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The Political Economy of Public Sector Absence: Experimental Evidence from Pakistan

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  • Michael Callen
  • Saad Gulzar
  • Syed Ali Hasanain
  • Muhammad Yasir Khan

Abstract

Public sector absenteeism undermines service delivery in many developing countries. We report results from an at-scale randomized control evaluation in Punjab, Pakistan of a reform designed to address this problem. The reform affects healthcare for 100 million citizens across 297 political constituencies. It equips government inspectors with a smartphone monitoring system and leads to a 76% increase in inspections. However, the surge in inspections does not always translate into increased doctor attendance. The scale of the experiment permits an investigation into the mechanisms underlying this result. We find that experimentally increasing the salience of doctor absence when communicating inspection reports to senior policymakers improves subsequent doctor attendance. Next, we find that both the reform and the communication of information to senior officials are more impactful in politically competitive constituencies. Our results suggest that interactions between politicians and bureaucrats might play a critical role in shaping the success or failure of reforms.

Suggested Citation

  • Michael Callen & Saad Gulzar & Syed Ali Hasanain & Muhammad Yasir Khan, 2016. "The Political Economy of Public Sector Absence: Experimental Evidence from Pakistan," NBER Working Papers 22340, National Bureau of Economic Research, Inc.
  • Handle: RePEc:nbr:nberwo:22340
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    2. Sylvain Chassang & Gerard Padró i Miquel, 2014. "Corruption, Intimidation, and Whistle-blowing: a Theory of Inference from Unverifiable Reports," NBER Working Papers 20315, National Bureau of Economic Research, Inc.
    3. Ruben Enikolopov, 2011. "Are Bureaucrats Really Paid Like Bureaucrats?," Working Papers w0165, Center for Economic and Financial Research (CEFIR).
    4. Meeks, Robyn C. & Omuraliev, Arstan & Isaev, Ruslan & Wang, Zhenxuan, 2023. "Impacts of electricity quality improvements: Experimental evidence on infrastructure investments," Journal of Environmental Economics and Management, Elsevier, vol. 120(C).
    5. Chicoine, Luke & Guzman, Juan Carlos, 2017. "Increasing Rural Health Clinic Utilization with SMS Updates: Evidence from a Randomized Evaluation in Uganda," World Development, Elsevier, vol. 99(C), pages 419-430.
    6. Sylvain Chassang & Gerard Padro i Miquel, 2014. "Corruption, Intimidation, and Whistleblowing: A Theory of Inference from Unverifiable Reports," Working Papers 062-2014, Princeton University, Department of Economics, Econometric Research Program..
    7. Dhaliwal, Iqbal & Hanna, Rema, 2017. "The devil is in the details: The successes and limitations of bureaucratic reform in India," Journal of Development Economics, Elsevier, vol. 124(C), pages 1-21.
    8. Marianne Bertrand & Robin Burgess & Arunish Chawla & Guo Xu, 2020. "The Glittering Prizes: Career Incentives and Bureaucrat Performance," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 87(2), pages 626-655.
    9. Hasanain, Syed Ali & Khan, Muhammad Yasir & Rezaee, Arman, 2023. "No bulls: Experimental evidence on the impact of veterinarian ratings in Pakistan," Journal of Development Economics, Elsevier, vol. 161(C).
    10. Thomas Bossuroy & Clara Delavallade & Vincent Pons, 2019. "Biometric Tracking, Healthcare Provision, and Data Quality: Experimental Evidence from Tuberculosis Control," NBER Working Papers 26388, National Bureau of Economic Research, Inc.
    11. Muhammad Haseeb & Kate Vyborny, 2016. "Imposing institutions: Evidence from cash transfer reform in Pakistan," CSAE Working Paper Series 2016-36, Centre for the Study of African Economies, University of Oxford.
    12. Friedman, Willa, 2018. "Corruption and averting AIDS deaths," World Development, Elsevier, vol. 110(C), pages 13-25.
    13. De La O, Ana L. & González, Lucas I. & Weitz-Shapiro, Rebecca, 2023. "Voluntary audits: Experimental evidence on a new approach to monitoring front-line bureaucrats," World Development, Elsevier, vol. 162(C).
    14. Zubair K. Bhatti & Jody Zall Kusek & Tony Verheijen, 2015. "Logged On : Smart Government Solutions from South Asia," World Bank Publications - Books, The World Bank Group, number 20487, December.

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    More about this item

    JEL classification:

    • D02 - Microeconomics - - General - - - Institutions: Design, Formation, Operations, and Impact
    • D72 - Microeconomics - - Analysis of Collective Decision-Making - - - Political Processes: Rent-seeking, Lobbying, Elections, Legislatures, and Voting Behavior
    • D73 - Microeconomics - - Analysis of Collective Decision-Making - - - Bureaucracy; Administrative Processes in Public Organizations; Corruption

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