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

Rebecca Dizon-Ross, Pascaline Dupas, Jonathan Robinson

Research output: Contribution to journalArticlepeer-review

16 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)150-169
Number of pages20
JournalJournal of Public Economics
Volume156
DOIs
StatePublished - Dec 2017
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Economics and Econometrics
  • Finance

Keywords

  • Extortion
  • Leakage
  • Motivation
  • Shirking

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