Testing the virtuous cycle of public services delivery and human resource development
This project considers the role of Community Health Workers in Zambia and seeks to estimate how much surplus value these workers have on their respective communities.
In rural communities in Zambia, job opportunities are scarce. Most school children are forced to choose between staying in their communities to work in low-skilled manual labour or agriculture, or moving to larger cities where the returns to education are higher. Building on research on a nationwide recruitment drive to hire Community Health Workers (CHAs) (Ashraf, Bandiera, Davenport, and Lee, 2020), we hypothesise that the positive impacts of this initiative extend beyond health. In particular, we hypothesise that communities where CHAs were recruited and posted are more likely to embark on a reinforcing feedback loop in which the positive effects of an initial investment in public procurement create a self-sustaining cycle of improvement – what we call the ‘Virtuous Cycle.’
By conducting this study, we can provide a causal estimate of how much surplus value the presence of a locally recruited civil servant, in this case a health worker, has on their respective community. We will be able to measure both health and educational outcomes across generations. If this impact is sizable, as current preliminary evidence suggests, then this research project could function as an evidence-based foundation for an extremely cost-effective and scalable policy instrument to improve the long-run outcomes of rural communities.