Publications and Working Papers

The implicit contract in most primary healthcare provision has been the responsiveness of doctors to signals of ill-health by patients. For this to be socially optimal, patients must effectively identify underlying health issues or primary care doctors must effectively screen and identify latent conditions. This paper examines the impacts of doctors and patients writing an explicit contract for more holistic primary care. Without punishments for reneging on contract stipulations, the intervention aimed to shift the relational contract between the two parties away from episodic curative care and towards a holistic plan for patient welfare. In a large-scale randomized evaluation of these contracts tracked through the universe of patient records, the program caused changes in doctor activities towards greater screening, diagnosis and treatment of underlying health issues. For mild-risk patients, we see reductions in overall mortality of 40%. Thus, this paper provides evidence that shifts in the nature of the contracting relationship between patients and their care providers can have substantial welfare effects.

Winner of the World Bank's Europe and Central Asia `Most Innovative Research Relevant to the Region' Award 2024

The corresponding pre-results paper is `Benjamin Daniels, Daniel Rogger, Meyhar Mohammed, Katre Väärsi and Kevin Croke (2023) Evaluation of Estonia's Enhanced Care Management Program: Protocol for a cluster randomized trial, Pre-Results Submissions, International Journal of Clinical Trials'

Organizational culture is an important driver of organizational performance, but evidence on how to improve performance-oriented organizational cultures is scarce - especially in the public sector. We partnered with Ghana's Civil Service to design a new innovation training module geared towards such culture change and deliver it on a randomized basis to mid-level bureaucrats in central government. The intervention was delivered at full scale by integrating it into the Civil Service's standard training routine for one year. We find that the training improved organizational culture and performance 6-18 months post-training. Our design was split between an individual-focused training arm and one in which officials from an entire organizational unit were trained together. Our results are completely driven by the individual-focused arm, with the team-based treatment arm having no impact on culture or performance. We discuss potential explanations for this difference in effectiveness. Simple and scalable training interventions can thus have significant impacts on culture and performance, but their design matters.

A DIME Policy Brief on the wider engagement with the Ghanaian Government that acted as the platform for this research can be found here.

The wider Ghana project in which this paper was produced was chosen by the International Growth Centre as one of their `Transformational Change Cases'.

A long-established approach to management in government has been the transmission of information up a hierarchy, centralized decision-making by senior management, and corresponding centralized accountability; colloquially known as `command and control'. This paper examines the effectiveness of a centralized accountability system implemented at scale in Punjab, Pakistan for six years. The scheme automatically identified poorly performing schools and jurisdictions for the attention of central management. We find that flagging of schools and corresponding de facto punishments had no impact on school or student outcomes. We use detailed data on key elements of the education production function to show that command and control approaches to managing the general public sector do not induce bureaucratic action towards improvements in government performance.

The reproducibility package for the paper is published here.

Coverage by Jishnu Das is available here.

We study how local public infrastructure investment affects neighborhood economies. By tracking the impacts of US$68 million of randomized investments in Mexican municipalities, we document how government investment leads to sustained increases in the size and profitability of treated private-sector companies. Initially, wages rise to compensate for higher costs of living, inefficient firms die, and more efficient firms grow faster. Over the subsequent decade treated firms increase their capital stocks and revenues, suggesting durable improvements in the structure of the local economy. Our results provide novel evidence of linkages between government investment, business growth, and the dynamics of local economies.

Winner of the World Bank's Latin America and Caribbean `Most Innovative Research Relevant to the Region' Award 2023

Our associated 'VoxDev' blog is here.

