Decentralization, Ethnic Fractionalization, and Public Services: Evidence from Kenyan Healthcare

Camille Hemet, Liam Wren-Lewis and Jessica Mahoney

No em3js, SocArXiv from Center for Open Science

Abstract: This paper examines how use of public services changed following a major constitutional reform in Kenya. Following an important period of inter-ethnic conflict, responsibility for local health services was decentralized to 47 newly created county governments. Using an event-study design, we find that use of public clinics for births increased significantly after the reform, but only in counties that were relatively ethnically homogeneous. We also find a significant increase in the correlation between county ethnic fractionalization and a range of other measures of public health service use. Results suggest that services in these counties are less likely to require payments after devolution. Additionally, using within-county variation, we find an increase in public service use among individuals that are of the same ethnicity as the members of the county government executive.

Date: 2023-03-22
New Economics Papers: this item is included in nep-dev, nep-hea and nep-ure
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https://osf.io/download/641c812552aa10007dc1baad/

Related works:
Working Paper: Decentralization, Ethnic Fractionalization, and Public Services: Evidence from Kenyan Healthcare (2024)
Working Paper: Decentralization, Ethnic Fractionalization, and Public Services: Evidence from Kenyan Healthcare (2024)
Working Paper: Decentralization, Ethnic Fractionalization, and Public Services: Evidence from Kenyan Healthcare (2023)
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Persistent link: https://EconPapers.repec.org/RePEc:osf:socarx:em3js

DOI: 10.31219/osf.io/em3js

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