Working Paper: NBER ID: w31269
Authors: Zachary Wagner; Corrina Moucheraud; Manisha Shah; Alexandra Wollum; Willa H. Friedman; William H. Dow
Abstract: Bias among health care providers can lead to poor-quality care and poor health outcomes, and it can exacerbate disparities. We use a randomized controlled trial to evaluate an intervention to reduce family planning provider bias towards young women in 227 clinics in Tanzania, Burkina Faso, and Pakistan. The intervention educated providers about bias towards young women, facilitated communication about bias with other providers, and offered non-financial public awards to clinics with the least biased care. After 12 months, the intervention led to less-biased attitudes and beliefs among providers and more comprehensive counseling. Clients also perceived better treatment at intervention clinics compared to control clinics. Despite reductions in reported bias, we find mixed evidence regarding changes in method dispensing
Keywords: provider bias; family planning; health care disparities; randomized controlled trial
JEL Codes: D12; I11; I12; O12
Edges that are evidenced by causal inference methods are in orange, and the rest are in light blue.
| Cause | Effect |
|---|---|
| intervention (D74) | less-biased attitudes and beliefs among providers (I24) |
| intervention (D74) | improvements in provider behaviors (I11) |
| less-biased attitudes and beliefs among providers (I24) | better information provided to clients (G24) |
| intervention (D74) | clients feeling better treated at intervention clinics (I11) |
| clients feeling better treated at intervention clinics (I11) | higher likelihood of recommending these clinics to friends (I11) |
| reduced bias (C46) | actual service delivery outcomes (L87) |