Monday, July 19, 2010

What am I actually doing?

So far TEPAV has been an exciting place to work, and I've met dozens of bright, enthusiastic people working on interesting projects, who are always looking for new chances to inform policy through research or direct consultation. I've been involving myself in their efforts to expand their influence in social policy, especially in health, education, and women's policy. So far I've been collaborating with Esen, Asli, Sarp, Emin, Sibel and Selin.


TEPAV had never done any work in the health sector before, so we started with a background note describing Turkey's health system, recent reform efforts, and their impact. Turkey has been succesful in expanding health insurance coverage, to 95% of it's population according to some sources, which inspired the headline "Obama imitated Turkey in health reform." It seems that while Turkey has been increasing financial risk protection simply by spending more money (including tripling the salaries of health workers) - they neglected the politically difficult step of establishing cost-control mechanisms, so maybe Obama copied Turkey more than the journalist realized.

But Turkey's challenges are perhaps greater than in the US, as Turkey suffers from a double disease burden - infectious diseases faced by many poorer countries, and rising rates of obesity and diabetes as in richer countries. As one colleague bluntly put it - "Turkey is part Europe, part Africa." This is not entirely an exaggeration - under-five-mortality among the children least educated mothers in Turkey is comparable to that of Algeria, Namibia and South Africa (World Health Organization).


TEPAV has somewhat more experience in education, because of education's role in developing workers for the economy, which is closer to TEPAV's founding interests. Similar to the health sector, we are starting with a background on Turkey's complex education system, the subject of constant tinkering without any deep reform. One encouraging sign here is that female enrollment in primary, secondary, and tertiary education has been increasing in the past decade, though we're still learning how trustworthy the data is. The education ministry brags about increases in female enrollment, but it seems much of the increase has been due to revisions in the census methodology. More on that later.

Within both health and education, I am helping TEPAV grow by planning impact evaluations of specific policies and pilot programs. Specifically, I am interested in using randomized evaluations, which I have several years experience in while working with my previous employer, the Jameel Poverty Action Lab, but integrating this methodology in an approach that HKS professor Lant Pritchett calls evaluation with a "little e". Essentially, policy-makers must admit relative ignorance in what policy will work, design several variants of a program, and using monitoring data, see which seem to be the most cost effective. The most effective program could be a candidate for scaling up, but the learning does not stop there. The goal is not to identify a permanent solution to increasing girls enrollment, but to use "little e" as a good problem solving system, as Bill Easterly recently wrote about.

Women's (labor force) policy

While we're not ignoring how education and health policies affect women and girls, I've been working on another topic with a pure focus on women's policy - female labor - the subject of an earlier blog post. This research has shown that while female labor force participation is very low in Turkey, it is significantly higher than what would be expected given Turkey's level of economic development, the percentage of Muslims in Turkey (and a few other controls). Now I am reviewing the policy options available to Turkey to increase opportunities for women who want to work, for example: removing the headscarf ban in public buildings (including universities and civil service), increasing preschool subsidization and provision (so mothers who want to work can), subsidizing child care, and policies such as conditional cash transfers to increase girls' school enrollment.

The headscarf ban is of course a very complex, politically charged issue, which I'm still learning about after more than 10 years of visiting Turkey. At first I thought it was merely an Orientalist obsession, just a symbol of what separates West and East. While the symbolic value is there, it is a hotly debated issue internally in Turkey, which I'll write more about later. However, TEPAV does not want to inject itself into the complex political and cultural aspects of the debate. If possible, TEPAV wants to conduct neutral research to inform the arguments, especially relating to the effect on the economy, and female education, labor, and general participation in society.

But is there any neutral territory? Will those who dislike our research findings label us disingenuous, concealing ulterior motives? We'll see!

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