We evaluate the impact of a large-scale information and mobilization intervention designed to improve health service delivery in rural Uganda by increasing citizens’ ability to monitor and apply bottom-up pressure on underperforming health workers. Modeled closely on the landmark “Power to the People” study (Bjorkman and Svensson, 2009), the intervention was undertaken in 376 health centers in 16 districts and involved a three wave panel of more than 14,000 households. We find that while the intervention had a positive impact on treatment quality and patient satisfaction, it had no effect on utilization rates or health outcomes (including child mortality). We also find no evidence that the channel through which the intervention affected treatment quality was citizen monitoring. The results hold in a wide set of pre-specified subgroups and also when, via a factorial design, we break down the complex intervention into its two most important components. While our findings validate the power of information provision to change the behavior of frontline service providers, they cast doubt on the power of information to foster community monitoring or to generate improvements in health outcomes, at least in the short term.
In Mexico, we have continued our global tradition of rigorous, applicable research by building foundational research capacity and conducting evaluations in areas of pressing national concern. Examples of our work detailed in this brief promising insights into everyday issues that affect the lives of people in Mexico.
Designers and funders of payments for ecosystem services (PES) programs have long worried that payments flow to landholders who would have conserved forests even without the program, undermining the environmental benefits (“additionality”) and cost-effectiveness of PES. If landholders self-select into PES programs based on how much conservation they were going to undertake anyway, then those who were planning to conserve should always enroll. This paper discusses the less-appreciated fact that enrollment is often based on other factors too. The hassle of signing up or financial costs of enrollment (e.g., purchasing seedlings) can affect who participates in a PES program. These enrollment costs reduce overall take-up, and, importantly, they can also influence the composition of landholders who select into the program—and thereby the program’s environmental benefits per enrollee. Enrollment costs can increase a program’s benefits per enrollee if they are systematically higher for (and thus deter enrollment by) landholders who would have conserved anyway. Alternatively, enrollment costs can dampen per-enrollee benefits if their correlation with status-quo conservation is in the opposite direction. We illustrate these points with evidence from two studies of randomized trials of PES programs aimed at increasing forest cover in Uganda and Malawi. We also discuss how in other sectors, such as social welfare, policy designers have purposefully adjusted the costs of program enrollment to influence the composition of participants and improve cost-effectiveness. We propose that these ideas for targeting could be incorporated into the design of PES programs.
In 2008, Uganda granted hundreds of small groups $400/person to help members start individual skilled trades. Four years on, an experimental evaluation found grants raised earnings by 38% (Blattman, Fiala, Martinez 2014). We return after 9 years to find these start-up grants acted more as a kick-start than a lift out of poverty. Grantees' investment leveled off; controls eventually increased their incomes through business and casual labor; and so both groups converged in employment, earnings, and consumption. Grants had lasting impacts on assets, skilled work, and possibly child health, but had little effect on mortality, fertility, health or education.
Governments are tasked with delivering basic services such as education, security, and infrastructure, but access to and quality of these services is often undermined by poor oversight, corruption, and lack of community participation.
While countless programs aim to address these issues, their effectiveness is often not clear. IPA’s governance research investigates ways to increase the performance of the government institutions that serve as the foundation for development. Our research teams have shed light on pressing questions including how to reduce vote-selling, how to increase the demand for government accountability, how technology can be used to reduce corruption, and how information can improve voting behavior, but many unanswered questions remain.
Un equipo de investigadores de Innovations for Poverty Action, en colaboración con el Gobierno Colombiano, desarrolló una auditoría aleatoria de dos de los programas sociales más grandes del país—Sistema de Identificación de Potenciales Beneficiarios de Programas Sociales (Sisbén) y Más Familias en Acción (MFA)—para medir cómo el estatus social de los ciudadanos y los factores políticos locales afectan la eficiencia de los servidores municipales en el procesamiento y atención de las solicitudes ciudadanas.
- La tasa de respuesta de las llamadas a las alcaldías municipales del territorio nacional y las alcaldías locales en Bogotá fue baja: cerca del 65% de los solicitantes recibieron una respuesta en hasta seis intentos.
- Un número importante de alcaldías (148/618 o 23%) son inaccesibles por teléfono durante horas de servicio al ciudadano.
- Era menos probable que las llamadas fueran respondidas en horas de la tarde (después de almuerzo) que, en horas de la mañana, proporcionando una leve evidencia de ausentismo. » Dentro de las llamadas respondidas, menos del 50% de los solicitantes recibieron información correcta sobre Más Familias en Acción o Sisbén.
- El equipo investigador encontró evidencia moderada de discriminación según el acento regional, la clase socioeconómica y el estado migratorio cuando los solicitantes preguntaban cómo acceder a beneficios de MFA y Sisbén.
