Power to the People: Evidence from a Randomized Field Experiment of a Community-Based Monitoring Project in Uganda

Jakob Svensson and Björkman Nyqvist, Martina

No 6344, CEPR Discussion Papers from C.E.P.R. Discussion Papers

Abstract: Strengthening the relationship of accountability between health service providers and citizens is by many people viewed as critical for improving access to and quality of health care. How this is to be achieved, and whether it works, however, remain open questions. This 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, we find large increases in utilization, significant weight-for-age z-scores gains of infants, and markedly lower deaths among children. The findings on staff behaviour 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.

Keywords: Accountability; Field experiment; Health; Monitoring (search for similar items in EconPapers)
JEL-codes: D78 I12 O15 (search for similar items in EconPapers)
Date: 2007-06
New Economics Papers: this item is included in nep-afr, nep-dev, nep-exp and nep-ppm
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (15)

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Working Paper: Power to the people: evidence from a randomized field experiment of a community-based monitoring project in Uganda (2007)
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