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Policymaking, Trust, and the Demand for Public Services: Evidence from a Mass Sterilization Campaign

Author

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  • Gianmarco León-Ciliotta
  • Dijana Zejcirovic
  • Fernando Fernandez

Abstract

We study a large-scale family planning intervention in which more than 260,000 Peruvian women were sterilized. Many of these medical procedures are alleged to have been performed without patient consent. The subsequent disclosure of alleged illegal sterilizations caused reductions in the usage of contraceptive methods and prenatal and birth delivery services and, more generally, the demand for medical services in affected areas. As a result, child health worsened. The results persist for at least 17 years after the information disclosure and are driven by disappointed supporters of the implementing government. Learning about the government's malpractices undermined trust in institutions.

Suggested Citation

  • Gianmarco León-Ciliotta & Dijana Zejcirovic & Fernando Fernandez, 2025. "Policymaking, Trust, and the Demand for Public Services: Evidence from a Mass Sterilization Campaign," American Economic Journal: Economic Policy, American Economic Association, vol. 17(1), pages 181-215, February.
    • Handle: RePEc:aea:aejpol:v:17:y:2025:i:1:p:181-215
    DOI: 10.1257/pol.20230155
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    More about this item

    JEL classification:

    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • I38 - Health, Education, and Welfare - - Welfare, Well-Being, and Poverty - - - Government Programs; Provision and Effects of Welfare Programs
    • J13 - Labor and Demographic Economics - - Demographic Economics - - - Fertility; Family Planning; Child Care; Children; Youth
    • J16 - Labor and Demographic Economics - - Demographic Economics - - - Economics of Gender; Non-labor Discrimination
    • J18 - Labor and Demographic Economics - - Demographic Economics - - - Public Policy
    • O15 - Economic Development, Innovation, Technological Change, and Growth - - Economic Development - - - Economic Development: Human Resources; Human Development; Income Distribution; Migration

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