior, patient responses, and the design of monitoring and enforcement in paid sick-leave systems.

Study Results

Pending.

Study Overview

This project evaluates whether artificial intelligence (AI) can improve competition, efficiency, and inclusion in public procurement. In partnership with ChileCompra and DIPRES, the research will develop and rigorously test two AI tools: one that helps public buyers draft clearer, standardized procurement specifications, and another that helps suppliers—particularly small and medium enterprises (SMEs)—identify relevant opportunities and prepare more competitive bids. Using a large-scale randomized controlled trial on Chile's national procurement platform, the study will measure impacts on bidder participation, procurement prices, SME success, and government spending efficiency. The project aims to generate evidence on how AI can strengthen public institutions, expand economic opportunity, and improve the delivery of public services through more effective and competitive procurement systems.

Intervention Partner: ChileCompra

Populations: Small and medium enterprises (SME)

Study Overview

In India, over 90 percent of workers are informally employed, often under short-term verbal contracts that require repeated negotiation. Standard models of relational contracting predict that repeated interaction and reputation should limit disputes, yet wage disputes persist in daily wage labor markets. This project studies the puzzle in Mumbai's labor nakas, informal hiring points where contractors and over 500,000 casual workers negotiate daily employment. Survey and administrative evidence show that disputes are widespread and arise on both sides: workers report non-payment, underpayment, and delayed wages, while contractors cite uncertainty about absenteeism, effort, and quality.

Study Results

The study is ongoing.

Populations: workers

IBSI Initiative or Center: Lab for Inclusive FinTech (LIFT)

Study Overview

In growth markets, where an estimated 1.4 billion individuals remain unbanked, the reliable and consistent delivery of last-mile banking services remains a critical challenge despite multi-sector technological advancements. In emerging markets, neighborhood mom-and-pop store owners acting as micro-fintech agents are crucial basic banking service providers in underserved communities. However, efforts to improve access to banking services through these agents often face a significant challenge known as 'merchant dormancy'. Empowering last-mile micro-fintech agents with meaningful, actionable information on financial products and how to manage and maintain them could reduce dormancy, potentially catalyzing an estimated USD 380 billion in annual economic value and fostering local economic development. For micro-fintech agents serving the underbanked in emerging markets, the AI revolution offers an opportunity to jumpstart their productivity supported by access to personalized and timely advice. This research leverages Large Language Models (LLMs) in two ways a) Personalized recommendation (curation) with an AI virtual secretary and b) Low-cost and fast content creation through Generative AI models aimed to reduce merchant dormancy, increase access to and improve quality of financial services offered by micro-fintech agents in rural and peri-urban India.

Study Results

Pending

Intervention: AI-generated personal support for micro-fintech agents

Research Partner: Center for Growth Markets

Intervention Partner: FINO

Populations: Small, micro enterprises, unbanked households and individuals

IBSI Initiative or Center: Lab for Inclusive FinTech (LIFT)

Study Overview

Women- and youth-led SMEs in East Africa face complementary constraints to growth — limited business capabilities, restricted access to finance, and indivisible production infrastructure. Which of these bind, and for which entrepreneurs, remains an open empirical question. We propose a pilot in Kenya with Somo Africa to lay the foundations for a full-scale RCT of Somo's integrated training–financing–hub model, in which financing decisions are driven by the Somo Scorecard, a proprietary AI-based alternative-data credit score that replaces collateral and formal credit history with performance data derived from Somo's DigiKua record-keeping tool. The pilot is designed to (i) validate a two-stage randomization against Somo's programmatic funnel; (ii) quantify take-up, compliance, and attrition by arm and by Somo Scorecard tier — in particular, whether low financing take-up reflects selection of not-yet-finance-ready applicants, an AI scorecard calibrated too tightly, or demand-side risk aversion; (iii) characterize outcome distributions needed for power calculations for the full RCT; (iv) validate instruments including DigiKua-derived business records that serve as the alternative data underlying the Scorecard; (v) identify operational considerations to resolve before scale-up. These learnings will shape the full RCT that can identify which constraints bind and for whom — and whether AI-based alternative-data credit scoring can independently identify the women entrepreneurs for whom credit is most productive.

Intervention Partner: Somo

Populations: Small, micro enterprises, Small businesses

Study Overview

Soft-skills training is increasingly used to improve youth employment and entrepreneurship, yet little is known about how instructor heterogeneity shapes program effects. Most evaluations compare curricula or program models while treating instruction as a black box. We study whether teachers generate meaningful variation in skill acquisition and long-run economic outcomes, and which teacher attributes predict effectiveness. We exploit the experimental design of the Skills for Effective Entrepreneurship Education (SEED) program in Uganda. Recent secondary-school graduates were randomly assigned to hard-skills training, soft-skills training, or control; participating students were randomized across classes; and teachers were assigned to curricula and locations through structured randomization procedures. Because teachers rotated across classes, we estimate curriculum-specific value-added models in which student outcomes are regressed on teacher exposure shares, baseline covariates, and randomization-stratum fixed effects. Teacher effects are normalized to sum to zero within curriculum, and inference is based on randomization procedures that preserve the original assignment blocks. We first estimate the dispersion of teacher effects on technical and socioemotional learning. We then relate estimated value added to teacher curriculum knowledge, cognitive ability, personality, socioemotional skills, prior experience, and socioeconomic background, accounting for estimation error in the first-stage effects. Finally, we test whether exposure-weighted teacher value added predicts students’ long-run employment, entrepreneurship, and income. The study extends the teacher-value-added literature beyond formal schooling and provides evidence on whether experimentally identified instructor effects persist across outcome domains and over time.

