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Recent Scientific Accomplishments Leonard’s area of research is the delivery of key public services to rural populations in developing countries and most of his work has focused on the delivery of curative health services in such areas. His early work in this area, “African Traditional Healers and Outcome-Contingent Contracts in Health Care?(Journal of Development Economics) and “Outcome Versus Service Based Payment in Health Care: Lessons from African Traditional Healers? (Health Economics) focused on the role played by traditional healers and particularly on the lessons for modern health care delivery that can be drawn from their continued popularity. These lessons, as applied to modern sector providers, point to the non-governmental sector as a potentially important organizational form for service delivery. Papers on this subject include, “When Both States and Markets Fail: Asymmetric Information and the Role of NGOs in African Health Care?(International Review of Law and Economics) and “The Political Economy of Improving Health Care for the Poor in Rural Africa: Institutional Solutions to the Principal-Agent Problem? (Journal of Development Studies). Leonard administered an NSF-funded research project in the Arusha region of Tanzania that sought to tie objective measures of health care quality to households?subjective assessment of the quality of care available to them. In order to do this, Leonard developed two new data collection instruments to measure the quality of care available in health facilities. Together with colleagues at the World Bank, his work has led to a better understanding of how to use key survey instruments in developing countries. Papers on this subject include, “Outpatient process quality evaluation and the Hawthorne Effect?and “Comparing vignettes and direct clinician observation in a developing country context?(both in Social Science & Medicine). Leonard’s current research focuses on showing how information about quality of care is shared in rural communities and how households use this information to improve outcomes by choosing doctors according to their illnesses. Papers on this subject include, “Learning in Health Care: Evidence of learning about clinician quality in Tanzania?(forthcoming in Economic Development and Cultural Change) and “Bypassing Health Centers in Tanzania: Revealed Preferences for Observable and Unobservable Quality?(Journal of African Economies). Leonard currently has an R21 pending review at NICHD, to test the association between medical adherence to protocols and health outcomes in rural Tanzania. Together with Jishnu Das and Jeffery Hammer of the World Bank, Leonard is preparing a paper for publication in the Journal of Economic Perspectives on the quality of health care in developing countries and how the distribution of quality differentially impacts the poor and residents of rural areas. With J. Das and Paul Gertler, Leonard is working on a project to describe the role of competence and training in health care quality in India, Rwanda, Tanzania and Indonesia. This project aims to improve our understanding of the reasons why doctors in developing countries appear to practice at levels of quality significantly below their capacity. A significant portion of his future work is devoted to randomized trials to improve health care in developing countries, specifically in Tanzania. He has a pending R21 to conduct a pilot intervention study where facilities assigned to treatment will receive both intense monitoring of doctors coupled with in the field training on adherence to medical protocol. The study will link patient outcome data with data from how they were treated by medical personnel over the study. | ||||||||
Maryland Population Research Center
0124N Cole Student Activities Building (#162)
College Park, MD 20742
Phone: 301-405-6403
Fax: 301-405-5743