The political economy of public sector absence

• 成果类型: Article
• 署名作者: Callen, Michael; Gulzar, Saad; Hasanain, Ali; Khan, Muhammad Yasir; Rezaee, Arman
• 署名单位: University of London; London School Economics & Political Science; Princeton University; Lahore University of Management Sciences; Pennsylvania Commonwealth System of Higher Education (PCSHE); University of Pittsburgh; University of California System; University of California Davis
• 刊物名称: JOURNAL OF PUBLIC ECONOMICS
• ISSN/ISSBN: 0047-2727
• DOI: 10.1016/j.jpubeco.2022.104787
• 发表日期: 2023
• 关键词: Health sector reforms; absenteeism; Information Communication Technology

摘要

The paper examines how politics relates to public sector absenteeism, a chronic and intractable public service delivery problem in many developing countries. In Punjab, Pakistan, we document that political interference routinely protects doctors from bureaucratic sanction, while personal connections between doctors and politicians and a lack of political competition are associated with more doctor absence. We then examine how politics impacts the success of an at-scale policy reform to combat absenteeism. We find that the reform was more effective at increasing doctor attendance in politically competitive con-stituencies, both through increased monitoring and through senior health officials being able to respond more effectively to the data gathered on poor performing clinics. Our results demonstrate that politics can block the success of reform; instead of lifting poor performers up, the reform only improved places that had already been performing better. The evidence collectively points to the fundamental importance of accounting for political incentives in policy design and implementation.(c) 2022 The Author(s). Published by Elsevier B.V. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).