IBSI Initiative or Center: Lab for Inclusive FinTech (LIFT)

Study Overview

This project evaluates the scale-up of Skills for Effective Entrepreneurship Development (SEED) through a randomized controlled trial involving more than 8,000 Ugandan youth. SEED is an intensive three-week residential “mini-MBA” that combines business, entrepreneurship, and broader skills training and was first evaluated experimentally in Uganda in 2013. The new study will test whether the program retains its effectiveness when implemented at scale and estimate the incremental value of supplementing the core curriculum with a digital business skills module and a generative AI tool. The SEED-tailored, AI-powered virtual tutor will support participants during training and remain available as they launch and develop their businesses. The trial will generate rigorous evidence on the scalability of a previously tested youth entrepreneurship program and on whether sustained access to AI-enabled guidance can strengthen business practices, productivity, entrepreneurship, and economic opportunities among young people.

Populations: Small and medium enterprises (SME)

IBSI Initiative or Center: Lab for Inclusive FinTech (LIFT)

Study Overview

This research examines how the prolonged regulatory uncertainty surrounding blockchain and digital assets relates to entrepreneurial activity. Exploiting variation in U.S. congressional voting patterns, close-call elections of crypto-friendly politicians, and spatial distribution of crypto PAC contributors, we analyze startup formation, failure rates, capital raising, and strategic pivots inferred from hiring data.

Study Results

We find that regulatory uncertainty significantly influences entrepreneurial outcomes, with increased legislative support associated with positive startup performance. Paradoxically, while the industry advocates for regulation, startups’ hiring patterns suggest reluctance to prioritize regulatory compliance. Overall, our study helps to quantify the magnitude of regulatory uncertainty’s impact on emerging technology and offer insights for policymakers seeking to balance oversight with innovation.

Intervention: Regulation

Research Partner: Emory University

Populations: Blockchain start-ups, Government regulators

IBSI Initiative or Center: Lab for Inclusive FinTech (LIFT)

Study Overview

We study the impacts of an entrepreneurship business training on negotiation skills. The Skills for Effective Entrepreneurship Development (SEED) program is 3-week mini-MBA for youth who just graduated secondary school in Uganda. SEED was implemented as an at scale Randomized Controlled Trial (RCT) and presented two separate curricula. The hard skills MBA featured a mix of approximately 75% hard-skills and 25% soft-skills; the soft-skills curriculum had the reverse mix. Only youth in the Soft SEED arm received explicit training in communication, negotiation, and persuasion. Four years after the intervention, we conducted a lab-in-the-field experiment and collected speech-to-text data as youth engaged in incentivized negotiation involving financing and start dates for a possible sale agreement. Study participants in the soft SEED group struck better deals than the control and hard SEED groups. Leveraging large language model (LLM) annotation, we investigate how negotiation strategies profiles differ across experimental groups. Preliminary results suggest that youth in the soft SEED group adopted more aggressive stances in their initial offers; their communication style was more assertive, but they were also more able to manage disagreement, avoiding communication breakdowns. Future work will provide richer characterization of study participants' negotiation profiles by examining win-win strategies, which were an explicit focus of the soft SEED training.

IBSI Initiative or Center: Lab for Inclusive FinTech (LIFT)

Study Overview

Causal evidence on the long-run and intergenerational effects of entrepreneurship and skills training in low-income countries is scant at best. Existing evidence is concentrated in adolescent empowerment programs, which show persistent effects on fertility, marriage, and schooling (Austrian et al., 2020; Bandiera et al., 2020). Evidence on outcomes for participants’ children is rarer still, in contrast to the education literature, where intergenerational effects are increasingly well established.We propose a long-run follow-up of the Study of Entrepreneurship and Entrepreneurial Development (SEED), a randomized evaluation of entrepreneurship and soft-skills training for youth in Uganda. Linking a new survey to multiple prior waves, the study will estimate effects on economic outcomes, psychological well-being, family formation, household decision-making, and children’s human-capital investments and well-being. Repeated measures of soft skills, mental health, and livelihoods will allow us to examine whether early socio-emotional gains persist, expand economic opportunities, and ultimately improve outcomes for participants’ families and children. The study will provide rare experimental evidence on the durability, mechanisms, and intergenerational reach of youth skills investments.

Study Overview

Depression and anxiety have risen sharply among U.S. college students, yet a large share of affected students receive no clinical care. A central barrier is navigation: students encounter fragmented/static resources with no personalized front-door, no adaptive-triage, and limited support before distress escalates. This study evaluates Flourish@Berkeley, a purpose-built AI wellness platform embedded in UC Berkeley’s University Health Services (UHS), in the context of an at-scale randomized controlled trial (RCT) with 10,000 students. Treatment-assigned students gain access to an app with an AI companion, which delivers evidence-based micro-practices for coping, emotion regulation, problem solving, and positive functioning, scaffolding them into durable habits, and dynamically. routes students with conversational navigation to UC Berkeley’s campus resource ecosystem (e.g., financial aid, academic and peer support, wellness, UHS resources, crisis and clinical referrals). Students assigned to the control group retain full access to existing resources via traditional channels. The study tests whether low-stigma, institutionally integrated AI support reduces unmet need, improves validated survey measures of depression, anxiety, well-being, and cognitive functioning. We will also measure the impact on administrative measures of academic progress, service utilization (i.e., changes in who reaches which types of care) and longer-run labor market outcomes. The zero-infrastructure solution minimizes adoption frictions; the deployment model would be directly scalable across the UC system and other U.S. colleges, including community colleges with more limited services/infrastructure.

Study Results

Pending

Populations: University students

Study Overview

This project examines whether technology-enabled enforcement can strengthen legal protections for women at risk of domestic violence. Conducted in partnership with Brazil’s Ministry of Justice, the study will evaluate Brazil’s new bilateral electronic monitoring program, which combines GPS ankle bracelets for perpetrators with real-time alerts to victims when court-ordered protection perimeters are breached. Brazil has a strong legal framework for domestic violence, but enforcement remains limited. In 2025, femicides reached a record high, with 1,568 women killed, more than 945,000 new domestic violence cases processed, and over 619,000 protective orders granted. At least 18.3% of protective orders are violated, and 13.1% of women killed had an active protective order. The research will study whether bilateral monitoring improves compliance with protective orders, accelerates enforcement, deters further violence, and strengthens victims’ safety, mental health, labor market participation, and agency.

