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Does high workload reduce the quality of healthcare? Evidence from rural Senegal

Roxanne J. Kovacs and Mylène Lagarde

LSE Research Online Documents on Economics from London School of Economics and Political Science, LSE Library

Abstract: There is a widely held perception that staff shortages in low and middle-income countries (LMICs) lead to excessive workloads, which in turn worsen the quality of healthcare. Yet there is little evidence supporting these claims. We use data from standardised patient visits in Senegal and determine the effect of workload on the quality of primary care by exploiting quasi-random variation in workload. We find that despite a lack of staff, average levels of workload are low. Even at times when workload is high, there is no evidence that provider effort or quality of care are significantly reduced. Our data indicate that providers operate below their production possibility frontier and have sufficient capacity to attend more patients without compromising quality. This contradicts the prevailing discourse that staff shortages are a key reason for poor quality primary care in LMICs and suggests that the origins likely lie elsewhere.

Keywords: workload; quality of care; standardised patients; Sengal; ESRC/MRC/DfID/Wellcome Trust grant MR/M014681/1; Research Fellowships in Humanities and Social Science 219744/Z/19/Z.; MR/M014681/1 (search for similar items in EconPapers)
JEL-codes: I10 I11 J45 (search for similar items in EconPapers)
Pages: 15 pages
Date: 2022-03-01
New Economics Papers: this item is included in nep-ban and nep-hea
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Published in Journal of Health Economics, 1, March, 2022, 82. ISSN: 0167-6296

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