Governance reform, decentralization, and teamwork in public service delivery: Evidence from the Honduran health sector
Governance reform, decentralization, and teamwork in public service delivery: Evidence from the Honduran health sector
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公共服务提供中的治理改革、权力下放和团队合作：来自洪都拉斯卫生部门的证据
DOI：
10.1111/padm.12722
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发表时间：
2021
影响因子：
3.5
通讯作者：
Andersson, Krister
中科院分区：
文献类型：
--
作者：
Grillos, Tara;Zarychta, Alan;Andersson, Krister
当公务员作为团队有效地合作时，公共服务的提供就会得到改善。虽然权力下放改革是发展中国家加强保健服务提供的常见战略，但大多数研究强调其通过理性选择机制产生的影响。很少有研究考虑权力下放的行为影响及其改善或阻碍卫生部门工作人员日常工作环境的潜力。我们使用激励行为博弈来评估洪都拉斯分散的和类似的中央管理的市政卫生系统中公务员团队合作的有效性。我们发现，来自分散管理的市政当局的团队在合作方面效率较低，这是由于改革对现有工作人员产生的不利影响：新的工作人员对相对有效，而现有工作人员彼此之间以及在混合团队中的工作效果不佳。我们的发现表明，政策制定者应该采取措施，帮助确保治理改革不会破坏现有员工的有效性。
Public service delivery improves when civil servants work together effectively as teams. While decentralization reforms are common strategies for enhancing the delivery of health services in developing countries, most studies emphasize their effects through rational‐choice mechanisms. Fewer studies consider the behavioral implications of decentralization and its potential to improve or hinder the day‐to‐day work environment for health sector staff. We use an incentivized behavioral game to assess the effectiveness of teamwork among civil servants in decentralized and comparable centrally administered municipal health systems in Honduras. We find that teams from decentralized municipalities are less effective at working together and that this is driven by the adverse effects of the reform among existing staff: new staff pairs are relatively effective, while existing staff do not work as well with each other and in mixed teams. Our findings suggest that policymakers should take measures to help ensure that governance reforms do not undermine the effectiveness of existing staff.