Time, incentives, and the integrity of frontline health data
Public health workers rely on self reported household visits to inform health planning, but many of these reported visits never take place, undermining the accuracy of health data. The study finds that false reporting increases sharply over the course of the reporting week, rising from around one in ten reports on Monday to about two thirds by Saturday as deadlines approach. Introducing financial incentives linked to reported visits improves reporting accuracy and worker performance. In particular, rewarding early week effort increases genuine household visits, while a consistent per visit payment reduces false reporting and lowers the number of fabricated reports. The findings show that well designed incentive schemes can strengthen the quality of frontline health data and support better informed public health decisions.
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Khan-Mustafi-Policy-Brief-June-2026.pdf
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- Public health workers, such as community health workers, self-report the household visits they make, and these reports feed directly into health planning. But a large share of reported visits never actually happen: under the status quo, about 36% of all reported visits are false.
- Misreporting is not constant; it climbs steadily over the reporting period (a week). Only about one in ten reports are false on Monday, but the false-report rate rises to roughly two-thirds (about 66%) by Saturday, as the reporting deadline approaches.
- Linking pay to reported visits improves honesty, and its timing matters. A front-loaded incentive that rewards early-week effort raised visits by about 8% without increasing fabrication, while a uniform per-visit incentive of equal expected value cut the late-week false-report rate from 56% to 42% and lowered the estimated number of fabricated reports per worker by roughly one to two each week.