Transcript Addressing Absence

Addressing Absence
Banerjee & Duflo (2006)
MED06006 Rie Muraoka
MED06007 Miki Kataoka
MEP06049 Rafique Buriro
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Overview
1. Introduction
2. External Control
3. Beneficiary Control over Service Providers
4. Demand-Side Intervention
5. Conclusion
6. Questions
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1. Introduction
 Absenteeism – Absence of service providers
 Major issue in public health and education services
 Common problem for all facilities
Absences in the worst quartile of the health subcenters
– 36% of overall absences
Absences in the best quartile – 14%
 Erratic patterns
→ Low utility in the public primary health centers and
schools
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1. Introduction (Cont.)
In India (Reported by Chaudhury and others)
Absence rate for teachers – over 24%
Absence rate for health service providers- over 40%
 Surveys by authors in Udaipur district, the state of
Rajasthan in India (2004)
Absence rate in the primary health care facilities
The larger centers – 36%
Rural subcenters – 45%
Absence rate for teachers – 36%
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1. Introduction (Cont.)
 Need efforts to improve attendance
 Identify the effect of a reform on attendance
– Use the randomized evaluation methodology
 Major strategies
1.External Control
2.Beneficiary Control over Service Providers
3.Demand-Side Intervention
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2. External Control
 Improve incentives for providers through rewards and
punishments implemented by external monitors
 Set rules and monitor the attendance/ performance
 Give rewards /punishment based on the attendance/
performance
 Monitored with
- Personal method (cf. monitored by the headmaster)
- Impersonal method (cf. monitored by a camera)
- Performance (cf. measured by student test scores)
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2.External Control (Cont.)
Impersonal monitoring by Camera
 Case study in the rural Udaipur district in India
- Absence rate for the education center – 44% ( August, 2003)
- Selected 120 schools (picked 60 treatment schools and 60 the
comparison schools)
- Rewards – Rs 1,000 monthly if a teacher is present at least 21
days in a month
– For each additional valid day, a bonus of Rs 50
– The maximum salary up to Rs 1,300
- Punishments – For each absence, Rs -50, relative to the 21-days
benchmark
- Monthly salary ranges from Rs 500 to Rs 1,300 per month
- Monthly salary in the comparison school is Rs 1,000
- Teachers provided with cameras to take pictures at the beginning and end
of the day
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2.External Control (Cont.)
Effect of Impersonal monitoring by Camera
 Improvement in the treatment school
- The absence rate: the treatment schools - 18%
the comparison schools - 36%
 More 88 children-days per month than in a
comparison school
 The average salary in the treatments school is
almost same as that in the comparison schools
 Simple program with impersonal monitoring is
very effective
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2.External Control (Cont.)
Personal monitoring
 Case study in Kenya, Kremer & Chen (2001)
 Personal method – monitored by school
headmasters
 A prize (a bicycle) based on attendance
 No impact on absence rate
 The headmasters cheated
- To avoid the unpleasantness of a personal confrontation
- Compassion for the teachers
 Strategy involved human judgment is easy to be
perverted
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2.External Control (Cont.)
Rewards for Performance Rather than Presence
 Case study in Kenya, (Glewwe, Ilias & Kremer, 2003)
 Provide prizes to teachers based on the test
scores of students
 Improved test records but no effect on long term
learning
 No effect on teacher absence
 Lesson: Rewards for attendance, rather than
performance
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3. Beneficiary Control over Service Providers
Beneficiary Control
 An alternative way to improve incentives of
beneficiaries
 Advocated by the World Bank
(World Development Report in 2004 )
“ Service can work when poor people stand at the
center of service provision”
 If the poor avoid poor service providers, while rewarding
good providers, then the service providers have incentives
to serve the poor.
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3. Beneficiary Control over Service Providers
 Two necessary components for Beneficiary Control
1. Beneficiaries have a strong demand for the service.
2. Beneficiaries have a way to exert control over
the providers.
ex) Power to decide punishment against
absence and delinquency of the providers
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3. Beneficiary Control over Service Providers
(Cont.)
 Advantages of beneficiary control:
1.
Less costly to monitor the providers
2.
It reflects the degree of willingness for the
beneficiaries to conduct the monitoring
 But, no guarantee that beneficiary control will work
even if there is demand for the service.
Especially in many developing countries. Why?
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3. Beneficiary Control over Service Providers
(Cont.)
Because in many developing countries,
 Teachers or health care workers are likely to be social
superior to the beneficiaries.
 Government workers tend to have power to revenge
the beneficiaries.
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3. Beneficiary Control over Service Providers
(Cont.) Empirical Study
A. Local Monitoring
 India case (Banerjee, et al,2004b)
143 health sub-centers for 12 months
 Check the absence of the auxiliary nurse-midwife
 Parallel check system :
a. unannounced visit by a paid community member
once a week on 143 sites in 12 months
b. confirmed monthly visit by a member of
survey team on 80 sites in the last four months
 No rewards or punishment by monitoring outcome
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3. Beneficiary Control over Service Providers
(Cont.) Local Monitoring
Findings:
 Checks by both revealed the same absence rates
44% - by community member
42% - by survey team
 Community monitoring itself fails to reduce the staff
absence.
 Community monitoring does
improvement of attendance.
not
impact
on
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3. Beneficiary Control over Service Providers
(Cont.) Empirical study
B. Community Participation
 Kenya (Kremer, et al, 2004)
36 schools out of 72 randomly selected
School committee consisted of parents
Assuring the authority of parents to :
 allocate supplemental funds to teachers
 monitor the performance
Findings:
 Not significant impact on teachers’ absence rate
 No difference in children’s performance
 Participation of community controlling over resource
is not enough to reduce teacher’s absence.
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4. Demand-side Interventions
Target :
to increase in people’s demand for public service
since community does not value it much.
a. Incentive to study
India case
(Kremer, et al. 2004)
Providing scholarship for well-performing girls
Finding:
 Increase in attendance for both children &
teachers.
 The attendance and performance of girls as well
as boys increased.
 Teachers had higher motivation to work.
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4. Demand-side Interventions (Cont.)
b. Incentive to attend
i) Mexico case (Schultz, 2000)
Cash given to parents if they send children to school
and for their health care.
Finding:
Increase in enrollment but not in student attendance.
ii) Kenya case (Vermeersch and Kremer 2005)
School breakfast for children and teachers.
Finding:
Children attendance increased by 30%,
but no impact on local teachers’ absence.
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5. Conclusion
Indeterminate conclusions:
 External impersonal monitoring along with extrinsic
incentives reduces teachers’ absence, such as
camera and rewards.
 Beneficiary control by both community monitoring and
participation does not affect on absence.
 Increase in incentives for students to learn affects
negatively on teachers’ absence.
 Low demand of people for public service is one of
critical issues.
 Working / living circumstances and job descriptions of
service providers are another critical factors.
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6. Questions
 Limited Samples (Udaipur in India and Kenya), is study
universally applicable?
 Extrinsic controls: are they sustainable in the long term?
 Viability of Mechanical / Impersonal monitoring
(How to make digital cameras work in villages with no
electricity and how to transfer photographs taken without
efficient internet connection?)
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6. Questions (Cont.)
 Why beneficiary control doesn’t work: Unsatisfactory
explanation.
Is community empowerment the answer?
How about accountability and favoritism?
 Study ignores critical factors for absenteeism:


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

Road and Access
Residence and Job
Origin of providers
Time of the year
Transport availability …
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