Health systems around the world increasingly seek to compensate health care providers at least in part based on their performance. Bonus payments are frequently linked to a provider's delivery of a particular level of services.  Such schemes typically fix the ratio of reward to service irrespective of the costs involved to the provider of achieving the requisite level of service.  This approach reduces the efficiency of the incentive by inversely linking the likelihood of reward to patient need.  This paper proposes an incentive scheme that aims to equalize marginal rewards across corresponding marginal welfare gains from the behavior they induce.  It does so by defining reward weights based on the empirical prevalence of patient need.  If a doctor faces a patient population with a substantial disease burden, they receive a greater reward for achieving target levels of service.  The specific reward schedule is determined endogenously by the empirical distribution of burden.  Regularly updated micro-data contained in modern health management information systems make such marginal rewards feasible to communicate in near real-time. We illustrate the feasibility of the evaluation scheme by applying it to data on the entire patient population of Estonia.  The empirical application indicates that the proposed scheme improves the equalization of rewards within and across patients.

With the digitization of administrative systems, governments have gained access to rich data about their administrative operations. How governments leverage such data to improve their administration - what we call government analytics - will shape government effectiveness. This article summarizes a conceptual framework which showcases that data can help diagnose and improve all components of a public administration production function - from inputs such as personnel and goods, to processes and management practices, to outputs and outcomes. We then assess to what extent public administration scholarship analyses these data sources and can thus inform government analytics. A review of 689 quantitative articles in two public administration journals in 2013-2023 finds that 50% draw on surveys of public employees, and 25% on surveys of citizens or firms. By contrast, administrative micro data (14% of articles) is underexploited. Practitioners and scholars would thus do well to expand the data sources used to inform better government.

Nearly half of the communal water points in Tanzania do not produce water. While local government and communities are each expected to contribute to infrastructure maintenance, task responsibility is often ambiguous in practice, leading to inefficiency and inertia. We explore whether strengthening coproduction between district governments and village water community organizations can improve coordination between both parties, strengthen maintenance practices, and increase communal water point functionality. Specifically, we conduct a large-scale cluster-randomized controlled trial to assess the impacts of repeated `action-learning' consultations led by an independent facilitator that encourages information sharing and the resolution of maintenance responsibility ambiguities between the two parties.

What determines the quality of a nation's infrastructure? We show that electoral incentives at the time of construction have persistent effects on the functionality of contemporary African water systems. We apply a common regression discontinuity approach to the universe of water points in Nigeria, Sierra Leone, and Tanzania built over the period from 1970-2014. Across all three settings, we find that infrastructure installed in the run-up to an election is significantly more likely to be functioning today than those installed shortly after elections. Our results suggest that politicians respond to electoral incentives by adjusting the technology and provider of installed water systems. Together, the findings suggest that public officials optimally respond to responsive but myopic citizen evaluations of public performance.

The information that public officials use to make decisions determines the distribution of public resources and the efficacy of public policy. This paper develops a measurement framework for assessing the accuracy of a set of fundamental bureaucratic beliefs and provides experimental evidence on the possibility of `evidence briefings' improving that accuracy. The errors of public officials are large, with 49 percent of officials making errors that are at least 50 percent of objective benchmark data. The provision of briefings reduces these errors by a quarter of a standard deviation, but in line with theoretical predictions, organizational incentives mediate their effectiveness.

The World Bank Working Paper version (8644) can be accessed here.

Our associated 'Let's Talk Development' blog is here.

Our associated 'VoxDev' blog is here.

Coverage in The Economist is available here.

Understanding how public administrations around the world function and differ is crucial for strengthening their effectiveness. Most comparative measures of bureaucracy rely on surveys of experts, households, or firms, rather than directly questioning bureaucrats. Direct surveys of public officials create granular data for analysis and government action, so are becoming a cornerstone of public sector management. This article introduces the Global Survey of Public Servants (GSPS), a global initiative to collect and harmonize large-scale, comparable survey data on public servants. The corresponding GSPS data set currently contains responses from 1,300,000+ bureaucrats in 1,300+ government institutions in 23 countries. The surveys measure both employee attitudes (such as job satisfaction and motivation), and their experience with management practices (such as recruitment and performance management). This harmonized data enables governments to benchmark themselves and scholars to study comparative public administration and the state differently, based on micro-data from actors who experience government first-hand.

