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Power to the People: Evidence from a Randomized Field Experiment on Community-based Monitoring in Uganda

By: Martina Björkman, Jakob Svensson

This paper, published in the Quarterly Journal of Economics in May 2009, presents a randomized field experiment on community-based monitoring of public primary health care providers in Uganda. Through two rounds of village meetings, localized nongovernmental organizations encouraged communities to be more involved with the state of health service provision and strengthened their capacity to hold their local health providers to account for performance. A year after the intervention, treatment communities are more involved in monitoring the provider, and the health workers appear to exert higher effort to serve the community. We document large increases in utilization and improved health outcomes—reduced child mortality and increased child weight—that compare favorably to some of the more successful community-based intervention trials re-
ported in the medical literature.