Representative bureaucracy and family planning service delivery in Tanzania

• 成果类型: Article
• 署名作者: Bishu, Sebawit G.; Osei-Kojo, Alex
• 署名单位: University of Washington; University of Washington Seattle; University of Tennessee System; University of Tennessee Knoxville; University of Washington; University of Washington Seattle
• 刊物名称: PUBLIC ADMINISTRATION REVIEW
• ISSN/ISSBN: 0033-3352
• DOI: 10.1111/puar.13687
• 发表日期: 2024
• 页码: 274-292
• 关键词: active representation; patient communication; contraceptive use; physician gender; developing-countries; student performance; public-service; QUALITY; care; DISCRETION

摘要

We apply the theory of representative bureaucracy to examine if gender congruence between family planning care providers and service recipients correlates with communication behaviors during consultation. We use nationally representative administrative data from Tanzania's Demographic and Health Survey (DHS). We apply a series of logistic and ordered logistic regression analyses and find that gender congruence is correlated with both family planning service recipients' and care providers' communication behaviors. Despite confirming the principal tenets of the theory of representative bureaucracy, we also document mixed results when considering the moderating effects of service recipients' prior experience with service on communication behaviors. Taken together, representation has a positive effect on female providers' communication behavior. Yet, for service recipients, its benefits are contingent upon the type of outcome assessed and prior experience with service. We discuss the policy and practical implications of our study in the context of the benefits and limits of representation.