Dealing with public provider absenteeism

economics ▪ development ▪

Absenteeism of public service providers in education and health facilities has often been cited to be a serious problem in developing countries. A recent paper by Abhijit Banerjee and Esther Duflo of MIT's Poverty Action Lab document what is known about the effectiveness of various strategies to control such absenteeisms from policy experiments done in India and Africa.

One effective strategy that I find interesting is the requirement that teachers take pictures of themselves and their students using tamper-proof cameras coupled with bonuses for teachers with high attendance. In regions in Indonesia where absenteeism is a serious problem, this is worth a try.

From the paper's abstract:

This paper brings together evidence from a number of randomized experiments designed to address the problem of absence of teachers and health providers in developing countries. The goal is to see what, if any, lessons we can draw from them. Our tentative conclusion is that these service providers are willing to respond even to quite moderate incentives. The constraint seems to be in getting the incentives implemented: participants in the system, including both supervisors and beneficiaries, seem unwilling or unable do so. This suggests that, at this stage, fighting absence will either require incentives implemented from outside the system or a large enough boost to demand that the beneficiaries are willing to assume some degree of control. The long-run benefits might be large if these interventions help to break the vicious cycle of low performance and low expectations.