Preference parameters and public sector contracts: A field study with polio vaccinators in Pakistan

Workers' time preferences can be measured using their intertemporal allocations of real work tasks and then used to individually customise incentive contracts. In a previous study, we worked with polio vaccinators in Lahore who travelled door-to-door to deliver polio vaccine. The intervention led both to better polio vaccine coverage and provided proof-of-concept that customising contracts based on individual incentives provides new means of achieving policy goals.

The COVID-19 crisis set the global polio eradication back substantially because public health resources were redirected to the much more pressing global pandemic. This project seeks to expand and build on this previous study and provide useful evidence relevant to getting global vaccination efforts back on track.

Eradicating polio remains a fundamental global public health challenge in Pakistan despite having been nearly eradicated several times over the last 15 years. Eradication eliminates all of the palliative and preventive costs associated with the disease and so would yield an enormous dividend. This is an issue relevant for many developing countries, even for countries that have eradicated the disease in wild, since it can come back as seen recently in India, the Philippines, and in Nigeria.

The proposed design involves two core elements. First, we elicit economic preferences. Then, we evaluate the benefits of individualised contracts that incorporate information about economic preferences in a randomised control trial. Measuring the provision of vaccinations also requires the implementation of a monitoring system, which will be done in collaboration with the Punjab Department of Health.