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Power to the people : evidence from a randomized field experiment of a community-based monitoring project in Uganda

Author

Listed:
  • Bjorkman, Martina
  • Svensson, Jakob

Abstract

This paper analyzes the importance of strengthening the relationship of accountability between health service providers and citizens for improving access to and quality of health care. How this is to be achieved, and whether it works, however, remain open questions. The 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, there are large increases in utilization, significant weight-for-age z-score gains of infants, and markedly lower deaths among children. The findings on staff behavior 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

  • Bjorkman, Martina & Svensson, Jakob, 2007. "Power to the people : evidence from a randomized field experiment of a community-based monitoring project in Uganda," Policy Research Working Paper Series 4268, The World Bank.
    • Handle: RePEc:wbk:wbrwps:4268
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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.
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    9. Timothy Besley & Robin Burgess, 2002. "The Political Economy of Government Responsiveness: Theory and Evidence from India," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 117(4), pages 1415-1451.
    10. Ritva Reinikka & Jakob Svensson, 2004. "Local Capture: Evidence from a Central Government Transfer Program in Uganda," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 119(2), pages 679-705.
    11. Svensson, Jakob & Reinikka, Ritva, 2004. "Working for God?," CEPR Discussion Papers 4214, C.E.P.R. Discussion Papers.
    12. Benjamin A. Olken, 2007. "Monitoring Corruption: Evidence from a Field Experiment in Indonesia," Journal of Political Economy, University of Chicago Press, vol. 115(2), pages 200-249.
    13. 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.
    14. Simon Appleton, 2001. "‘The Rich Are Just Like Us, Only Richer’: Poverty Functions or Consumption Functions?," Journal of African Economies, Centre for the Study of African Economies, vol. 10(4), pages 433-469.
    Full references (including those not matched with items on IDEAS)

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    Blog mentions

    As found by EconAcademics.org, the blog aggregator for Economics research:
    1. AusAID needs a Technology for Development Strategy
      by Gerard McCarthy in Development Policy Blog on 2013-08-07 01:00:11
    2. 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

    Citations

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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. Bet Caeyers, 2014. "Peer effects in development programme awareness of vulnerable groups in rural Tanzania," CSAE Working Paper Series 2014-11, Centre for the Study of African Economies, University of Oxford.
    3. Sarwari, Abdul Nafi & Jinnai, Yusuke, 2017. "Does the community-based development program contribute to the economic welfare of rural households? Evidence from a randomized experiment in Afghanistan," Economics Discussion Papers 2017-18, Kiel Institute for the World Economy (IfW).
    4. Vasylyeva, Anna & Merkle, Ortrun, 2018. "Combatting corruption in higher education in Ukraine," MERIT Working Papers 2018-021, United Nations University - Maastricht Economic and Social Research Institute on Innovation and Technology (MERIT).
    5. Miriam Bruhn & David McKenzie, 2009. "In Pursuit of Balance: Randomization in Practice in Development Field Experiments," American Economic Journal: Applied Economics, American Economic Association, vol. 1(4), pages 200-232, October.
    6. 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.
    7. 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.
    8. Frederico Gil Sander & Intan Nadia Jalil & Rabia Ali, 2013. "Malaysia Economic Monitor, December 2013 : High-Performing Education," World Bank Publications - Reports 16705, The World Bank Group.
    9. Elisabeth King & Cyrus Samii & Birte Snilstveit, 2010. "Interventions to promote social cohesion in sub-Saharan Africa," Journal of Development Effectiveness, Taylor & Francis Journals, vol. 2(3), pages 336-370.
    10. Julia E. Tobias & Sudarno Sumarto & Habib Moody, "undated". "Assessing the Political Impacts of a Conditional Cash Transfer: Evidence from a Randomized Policy Experiment in Indonesia," Working Papers 262, Publications Department.
    11. Devra C. Moehler, 2010. "Democracy, Governance, and Randomized Development Assistance," The ANNALS of the American Academy of Political and Social Science, , vol. 628(1), pages 30-46, March.
    12. repec:oxf:wpaper:wps/2014-11 is not listed on IDEAS
    13. World Bank, 2011. "Accountability in Public Services in South Africa," World Bank Publications - Reports 29723, The World Bank Group.
    14. Anushka Verma & Arun K. Giri & Byomakesh Debata, 2023. "Does ICT diffusion reduce poverty? Evidence from SAARC countries," Poverty & Public Policy, John Wiley & Sons, vol. 15(1), pages 8-28, March.

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    More about this item

    Keywords

    Health Monitoring&Evaluation; Housing&Human Habitats; Health Economics&Finance; Disease Control&Prevention; Health Systems Development&Reform;
    All these keywords.

    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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