Does involvement of local NGOs enhance public service delivery? Cautionary evidence from a malaria-prevention program in India
基于印度奥里萨邦两个疟疾流行县的实验数据，发现政府与非政府组织合作提升蚊帐使用和就医行为的项目效果因地区而异，人口特征和NGO特征显著影响成效，其中实施者的质量与努力是关键因素。
Partnerships between government and non-state actors that aim to enhance the quality or efficiency of service delivery are increasingly common in today's development policy landscape. We investigate the impacts of such an approach using data from an experimental supportive intervention to India's malaria control program that leveraged local non-state capacity in order to promote mosquito net usage and recommended fever care-seeking patterns. The supportive activities were conducted simultaneously by 3 NGOs, contracted out by the Indian government, in 2 endemic districts in the state of Odisha. We find that program impact significantly varied by location. Examining 3 potential sources of this variation (differential population characteristics, differential health worker characteristics, and differential implementer characteristics), we provide evidence that both population and NGO characteristics significantly affected the success of the program. Specifically, the results suggest that the quality and effort of the local implementer played a key role in the differential effectiveness. We discuss these findings as they relate to the external validity of development policy evaluations and, specifically, for the ability of health and other service delivery systems to benefit from limited non-state capacity in underresourced areas.