Governance and the effectiveness of public health subsidies: Evidence from Ghana, Kenya and Uganda

• 成果类型: Article
• 署名作者: Dizon-Ross, Rebecca; Dupas, Pascaline; Robinson, Jonathan
• 署名单位: University of Chicago; Stanford University; National Bureau of Economic Research; University of California System; University of California Santa Cruz
• 刊物名称: JOURNAL OF PUBLIC ECONOMICS
• ISSN/ISSBN: 0047-2727
• DOI: 10.1016/j.jpubeco.2017.09.005
• 发表日期: 2017
• 页码: 150-169
• 关键词: Leakage; extortion; shirking; motivation

摘要

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 bed net 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. (C) 2017 Elsevier B.V. All rights reserved.