Pro-social Incentives and Medicine Theft During COVID: Evidence from Malawi

• In Event: Agents of Accountability: Monitors and Claimants in Accountability Processes

Abstract

Medicine theft is a common and lucrative form of public corruption within the health sector of many developing countries. In addition to the growth-inhibiting and poverty-inducing effects that accompany corruption, drug theft has slowed government responses to COVID-19, as well as more chronic diseases as malaria. In this paper, we seek to uncover spatial patterns of medicine theft in public health clinics in Malawi during the COVID-19 pandemic, and identify how public health messaging can shift patterns of theft and affect citizens’ access to medicines. To detect and measure drug theft, we introduce a novel measurement strategy using GPS tracking devices to observe 2,400 medicine deliveries in real time. In collaboration with the Malawi Ministry of Health, we used this measurement tool to experimentally test two messaging interventions designed to reduce theft and improve procurement efficiency. The first message tested whether knowledge of monitoring affected official’s behavior. The second tested the effects of pro-social messaging. The results indicate that digital tracking can be a powerful and relatively low-cost tool to improve accountability in high risk contexts and during pandemic responses. The results also offer insights into how officials weigh pro-social motivations and government monitoring in decisions over whether to engage in corruption.

Authors

• Ryan Steele Jablonski, London School of Economics and Political Science

• Brigitte Seim, University of North Carolina-Chapel Hill

• Mariana Carvalho, University of California, San Diego

• Clark C. Gibson, University of California, San Diego