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\n\n \n \n \n \n \n \n Using Remote Tracking Technologies to Audit and Understand Medicine Theft.\n \n \n \n \n\n\n \n Ryan Jablonski; Brigitte Seim; Clark Gibson; and Mariana Carvalho.\n\n\n \n\n\n\n 2023.\n
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paper\n \n \n \n pre-analysis plan\n \n \n\n \n\n \n link\n \n \n\n bibtex\n \n\n \n \n \n abstract \n \n\n \n \n \n 15 downloads\n \n \n\n \n \n \n \n \n \n \n\n \n \n \n\n\n\n
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@unpublished{JablonskiTracking,\r\n title={Using Remote Tracking Technologies to Audit and Understand Medicine Theft},\r\n author={ Jablonski, Ryan and Seim, Brigitte and Gibson, Clark and Carvalho, Mariana},\r\nyear={2023},\r\nabstract={Medicine theft is a leading cause of inadequate healthcare. Audits of public health procurement suggest that up to a third of medicines go missing in several low income countries, disproportionately affecting those with higher health risk and poverty. In an experiment with the Malawi Ministry of Health, we employ novel measurement strategies and an experiment to determine the pattern of corruption and the effect of a policy response designed to increase the visibility of theft. We placed tracking devices on 2,400 medicine deliveries that could observe their positions in real time. We assigned some medicines with messages about monitoring and the consequences of theft. Using these data, we provide some of the most comprehensive estimates to-date on the scale and consequences of medicine theft. We show that corrupt actors appear to select less observed sections of procurement networks and locations more proximate to smuggling routes. We also show that measures of theft are strongly correlated with patients' ability to access needed medicines from government clinics. Despite this, we estimate only small effects of our visibility treatment. Evidence from surveys with patients and public health officials suggest these small effects of greater visibility may be due to systematic weaknesses in institutional accountability mechanisms and efforts by public officials to circumvent digital auditing activities. We suggest that digital tracking technologies can be an important tool in preventing theft, especially in combination with efforts to bolster institutional mechanisms of accountability.},\r\nurl_Paper={https://doi.org/10.35188/UNU-WIDER/2023/434-2},\r\nurl_Pre-Analysis_Plan={http://egap.org/registration/2611}\r\n}\r\n\r\n\r\n\n
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\n Medicine theft is a leading cause of inadequate healthcare. Audits of public health procurement suggest that up to a third of medicines go missing in several low income countries, disproportionately affecting those with higher health risk and poverty. In an experiment with the Malawi Ministry of Health, we employ novel measurement strategies and an experiment to determine the pattern of corruption and the effect of a policy response designed to increase the visibility of theft. We placed tracking devices on 2,400 medicine deliveries that could observe their positions in real time. We assigned some medicines with messages about monitoring and the consequences of theft. Using these data, we provide some of the most comprehensive estimates to-date on the scale and consequences of medicine theft. We show that corrupt actors appear to select less observed sections of procurement networks and locations more proximate to smuggling routes. We also show that measures of theft are strongly correlated with patients' ability to access needed medicines from government clinics. Despite this, we estimate only small effects of our visibility treatment. Evidence from surveys with patients and public health officials suggest these small effects of greater visibility may be due to systematic weaknesses in institutional accountability mechanisms and efforts by public officials to circumvent digital auditing activities. We suggest that digital tracking technologies can be an important tool in preventing theft, especially in combination with efforts to bolster institutional mechanisms of accountability.\n
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\n\n \n \n \n \n \n \n How corruption harms public health: An experimental impact evaluation of corruption in medicine procurement.\n \n \n \n \n\n\n \n Ryan Jablonski; Brigitte Seim; Clark Gibson; and Mariana Carvalho.\n\n\n \n\n\n\n 2023.\n
