Library Header Image
LSE Research Online LSE Library Services

Does high workload reduce the quality of healthcare? Evidence from rural Senegal

Kovacs, Roxanne J. and Lagarde, Mylène ORCID: 0000-0002-5713-2659 (2022) Does high workload reduce the quality of healthcare? Evidence from rural Senegal. Journal of Health Economics, 82. ISSN 0167-6296

[img] Text (Lagarde_does-high-workload-reduce-quality-of-healthcare--published) - Published Version
Available under License Creative Commons Attribution.

Download (825kB)

Identification Number: 10.1016/j.jhealeco.2022.102600


There is a widely held perception that staff shortages in low and middle-income countries (LMICs) lead to excessive workloads, which in turn worsen the quality of healthcare. Yet there is little evidence supporting these claims. We use data from standardised patient visits in Senegal and determine the effect of workload on the quality of primary care by exploiting quasi-random variation in workload. We find that despite a lack of staff, average levels of workload are low. Even at times when workload is high, there is no evidence that provider effort or quality of care are significantly reduced. Our data indicate that providers operate below their production possibility frontier and have sufficient capacity to attend more patients without compromising quality. This contradicts the prevailing discourse that staff shortages are a key reason for poor quality primary care in LMICs and suggests that the origins likely lie elsewhere.

Item Type: Article
Official URL:
Additional Information: © 2022 The Authors
Divisions: Health Policy
Subjects: R Medicine > RA Public aspects of medicine
H Social Sciences > HD Industries. Land use. Labor
JEL classification: I - Health, Education, and Welfare > I1 - Health > I10 - General
I - Health, Education, and Welfare > I1 - Health > I11 - Analysis of Health Care Markets
J - Labor and Demographic Economics > J4 - Particular Labor Markets > J45 - Public Sector Labor Markets
Date Deposited: 16 Feb 2022 15:27
Last Modified: 26 May 2022 08:48

Actions (login required)

View Item View Item


Downloads per month over past year

View more statistics