Political Dynasties and Service Delivery: Evidence from Rural Health Clinics in Punjab Pakistan Vol. 30, Issue 2

Abstract

Research suggests that politics plays a pivotal role in public service provision in contexts of scarce resources. However, there is limited evidence available on how dynastic politicians influence public service delivery. We examine this question in the context of the health sector in Punjab, Pakistan. By employing a representative sample of rural health clinics, we develop measures to capture doctors’ outcomes at the clinic level. These data are then matched with provincial constituency-level data to study the impact of having a dynastic member of the parliament (MP) on doctors’ assignment, attendance, and tenure in their respective constituencies. Our findings show that having a dynastic MP has no discernible impact on the assignment and attendance of doctors. However, clinics in constituencies with a dynastic MP have relatively experienced doctors. Furthermore, our suggestive evidence from the Pakistan Household and Living Measurement Survey (PSLM) shows that individuals living in districts with a higher proportion of dynastic MPs report lower improvements in clinic services and are less satisfied with those services. Our main findings remain robust to various alternative explanations.