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@unpublished{JablonskiHealth,\r\n title={How corruption harms public health: An experimental impact evaluation of corruption in medicine procurement},\r\n author={ Jablonski, Ryan and Seim, Brigitte and Gibson, Clark and Carvalho, Mariana},\r\nyear={2023},\r\nabstract={Medicine theft is a leading cause of inadequate healthcare. Audits of public health procurement suggest that up to a third of medicines go missing in several low income countries, disproportionately affecting those with higher health risk and poverty. In an experiment with the Malawi Ministry of Health, we employ novel measurement strategies and an experiment to determine the pattern of corruption and the effect of a policy response designed to increase the visibility of theft. We placed tracking devices on 2,400 medicine deliveries that could observe their positions in real time. We assigned some medicines with messages about monitoring and the consequences of theft. Using these data, we provide some of the most comprehensive estimates to-date on the scale and consequences of medicine theft. We show that corrupt actors appear to select less observed sections of procurement networks and locations more proximate to smuggling routes. We also show that measures of theft are strongly correlated with patients' ability to access needed medicines from government clinics. Despite this, we estimate only small effects of our visibility treatment. Evidence from surveys with patients and public health officials suggest these small effects of greater visibility may be due to systematic weaknesses in institutional accountability mechanisms and efforts by public officials to circumvent digital auditing activities. We suggest that digital tracking technologies can be an important tool in preventing theft, especially in combination with efforts to bolster institutional mechanisms of accountability.},\r\nurl_Pre-Analysis_Plan={http://egap.org/registration/2611}\r\n}\r\n\r\n\n
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\n Medicine theft is a leading cause of inadequate healthcare. Audits of public health procurement suggest that up to a third of medicines go missing in several low income countries, disproportionately affecting those with higher health risk and poverty. In an experiment with the Malawi Ministry of Health, we employ novel measurement strategies and an experiment to determine the pattern of corruption and the effect of a policy response designed to increase the visibility of theft. We placed tracking devices on 2,400 medicine deliveries that could observe their positions in real time. We assigned some medicines with messages about monitoring and the consequences of theft. Using these data, we provide some of the most comprehensive estimates to-date on the scale and consequences of medicine theft. We show that corrupt actors appear to select less observed sections of procurement networks and locations more proximate to smuggling routes. We also show that measures of theft are strongly correlated with patients' ability to access needed medicines from government clinics. Despite this, we estimate only small effects of our visibility treatment. Evidence from surveys with patients and public health officials suggest these small effects of greater visibility may be due to systematic weaknesses in institutional accountability mechanisms and efforts by public officials to circumvent digital auditing activities. We suggest that digital tracking technologies can be an important tool in preventing theft, especially in combination with efforts to bolster institutional mechanisms of accountability.\n
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\n\n \n \n \n \n \n \n Foreign aid is neither a curse nor a blessing: Explaining the effects of foreign aid on voting behavior and accountability.\n \n \n \n \n\n\n \n Ryan Jablonski; Brigitte Seim; and Johan Ahlback.\n\n\n \n\n\n\n 2023.\n
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\n\n \n \n pre-analysis plan\n \n \n\n \n\n \n link\n \n \n\n bibtex\n \n\n \n \n \n abstract \n \n\n \n \n \n 2 downloads\n \n \n\n \n \n \n \n \n \n \n\n \n \n \n\n\n\n
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@unpublished{JablonskiAidVotes,\r\n title={Foreign aid is neither a curse nor a blessing: Explaining the effects of foreign aid on voting behavior and accountability},\r\n author={Jablonski, Ryan and Seim, Brigitte and Ahlback, Johan},\r\nyear={2023},\r\nabstract={How does foreign aid change electoral behavior? We provide a theory to reconcile mixed evidence. We argue that when foreign aid is seen by voters as highly politicized, aid can be a double-edged sword for politicians. The net effects of aid on elections will depend on the dispersion of aid and citizen beliefs about how aid \\textit{should} have been distributed. To test our argument, we conducted a survey among 2,331 citizens around a sample of 180 schools in Malawi before and after the delivery of a highly targeted foreign aid project in the education sector. Additionally, we conducted a SMS-based information experiment which varied voter knowledge about the aid allocation process. In line with expectations, we confirm that voters who live in an area that receives foreign aid were more likely to anticipate voting for incumbent councillors and rate incumbent performance as high. Further, we show that aid increased the number of visits by incumbents and we provide anecdotal evidence of more credit claiming activity by politicians. The results of the SMS experiment, however, demonstrate that aid can also be a double-edged sword: when citizens learn about aid, but fail to benefit, we document a sizable backlash against incumbents. Citizens were less likely to be satisfied with or vote for incumbents in this condition. Collectively, these finding imply highly variable net effects of foreign aid on electoral outcomes. The study also implies ways in which donors might minimize adverse political consequences from aid delivery.},\r\nurl_Pre-Analysis_Plan={http://egap.org/registration/2611}\r\n}\r\n\r\n\r\n\n
