Service delivery to the poor is complicated by the extra effort required to deliver services to them and the intrinsic incentives of service providers to exert this effort. Incentive schemes typically fail to account for these complications. A lab-in-the-field experiment with nearly 400 health workers in rural Burkina Faso provides strong evidence that the interaction of effort costs, ability, and intrinsic and extrinsic incentives significantly influences service delivery to the poor.
To investigate these interactions, this research used a lab-in-the-field asking health workers to review video vignettes of medical cases involving poor and nonpoor patients under a variety of bonus schemes and contract types. The results indicate strong differences on the effect of bonuses to serve the poor versus nonpoor, as well as differences in preferences of contract types for pro-poor workers.
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