Health Service Delivery and Political Trust in Nigeria

Do improvements in health service delivery affect trust in political leaders in Africa? Citizens expect their government to provide social services. Intuitively, improvements in service delivery should lead to higher levels of trust in and support for political leaders. However, in contexts where in...

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Main Authors:	Chukwuma, Adanna, Bossert, Thomas J., Croke, Kevin
Format:	Journal Article
Published:	Elsevier 2021
Subjects:	SOCIAL SERVICES HEALTH POLICY POLITICAL TRUST HEALTH SERVICE DELIVERY
Online Access:	http://hdl.handle.net/10986/35575

id	okr-10986-35575
recordtype	oai_dc
spelling	okr-10986-355752021-07-19T16:31:13Z Health Service Delivery and Political Trust in Nigeria Chukwuma, Adanna Bossert, Thomas J. Croke, Kevin SOCIAL SERVICES HEALTH POLICY POLITICAL TRUST HEALTH SERVICE DELIVERY Do improvements in health service delivery affect trust in political leaders in Africa? Citizens expect their government to provide social services. Intuitively, improvements in service delivery should lead to higher levels of trust in and support for political leaders. However, in contexts where inadequate services are the norm, and where political support is linked to ethnic or religious affiliation, there may be weak linkages between improvements in service delivery and changes in trust in political leaders. To examine this question empirically, we take advantage of a national intervention that improved health service delivery in 500 primary health care facilities in Nigeria, to estimate the impact of residence within 10 km of one or more of the intervention facilities on trust in the president, local councils, the ruling party, and opposition parties. Using difference-in-difference models, we show that proximity to the intervention led to increases in trust in the president and the ruling party. By contrast, we find no evidence of increased trust in the local council or opposition parties. Our study also examines the role of ethnicity and religious affiliation in mediating the observed increases in trust in the president. While there is a large literature suggesting that both the targeting of interventions, and the response of citizens to interventions is often mediated by ethnic, geographic or religious identity, by contrast, we find no evidence that the intervention was targeted at the president's ethnic group, zone, or state of origin. Moreover, there is suggestive evidence that the intervention increased trust in the president more among those who did not share these markers of identity with the president. This highlights the possibility that broad-based efforts to improve health services can increase trust in political leaders even in settings where political attitudes are often thought to be mediated by group identity. 2021-05-13T20:10:41Z 2021-05-13T20:10:41Z 2019-04 Journal Article SSM - Population Health http://hdl.handle.net/10986/35575 CC BY 3.0 IGO http://creativecommons.org/licenses/by/3.0/igo World Bank Elsevier Publications & Research :: Journal Article Publications & Research Africa Africa Western and Central (AFW) Nigeria
repository_type	Digital Repository
institution_category	Foreign Institution
institution	Digital Repositories
building	World Bank Open Knowledge Repository
collection	World Bank
topic	SOCIAL SERVICES HEALTH POLICY POLITICAL TRUST HEALTH SERVICE DELIVERY
spellingShingle	SOCIAL SERVICES HEALTH POLICY POLITICAL TRUST HEALTH SERVICE DELIVERY Chukwuma, Adanna Bossert, Thomas J. Croke, Kevin Health Service Delivery and Political Trust in Nigeria
geographic_facet	Africa Africa Western and Central (AFW) Nigeria
description	Do improvements in health service delivery affect trust in political leaders in Africa? Citizens expect their government to provide social services. Intuitively, improvements in service delivery should lead to higher levels of trust in and support for political leaders. However, in contexts where inadequate services are the norm, and where political support is linked to ethnic or religious affiliation, there may be weak linkages between improvements in service delivery and changes in trust in political leaders. To examine this question empirically, we take advantage of a national intervention that improved health service delivery in 500 primary health care facilities in Nigeria, to estimate the impact of residence within 10 km of one or more of the intervention facilities on trust in the president, local councils, the ruling party, and opposition parties. Using difference-in-difference models, we show that proximity to the intervention led to increases in trust in the president and the ruling party. By contrast, we find no evidence of increased trust in the local council or opposition parties. Our study also examines the role of ethnicity and religious affiliation in mediating the observed increases in trust in the president. While there is a large literature suggesting that both the targeting of interventions, and the response of citizens to interventions is often mediated by ethnic, geographic or religious identity, by contrast, we find no evidence that the intervention was targeted at the president's ethnic group, zone, or state of origin. Moreover, there is suggestive evidence that the intervention increased trust in the president more among those who did not share these markers of identity with the president. This highlights the possibility that broad-based efforts to improve health services can increase trust in political leaders even in settings where political attitudes are often thought to be mediated by group identity.
format	Journal Article
author	Chukwuma, Adanna Bossert, Thomas J. Croke, Kevin
author_facet	Chukwuma, Adanna Bossert, Thomas J. Croke, Kevin
author_sort	Chukwuma, Adanna
title	Health Service Delivery and Political Trust in Nigeria
title_short	Health Service Delivery and Political Trust in Nigeria
title_full	Health Service Delivery and Political Trust in Nigeria
title_fullStr	Health Service Delivery and Political Trust in Nigeria
title_full_unstemmed	Health Service Delivery and Political Trust in Nigeria
title_sort	health service delivery and political trust in nigeria
publisher	Elsevier
publishDate	2021
url	http://hdl.handle.net/10986/35575
_version_	1764483360597475328

Health Service Delivery and Political Trust in Nigeria

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