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Governance and the Effectiveness of Public Health Subsidies

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  • Dupas, Pascaline
  • Robinson, Jonathan
  • Dizon-Ross, Rebecca

Abstract

Heavily subsidizing essential health products through existing health infrastructure has the potential to substantially decrease child mortality in sub-Saharan Africa. There is, however, widespread concern that poor governance and in particular limited accountability among health workers seriously undermines the effectiveness of such programs. We performed innovative audits on bed net distribution programs in three countries (Ghana, Kenya and Uganda) to investigate local agency problems and their determinants in the allocation of targeted subsidies. Overall, agency concerns appear modest. Around 80% of the eligible receive the subsidy as intended and leakage to the ineligible appears limited, even when the ineligible have a high willingness to pay. The estimated level of mistargeting only modestly affects the cost-effectiveness of free distribution.

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  • Dupas, Pascaline & Robinson, Jonathan & Dizon-Ross, Rebecca, 2015. "Governance and the Effectiveness of Public Health Subsidies," CEPR Discussion Papers 10690, C.E.P.R. Discussion Papers.
    • Handle: RePEc:cpr:ceprdp:10690
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    More about this item

    Keywords

    Extortion; Leakage; Motivation; Shirking;
    All these keywords.

    JEL classification:

    • D73 - Microeconomics - - Analysis of Collective Decision-Making - - - Bureaucracy; Administrative Processes in Public Organizations; Corruption
    • H11 - Public Economics - - Structure and Scope of Government - - - Structure and Scope of Government
    • I15 - Health, Education, and Welfare - - Health - - - Health and Economic Development
    • I38 - Health, Education, and Welfare - - Welfare, Well-Being, and Poverty - - - Government Programs; Provision and Effects of Welfare Programs

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