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Management, Supervision, and Health Care: A Field Experiment

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  • Felipe A. Dunsch
  • David K. Evans
  • Ezinne Eze-Ajoku
  • Mario Macis

Abstract

We used a randomized management consulting intervention with 80 public-sector healthcare facilities in Nigeria to study the role of information, training, and supervision on the adoption of improved organizational practices. Facilities that received detailed improvement plans and nine months of implementation support—including regular visits to monitor progress and set intermediate goals related to the plans—showed large, significant short-term effects on the adoption of practices that were under the responsibility of facility staff. Facilities that received general improvement advice but no implementation support showed no change in practices. Implementation support appears crucial for improvements, especially in contexts without market incentives for the adoption of effective managerial practices.

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  • Felipe A. Dunsch & David K. Evans & Ezinne Eze-Ajoku & Mario Macis, 2017. "Management, Supervision, and Health Care: A Field Experiment," NBER Working Papers 23749, National Bureau of Economic Research, Inc.
    • Handle: RePEc:nbr:nberwo:23749
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    2. Daniela Scur & Raffaella Sadun & John Van Reenen & Renata Lemos & Nicholas Bloom, 2021. "The World Management Survey at 18: lessons and the way forward," Oxford Review of Economic Policy, Oxford University Press and Oxford Review of Economic Policy Limited, vol. 37(2), pages 231-258.
    3. Harris, Donna & Borcan , Oana & Serra, Danila & Telli, Henry & Schettini, Bruno & Dercon, Stefan, 2024. "Proud to Belong: The Impact of Ethics Training on Police Officers in Ghana," CEPR Discussion Papers 19141, C.E.P.R. Discussion Papers.
    4. Erlyn K Macarayan & Hannah L Ratcliffe & Easmon Otupiri & Lisa R Hirschhorn & Kate Miller & Stuart R Lipsitz & Atul A Gawande & Asaf Bitton, 2019. "Facility management associated with improved primary health care outcomes in Ghana," PLOS ONE, Public Library of Science, vol. 14(7), pages 1-19, July.
    5. Donna Harris & Oana Borcan & Danila Serra & Henry Telli & Bruno Schettini & Stefan Dercon, 2022. "Proud to belong: The impact of ethics training on police officers," CSAE Working Paper Series 2022-05, Centre for the Study of African Economies, University of Oxford.
    6. Dunsch, Felipe Alexander & Velenyi, Edit, 2019. "Job Preferences of Frontline Health Workers in Ghana - A Discrete Choice Experiment," SocArXiv bqx5k, Center for Open Science.
    7. Shamma Adeeb Alam & Bijetri Bose, 2022. "Stepping into adulthood during a recession: Did job losses during the Great Recession impact health of young adults?," Health Economics, John Wiley & Sons, Ltd., vol. 31(8), pages 1730-1751, August.
    8. Sandra G. Sosa-Rubí & Sergio Bautista-Arredondo & Carlos Chivardi-Moreno & David Contreras-Loya & Gina Hera-Fuentes & Marjorie Opuni, 2021. "Efficiency, quality, and management practices in health facilities providing outpatient HIV services in Kenya, Nigeria, Rwanda, South Africa and Zambia," Health Care Management Science, Springer, vol. 24(1), pages 41-54, March.
    9. Gauri, Varun & Jamison, Julian C. & Mazar, Nina & Ozier, Owen, 2021. "Motivating bureaucrats through social recognition: External validity—A tale of two states," Organizational Behavior and Human Decision Processes, Elsevier, vol. 163(C), pages 117-131.
    10. Gauri, Varun & Jamison, Julian C. & Mazar, Nina & Ozier, Owen, 2019. "Motivating Bureaucrats through Social Recognition: External Validity — A Tale of Two States," IZA Discussion Papers 12251, Institute of Labor Economics (IZA).

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    More about this item

    JEL classification:

    • I15 - Health, Education, and Welfare - - Health - - - Health and Economic Development
    • M10 - Business Administration and Business Economics; Marketing; Accounting; Personnel Economics - - Business Administration - - - General
    • O15 - Economic Development, Innovation, Technological Change, and Growth - - Economic Development - - - Economic Development: Human Resources; Human Development; Income Distribution; Migration

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