Innovations for Poverty Action (IPA) is a research and policy non-profit that discovers and promotes effective solutions to global poverty problems. IPA brings together researchers and decision-makers to design, rigorously evaluate, and refine these solutions and their applications, ensuring that the evidence created is used to improve the lives of the world’s poor. Since our founding in 2002, IPA has worked with over 575 leading academics to conduct over 650 evaluations in 51 countries. Future growth will be concentrated in focus countries, such as Myanmar, where we have local and international staff, established relationships with government, NGOs, and the private sector, and deep knowledge of local issues.
Gender gaps in participation and representation are common in new democracies, both at the elite level and at the grassroots. We investigate efforts to close the grassroots gender gap in rural Ghana, a patronage-based democracy in which a dense network of political party branches provides the main avenue for local participation. We report results from a randomized field experiment to address norms against women's participation and encourage women's participation ahead of Ghana's December 2016 elections. The treatment is a large community meeting presided over by the traditional chief, known locally as a durbar. We find null results. The treatment was hampered in part by its incomplete implementation, including by local political party leaders who may have feared an electorally-risky association with a controversial social message. The study emphasizes the importance of social norms in explaining gender gaps in grassroots politics in new democracies and contributes new evidence on the limitations of common civic education interventions used in the developing world.
Can democratic elections reduce rent extraction by public decision makers? Existing research suggests that reelection incentives can reduce the embezzlement of public funds. This paper examines three additional mechanisms through which democratic elections could have an impact on embezzlement, even in the absence of reelection incentives: (1) electoral selection effects, (2) social norms and norm enforcement, and (3) citizens’ trust in decision makers. Evidence from an experiment with 472 groups of citizens in rural Burkina Faso suggests that electoral selection favors benevolent candidates. Furthermore, elections increase citizens’ willingness to punish corrupt decision makers, even if their ability to do so remains unchanged. However, these beneficial effects of elections are offset by an unexpected adverse effect: elections cause citizens to trust decision makers more than they should be trusted. These findings have important implications for the role of information in electoral democracy.
Politicians shirk when their performance is obscure to constituents. We theorize that when politician performance information is disseminated early in the electoral term, politicians will subsequently improve their performance in anticipation of changes in citizens’ evaluative criteria and possible challenger entry in the next election. However, politicians may only respond in constituencies where opposition has previously mounted. We test these predictions in partnership with a Ugandan civil society organization in a multiyear field experiment conducted in 20 district governments between the 2011 and 2016 elections. While the organization published yearly job duty performance scorecards for all incumbents, it disseminated the scorecards to constituents for randomly selected politicians. These dissemination efforts induced politicians to improve performance across a range of measures, but only in competitive constituencies. Service delivery was unaffected. We conclude that, conditional on electoral pressure, transparency can improve politicians’ performance between elections but not outcomes outside of their control.
Past research suggests that improving citizen political knowledge and coordination can increase political participation and accountability and help channel grievances through democratic processes rather than conflict. A randomized field experiment in Peru demonstrates that civic education can sometimes have perverse effects on these outcomes. I find that civic education workshops reduce participation in the district’s “participatory budgeting” process and increase support for protest as a tool for sanctioning politicians. Although the intervention increases the initiation of recalls for poor-performing mayors, these mayors respond to the recall threat by further reducing their effort. Taken together the evidence suggests that improved information and coordination of local elites is not sufficient to improve government performance where it has previous lagged.
In Uganda, preliminary findings suggest watching video interviews of parliamentary candidates during party primary and multiparty elections increases knowledge about the candidates and increases the likelihood that voters change away from their intended vote choice on Election Day.
In Sierra Leone, we have continued our global tradition of rigorous, applicable research by building foundational research capacity and conducting evaluations in areas of pressing national concern. Examples of our work described in this brief offer promising insights into everyday issues that affect the lives of the poor in Sierra Leone.
In Burkina Faso, Côte d'Ivoire, and Mali, we have continued our global tradition of rigorous, applicable research by building foundational research capacity and conducting evaluations in areas of pressing national concern. Examples of our work below offer promising insights into everyday issues that affect the lives of the Francophone West African poor.
Distributing subsidized health products through existing health infrastructure could substantially and cost-effectively improve health in sub-Saharan Africa. There is, however, widespread concern that poor governance – in particular, limited health worker accountability – seriously undermines the effectiveness of subsidy programs. We audit targeted bednet distribution programs to quantify the extent of agency problems. We find that around 80% of the eligible receive the subsidy as intended, and up to 15% of subsidies are leaked to ineligible people. Supplementing the program with simple financial or monitoring incentives for health workers does not improve performance further and is thus not cost-effective in this context.