Study Overview

Whether generative AI narrows or widens inequality in low-income economies, and whether it builds or erodes human capital, remains largely untested outside high-income, short-horizon settings. We study these questions among young entrepreneurs in Uganda by embedding a randomized take-up experiment in the SEED 2.0 program, which in 2025 randomized 8,455 secondary-school graduates into a control group and two entrepreneurship-training arms. At the 2027 follow-up, we offer a purpose-built AI assistant—trained on the program curriculum and locally developed content and delivered over WhatsApp—to three quarters of participants in each arm, retaining the rest as a within-arm comparison group, with assignment stratified by baseline knowledge, prior training take-up, and gender. Among those offered, we cross-randomize the tool's mode (tutoring versus direct answers) and a take-up incentive. Intention-to-treat comparisons identify the effect of access and how it varies with baseline ability—whether AI complements or substitutes for skill—whether learning persists once the tool is withdrawn, whether adoption is itself selected on ability, and whether AI substitutes for or complements training. The study tests not only whether AI helps, but whether its design and deployment can make the benefits inclusive.

Study Overview

Causal evidence on the long-run and intergenerational effects of entrepreneurship and skills training in low-income countries remains limited. The strongest existing evidence comes from adolescent life-skills and empowerment programs, which generated persistent effects on fertility, marriage, and schooling four to seven years after implementation (Austrian et al., 2020; Bandiera et al., 2020). Evidence on impacts extending to the next generation is scarcer still. Outside cash-transfer programs, one of the few experimental studies documents increased investment in children following the introduction of flexible microfinance repayment schedules in India (Field et al., 2021). This gap contrasts sharply with the education literature, which provides growing evidence that schooling investments affect outcomes across generations (Duflo et al., 2024, and references therein).

We propose a 13-year follow-up of the Study of Entrepreneurship and Entrepreneurial Development (SEED), a randomized evaluation of entrepreneurship and soft-skills training for youth in Uganda. Combining a new survey with existing baseline, four-year, and nine-year data, the study will estimate treatment effects on long-run economic outcomes, psychological well-being, family formation, intra-household decision-making, and children’s human-capital investments and well-being. Repeated measures of soft skills, mental health, and economic outcomes will allow us to study the mechanisms underlying persistence: whether early improvements in socio-emotional skills endure, whether they expand economic opportunities, and whether these gains translate into improved outcomes for participants’ households and children. The study will thus provide rare experimental evidence on both the durability and intergenerational reach of youth skills investments.

Study Overview

We study the medium and long term impacts of Skills for Effective Entrepreneurship Development (SEED), a 3-week entrepreneurship training program for secondary school students in Uganda. The mini-MBA, modeled after business school curricula, was implemented as a randomized field experiment with a nationally representative sample of 4,402 youth.

Study Results

After four years, the training improved both hard and soft skills. SEED graduates became more effective negotiators and communicators and exhibited improved self-efficacy, stability, plasticity, and stress management. In the medium run, treated youth were more likely to start enterprises and more successful in ensuring their survival, thereby gaining greater entrepreneurial experience. Their ventures were also of higher quality: more likely to be formal, have employees, be in collaboration with other entrepreneurs, and use effective business management practices. With 52% of the sample still enrolled in post-secondary education, we find suggestive evidence that businesses led by the treatment groups performed better. After nine years, business ownership converged between treatment and control groups as control ownership rates doubled. However, SEED graduates maintained their edge in terms of business quality and operated firms with 20% higher revenues and 16% higher profits, without corresponding increases in capital or labor inputs, consistent with higher total factor productivity. Entrepreneurial success was achieved through the adoption of better business practices and experimentation, with soft skills related to entrepreneurial mindset playing a complementary role. SEED generated high returns on investment: the present discounted values of SEED-induced business and total earnings equal 20 and 27 times program costs, respectively.

Working Paper: Laura Chioda, Paul Gertler, David Contreras-Loya, and Dana R. Carney, "Making Entrepreneurs: Long Term Returns to Training Youth in Business Skills," NBER Working Paper 34637 (2026), https://doi.org/10.3386/w34637.

Study Overview

Access to modern family planning impacts women's health, education, and economic well-being. Persistent barriers to accessing long-acting methods, such as price and lack of information, limit adoption. This study highlights the potential of a novel payment and incentive structure for pharmacies, a key access point for contraceptives for young women in particular, to improve access to subcutaneous depot medroxyprogesterone acetate (DMPA-SC). By targeting incentives to either patients or providers through a low-cost digital tool, the intervention aims to enhance contraceptive choice cost-effectively with potential for scale. We randomized 137 pharmacies in Kenya into three intervention arms, varying patient copay, pharmacy profit, or pharmacy cost to stock DMPA-SC, plus a status quo control group that conducted pharmacy operations as usual. All pharmacies used an app-based platform for sales and inventory tracking, and a digital tool to manage family planning sales, through which client discounts for DMPA-SC, pharmacy cost to stock DMPA-SC, or pharmacy profit for DMPA-SC were experimentally varied in the intervention arms. We used double/debiased machine learning for adjusted models, with the primary outcome being uptake of DMPA-SC, and secondary outcomes being couple-years of protection, and an analysis of price and information mechanisms.

