Social Accountability and Service Delivery: Experimental Evidence from Uganda

Fiala, Nathan; Premand, Patrick

doi:10.1596/1813-9450-8449

Cited by 20 publications

(53 citation statements)

References 11 publications

(12 reference statements)

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“…Instead, they are consistent with previous work suggesting that social incentives such as nonfinancial awards can be used to boost worker performance in mission-oriented settings (Ashraf et al 2014), as well as other experimental settings (Kosfeld and Neckermann 2011) and the private sector (Markham et al 2002). Empowering citizens through community monitoring has also been examined as a tool for improving service delivery in a variety of social sectors, including education (Banerjee et al 2010;Pradhan et al 2011;Barr et al 2012;Andrabi et al 2018), corruption (Fiala and Premand 2018;Olken 2007) and health. As discussed above, our results align closely with Björkman and Svensson (2009), but are further from the more recent work of Raffler et al (2019) who also examine community monitoring of health clinics in Uganda, but find weak effects.…”

Section: Introductionsupporting

confidence: 82%

Building Resilient Health Systems: Experimental Evidence from Sierra Leone and the 2014 Ebola Outbreak

Christensen¹,

Dube

Haushofer

et al. 2020

SSRN Journal

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Developing countries are characterized by high rates of mortality and morbidity. A potential contributing factor is the low utilization of health systems, stemming from the low perceived quality of care delivered by health personnel. This factor may be especially critical during crises, when individuals choose whether to cooperate with response efforts and frontline health personnel. We experimentally examine efforts aimed at improving health worker performance in the context of the 2014-15 West African Ebola crisis. Roughly two years before the outbreak in Sierra Leone, we randomly assigned two accountability interventions to government-run health clinics -one focused on community monitoring and the other gave status awards to clinic staff. We find that over the medium run, prior to the Ebola crisis, both interventions led to improvements in utilization of clinics and patient satisfaction with the health system. In addition, child health outcomes improved substantially in the catchment areas of community monitoring clinics. During the crisis, the interventions also led to higher reported Ebola cases, as well as lower mortality from Ebola -particularly in areas with community monitoring clinics. We explore three potential mechanisms: the interventions (1) increased the likelihood that patients reported Ebola symptoms and sought care; (2) unintentionally increased Ebola incidence; or (3) improved surveillance efforts. We find evidence consistent with the first: by building trust and confidence in health workers, and improving the perceived quality of care provided by clinics prior to the outbreak, the interventions encouraged patients to report and receive treatment. Our results suggest that accountability interventions not only have the power to improve health systems during normal times, but can additionally make health systems resilient to crises that may emerge over the longer run.

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Section: Introductionsupporting

confidence: 82%

Building Resilient Health Systems: Experimental Evidence from Sierra Leone and the 2014 Ebola Outbreak

Christensen¹,

Dube

Haushofer

et al. 2020

SSRN Journal

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“…The enumerator experiment described in this paper was conducted during the data collection of a separate research project, described in detail in Fiala and Premand (2018).…”

Section: Experimental Designmentioning

confidence: 99%

Be Wary of Those Who Ask: A Randomized Experiment on the Size and Determinants of the Enumerator Effect

Maio

Fiala

2019

The World Bank Economic Review

Self Cite

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The Policy Research Working Paper Series disseminates the findings of work in progress to encourage the exchange of ideas about development issues. An objective of the series is to get the findings out quickly, even if the presentations are less than fully polished. The papers carry the names of the authors and should be cited accordingly. The findings, interpretations, and conclusions expressed in this paper are entirely those of the authors. They do not necessarily represent the views of the International Bank for Reconstruction and Development/World Bank and its affiliated organizations, or those of the Executive Directors of the World Bank or the governments they represent.

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“…The most studied area for included interventions is Sub-Saharan Africa (n = 13), representing almost 40 per cent of the included studies. We included five studies of interventions that took place in Uganda (Björkman et al, 2017(Björkman et al, , 2009incorporating Donato & Mosqueira, 2016;Fiala & Premand, 2017;Grossman et al, 2017;Grossman & Michelitch, 2018;Humphreys & Weinstein, 2012), two from the Democratic Republic of Congo (DRC) (Humphreys et al, 2014;Palladium, 2015), one each respectively from Ghana (Alhassan et al, 2016), Tanzania , Madagascar (Rasamoelina et al, 2015), Malawi (Gullo et al, 2017), Namibia (Bandyopadhyay et al, 2004) and a study that took place in both Kenya and Guinea (Bradley & Igras, 2005).…”

Section: Settingmentioning

confidence: 99%

“…Facilitated citizen feedback covers interventions that solicited concerns from citizens through community meetings or focus groups in order to feed back to service providers, often using a local facilitator or civil society organization, for example Björkman et al (2017;2009) and Ananthpur et al (2016). Unfacilitated feedback interventions gave citizens the tools or opportunities to give feedback or monitor but the collection of these concerns is not through a facilitated group meeting, for example Fiala & Premand (2017) which trains communities to monitor community CDD projects, as well as identify and make complaints about corruption and mismanagement, but does not set up forums to do so. We only identified one study that used technology to solicit feedback on service provision, namely Grossman et al's (2017) study of the U-Bridge programme in Uganda that introduced a SMS-based service for citizens and local government officials to submit, monitor and respond to requests around public service delivery.…”

Section: Interventions and Pita Mechanismsmentioning

confidence: 99%

“…A majority of randomized studies are protected from this bias (56%). When a process evaluation of the intervention was conducted (Fiala & Premand, 2017) it was done on a subsample of the treatment group. Banerjee et al (2014), which was also at risk of motivation bias due to the decoy visits used as a monitoring technique, overcame this risk by adding a pure control study arm (placebo group), free from monitoring visits.…”

Section: Performance Biasmentioning

confidence: 99%

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Incentives for climate mitigation in the land use sector – the effects of payment for environmental services (PES) on environmental and socio-economic outcomes in low- and middle-income countries: a mixed-method systematic review

Snilsveit¹,

Stevenson²,

Langer³

et al. 2019

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Although interventions to improve governance via the "short route" between service users and service providers are often effective in engaging citizens in service delivery and improving access to and quality of services, citizen engagement interventions alone are not likely to improve key well-being outcomes for citizens. Interventions that work through local civil society and stimulate capacity for collective action, particularly amongst vulnerable groups, may be more effective than those that rely on engaging unorganized citizens. This is particularly critical for services wherein citizens do not engage regularly with the providers while using the service, such as infrastructure, and thus pose weaker social sanction threats. Citizen-service provider engagement is more effective when implemented through phased, facilitated processes that are framed collaboratively, as opposed to one-off accountability meetings that are interpreted as confrontational. Interventions that do not incorporate specific measures to facilitate the inclusion of vulnerable groups may not realize equitable outcomes for those groups in the short-term. Barriers to vulnerable groups' inclusion varies widely by context, and inclusion components should be adapted in response to local contexts and needs. 1 Killias et al. (2016) are registering a review on the effectiveness of anti-corruption measures.

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Social Accountability and Service Delivery: Experimental Evidence from Uganda

Cited by 20 publications

References 11 publications

Building Resilient Health Systems: Experimental Evidence from Sierra Leone and the 2014 Ebola Outbreak

Building Resilient Health Systems: Experimental Evidence from Sierra Leone and the 2014 Ebola Outbreak

Be Wary of Those Who Ask: A Randomized Experiment on the Size and Determinants of the Enumerator Effect

Incentives for climate mitigation in the land use sector – the effects of payment for environmental services (PES) on environmental and socio-economic outcomes in low- and middle-income countries: a mixed-method systematic review

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