Improving School Preparedness and Child Health Outcomes Through ICDS

In India, programs that promote early childhood development are delivered primarily by Integrated Child Development Services (ICDS) through anganwadi centers (AWCs) staffed by anganwadi workers (AWWs). ICDS overall and AWCs in particular are under-resourced relative to their importance for human development, resulting in uneven quality (PEO, 2011). Yet, fiscal constraints make large increases in ICDS spending difficult. It is thus critical to determine the most cost-effective methods for boosting ICDS quality so that scarce resources can be directed to programs that generate maximal social value.

The researchers propose to study the impact of pay-for-performance (P4P) bonuses to frontline childcare workers on child health in the state of Tamil Nadu, using an RCT conducted across a representative sample of childcare centers. Key features of the study include: (1) The bonus will represent roughly 20% of the annual pay of each worker, a large payment that we expect will motivate workers to exert considerable extra effort; (2) The impact of the P4P program will be measured both against a control group, and against a second treatment arm where workers are provided an unconditional across-the-board pay increase equal to the average pay increase provided by the P4P program; (3) Researchers pay careful attention to the details of the P4P scheme, and aim to overcome design challenges of previous P4P schemes in health and education by adopting an optimal incentive pay formula developed in recent theoretical work.