Study Results

We analyzed data from 26,883 family planning visits (C = 7605, T1 = 7774, T2 = 5009, T3 = 6495) between August 2022 and May 2023. Providing consumer discounts and provider incentives through a pharmacy-facing intervention increases adoption of DMPA-SC by 14 percentage points (control mean: 0.03), while decreasing use of short-acting methods by 13 percentage points (control mean: 0.92), compared to a control group. Interventions alleviated both price and information barriers to access through a 100% price pass through in the consumer discount arm and an increase in comprehensive counseling by 68 percentage points in the provider-side arms, all compared to the status quo control group. Targeted incentives increase couple-years of protection (CYP) for $2.56–$12.50 per CYP.

Intervention Partner: Maisha Meds

Journal Publication: Dieci M, Paramo C, Gertler P. Alleviating price and information barriers to long-acting contraception uptake in Kenyan pharmacies using patient and provider incentives: a cluster randomized control trial eClinicalMedicine, 2026; 93

Impacts on Policy and Practice: Pharmacy-based interventions that reduce price and information barriers of DMPA-SC can expand women's contraceptive options, with implications for choosing longer-acting methods. Pharmacies are crucial access points for family planning in Kenya and globally. Understanding how pharmacy-specific interventions influence access to modern methods can generate evidence on this understudied and important care setting.

Study Overview

Scalable and low-cost artificial intelligence (AI) assistance has the potential to improve firm decision making and economic performance, particularly in emerging markets. However, running a business involves a wide range of open-ended problems, making it unclear whether and how recent advances in AI can help business owners around the world make better decisions. In a field experiment with Kenyan entrepreneurs, we evaluated the impact of AI advice on small business revenues and profits by randomizing access to a GPT-4-powered AI business assistant.

Study Results

Although we are unable to reject the null hypothesis of no average treatment effect on firm revenues and profits, we find that the effect for entrepreneurs who were low performing at baseline is over 0.20-standard-deviations lower than for initial high performers. Subsample analyses show that low performers did nearly 10% worse because of the AI assistant, whereas high performers may have benefited by over 15%. This differential impact does not appear to result from differences in the questions posed to the AI or the advice that it provided but rather, from the advice that entrepreneurs chose to implement. More broadly, these results show that generative AI is already capable of impacting real-world business performance—although in uneven and sometimes unexpected ways.

Journal Publication: Nicholas G. Otis, Rowan Clarke, Solène Delecourt, David Holtz, Rembrand Koning (2026) The Uneven Impact of Generative Artificial Intelligence on Entrepreneurial Performance: Evidence from a Field Experiment in Kenya. Management Science 0(0). https://doi.org/10.1287/mnsc.2024.06909

Study Overview

IBSI partnered with the BHSOAC to establish a Center of Excellence (COE) at the University of California, led by UC Berkeley, to address workplace mental health. In collaboration with One Mind at Work, and UCLA’s Semel Center, the COE will focus on creating curriculum, training, and innovative research that will help organizations implement strategies to improve workplace mental health outcomes. Outcomes of the new center include a landscape analysis report summarizing the most effective approaches to workplace mental health, a process foe engaging employers in workplace mental health, results of mental health engagement activities with employers across sectors, and a comprehensive workplace mental health roadmap.

Study Results

This deliverable was submitted to BHSOAC.

Study Overview

This article examines the potential formation of an Association of Cooperative Labor Contractors (ACLC) in light of the goals of the California Future of Work Commission. An ACLC would give contract workers an ownership stake in the cooperative labor contractors (CLCs) that employ them. By linking the CLCs to an association that provides shared services and upholds labor standards, an ACLC could present a more equitable employment model. An ACLC also addresses specific challenges faced by both workers and firms in contract labor markets today.

Study Results

The analysis presented here finds meaningful opportunities for an ACLC to improve job conditions for contract labor. These include the opportunity to leverage competitive advantages of worker ownership in staffing; the opportunity for scale associated with shared services (such as HR management, employer of record services, capital access, and technology) provided by the association; the opportunity for workers to access profit-sharing benefits and ownership; and the overall opportunity for bold experimentation that an ACLC represents. However, significant challenges exist for CLCs. These include assuming employer liability for workers who are staffing other companies, securing market share, and competition in low-wage sectors known for labor violations. Additionally, there is tension between the need for cohesive workplaces and the reality of temporary staffing arrangements. Short-term contracts and highly mobile workforces can hinder CLCs from fully leveraging the competitive advantages of participatory, worker-owned business models.

Intervention: Employee ownership models

Research Partner: Institute for the Study of Employee Ownership and Profit Sharing

Populations: Low-wage workers

Working Paper: Scharf, Adria. 2025. Article 8: Analysis of the Association of Cooperative Labor Contractors (ACLC)

Study Overview

The use of telemedicine has been on the rise. Although telemedicine has increased access to health care, little is known about how the medium changes providers’ medical decision-making. To evaluate how telemedicine differs from in-person care, we compare the quality and cost of in-person clinic visits and virtual visits over the phone for common conditions in Rwanda. To control for patient selection, we conduct an audit study with 2,532 standardized patient visits, where individuals portraying real patients presented standardized cases for malaria and upper respiratory infection (URI).

Study Results

Intervention: virtual consultations compared to in-person consultations

Working Paper: Wellsjo, A. S., Gertler, P., Kwan, A., Remera, E., Irakiza, P., Condo, J., & Humuza, J. (2025). The Medium Matters: Medical Decision-Making in Telemedicine versus In-person Care (Working Paper No. 34185). National Bureau of Economic Research. https://www.nber.org/papers/w34185

Study Overview

As a growing number of employers hire contractors and staffing agencies to build and run their business, some worker rights advocates view staffing cooperatives as a strategy to advance job quality, firm performance, and social outcomes. However, with only a few staffing co-ops and limited past research, a successful strategy requires close study of cooperative labor contracting. What kinds of staffing co-op models can create quality jobs, provide quality services, and scale? This article presents original research on goals, models, and growth among staffing co-ops and “umbrella groups,” a variety of nonprofits, secondary co-ops, and other organizations that provide multiple co-ops with shared services and pooled resources. We present in-depth profiles describing goals, models, and growth for three staffing co-ops and three umbrella groups, all based in the U.S., launched within the past six years, each with fewer than 500 members.