The World Bank Working Paper version (10333) can be accessed here. Note that this differs from the published article to the extent that it is framed as 'A Foundation for Research on Public Servants around the World' and thus has corresponding differences.

Bureaucratic effectiveness is an important input into state capacity. The tasks public officials choose to spend their time on determines how their human capital impacts national development. Yet empirical evidence on the measurement and allocation of public officials’ time use is scarce. We provide empirical evidence in this domain through a survey experiment with Ethiopian bureaucrats. We randomly test alternative measures of bureaucratic time use by varying recall period, enumeration methodology and the degree of task detail in recall surveys. Relative to time-use diaries, we find that the best-performing survey modules differ by roughly a third of working time and that requesting more detailed breakdowns of time use significantly increases this disparity. We explore empirically how the allocation of time use correlates with individual characteristics, management practices, and service delivery outcomes.

Building a capable public service is a key component of post-conflict state building. An effective public service is fundamental to the regulation of society, management of public funds and implementation of public infrastructure. Yet in post-conflict environments there is typically a tradeoff between short-term stability and the long-term objective of state building. To buy peace, political elites hand out public jobs and resources to constituents regardless of merit. Donors frequently rely on “parallel” project delivery structures rather than public servants to address citizens’ pressing service delivery needs. Both of these practices may achieve short-term objectives but undermine state building. In the face of these trade-offs, how can capable public services be built in post-conflict societies? This paper aims to summarize the evidence-base on this question. It does so by reviewing the evidence from post-conflict settings and by discussing the validity of findings on civil service reform from non-conflict settings. Given the fundamental tradeoffs invoked by securing the peace, this topic presents a wide-open research agenda.

The public sector employs roughly a third of the world's paid workforce. Their wages not only represent the income of a substantial portion of the population but also influence pay setting across the rest of the economy. However, global data on employment and compensation within the public sector, and how these compare to the private sector, has been limited to date. This paper describes a novel dataset produced by the World Bank's `Bureaucracy Lab' attempting to fill this gap. The `Worldwide Bureaucracy Indicators' (WWBI) are made up of 92 variables recording the characteristics of public-sector employment, compensation, and the overall wage bill for 132 countries covering the period 2000-2018. The indicators are generated from harmonized household surveys, and thus present a micro-founded picture of public sector labor markets across the world. In providing information on the patterns within public employment, the WWBI enables practitioners and researchers to gain new insights on the public sector across the world.

Bureaucracy Lab/World Bank (2020) Worldwide Bureaucracy Indicators' (WWBI) available here [v2 (May 2021); v1.1 (June 2020); v1.0 (December 2018); also see GitHub repository; v2 flyer here]

Winner of the American Society for Public Administration's Chester Newland Award

Our associated `Let's Talk Development' blog is here.

We study the relationship between management practices, organizational performance, and task clarity, using observational data analysis on an original survey of the universe of Ghanaian civil servants across 45 organizations and novel administrative data on over 3,600 tasks they undertake. We first demonstrate that there is a large range of variation across government organizations, both in management quality and in task completion, and show that management quality is positively related to task completion. We then provide evidence that this association varies across dimensions of management practice. In particular, task completion exhibits a positive partial correlation with management practices related to giving staff autonomy and discretion, but a negative partial correlation with practices related to incentives and monitoring. Consistent with theories of task clarity and goal ambiguity, the partial relationship between incentives/monitoring and task completion is less negative when tasks are clearer ex ante and the partial relationship between autonomy/discretion and task completion is more positive when task completion is clearer ex post. Our findings suggest that organizations could benefit from providing their staff with greater autonomy and discretion, especially for types of tasks that are ill-suited to predefined monitoring and incentive regimes.

Part of the JPART Developing and Emerging Economies Virtual Issue.

The World Bank Working Paper version (8595) can be accessed here.

A comic strip summary for this paper can be found here on the 'Let's Talk Development' blog, and is below...

