Selection, Performance of Health Workers and State Legitimacy

缺乏国家能力是许多低收入国家经济发展的严重障碍。这往往最终导致无法提供基本公共服务，进而导致国家合法性的进一步降低。在拟议的研究项目中，我们着眼于公共服务质量和国家能力的一个主要决定因素：公共雇员的素质。虽然国家更好地选择雇员可能会对公共服务的质量产生直接和巨大的影响，进而影响国家的合法性，但发展中国家的工作申请过程可能成本高得令人望而却步，无法让有才华的工人被选入申请者名单。这个计划中的项目的目的是研究减少搜索摩擦是否会改善公共雇员的选择和公共服务的提供，从而增加公民眼中的国家合法性。重点将放在发展背景下特别普遍的搜索摩擦的两个重要组成部分：关于就业机会的信息障碍和申请成本。我们的研究背景是在巴基斯坦农村提供公共卫生服务。这一背景非常适合我们的目的，因为这些服务是由社区卫生工作者提供的，他们直接决定了他们提供的服务的质量，他们的业绩可以客观地衡量。我们将在200个随机选择的社区进行实地研究，包括对符合条件的申请者进行基线调查，以及一项随机对照试验，该试验改变了我们关注的搜索摩擦的不同组成部分。因此，我们的设置将允许我们(I)直接确定搜索摩擦对社区卫生工作者的选择和随后的公共服务质量的影响，以及(Ii)在单一框架内通过更好的服务质量来确定它们对国家合法性的影响。此外，这个框架将使我们能够详细说明根据基线调查数据自行挑选申请者的情况，并仔细审查服务质量筛选过程的作用。这个项目的结果具有很高的相关性，因为了解选择公职人员对于改善公共部门治理至关重要。此外，目前的大流行突出了高效卫生系统的重要性。加强提供更好公共卫生服务的能力对于成功应对可能更加频繁地复发的流行病和其他卫生紧急情况至关重要。

The lack of state capacity is a critical impediment for economic development in many low-income countries. This often culminates in an inability to provide basic public services, which in turn contributes to a further reduction of the legitimacy of the state. In the proposed research project, we look at a major determinant of public service quality and state capacity: the quality of public employees. While better selection of employees by the state can have direct and large effects on the quality of public services and subsequently on state legitimacy, the job application process in developing countries can be prohibitively costly preventing talented workers to select into the applicant pool. The aim of the planned project is to study whether lowering search frictions improve the selection of public employees and public service provision and subsequently increase state legitimacy in the eyes of its citizens. The focus will be on two important components of search frictions that are particularly prevalent in a development context: barriers on information about job opportunities and application costs. Our study context is the provision of public health services in rural Pakistan. This context is well suited for our purposes because the services are performed by community health workers who directly determine the quality of the services they provide and whose performance can be objectively measured. We will run a field study in 200 randomly selected communities, including a baseline survey of the universe of eligible applicants and a randomized controlled trial that varies the different components of search frictions we focus on. Therefore, our setup will allow us (i) to directly identify the impact of search frictions on the selection of community health workers and subsequent public service quality and (ii) to identify their impact on state legitimacy through better service quality, within a single framework. In addition, this framework will allow us to provide a detailed account of self-selection into the applicant pool based on the baseline survey data and to scrutinize the role of the screening process for service quality.The findings of this project are of high relevance as understanding selection of public employees is crucial for improving public sector governance. Moreover, the current pandemic has highlighted the importance of an efficient health system. Strengthening the ability to deliver better public health services is essential for successfully dealing with potentially more frequently recurring pandemics and other health emergencies.