Study Results

We found that staffing co-ops develop a competitive advantage that enables them to create or sustain quality jobs with higher wages, but struggle to secure clients and to scale. By contrast, we found that all umbrella groups create and sustain quality jobs among the co-ops they support, and demonstrate an ability to scale their business. Overall, our findings suggest that a competitive advantage is not sufficient for staffing co-ops, to scale. Umbrella groups can boost co-op scale and financial sustainability by providing shared services and enabling administrators to focus on core competencies around quality jobs and quality services. One structural limit to scale, however, remains the low value employers place on domestic work such as cleaning, home care, and related fields, where many women, people of color, immigrants, and other historically underrepresented communities find work.

Intervention: Employee ownership models

Research Partner: Institute for the Study of Employee Ownership and Profit Sharing

Populations: Low-wage workers

Working Paper: Spitzberg, Daniel and Morshed Mannan. 2025. Article 7: Analysis of Expert Interviews on Staffing Co-ops and Umbrella Groups

Study Overview

California’s home care system struggles to meet its growing needs, partly due to poor job quality for frontline caregivers. It leans on historically marginalized women of color and immigrants. These dynamics put at risk not only the workers, but also those who need care. Affordability challenges for individuals have led to heavy reliance on state programs for funding. Limited state budgets for care result in low reimbursement rates, shaping market prices. Further, immigration rules and gray markets empower unscrupulous employers to exploit and abuse vulnerable workers. Of existing models, entrepreneurship and worker ownership may particularly attract immigrant care workers and others with barriers to employment because owning a business can offer a way out of exploitative employment conditions.

Study Results

Testing this hypothesis are two home care agencies that are owned and run by immigrants: COURAGE LLC and SplenDoor in Home Care LLC. Key takeaways from the analysis of these two models are: (1) State policies & practices could be modified to support worker-owned business; (2) Cooperative development remains experimental and inadequately supported, relative to more traditional small business development; (3) Financial and voice benefits are mutually important, especially for immigrant owners; (4) At current wage rates for care work, it is unclear whether worker-owned home care businesses are sustainable without external support.

Intervention: Employee ownership models

Research Partner: Institute for the Study of Employee Ownership and Profit Sharing

Populations: Low-wage workers, immigrant workers

Working Paper: Scott, K. MacKenzie. 2025. Article 3: Case Studies of Immigrant Entrepreneurship and Co-op Development in Home Care

Study Overview

This statistical analysis examines the effects of employee ownership on worker outcomes, and whether these effects are different for disadvantaged workers. While previous studies have established that ESOP firms exhibit productivity levels equal to or higher than conventional firms and that ESOP members tend to benefit from wealth building, there is limited research on worker experiences within ESOPs.

Study Results

The analysis of self-reported attitudes and perceptions in two datasets, the General Social Survey and the National ESOP Employee Survey, finds that ESOP membership is related with several outcomes: increased worker satisfaction, participation in decision-making, commitment to the firm, and less searching for alternative jobs. While the GSS data shows mixed results with only some findings remaining statistically significant after adjusting for multiple comparisons, the NEES data consistently indicates robust positive impacts of ESOP membership on job satisfaction, organizational commitment, and reduced intentions to seek new employment. However, the analysis also finds no significant evidence that these effects vary significantly between disadvantaged and non-disadvantaged workers. These findings suggest that ESOP membership can enhance job quality and employee well-being in certain measures. However, given a modest sample size, these findings have limited precision, with insufficient data to draw firm conclusions about the experiences for disadvantaged workers.

Intervention: Employee ownership models

Research Partner: Institute for the Study of Employee Ownership and Profit Sharing

Populations: Low-wage workers

Working Paper: Costa, Gonçalo Pessa and David Levine. 2025. Article 2: Statistical Analysis of ESOP Membership and Worker Outcomes

Study Overview

Converting existing businesses into cooperatives is a strategy to preserve jobs and wealth when an owner wishes to sell or close their business. Conversions typically seek higher compensation, a better working environment, and to create a democratic culture. However, little empirical research exists on the benefits and challenges for owners and workers across different models of employee ownership. This paper presents two case studies of employee ownership conversions. Proof Bakery in Los Angeles converted to a worker cooperative in 2021, while Firebrand Artisan Breads in Oakland was converted to a steward-ownership company in the form of a perpetual purpose trust in 2020.

Study Results

The paper finds that as a worker co-op, Proof Bakery experienced increased revenues, higher wages, and improved job satisfaction among its worker-owners. As a perpetual purpose trust, Firebrand maintained its social mission of hiring marginalized populations while achieving financial stability with the support of value-aligned investors. Additionally, Proof Bakery’s worker co-op model gives direct ownership and control by workers to generate specific outcomes like raising prices and tripling revenues, while Firebrand’s steward-ownership model does not give direct control to workers but operates with a similar purpose to improve wages and working environments for employees. ​​The findings suggest that both enhanced job quality and business stability through their respective ownership conversion models. Additionally, these cases offer lessons on the importance of founder vision in exploring and initiating a conversion; the considerations for company size for selecting different ownership models; and the importance of ecosystem players in enabling the conversion processes.

Intervention: Employee ownership models

Research Partner: Institute for the Study of Employee Ownership and Profit Sharing

Populations: Low-wage workers

Working Paper: Ji, Minsun. 2025. Article 6: Case Studies of Worker Ownership Conversion: Proof Bakery and Firebrand Artisan Breads

Study Overview

Workers in low-wage sectors such as agriculture and allied healthcare face challenges such as labor shortages and high turnover. At the same time, a small number of staffing agencies dominate each sector and continue to generate substantial profits while labor violations continue to persist despite attempts at regulation and penalties. This paper presents two case studies of worker-owned labor contractors: California Harvesters, Inc. (CHI), a farm labor contractor with an employee-owned trust, and AlliedUP, a healthcare staffing cooperative.

