Public service provision: Health

Imperfect monitoring and weak accountability have often been held responsible for the low quality of health care delivery in many developing countries. In response, many have argued for policies to enhance beneficiary involvement as way to strengthen demand-responsiveness and local accountability. Despite the recent enthusiasm for this approach, however, the evidence provides mixed results about its short-run effectiveness. Whether it can lead to sustained improvements in service provision is largely unknown. This project will explore policy avenues to improve service delivery in the health sector, including the effects and suitability of performance contracts; voucher programs; institutional reforms, and efforts to stimulate community empowerment and involvement. Among other things, the project wishes to highlight the interaction between beneficiary control and the provision of information on the staff's performance as a way to identify and challenge (mis)behaviour by the provider.