Randomised controlled trial testing the effects of transparency on health care in Uganda

Posted on 18 January, 2012 – 7:11 PM

(from the great AidInfo website)

“At aidinfo we conduct research and liaise with aid donors and recipients to build up a case for aid transparency. We want to show that improving and increasing the amount that donors report on their aid contributions can help communities to track aid spending. In turn, donors and governments will be more accountable for their aid spending. It is expected that in this way aid will reach more people on the ground, helping to contribute more in the fight against poverty.

This is all well and good, but it is difficult to prove. Svensson’s work, then, is of great importance to us here.

This Study by Reinikka and Svensson (2005) found that in 1995 only 20 percent of a primary education grant program to rural Uganda actually reached its intended target. This figure rose by a striking 60 percent in 2001 when information was published detailing where this money was going; a full 80 percent of funds reached their intended destination, greatly improving education services in the area.

Björkman and Svensson (2009) followed up on this study with a compelling randomised controlled trial testing the effects of transparency on health care in Uganda. The experiment randomly assigned community health clinics to receive published ‘report cards’ and NGO-organised public meetings on the quality of the clinics’ health care.

The results of this transparency ‘treatment’ rivalled the effects of the best health interventions involving expensive new medicines, equipment, and procedures. Waiting time for care decreased, absenteeism among doctors and nurses plummeted, clinics got cleaner, fewer drugs were stolen, 40-50 percent more children received dietary supplements and vaccines, health services got used more, and, powerfully, 33 percent fewer children died under the age of five. This amounted to 550 saved lives in a small area of Uganda encompassing merely 55,000 households.

This is strong evidence that access to information about services empowers citizens to get better services and saves lives.”

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