Study Results

Both face similar challenges: securing market share (securing long-term clients and recruiting talented workers), managing tight business margins in competitive sectors, and engaging a supportive ecosystem of partners. While both organizations are relatively new, having launched within the last five years, their capacity for leveraging worker voice and decision-making in their respective ownership and governance models remains slow to come online as both are prioritizing stabilizing their business operations. Despite these challenges, both have demonstrated success; CHI has ensured good working conditions for workers even though pay is still at the $16 minimum wage rate, and AlliedUP increased wages for some workers but has only 15 members as of 2023. ​​The findings of this case study suggest that improving job quality through worker-owned labor contracting in competitive, low-wage sectors with tight labor markets has clear advantages but major challenges. Overcoming these challenges may gain from business assistance with securing clients and workforce partnerships to recruit workers, but more targeted support may be necessary to enable success

Intervention: Employee ownership models

Research Partner: Institute for the Study of Employee Ownership and Profit Sharing

Populations: Low-wage workers

Working Paper: Ji, Minsun. 2025. Article 4: Case Studies of Worker-Owned Labor Contracting in Agriculture and Healthcare: California Harvesters, Inc. and AlliedUP

Study Overview

This paper reviews academic and non-peer-reviewed research examining how worker ownership impacts workers and firms, with a specific focus on how worker cooperatives impact low-wage and marginalized workers.

Study Results

The review finds that ESOP participants earn higher median wages than non-employee owners, while worker-owned cooperatives in low-wage sectors (allied health, agriculture, food service) pay roughly equal wages to their competition. Wealth accumulation through retirement or investment accounts is strong within ESOPs but remains more limited in cooperatives. More research is needed to understand the wage and wealth effects of worker coops and if these ownership models can consistently be used to improve the economic inequality and work experiences of people of color, immigrants, and other historically underserved populations, particularly in low-wage sectors. Worker-owned firms showed an improved ability to mitigate staff layoffs during economic shocks. Job satisfaction increases when worker ownership is combined with high-performance work practices, such as participation in decision-making and access to training. Productivity gains are more likely when combined with participatory management practices and knowledge sharing. Findings suggest that while worker-ownership may improve job quality, firm performance, and other social and economic outcomes, it is not a complete solution for labor market challenges and does not fully resolve systemic issues of gender and racial discrimination.

Intervention: Employee ownership models

Research Partner: Institute for the Study of Employee Ownership and Profit Sharing

Populations: Low-wage workers

Working Paper: Foley, William. 2025. Literature Review on Worker Ownership

Study Overview

The choice to adopt an effective healthcare product is often a joint decision between the patient and their medical professional. Many governments and payers use patient subsidies and provider incentives to increase the adoption of new health technologies. Using data from a randomized field experiment in Kenya, I estimate a structural model of patient demand and provider advice for a new contraceptive method. I then use the model to study the welfare effects to the patient from the introduction of demand and supply side incentives to adopt the new technology. This approach allows the study of channels that promote diffusion, including the roles of provider advice, financial incentives and altruism, as well as patient preferences.

Study Results

Taken together, the results suggest that changes in provider advice due to their altruism and financial incentives are key to increasing adoption of the new technology and making incentive programs effective, regardless of whether the incentive targets the patient or the provider. In fact, changes in provider advice account for 79% of the welfare benefits of a policy that reduces the price to the patient. To be effective, incentive policies need to account for the central role that the provider takes in medical decision-making.

Intervention: Diagnostic-contingent incentive contract

Intervention Partner: Maisha Meds

Working Paper: Paramo, Carlos. 2025. "Who calls the shots? Financial incentives and provider influence in the adoption of new technology"

Study Overview

Over the next two decades, millions of small business owners will face retirement, yet the majority are unprepared–only one-third have an exit plan in place. While numerous buyers are available for many small business owners, selling to employees offers an opportunity to ensure continuity while (usually) enjoying tax advantages. However, despite its benefits, most business owners are unaware of employee ownership as a viable exit strategy. Even for those interested, determining whether an employee ownership conversion is the right fit for their business can be complex and uncertain. Employee ownership conversions require specialized expertise that most business lawyers, lenders, and advisors do not have. This report describes a chatbot designed to help business owners learn if worker ownership might be a good fit for their business.

Study Results

We find that AI chatbots can be a useful tool to advance worker ownership. First, it lowers the barriers for potential sellers to learn about selling to employees. Second, it automates the initial steps of the conversion process for those who advise on worker ownership, freeing up their time for deals likely to go through. We conclude by discussing the implications of this finding and suggestions for future research and chatbot development. While this version focuses only on selling to worker-owners, a natural extension can help any business owner identify plausible buyers such as family members, current managers, and outsiders.

Intervention: Employee ownership models

Research Partner: Institute for the Study of Employee Ownership and Profit Sharing

Populations: Low-wage workers

Working Paper: Foley, William and Drew McArthur. 2025. Article 9: Examining the Feasibility of a Worker-Ownership Conversion AI Chatbot

Study Overview

This case study shares the story of a road construction company in California, how it came to be 100% worker-owned, and how its Employee Stock Ownership Plan (ESOP) relates to governance, management, and work at the company.

