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Citizen participation in decision making has been widely lauded as a method for improving societal outcomes. Deliberative discussion, in particular, is believed to be more transformative than a mere aggregation of individual preferences, leading to more socially optimal decision making and behavior. I report the results from a laboratory experiment with 570 subjects in Nairobi, directly testing the effect of participation in deliberative group decision making on collective outcomes. Participants engage in a group task to earn compensation toward a shared group fund. Randomly assigned treatments vary according to whether decision making over the task to be completed involves: (1) external assignment; (2) non-deliberative majority voting; or (3) consensus through deliberative discussion. I find that deliberation improves collective decision making. Deliberation is also associated with changes in preferences, greater agreement with decision outcomes, and greater perceived fairness. Evidence for behavior change is weaker, but there is some support for further research into the relationship between preference change and behavior change.

 

Abstract Scholars and practitioners often promote direct engagement between policymakers, health workers and researchers as a strategy for overcoming barriers to utilizing scientific knowledge in health policy. However, in many settings public health officials rarely have opportunities to interact with researchers, which is a problem further exacerbated by the coronavirus disease 2019 pandemic. One prominent theory argues that policy actors will trust and utilize research findings when they perceive them to be salient, credible and legitimate. We draw on this theory to examine the conditions facilitating greater uptake of new knowledge among health officials when engagement is out of reach and they are instead exposed to new ideas through written mass communication. Using data from a survey experiment with about 260 health workers and administrators in Honduras, we find that messages from a technocratic sender based on statistical evidence improved perceptions of salience, credibility and legitimacy (SCL). Additionally, perceptions of SCL are three contextual features that operate as joint mediators between knowledge and action, and several individual characteristics also influence whether officials trust research findings enough to apply them when formulating and implementing health policies. This research can help inform the design of context-sensitive knowledge translation and exchange strategies to advance the goals of evidence-based public health, particularly in settings where direct engagement is difficult to achieve. 

Governance reforms like decentralization and performance-based management aim to improve public services by increasing accountability among street-level bureaucrats: bureaucrats may be held to account by communities, supervisors, intermediary organizations, or all of these. To assess the relationship between accountability and bureaucratic effort, we utilize data from a lab-in-the-field behavioral experiment conducted with Honduran health workers across decentralized and centrally administered municipalities. We presented health workers with an incentivized effort task that included instructions that were neutral, had a bottom-up political accountability prompt, or a top-down bureaucratic accountability prompt. Our results show that administrative context moderates the accountability-to-effort relationship. With neutral instructions, civil servants in decentralized systems exert greater quality effort than their counterparts under centralized administration. Importantly, both accountability prompts increase quality effort in centrally administered settings to levels comparable with those in decentralized settings. These findings support multiple accountability as a potentially important mechanism linking decentralization reform to improved service delivery. 

Collective action among public officials is necessary for the effective delivery of many social services, but relatively little is known about how it can be fostered through policy reforms. In this article, we compare cooperation among public officials within decentralized versus centrally‐administered municipalities in Honduras. Leveraging a quasi‐experiment in health sector reform, coupled with behavioral games and social network surveys, we find that decentralization is associated with greater cooperation. When they are able to communicate, health sector workers in decentralized municipalities contribute more to a public good than their centrally‐administered counterparts. This increase in cooperative behavior results in part from the decentralization reform engendering greater numbers of interactions and stronger ties across different levels of government. These findings indicate that institutional reforms like decentralization can favorably reconfigure patterns of social interactions across public organizations, which is an important component of administrative capacity in developing countries.