The International Growth Centre Policy Brief can be accessed here.

A DIME Policy Brief on the wider engagement with the Ghanaian Government that acted as the platform for this research can be found here.

Developing nations demand a different scholarly approach in the field of public administration. We advance an agenda for research that stands on four pillars. First, in the absence of easily accessible data scholars of developing world public administration must assemble novel data. Second, building and testing theory plays a paramount role because researchers face limited information. Third, in developing countries, multi-national and non-governmental organizations are often crucial and must be considered in studying public administration. Fourth, given the novelties and ambiguities researchers face, qualitative information must be integrated throughout the research process. Our essay and the articles in this volume constitute a call for developing country research to contribute to the study of public administration writ large, informing our understanding of both developing and developed states.

Part of a Governance Special Issue on Studying Public Administration in Developing Countries.

To what extent do public officials feel they have control over their lives in public service? We develop a new measure of perceived control in the bureaucracy based on the locus of control index. The ‘Bureaucratic Locus of Control’ (BLOC) index extends standard measures to a bureaucratic context as well as introduces an extension to these measures that focuses on the power of systemic forces in officials’ lives. Field tests amongst a representative sample of Ethiopian public officials suggest that the BLOC index has good internal reliability and that it is positively associated with promotion opportunities, rewards and motivation. We showcase its use by investigating the extent to which inequality in control impacts the general perception of control. Potential uses of the scale to study bureaucratic dynamics are discussed.

Limited replication package available here and at the World Bank's Development Data Hub (Some of the analysis undertaken in this paper requires data that cannot be fully anonymized. We therefore release a limited replication file with that data that assures the anonymity of our survey respondents.)

Part of a Governance Special Issue on Studying Public Administration in Developing Countries.

Responding to COVID-19 presents unprecedented challenges for public sector practitioners and addressing those challenges requires knowledge about the problems public sector workers face. This Viewpoint essay argues that timely, up-to-date surveys of public sector workers are an essential tool for identifying problems, resolving bottlenecks and enabling public sector workers to operate effectively during and in response to the challenges posed by the global pandemic. This article presents the COVID-19 Survey of Public Servants, which is currently rolled out in several countries by the Global Survey of Public Servants Consortium to assist governments in strategically compiling evidence to operate effectively during the COVID-19 pandemic.

This paper investigates the consequences of granting politicians power over bureaucrats in the implementation of small-scale public infrastructure projects. While potentially bolstering the incentive for the executive to perform, increased legislative oversight may lead to distortions in the technocratic process for political gain. By assembling a nationally representative data set from Nigeria that tracks public projects from inception to audit, the paper finds evidence of a clear trade-off between political oversight and bureaucratic autonomy. Using an instrumental variables strategy in which early career choices of politicians are key determinants of legislative committee membership, the analysis finds that legislative influence increases the likelihood that a project is launched by 18 percent, but at the cost of reducing project quality by 15 percent and increasing the reported misuse of funds. The results highlight the fundamental tension between bureaucratic inaction and political corruption.

The World Bank Working Paper version (8554) can be accessed here.

A comic strip abstract for this paper can be found here on the 'Let's Talk Development' blog, and is below...

How does the outside world enter village life? Understanding who visits a village, and when, requires comprehensive records of visitors and their purpose. Fortunately, many rural communities keep exactly that - detailed visitor log books that record visits from external organizations. We use a sample of such books to provide a detailed picture of the outside world's engagement with villages in Tanzania. Government officials make up half of these visits, and visit most intensively at the start of the year, and at the start of the week. The top three reasons for visits are related to social services in the health, water and agriculture/environment sectors. The paper argues why visitor books are a potentially useful source of data on the experience of villagers and the activities of the public officials who serve them.