Study Results

Key contributors to success include: (1) robust, capital-intensive markets that facilitate meaningful shared gains; (2) institutional labor protections for public contracts and tax incentives that help make competitive a high-road strategy with higher compensation for frontline workers; and (3) a shared ownership culture that helps support: internal promotions, high autonomy, and employee input and innovation. Headwinds for the company include concerns about leadership succession and buy-in of younger employees who are perceived as less oriented to building retirement wealth. This study notes that standard job quality metrics generally exclude employee ownership from consideration, but ownership can be a differentiating factor and increase shared gains within the firm. Relative to non-worker-owned peers, the firm has broader wealth-sharing in the compensation structure due to its high-performing ESOP and reportedly reduced executive compensation.

Intervention: Employee ownership models

Research Partner: Institute for the Study of Employee Ownership and Profit Sharing

Populations: Unionized workers, public infrastructure workforce

Working Paper: Scott, K. MacKenzie. 2025. Article 5: Case Study of a Unionized ESOP: Pavement Recycling Systems

Study Overview

We examine whether a diagnosis contingent incentive contract structure improves the treatment of malaria, and whether it’s best to target those incentives to patients or providers. The contract provides incentives to use rapid tests (RDTs) to diagnose patient malaria status combined with incentives to treat with antimalarial drugs (ACTs) if the patient tests positive but not if negative.

Study Results

Using data from a cluster randomized field experiment with 140 pharmacies in malaria endemic regions of Kenya, we find that both patient subsidies and provider incentives significantly increased RDT testing uptake. Absent incentives, 87% of suspected malaria patients purchase ACTs, of which as many as 66% are doing so unnecessarily because they do not have malaria. The incentives lead to an increase RDT test use by 25 pp, a 7 pp increase in the purchase of ACTs by malaria positive patients, and a 27 pp decline in the purchase of ACTs by malaria negative patients. The contract increases (decreases) ACTs for those who are malaria positive (negative) through both improved diagnostic information and incentives. Diagnosiscontingent contracts are highly cost effective, actually lowering the cost per malaria positive person being treated by reducing the unnecessary treatment of malaria negative patients.

Intervention: Diagnostic-contingent incentive contract

Intervention Partner: Maisha Meds

Working Paper: Maria Dieci & Paul Gertler & Jon Kolstad & Carlos Paramo, 2024. "Using Diagnosis Contingent Incentives to Improve Malaria Treatment"

Study Overview

We examine the effect of performance monitoring in public procurement through the lens of organizational culture in a principal-agent model where the manager (principal) and buyers (agents) may have different beliefs about how much the government values efficiency. We show that the effect of performance information not only increases efficiency but is greater when the buyer’s belief is stronger than the manager’s belief. We leverage a new e-procurement system in Chile to test these ideas by randomizing monthly reports on the purchasing performance of buyers and further whether the individual performance reports were disclosed to managers.

Study Results

We find that the reports generated sizable reductions in overspending — with savings reaching a 15% reduction or 0.1% of GDP — but only when individual performance was observable to managers. This is consistent with extrinsic motivation rather than intrinsic motivation driving buyer behavior. Consistent with the theoretical model, we also find that the gain in efficiency is concentrated in procurement units where buyer belief that the government cares about efficiency is stronger than manager belief. Our results highlight the key role played by organizational culture in mediating the impact of purchasing performance information on preventing the misuse of public resources.

Intervention: E-procurement platform and performance monitoring

Populations: Government procurement officers

Working Paper: Pablo A. Celhay & Paul Gertler & Marcelo Olivares & Raimundo Undurraga, 2024. "How Managers Can Use Purchaser Performance Information to Improve Procurement Efficiency," NBER Working Papers 32141, National Bureau of Economic Research, Inc.

Study Overview

Empowering adolescent girls through education has become a priority among numerous stakeholders. However, recent evidence suggests that education alone may not be sufficient if women remain in a low-empowerment equilibrium and face internal constraints as they relate to aspirations, self-efficacy, leadership, and other life (soft) skills. We study the long-term impacts of a school-based upper-secondary intervention, the Educate! Experience, designed to enhance adolescents' leadership and social entrepreneurship skills in Uganda. The program was implemented as a cluster randomized controlled trial (RCT) in 48 schools.

Study Results

Four years post-intervention, we document lasting impacts on a wide array of leadership and soft skills. Overall, Educate! graduates developed skills that are traditionally associated with greater focus on long-term goals; they reported being more in control of aspects of their lives (self-efficacy and grit) and more empowered to implement actions towards their plans. Young women in the treatment group are also more likely to complete secondary education, delay family formation, enroll in tertiary education, and pursue STEM and Business majors relative to their counterparts in the control group. The program yielded socially desirable and gender relevant spillovers, including expansions in women's agency. Both male and female Educate! graduates embraced more progressive views concerning women's standing in the society and women's ability to exercise their agency to engage in the labor market and refuse sex. The incidence of intimate partner violence (IPV) also improved among Educate! graduates, as did their attitudes toward IPV social acceptability.

Working Paper: Working Paper - 2024

Study Overview

Digital loans have exploded in popularity across low- and middle-income countries, providing short term, high interest credit via mobile phones. This paper reports the results of a randomized evaluation of a digital loan product in Nigeria. Being randomly approved for digital credit (irrespective of credit score) substantially increases subjective well-being after an average of three months. For those who are approved, being randomly offered larger loans has an insignificant effect. Neither treatment significantly impacts other measures of welfare. We rule out large short-term impacts– either positive or negative– on income and expenditures, resilience, and women’s economic empowerment.

Study Results

This project demonstrates evidence that increasing access to digital loans can improve subjective well-being among applicants, measured after an average of three months. The magnitude of this effect is similar to that of costly anti-poverty interventions, even though the digital loans do not consume government or donor resources. This result highlights how even small relaxations of constraints can substantially improve mental health. At the same time, offering applicants larger loans does not have a significant effect. Randomly allocated digital credit is not associated with large positive– and negative– effects on other dimensions of welfare, including income and expenditures, resilience, and women’s economic empowerment.

