Improving "Last Mile" Supply Chains for Ready-to-Use Therapeutic Foods

Client
Action Against Hunger USA
Faculty
Kate Bourne
Team
Alison Greer, Shawn Sippin, Jordan Sisson, Elodie Turchi

Action Against Hunger is an international humanitarian organization committed to ending world hunger. Through a system known as integrated community case management (iCCM) and nutrition, the organization seeks to expand the treatment of severe acute malnutrition (SAM)—a leading cause of death among children under the age of five. SAM can be treated in outpatient settings with Ready-to-Use Therapeutic Food (RUTF), such as Plumpy’Nut, which is difficult to transport. Action Against Hunger engaged a Capstone team to develop recommendations for how iCCM supply chains could be strengthened to support RUTF in remote, rural, or humanitarian contexts to ensure that patients receive the life-saving medicine. The team conducted a literature review and key informant interviews with logisticians, researchers, and program specialists in order to identify common challenges and possible means for improving drug management across settings. Based on its findings, the team drafted an innovative research proposal to field test its idea.

Inputs to Development: How the Millennium Development Goals Affect Nonprofit Resources

Client
U.S. Nonprofit International Development Industry Response to United Nations Millennium Development Goal Adoption
Faculty
Aram Hur
Team
Anupama Sharma, Erilia Wu, Luke Douglas

A set of eight global priorities to eradicate extreme poverty, the United Nations Millennium Development Goals (MDGs) were met with great optimism in 2000. While many studies have examined developmental progress in the intervening 15 years, how much of these outputs are directly attributable to the MDGs remains unclear. The Capstone team’s novel study focused on a different part of the causal chain: inputs. What effect, if any, did the MDGs have on the funding and spending activities of international development nonprofit organizations? Nonprofit organizations are key players in the international development sector. Using a rare IRS dataset that includes over one million firm-level records on funding and spending areas from 1987-2015, the Capstone team analyzed changes in the total funding and spending of U.S.-based MDG-aligned nonprofits before and after the adoption of the MDGs in 2000. The team’s findings have significant implications for the role of nonprofits in the development sector and provide a creative impact evaluation model for the recently-adopted Sustainable Development Goals.

Searching for Strategies to Improve the Value of Healthcare in Accountable Care Organizations

Client
Healthcare in Accountable Care Organizations
Faculty
Aram Hur
Team
Cary Blum, Joy Kim, Diana Rosenthal, Sarah Trench

Accountable Care Organizations (ACOs) were established by the Affordable Care Act as a way to improve the value of healthcare—defined as the ratio of healthcare quality to cost—in the Medicare population. ACOs are incentivized to achieve high-value care by keeping a portion of their cost savings below a set benchmark. This model has created an environment of experimentation in which organizations are choosing different inputs to achieve the same goal of high-value care. While the number of healthcare providers opting into ACOs is rapidly increasing, the novelty of this policy has resulted in a paucity of systematic studies examining what factors contribute to high-performance ACOs. To address this gap, the Capstone team analyzed the most up-to-date, partial panel data on ACO characteristics from the Center for Medicare and Medicaid Services public use files. The team identified the specific strategies associated with holistic measures of high-value care that include lower costs as well as better health outcomes.

Can Consumer Protection Practices Help Microfinance Clients Avoid the Perils of Debt?

Client
Financial Inclusion
Faculty
Aram Hur
Team
Anita Gardeva, Charles Reinhardt, Jong Myeong Lim, Pattrapa Vejpattarasiri

A means to help low-income individuals gain access to credit, microfinance has been met with mixed results, sometimes increasing clients’ over-indebtedness and threatening their financial welfare. A growing industry solution is the implementation of a set of “consumer protection policies,” one of which is a simple fact sheet that fully discloses a loan’s interest rates and terms. This study provides one of the few systematic tests of the effectiveness of such policies. The Capstone team used detailed data from the microfinance database MIX Market, which tracks the write-off ratios for loans, a useful proxy for over-indebtedness. Using various statistical methods to address selection bias and delayed effects, the team found that on average, full disclosure policy is robustly associated with lower write-off ratios. The fact that the team detected policy effects with write-off ratios, a distant and conservative estimate of actual over-indebtedness, suggests a clear policy recommendation: the provision of fact sheets and general consumer protection policies prior to engaging in microfinance can significantly mitigate its negative effects

Beyond Classroom Diversity: How Community Context Conditions Student Achievement in New York State

Client
Diversity in New York State’s Public Schools
Faculty
Aram Hur

Over the past 30 years, an interesting phenomenon has taken shape in education systems in the United States: despite rising levels of national diversity, public schools have become increasingly racially segregated. While previous studies link greater diversity to better student performance, the focus remains largely on classroom diversity. Yet a large educational and psychological body of literature suggests that relational diversity—the discrepancy of diversity experienced in one’s surroundings versus the classroom—is an important factor in educational performance. A Capstone team provided the first empirical test of this hypothesis in the context of New York State, where blacks and Hispanics face the highest rates of educational segregation in the country. Using geocoded data on public schools merged with Census data on diversity in the surrounding area, the team found that a one-unit increase in a school’s relational diversity is associated with a 7 percentage point increase in the proportion of students who pass the State English Language Arts exam. The findings have important implications for how policies on school redistricting, zoning, and integration relate to academic performance.

Subscribe to