We study how the management practices bureaucrats operate under correlate to the quantity of public services delivered, using data from the Nigerian Civil Service. We have hand-coded independent engineering assessments of 4700 project completion rates. We supplement this with a management survey in the bureaucracies responsible for these projects, building on Bloom and Van Reenen [2007]. Management practices matter: increasing bureaucrats’ autonomy is positively associated with completion rates, yet practices related to incentives/monitoring of bureaucrats are negatively associated with completion rates. Our evidence provides new insights on the importance of management in public bureaucracies in a developing country setting.

Replication data and do files

Winner of the Deutsche Bahn Prize for Outstanding Research in Organisations and Management

In the news: World Bank blog post by Markus Goldstein, Slate Magazine article by Ray Fisman and Tim Sullivan, Vox EU article

Who are the civil servants that serve poor people in the developing world? This paper uses direct surveys of civil servants - the professional body of administrators who manage government policy - and their organisations from Ethiopia, Ghana, Indonesia, Nigeria, Pakistan and the Philippines, to highlight key aspects of their characteristics and experience of civil service life. Civil servants in the developing world face myriad challenges to serving the world’s poor, from limited facilities to significant political interference in their work. There are a number of commonalities across service environments, and the paper tries to summarise these in a series of ‘stylized facts’ of the civil service in the developing world. At the same time, the particular challenges faced by a public official vary substantially across and within countries and regions. For example, measured management practices differ widely across local governments of a single state in Nigeria. Using micro-level surveys of civil servants allows us to document these differences, build better models of the public sector, and make more informed policy choices.

An online appendix provides an overview of the major civil servant surveys of the last decade or so.

The World Bank Working Paper version (8051) can be accessed here.

My associated 'Governance for Development' blog is here.

My associated 'VoxDev' blog is here.

This paper explores the use of public appointments as an incentive for public action. In particular, it assesses whether making someone an honorary public official within a community shifts their identity or broader incentives towards the community’s aggregate welfare. We present a model of public appointments and test its predictions in a real-world appointment scheme focussed on residential streets in a borough of London, UK. We find that pure public appointments, with no accompanying increase in powers, increases citizens' efforts towards the production of street cleansing and beautification on their respective streets. Incentives accompanying the appointments turn out to be necessary for us to be able to detect substantive changes in the provision of these local public goods and on measures of social capital amongst neighbours. The nature of accompanying incentives influences the outcome of the appointment scheme. A regime that emphasizes citizens' identity as change agents in the community is more effective in improving citizen satisfaction with their neighbourhood, whilst incentives provided at the community level generate greater social cohesion amongst neighbours. The paper provides some of the first evidence of the incentive regimes that might underlie long-term service contracts between citizens and the state, and highlights the potential boundaries of citizen involvement in delivering public services.

An Institute for Fiscal Studies Observation summarises our findings on the scheme

An Institute for Fiscal Studies Briefing Note provides the policy version of the paper

The ESRC Policy Briefing on the project

The Lambeth Street Champions Scheme web site, showcasing the scale up of the Scheme across the Borough

In the news: ESRC news article, Medium article by Noel Hatch

We document the correlation between the workplace diversity in bureaucratic organizations and public service delivery. We do so in the context of Nigeria, where ethnicity is a salient form of self-identity. We thus expand the empirical management literature highlighting beneficial effects of workplace diversity, that has focused on private sector firms operating in high-income settings. Our analysis combines two data sources: (i) a survey to over 4000 bureaucrats eliciting their ethnic identities; (ii) independent engineering assessments of completion rates for 4700 public sector projects. The ethnic diversity of bureaucracies matters positively: a one standard deviation increase in the ethnic diversity of bureaucrats corresponds to 9% higher completion rates. In line with the management literature from private sector firms in high-income countries, this evidence highlights a potentially positive side of ethnic diversity in public sector organizations, in the context of Sub Saharan Africa.

Replication data and do files

This essay presents a view of the frontiers of research on public service delivery in the developing world, based on a series of interviews with researchers and practitioners actively working in this field. It reviews how far the research literature has come since the publication of the World Development Report 2004 ten years ago. There is growing interest in expanding standard intervention-based research to determine effective methods for its delivery. However, a lack of data on the internal workings of many providers inhibits rapid progress in the development of this literature.

