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Health workers’ behavior, patient reporting and reputational concerns: lab-in-the-field experimental evidence from Kenya

Published online by Cambridge University Press:  14 March 2025

Isaac Mbiti  and
Danila Serra
Isaac Mbiti*
Affiliation:
University of Virginia, Charlottesville, VA, USA
Danila Serra*
Affiliation:
Texas A&M University, College Station, TX, USA
*
imbiti@virginia.edu
dserra@tamu.edu
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Abstract

We examine the effectiveness of accountability systems that rely on patient reporting in Kenyan health clinics. Patients and health care providers from public and private health clinics participate in a lab-in-the field experiment focusing on the relationship of trust between patient and provider. Patients decide whether to trust providers, providers have discretion over their reciprocity, and patients can complain. We compare the effectiveness of: (1) a client reporting system where patients’ complaints are disclosed to the providers’ professional peers, possibly leading to non-monetary penalties, (2) a system where complaints lead to monetary penalties, and (3) a system that, like a standard complaint box, attaches no tangible consequences to complaints. Overall, our findings suggest that citizen reporting systems that leverage peer pressure and reputational concerns can improve service delivery.

Keywords

Health servicesBottom-up accountabilityPatient reportingPeer shaming

JEL classification

M59: Other C90: General I15: Health and Economic Development
Type
Original Paper
Information
Experimental Economics , Volume 25 , Issue 2 , April 2022 , pp. 514 - 556
Copyright
Copyright © 2021 Economic Science Association

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Footnotes

Supplementary Information The online version contains supplementary material available at https://doi.org/10.1007/s10683-021-09721-y.

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Health Workers' Behavior, Patient Reporting and Reputational Concerns: Lab-in-the-Field Experimental Evidence from Kenya
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