Intervention: Randomized digital loan product

Populations: New customers on a popular digital credit platform

Working Paper: Björkegren, Daniel & Blumenstock, Joshua & Folajimi-Senjobi, Omowunmi & Mauro, Jacqueline & Nair, Suraj. (2022). Instant Loans Can Lift Subjective Well-Being: A Randomized Evaluation of Digital Credit in Nigeria. 10.48550/arXiv.2202.13540.

IBSI Initiative or Center: Lab for Inclusive FinTech (LIFT)

Study Overview

Public expenditures on non-contributory pensions are equivalent to at least 1 percent of GDP in several countries in Latin America and is expected to increase. We explore the effect of noncontributory pensions on the well-being of the beneficiary population by studying the Pensiones Alimentarias program established by law in Paraguay, which targets older adults living in poverty.

Study Results

Households with a beneficiary increased their level of consumption by 44 percent. The program improved subjective well-being in 0.48 standard deviations. These effects are consistent with the findings of Bando, Galiani and Gertler (2020) and Galiani, Gertler and Bando (2016) in their studies on the non-contributory pension schemes in Peru and Mexico. Thus, we conclude that the effects of non-contributory pensions on well-being in Paraguay are comparable to those found for Peru and Mexico and add to the construction of external validity.

Journal Publication: Bando, Rosangela, Sebastian Galiani, and Paul Gertler. 2022. “Another Brick on the Wall: On the Effects of Non-contributory Pensions on Material and Subjective Well Being.” Journal of Economic Behavior and Organization 195: 16–26.

Study Overview

We study the medium-term impacts of the Skills for Effective Entrepreneurship Development (SEED) program, an innovative in-residence 3-week mini-MBA program for high school students modeled after western business school curricula and adapted to the Ugandan context. The program featured two separate treatments: the hard-skills MBA features a mix of approximately 75% hard skills and 25% soft skills; the soft skills curriculum has the reverse mix.

Study Results

Using data on 4400 youth from a nationally representative sample in a 3-arm field experiment in Uganda, the 3.5 year follow-up demonstrated that training was effective in improving both hard and soft skills, but only soft skills were directly linked to improvements in self-efficacy, persuasion, and negotiation. The skill upgrade was rewarded in substantially higher earnings; 32.1% and 29.8% increases in earnings for those who attended hard- and soft-training, respectively, most of which, was generated through self-mployment. Furthermore, youth in both groups were more likely to start enterprises and more successful in ensuring their businesses' survival. The program led to significantly larger profits (24.2% and 27.2% for hard- and soft- treatment arms respectively) and larger business capital investments (38.4% and 32.6% for SEED hard and SEED soft, respectively). Both SEED curricula were very cost-effective; two months worth of the extra earnings caused by the training alone would exceed the cost of the program. These benefits abstract from the job- and business-creation benefits of the program, which were substantial: relative to the control group, SEED entrepreneurs created 985 additional jobs and 550 new businesses.

Intervention: Entrepreneurship training

Populations: Low-income youth

Working Paper: Laura Chioda & David Contreras-Loya & Paul Gertler & Dana Carney, 2021. "Making Entrepreneurs: Returns to Training Youth in Hard Versus Soft Business Skills," NBER Working Papers 28845, National Bureau of Economic Research, Inc.

Study Overview

The adoption of new clinical practice patterns by medical care providers is often challenging, even when they are believed to be both efficacious and profitable. This paper uses a randomized field experiment to examine the effects of temporary financial incentives paid to medical care clinics for the initiation of prenatal care in the first trimester of pregnancy.

Study Results

We show that costs of adjustment as opposed to low perceived value may explain why improved quality care practices diffuse slowly in the medical industry. Using a randomized field experiment conducted in Argentina, we find that temporary financial incentives paid to health clinics for the early initiation of prenatal care motivated providers to test and develop new strategies to locate and encourage pregnant women to seek care in the first trimester of pregnancy. These innovations raised the rate of early initiation of prenatal care by 34 percent while the incentives were being paid in the treatment period. We also find that this increase persisted for at least 24 months after the incentives ended. We show that this is consistent with the presence of up-front costs from adjusting care processes that made it too expensive to develop and implement new strategies to increase early initiation of care in the absence of the incentives. Despite large increases in early initiation of prenatal care, we find no effects on health outcomes.

Intervention: Performance-based financial incentives

Populations: Pregnant women, Mothers

Working Paper: Pablo Celhay & Paul Gertler & Paula Giovagnoli & Christel Vermeersch, 2015. "Long Run Effects of Temporary Incentives on Medical Care Productivity," NBER Working Papers 21361, National Bureau of Economic Research, Inc.

Journal Publication: Pablo A. Celhay & Paul J. Gertler & Paula Giovagnoli & Christel Vermeersch, 2019. "Long-Run Effects of Temporary Incentives on Medical Care Productivity," American Economic Journal: Applied Economics, vol 11(3), pages 92-127.

Study Overview

Disease management programs aim to reduce cost by improving the quality of care for chronic diseases. Evidence of their effectiveness is mixed. Reducing health care spending sufficiently to cover program costs has proved particularly challenging. This study uses a difference in differences design to examine the impact of a diabetes disease management program for high risk patients on preventive tests, health outcomes, and cost of care.

Study Results

Heterogeneity is examined along the dimensions of severity (measured using the proxy of poor glycemic control) and preventive testing received in the baseline year. Although disease management programs tend to focus on the sickest, the impact of this program concentrates in the group of people who had not received recommended tests in the preintervention period. If confirmed, such findings are practically important to improve cost-effectiveness in disease management programs by targeting relevant subgroups defined both based on severity and on (missing) test information.

Intervention: Disease management program

Journal Publication: Simcoe T, Catillon M, Gertler P. Who benefits most in disease management programs: Improving target efficiency. Health Economics. 2019; 28: 189–203. https://doi.org/10.1002/hec.3836