Is Hypertension Screening Effective in a Low-Resource Setting? A Multidimensional Regression Discontinuity Design

Fabrice Kämpfen, Owen O’Donnell, Carlos Riumalló Herl and Xavier Gómez-Olivé

Economic Development and Cultural Change, 2026, vol. 74, issue 4, 1437 - 1468

Abstract: Noncommunicable diseases impede development, yet evidence on screening in low-resource settings is scarce. We evaluate hypertension screening in rural South Africa using a multidimensional regression discontinuity: a survey measures blood pressure (BP) and refers individuals exceeding either of two thresholds. Overall, referral modestly raises treatment uptake but shows no average BP effect after 4 years. We use BP variation with time of day and temperature to identify screens that are less likely to produce false positives. For these, referrals lower systolic BP by 5 mm Hg and uncontrolled BP by 22 percentage points. Limiting false positives may increase referral impact and program cost-effectiveness.

Date: 2026
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