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Working for God? evualuating service delivery of religious not-for-profit health care providers in Uganda

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  • Reinikka, Ritva
  • Svensson, Jakob

Abstract

Reinikka and Svensson exploit a unique micro-level data set on primary health care facilities in Uganda to address the question: What motivates religious not-for-profit (RNP) health care providers? The authors use two approaches to identify whether an altruistic (religious) effect exists in the data. First, examining cross-section variation, they show that RNP facilities hire qualified medical staff below the market wage, are more likely to provide propoor services and services with a public good element, and charge lower prices for services than for-profit facilities, although they provide a similar (observable) quality of care. RNP and for-profit facilities both provide better quality care than their government counterparts, although government facilities have better equipment. These findings are consistent with the view that RNP facilities are driven in part by altruistic concerns and that these preferences matter quantitatively. Second, the authors exploit a near natural experiment in which the government initiated a program of financial aid for the RNP sector. They show that financial aid leads to more laboratory testing of suspected malaria and intestinal worm cases, and hence higher quality of service and lower prices, but only in RNP facilities. The findings suggest that working for God matters.

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Bibliographic Info

Paper provided by The World Bank in its series Policy Research Working Paper Series with number 3058.

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Date of creation: 31 May 2003
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Handle: RePEc:wbk:wbrwps:3058

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Keywords: Payment Systems&Infrastructure; Public Health Promotion; Labor Policies; Health Systems Development&Reform; Health Monitoring&Evaluation; Health Monitoring&Evaluation; Housing&Human Habitats; Health Systems Development&Reform; International Terrorism&Counterterrorism; Health Economics&Finance;

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  1. Okello, D. O. & Lubanga, R. & Guwatudde, D. & Sebina-Zziwa, A., 1998. "The challenge to restoring basic health care in Uganda," Social Science & Medicine, Elsevier, vol. 46(1), pages 13-21, January.
  2. Frank A. Sloan & Gabriel A. Picone & Donald H. Taylor, Jr. & Shin-Yi Chou, 1998. "Hospital Ownership and Cost and Quality of Care: Is There a Dime's Worth of Difference?," NBER Working Papers 6706, National Bureau of Economic Research, Inc.
  3. Tomas Philipson, 2000. "Asymmetric Information and the Not-for-Profit Sector Does Its Output Sell a a Premium?," NBER Chapters, in: The Changing Hospital Industry: Comparing For-Profit and Not-for-Profit Institutions, pages 325-356 National Bureau of Economic Research, Inc.
  4. Mark G. Duggan, 2000. "Hospital Ownership And Public Medical Spending," The Quarterly Journal of Economics, MIT Press, vol. 115(4), pages 1343-1373, November.
  5. Edward L. Glaeser & Andrei Shleifer, 1998. "Not-For-Profit Entrepreneurs," Harvard Institute of Economic Research Working Papers 1852, Harvard - Institute of Economic Research.
  6. Susan Rose-Ackerman, 1996. "Altruism, Nonprofits, and Economic Theory," Journal of Economic Literature, American Economic Association, vol. 34(2), pages 701-728, June.
  7. Ritva Reinikka & Paul Collier, 2001. "Uganda's Recovery : The Role of Farms, Firms, and Government," World Bank Publications, The World Bank, number 13850.
  8. Lakdawalla, Darius & Philipson, Tomas, 2006. "The nonprofit sector and industry performance," Journal of Public Economics, Elsevier, vol. 90(8-9), pages 1681-1698, September.
  9. Anup Malani & Tomas Philipson & Guy David, 2003. "Theories of Firm Behavior in the Nonprofit Sector. A Synthesis and Empirical Evaluation," NBER Chapters, in: The Governance of Not-for-Profit Organizations, pages 181-216 National Bureau of Economic Research, Inc.
  10. Pauly, Mark V & Redisch, Michael, 1973. "The Not-For-Profit Hospital as a Physicians' Cooperative," American Economic Review, American Economic Association, vol. 63(1), pages 87-99, March.
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Cited by:
  1. Deininger, Klaus & Mpuga, Paul, 2004. "Economic and Welfare Effects of the Abolition of Health User Fees : Evidence from Uganda," Policy Research Working Paper Series 3276, The World Bank.

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