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\n How does foreign aid change electoral behavior? We provide a theory to reconcile mixed evidence. We argue that when foreign aid is seen by voters as highly politicized, aid can be a double-edged sword for politicians. The net effects of aid on elections will depend on the dispersion of aid and citizen beliefs about how aid should have been distributed. To test our argument, we conducted a survey among 2,331 citizens around a sample of 180 schools in Malawi before and after the delivery of a highly targeted foreign aid project in the education sector. Additionally, we conducted a SMS-based information experiment which varied voter knowledge about the aid allocation process. In line with expectations, we confirm that voters who live in an area that receives foreign aid were more likely to anticipate voting for incumbent councillors and rate incumbent performance as high. Further, we show that aid increased the number of visits by incumbents and we provide anecdotal evidence of more credit claiming activity by politicians. The results of the SMS experiment, however, demonstrate that aid can also be a double-edged sword: when citizens learn about aid, but fail to benefit, we document a sizable backlash against incumbents. Citizens were less likely to be satisfied with or vote for incumbents in this condition. Collectively, these finding imply highly variable net effects of foreign aid on electoral outcomes. The study also implies ways in which donors might minimize adverse political consequences from aid delivery.\n
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\n\n \n \n \n \n \n How do we know if an election is stolen? Identifying human error and fraud in the 2019 Malawian election.\n \n \n \n\n\n \n Ryan Jablonski; and Johan Ahlback.\n\n\n \n\n\n\n 2023.\n
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@unpublished{JablonskiMalawiElection,\r\n title={How do we know if an election is stolen? Identifying human error and fraud in the 2019 Malawian election},\r\n author={Jablonski, Ryan and Ahlback, Johan},\r\nyear={2023},\r\nabstract={Voters and politicians often struggle to distinguish between fraudulent and non-fraudulent elections. This confusion undermines the credibility of elections and governance. We introduce several techniques to assess the causes of tallying error. Using these methods we revisit the case of the Malawian 2019 election, which was famously cancelled by the High Court due to widespread irregularities and accusations of fraud. We show --- contrary to the dominant consensus --- that the majority of these irregularities were plausibly due to human error rather than fraud. We show that patterns of irregularities are not consistent with common strategies of fraud, and that irregularities failed to significantly benefit incumbents. Further, using quasi-random variation in the administration of polling stations and allocation of ballots, we show that irregularities increased in proportion to the complexity of filling in result-sheets, suggesting a dominant role for human error. In addition to re-interpreting a historically important election, we provide generally useful methods for assessing the causes of errors in election tallying. We also make a case that policy efforts to improve electoral credibility could productively be reallocated towards electoral administration rather than anti-fraud measures.},\r\n}\r\n\r\n\r\n\r\n\r\n\n
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\n Voters and politicians often struggle to distinguish between fraudulent and non-fraudulent elections. This confusion undermines the credibility of elections and governance. We introduce several techniques to assess the causes of tallying error. Using these methods we revisit the case of the Malawian 2019 election, which was famously cancelled by the High Court due to widespread irregularities and accusations of fraud. We show — contrary to the dominant consensus — that the majority of these irregularities were plausibly due to human error rather than fraud. We show that patterns of irregularities are not consistent with common strategies of fraud, and that irregularities failed to significantly benefit incumbents. Further, using quasi-random variation in the administration of polling stations and allocation of ballots, we show that irregularities increased in proportion to the complexity of filling in result-sheets, suggesting a dominant role for human error. In addition to re-interpreting a historically important election, we provide generally useful methods for assessing the causes of errors in election tallying. We also make a case that policy efforts to improve electoral credibility could productively be reallocated towards electoral administration rather than anti-fraud measures.\n
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