The Unintended Consequences of NGO-Provided Aid on Government Services in Uganda

Deserranno, Erika; Nansamba, Aisha; Qian, Nancy

doi:10.3386/w26928

Cited by 12 publications

(9 citation statements)

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“…While a robust literature has found mixed results on the benefits of foreign aid for development (Burnside and Dollar, 2000;Moyo, 2009), a more recent literature has noted that health aid may have positive impacts on human capital outcomes particularly in asset constrained regions (Odokonyero et al, 2015;Kotsadam et al, 2018;Gyimah-Brempong, 2015;Miguel and Kremer, 2004;Bandiera et al, 2019;Ndikumana and Pickbourn, 2017). Our paper provides quantitative evidence of the barriers to targeting donor aid and adds to the evidence of partial crowd-out that may occur, in areas like routine vaccination, when donor aid increases in response to epidemics of infectious disease (Bloom, Canning et al, 2004;Deserrano, Nansamba, and Qian, 2020;Aldashev, Marini, and Verdier, 2019). Finally, we add to the literature on regional and ethnic favoritism in the distribution of resources (Alesina, Michalopoulos, and Papaioannou, 2016;Alesina, Baqir, and Easterly, 1999;Francois, Rainer, and Trebbi, 2015), and highlight the potential multiplier effects of regional favoritism in domestic redistribution of health resources post an epidemic.…”

Section: Shocksmentioning

confidence: 63%

“…One potential explanation for these patterns is, following the donor aid literature that suggests that health aid from donor agencies in response to epidemics/during epidemic years, may crowd-out routine vaccination, that there is crowd-out of routine vaccines in years declared epidemic years. The effect is then particularly strong for vaccines that should be administered at or close to the time of birth 20 (Deserrano, Nansamba, and Qian, 2020;Boone, 1996;Bräutigam and Knack, 2004).…”

Section: Results For Child Health Outcomesmentioning

confidence: 99%

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The Epidemic Effect: On the Politics and Economic Burden of Infectious Disease

2020

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Epidemics of infectious disease can have deleterious effects on economic development except mitigated through global health governance and domestic institutions. We investigate this hypothesis by examining the effects of sudden exposure to meningitis on economic outcomes using evidence from the meningitis belt in sub-Saharan Africa. Meningitis shocks reduce economic activity and child health outcomes in periods when the World Health Organization (WHO) does not declare an epidemic year. These effects are reversed when the WHO declares an epidemic year. A primary mechanism explaining the heterogeneity in results may be the influx of donor aid when the WHO declares an epidemic year. We document an increase in World Bank health aid projects approved during epidemic years. Areas that receive more health aid have more economic activity though health projects funded during epidemic years are rated relatively worse by independent evaluators. Domestic institutions influence resource distribution, with regions that are co-ethnic with the president having better outcomes than non-co-ethnic areas. The results are robust to extensive controls and using the timing of the Islamic Hajj to instrument for meningitis shocks. * Thanks to Nancy Qian and participants at the Southern Economics Association conference for useful comments and suggestions. Thanks to Sophie Danzig and Bertina Kudrin for excellent research assistance. The research benefited from conversations with World Bank employees, and we thank them for helpful comments as well. We are grateful to

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Section: Shocksmentioning

confidence: 63%

Section: Results For Child Health Outcomesmentioning

confidence: 99%

The Epidemic Effect: On the Politics and Economic Burden of Infectious Disease

2020

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“…They may enhance accountability pressures on government providers due to greater competition or they may result in shrinking government services in ways that end up adversely affecting those citizens who continue to rely on government providers. For instance, in Uganda, Deserranno, Nansambaz, and Qian (2021) found that the entry of NGO health clinics in areas with pre-existing government health workers induced government workers to move to the NGO clinics (which offered higher salaries), resulting in a worsening of infant mortality and overall health care. In areas without pre-existing government health workers, on the other hand, overall health care improved in the absence of any negative spillovers.…”

Section: Delegating Authority To Othersmentioning

confidence: 99%

Decentralised targeting of transfer programmes: a reassessment

Mookherjee

2023

Decentralised Governance: Crafting Effective Democracies Around the World

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Decentralised governance has been widely adopted in developing countries in the hope of incorporating local information into policymaking, enhancing accountability and encouraging democratic participation in the delivery of public services to the poor and needy. However, evaluations of experience with this change have highlighted problems of corruption, elite capture, and clientelism that have undermined the success of decentralisation in improving targeting of transfer programmes. Given recent advances in information technology, this chapter suggests the need to consider suitable reforms, including enhanced monitoring and recentralisation initiatives that reduce local officials' scope for discretion. It provides an overview of recent research on these topics, and discusses key questions raised by their findings.

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“…In the context of rural Uganda,Deserranno et al (2021) exploit random variation in the entry of NGOprovided health care workers across villages to study crowding out. They find that the entry of NGO workers reduces the supply of government workers and total services.…”

mentioning

confidence: 99%

Bureaucracy and Development

et al. 2022

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In recent years, there has been increasing interest in whether and how bureaucratic effectiveness contributes to development. Just what makes for an effective bureaucracy and what are the building blocks of state capacity remain subject to debate. This article reviews the arguments connecting contemporary research using administrative data and field experiments to wider discussions of the origins of state capacity. Most current research has focused on understanding specific features of the environment in which bureaucrats operate. We connect this to discussions of bureaucratic systems, specifically the relationship to politics, citizens, firms, and nongovernmental organizations. Expected final online publication date for the Annual Review of Economics, Volume 14 is August 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

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The Unintended Consequences of NGO-Provided Aid on Government Services in Uganda

Cited by 12 publications

References 0 publications

The Epidemic Effect: On the Politics and Economic Burden of Infectious Disease

The Epidemic Effect: On the Politics and Economic Burden of Infectious Disease

Decentralised targeting of transfer programmes: a reassessment

Bureaucracy and Development

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