Africa & Development
Research insight
Editorial from
Anne Karing
Princeton University
November 16, 2022
3. Good health and well-being

3. Good health and well-being

Ensuring access to quality health and promoting well-being for all, at all ages

Social Signaling and Childhood Immunization: A Field Experiment in Sierra Leone

RESEARCH SEMINAR | Under the the theme Economic Development in Africa, the NOVAFRICA Knowledge Center welcomes Anne Karing from Princeton University to present her work on Social Signaling and Childhood Immunization in Sierra Leone.


This paper investigates social signaling in the context of childhood immunization in Sierra Leone. I introduce a durable signal – in the form of differently colored bracelets – which children receive upon vaccination and implement a 22-month-long experiment in 120 public clinics. Informed by theory, the experimental design separately identifies social signaling from leading alternative mechanisms. In a first main finding, I show that individuals use signals to learn about others’ actions. Second, I find that the impact of signals varies significantly with the social desirability of the action. In particular, the signal has a weak effect when linked to a vaccine with low perceived benefits and a large, positive effect when linked to a vaccine with high perceived benefits. Of substantive policy importance, signals increase timely and complete vaccination by 14 percentage points at a cost of approximately 1 USD per child. Finally, I structurally estimate a dynamic discrete-choice model to quantify the value of social signaling. I find that parents’ value of signaling completion is equivalent to the cost of walking 5-8 miles.

Read the paper here.

This content was originally published in Novafrica's website.

Anne Karing
Princeton University

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