Doctoral Dissertation Research in Economics: Governance, Citizenship, and Accountability: Democracy and Health Care Provision

经济学博士论文研究：治理、公民身份和责任：民主和医疗保健提供

• 批准号: 1824290
• 负责人: Hoyt Bleakley
• 金额: $ 1.89万
• 依托单位: Regents of the University of Michigan - Ann Arbor
• 依托单位国家: 美国
• 项目类别: Standard Grant
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-07-15 至 2020-06-30
• 项目状态: 已结题
• 来源: https://www.nsf.gov/awardsearch/showAward?AWD_ID=1824290&HistoricalAwards=false
• 关键词: Doctoral; Dissertation; Research; Economics; Governance

This proposed research will use experimental methods to study how best to improve government accountability as a way of improving the efficiency of providing public goods. The focus is on health care services provision and it is intended to find out whether the proposed approach to the research will work. The project will implement two experiments. The first experiment will involve a quarterly meeting in which local political leaders report on healthcare delivery at local government healthcare facilities to the general population. This experiment is designed as a test of how effectively local politicians are playing their supervisory roles in the health sector. The second experiment involves training of local political leaders on skills in monitoring local government health centers. The results of this research will help to address widespread management accountability failures that lead to inability to provide public services in many parts of the world. The results could also help improve the efficiency and effectiveness of US external assistance programs to low income countries. It will also provide ways of improving the delivery of public goods and democratic governance through sustained citizen engagement in many parts of the world. This project is a feasibility study and pilot randomized controlled trial of two governance interventions designed to address constraints on health service provision. The objective of the pilot study is to evaluate the feasibility of the intervention and data collection activities. Centering on the role of politicians' performance in delivering healthcare, the study will implement wo interventions: (a) increased citizen participation through quarterly reporting meetings with local politicians on the quality of health service delivery and (b) local leader skills training in monitoring local government health centers. Data collection will consist of pre- and post-intervention household surveys and health facility audits, along with observational surveys during the citizen-politician meetings. Despite the attention given to the role of governance in service delivery and development, relatively little rigorous evidence exists on interventions to strengthen local institutions. In contrast to studies that focus on interventions in laboratory settings, this study will evaluate a governance intervention targeting inefficiencies in the political economy. It also investigates supply-side barriers to healthcare delivery, which are likely another essential side of health care issues in many countries. Altogether, the study will shed light on institutional dynamics in low-resource health systems. The interventions themselves may spur significant improvements in public services delivery in the target communities. The project will also generate sustained citizen participation in governance, shifting the nature of political engagement in the involved communities.This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.

本研究将采用实验方法，研究如何最好地改善政府问责制，以提高提供公共产品的效率。 重点是保健服务的提供，目的是查明拟议的研究方法是否可行。 该项目将进行两项试验。 第一个实验将包括每季度举行一次会议，当地政治领导人在会上报告当地政府医疗机构向普通民众提供医疗保健的情况。 这一实验旨在检验地方政治家在卫生部门发挥监督作用的有效性。 第二项试验涉及培训地方政治领导人掌握监督地方政府保健中心的技能。 这项研究的结果将有助于解决在世界许多地方导致无法提供公共服务的普遍管理问责失误问题。 研究结果还有助于提高美国对低收入国家的外部援助计划的效率和有效性。 它还将通过世界许多地区公民的持续参与，提供改善公益物提供和民主治理的途径。 该项目是一个可行性研究和试点随机对照试验的两个治理干预措施，旨在解决卫生服务提供的制约因素。 试点研究的目的是评估干预和数据收集活动的可行性。 该研究以政治家在提供保健方面的表现为中心，将实施两项干预措施：（a）通过与当地政治家就保健服务提供质量举行季度报告会议，提高公民参与;（B）对地方领导人进行监测地方政府保健中心的技能培训。数据收集将包括干预前后的住户调查和保健设施审计，沿着公民-政治家会议期间的观察性调查。 尽管治理在提供服务和发展方面的作用受到关注，但在加强地方机构的干预措施方面，几乎没有确凿的证据。与专注于实验室环境中的干预措施的研究相反，本研究将评估针对政治经济中效率低下的治理干预措施。 它还调查了医疗保健提供的供应方障碍，这可能是许多国家医疗保健问题的另一个重要方面。总而言之，这项研究将揭示低资源卫生系统的机构动态。 这些干预措施本身可能促使目标社区的公共服务提供得到显著改善。 该项目还将产生持续的公民参与治理，改变参与社区的政治参与的性质。该奖项反映了NSF的法定使命，并已被认为是值得通过使用基金会的智力价值和更广泛的影响审查标准进行评估的支持。