Abstract:
Outreach workers are widely used to increase the access to health services, particularly for minority groups. The difference in ethnicity of an outreach worker and that of a prospective patient can limit the success of such efforts. Using a field experiment in Nepal, we investigate the extent of such barriers and if differential incentives can help offset them. We varied the amount of financial incentives provided to health outreach workers by the ethnicity of the client they recruited for a free sugar-level assessment. We also varied the amount the clients received for appearing for the assessment. We find that the barriers due to ethnicity are high. Even a highly differential incentive in the ratio of 5:2, geared toward encouraging the workers to recruit clients from an ethnic group different than their own, is insufficient to fully offset the barriers. In sub-group analysis, we find suggestive evidence that differential incentives to advantaged outreach workers have the potential to improve access for traditionally disadvantaged groups. We also find that the advantaged and disadvantaged health workers face different amounts of barriers to outreach efforts. Financial incentives to the clients had no effect on their decision to appear for the assessment.