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Power to the people : evidence from a randomized field experiment of a community-based monitoring project in Uganda

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Author Info
Bjorkman, Martina
Svensson, Jakob
Abstract

This paper analyzes the importance of strengthening the relationship of accountability between health service providers and citizens for improving access to and quality of health care. How this is to be achieved, and whether it works, however, remain open questions. The paper presents a randomized field experiment on increasing community-based monitoring. As communities began to more extensively monitor the provider, both the quality and quantity of health service provision improved. One year into the program, there are large increases in utilization, significant weight-for-age z-score gains of infants, and markedly lower deaths among children. The findings on staff behavior suggest that the improvements in quality and quantity of health service delivery resulted from an increased effort by the staff to serve the community. Overall, the results suggest that community monitoring can play an important role in improving service delivery when traditional top-down supervision is ineffective.

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Paper provided by The World Bank in its series Policy Research Working Paper Series with number 4268.

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Date of creation: 01 Jun 2007
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Handle: RePEc:wbk:wbrwps:4268

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Related research
Keywords: Health Monitoring&Evaluation; Housing&Human Habitats; Health Economics&Finance; Disease Control&Prevention; Health Systems Development&Reform;

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  1. Timothy Besley & Robin Burgess, 2002. "The Political Economy Of Government Responsiveness: Theory And Evidence From India," The Quarterly Journal of Economics, MIT Press, vol. 117(4), pages 1415-1451, November. [Downloadable!] (restricted)
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  2. Jimenez, Emmanuel & Sawada, Yasuyuki, 1999. "Do Community-Managed Schools Work? An Evaluation of El Salvador's EDUCO Program," World Bank Economic Review, Oxford University Press, vol. 13(3), pages 415-41, September.
  3. Reinikka, Ritva & Svensson, Jakob, 2004. "The power of information : evidence from a newspaper campaign to reduce capture," Policy Research Working Paper Series 3239, The World Bank. [Downloadable!]
  4. David Strömberg, 2004. "Radio's Impact on Public Spending," The Quarterly Journal of Economics, MIT Press, vol. 119(1), pages 189-221, February. [Downloadable!] (restricted)
  5. Benjamin A. Olken, 2005. "Monitoring Corruption: Evidence from a Field Experiment in Indonesia," NBER Working Papers 11753, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
  6. Nazmul Chaudhury & Jeffrey Hammer & Michael Kremer & Karthik Muralidharan & F. Halsey Rogers, 2006. "Missing in Action: Teacher and Health Worker Absence in Developing Countries," Journal of Economic Perspectives, American Economic Association, vol. 20(1), pages 91-116, Winter. [Downloadable!] (restricted)
  7. Appleton, S., 1995. "'The Rich Are Just Like Us Only Richer' Poverty Functions or Consumption Functions?," Working Papers Series 95-4, Centre for the Study of African Economies, University of Oxford.
  8. Reinikka, Ritva & Svensson, Jakob, 2004. "Working for God?," CEPR Discussion Papers 4214, C.E.P.R. Discussion Papers. [Downloadable!] (restricted)
  9. Timothy Besley & Andrea Prat, 2005. "Handcuffs for the Grabbing Hand? Media Capture and Government Accountability," STICERD - Political Economy and Public Policy Paper Series 07, Suntory and Toyota International Centres for Economics and Related Disciplines, LSE. [Downloadable!]
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  10. Ritva Reinikka & Jakob Svensson, 2005. "Fighting Corruption to Improve Schooling: Evidence from a Newspaper Campaign in Uganda," Journal of the European Economic Association, MIT Press, vol. 3(2-3), pages 259-267, 04/05. [Downloadable!] (restricted)
  11. Ritva Reinikka & Jakob Svensson, 2004. "Local Capture: Evidence From a Central Government Transfer Program in Uganda," The Quarterly Journal of Economics, MIT Press, vol. 119(2), pages 678-704, May. [Downloadable!] (restricted)
  12. Abhijit V. Banerjee & Ruimin He, 2003. "The World Bank of the Future," American Economic Review, American Economic Association, vol. 93(2), pages 39-44, May. [Downloadable!]
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