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Governance and the effectiveness of public health subsidies: Evidence from Ghana, Kenya and Uganda

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

Abstract

Distributing subsidized health products through existing health infrastructure could substantially and cost-effectively improve health in sub-Saharan Africa. There is, however, widespread concern that poor governance - in particular, limited health worker accountability - seriously undermines the effectiveness of subsidy programs. We audit targeted bednet distribution programs to quantify the extent of agency problems. We find that around 80% of the eligible receive the subsidy as intended, and up to 15% of subsidies are leaked to ineligible people. Supplementing the program with simple financial or monitoring incentives for health workers does not improve performance further and is thus not cost-effective in this context.

Suggested Citation

  • Dizon-Ross, Rebecca & Dupas, Pascaline & Robinson, Jonathan, 2017. "Governance and the effectiveness of public health subsidies: Evidence from Ghana, Kenya and Uganda," Santa Cruz Department of Economics, Working Paper Series qt8352m5xv, Department of Economics, UC Santa Cruz.
    • Handle: RePEc:cdl:ucscec:qt8352m5xv
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    Cited by:

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    More about this item

    Keywords

    Economics; Applied Economics; Economic Theory; Cost Effectiveness Research; Health Services; Comparative Effectiveness Research; Clinical Research; Good Health and Well Being; Leakage; Extortion; Shirking; Motivation; extortion; leakage; motivation; shirking; Econometrics; Applied economics; Economic theory;
    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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