Can Consulting Improve Health Care Management? Evidence from a Field Experiment in NigeriaISER External Seminars

The lack of managerial or organizational “capital” has been highlighted as one of the potential determinants of the poor quality of health care delivery in developing countries. However, little is known about whether and how managerial capital can be increased to generate persistent improvements in quality. We present results from a field experiment conducted in 80 public primary healthcare centers (PHCs) in six Nigerian states to evaluate the effects of a healthcare management consulting intervention. Half of the treated facilities received an assessment, initial feedback, a detailed improvement plan and nine months of implementation support (“full intervention”), and the other half received the assessment and initial feedback only (“light intervention”). Another set of facilities served as a control group. The light intervention showed no effects. The full intervention had large and significant effects on the adoption of several practices that were under the direct control of the PHCs’ staff, and on some related intermediate outcomes, including cleanliness of toilets and waiting rooms and availability of hand-washing equipment. We found no effects on practices that require substantial additional effort on the part of staff, infrastructure investments, or support from central or state government agencies. Our main conclusion is that monitoring and support during implementation are important for managerial and organizational knowledge to translate into actions and produce outcomes, and that information alone on what practices should be adopted is not sufficient. (joint work with Felipe A. Dunsch (World Bank), David K. Evans (World Bank), Ezinne Eze-Ajoku (Johns Hopkins University))

Presented by:

Mario Macis (Johns Hopkins University, IZA and NBER)

Date & time:

February 29, 2016 4:00 pm - February 29, 2016 5:30 pm



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