This essay presents a view of the frontiers of research on public service delivery in the developing world, based on a series of interviews with researchers and practitioners actively working in this field. It recognizes the lasting contribution of the theoretical framework laid down by the World Development Report 2004 that emphasized accountability, and the randomized evaluations that have taken place to test and develop this theory. Research on other questions, such as those relating to the analysis of politics and the structure and organization of government, is at an earlier stage, and is likely to need a more structural approach. There are many questions still to be answered in this field.

Governments play a critical role in the economies of Europe and Central Asia, where government expenditures are close to 40 percent of gross domestic product and the public sector accounts for nearly 27 percent of total employment, which is almost twice the global average. The public sector often attracts some of the best educated workers in the region. And support for a larger public sector is increasing due to aging populations and their growing health care and long-term care needs, rising inequality and greater support for redistribution, and increasing expenditures as governments address the challenges posed by the COVID-19 crisis. The significant role that government plays underscores the importance of the quality of governance in determining productivity and growth and effectively responding to the region’s economic and social challenges. Digital technology and the data revolution offer the potential to increase efficiency, transparency, responsiveness, and citizen trust, directly impacting the quality of government. Across the world, the quality of government is increasingly informed by the extent to which governments harness digital tools and GovTech to optimize management, service delivery, and overall state capacity. Technology and data are also key for fostering collaboration between governments and civil society to improve public sector efficiency and service delivery. The COVID-19 pandemic has highlighted the costs associated with delaying digitalization and GovTech implementation and the opportunities that lie in public sector modernization.

The World Bank presentation of the report can be seen here.

We present the first descriptive look at dynamic spending patterns across a large representative sample of infrastructure projects, using unique project-year level panel data covering the universe of infrastructure projects conducted by the Government of Bangladesh between 2003 and 2013. This initial research allows us to draw two main preliminary conclusions: First, projects seem to follow a non-linear spending pattern, spending less in early stages of a project’s life, and more in the latter half of a project’s implementation period. This is true for both complete and incomplete projects, and shows that underspends do not appear only because projects get abandoned, but rather seem to be an issue arising early in a project’s life and surviving throughout. This suggests investigating further the planning and early life of projects. Second, when comparing complete and incomplete projects, we observe that successfully completed projects overall did better at predicting this non-linear spending trend, required smaller revisions to planned spendings, and departed less from plan throughout the life of a project. Implementation dynamics and a project’s completion status are therefore indeed correlated, and this relation should be explored further.

In 2010, the UK government spent £8.45 billion – 0.57% of Gross National Income (GNI) – on Overseas Development Aid (ODA), mainly through the Department for International Development. This is set to rise to £12 billion in 2013 in order to fulfil the commitment to spend 0.7% of GNI on ODA, something that is particularly controversial against the backdrop of fiscal austerity for almost all other areas of public expenditure. The decision to increase aid spending raises some obvious questions and concerns.

Climate change is the biggest global health threat of the 21st century. Effects of climate change on health will affect most populations in the next decades and put the lives and wellbeing of billions of people at increased risk. During this century, earth’s average surface temperature rises are likely to exceed the safe threshold of 2°C above preindustrial average temperature. Rises will be greater at higher latitudes, with medium-risk scenarios predicting 2–3°C rises by 2090 and 4–5°C rises in northern Canada, Greenland, and Siberia. In this report, we have outlined the major threats - both direct and indirect - to global health from climate change through changing patterns of disease, water and food insecurity, vulnerable shelter and human settlements, extreme climatic events, and population growth and migration. Although vector-borne diseases will expand their reach and death tolls, especially among elderly people, will increase because of heatwaves, the indirect effects of climate change on water, food security, and extreme climatic events are likely to have the biggest effect on global health.

See here for other associated documents.