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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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  • Björkman Nyqvist, Martina
  • Svensson, Jakob

Abstract

Strengthening the relationship of accountability between health service providers and citizens is by many people viewed as critical for improving access to and quality of health care. How this is to be achieved, and whether it works, however, remain open questions. This 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, we find large increases in utilization, significant weight-for-age z-scores gains of infants, and markedly lower deaths among children. The findings on staff behaviour 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.

Suggested Citation

  • Björkman Nyqvist, Martina & Svensson, Jakob, 2007. "Power to the People: Evidence from a Randomized Field Experiment of a Community-Based Monitoring Project in Uganda," CEPR Discussion Papers 6344, C.E.P.R. Discussion Papers.
  • Handle: RePEc:cpr:ceprdp:6344
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    References listed on IDEAS

    as
    1. 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.
    2. 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.
    3. Reinikka, Ritva & Svensson, Jakob, 2004. "Working for God?," CEPR Discussion Papers 4214, C.E.P.R. Discussion Papers.
    4. Timothy Besley & Robin Burgess, 2002. "The Political Economy of Government Responsiveness: Theory and Evidence from India," The Quarterly Journal of Economics, Oxford University Press, vol. 117(4), pages 1415-1451.
    5. Jimenez, Emmanuel & Sawada, Yasuyuki, 1999. "Do Community-Managed Schools Work? An Evaluation of El Salvador's EDUCO Program," World Bank Economic Review, World Bank Group, vol. 13(3), pages 415-441, September.
    6. Benjamin A. Olken, 2007. "Monitoring Corruption: Evidence from a Field Experiment in Indonesia," Journal of Political Economy, University of Chicago Press, vol. 115, pages 200-249.
    7. Timothy Besley & Andrea Prat, 2006. "Handcuffs for the Grabbing Hand? Media Capture and Government Accountability," American Economic Review, American Economic Association, vol. 96(3), pages 720-736, June.
    8. Ritva Reinikka & Jakob Svensson, 2004. "Local Capture: Evidence from a Central Government Transfer Program in Uganda," The Quarterly Journal of Economics, Oxford University Press, vol. 119(2), pages 679-705.
    9. 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.
    10. 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.
    11. David Strömberg, 2004. "Radio's Impact on Public Spending," The Quarterly Journal of Economics, Oxford University Press, vol. 119(1), pages 189-221.
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    Blog mentions

    As found by EconAcademics.org, the blog aggregator for Economics research:
    1. Time for a new approach to improving governance in PNG? Try transparency and social mobilisation
      by Stephen Howes in Development Policy Blog on 2013-06-12 01:00:39
    2. AusAID needs a Technology for Development Strategy
      by Gerard McCarthy in Development Policy Blog on 2013-08-07 01:00:11

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    Cited by:

    1. Abhijit V. Banerjee & Esther Duflo, 2009. "The Experimental Approach to Development Economics," Annual Review of Economics, Annual Reviews, vol. 1(1), pages 151-178, May.
    2. World Bank, 2011. "Accountability in Public Services in South Africa," World Bank Other Operational Studies 29723, The World Bank.
    3. Simeon Djankov & Rafael La Porta & Florencio Lopez-de-Silanes & Andrei Shleifer, 2010. "Disclosure by Politicians," American Economic Journal: Applied Economics, American Economic Association, vol. 2(2), pages 179-209, April.
    4. Shylashri Shankar & Raghav Gaiha & Raghbendra Jha, 2011. "Information, Access and Targeting: The National Rural Employment Guarantee Scheme in India," Oxford Development Studies, Taylor & Francis Journals, vol. 39(1), pages 69-95.
    5. Frederico Gil Sander & Intan Nadia Jalil & Rabia Ali, 2013. "Malaysia Economic Monitor, December 2013 : High-Performing Education," World Bank Other Operational Studies 16705, The World Bank.
    6. Julia, Tobias & Sumarto, Sudarno & Moody, Habib, 2014. "Assessing the Political Impacts of a Conditional Cash Transfer: Evidence from a Randomized Policy Experiment in Indonesia," MPRA Paper 59091, University Library of Munich, Germany.

    More about this item

    Keywords

    Accountability; Field experiment; Health; Monitoring;

    JEL classification:

    • D78 - Microeconomics - - Analysis of Collective Decision-Making - - - Positive Analysis of Policy Formulation and Implementation
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • O15 - Economic Development, Innovation, Technological Change, and Growth - - Economic Development - - - Economic Development: Human Resources; Human Development; Income Distribution; Migration

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