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Professors Oriana Bandiera and Nava Ashraf receive the 29th Arrow Award

Published/Broadcast 3 May 2021

Congratulations to Professor Oriana Bandiera and Professor Nava Ashraf who, together with Edward Davenport and Scott S Lee, received the 29th Arrow Award for the best paper in health economics.

Nava Ashraf, Oriana Bandiera, Edward Davenport, and Scott S. Lee, 2020. "Losing Prosociality in the Quest for Talent? Sorting, Selection, and Productivity in the Delivery of Public Services" American Economic Review, 110(5): 1355-1394.

The Committee for the Arrow Award of the International Health Economics Association is proud to acknowledge the authors of this innovative and informative paper, which investigates whether career benefits for health workers attract talent at the expense of prosocial motivation in Zambia. The professionalization of public service delivery, whereby career professionals replace informal local providers has raised concerns of a possible trade-off between qualifications and skills on the one hand, and intrinsic motivation and local rapport on the other. This study embeds a field experiment in a nationwide health care recruitment in Zambia to test whether career benefits, as measured by the salience of a career in civil service, attract talent at the expense of prosocial motivation. The authors collaborate with the government of Zambia as they formalize primary health care in remote rural areas by creating a new health worker position in the civil service. Due to the shortage of medical staff, hiring effective agents can potentially make a great difference for the quality of health services and, ultimately, health outcomes in these communities. The study finds that offering career opportunities attracts less prosocial applicants for a new health care position. However, the trade-off exists only at low levels of talent, while at higher levels of talents they are equally prosocial. Those who are hired, who are more talented and equally prosocial, perform better at every step of the causal chain. They provide more inputs: 29 percent more household visits, and twice as many community meetings. They increase facility utilization: the number of women giving birth at the health center is 30 percent higher, and the number of children undergoing health checks is 24 percent higher, being weighed 22 percent higher, and receiving immunization against polio 20 percent higher. They improve a number of health practices among the households they serve: breastfeeding and proper stool disposal increase, deworming, and the share of children on track with their immunization schedule. These are matched by changes in health outcomes: the share of children under age 5 who are underweight falls by 25 percent. In summary, offering a civil service position with career opportunities attracts workers who deliver services with remarkable health impact. We congratulate the authors on the publication of this important paper.

Find out more on the iHEA News website.