When financial incentives backfire: Evidence from a community health worker experiment in Uganda

Zachary Wagner, John Bosco Asiimwe and David Levine

Journal of Development Economics, 2020, vol. 144, issue C

Abstract: There is growing support for an entrepreneurial community health worker (CHW) model, but the benefits of such a design are unclear. We randomly assigned CHWs in Uganda to sell treatment for child diarrhea door-to-door and retain the profits or to deliver treatment to homes for free. We find that, despite stronger financial incentives, the entrepreneurial model led to substantially less effort (fewer household visits) than the free delivery model. Qualitative evidence suggests that selling had a social penalty whereas free distribution was socially rewarding. Our results call into question the notion that an entrepreneurial model necessarily increases CHW effort relative to free distribution.

Keywords: Community health workers; Social entrepreneurship; Financial incentives; Social incentives; Targeting; Child health; Motivation (search for similar items in EconPapers)
JEL-codes: D10 I11 I12 O12 (search for similar items in EconPapers)
Date: 2020
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (11)

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Persistent link: https://EconPapers.repec.org/RePEc:eee:deveco:v:144:y:2020:i:c:s0304387819307801

DOI: 10.1016/j.jdeveco.2019.102437

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