While designing pro-poor policies, it is vital to understand the different incentives and motivation of service providers can differ in providing for the poor.
The aim of welfare schemes is to benefit the poor vis-a-vis the non-poor. Efforts to reduce the income mismatch and improve the holistic well-being are at the forefront of all pro-poor public policies. This objective might be what drives policymakers but what of the attitudes of pro-poor service providers, who are responsible for bringing about the desired grassroots change? Indeed, ideally, they should be intrinsically motivated towards social, and especially pro-poor, work, but this is not always the case. Organisations address these conflicts through careful selection procedures and pecuniary compensation schemes that make sure workers’ motivation is geared towards assisting those that require it the most. In the backdrop of complex interactions of and between these intrinsic motivations, the attitudes of those who receive aid also matter, as, at times, communication difficulties, remoteness and weak compliance might deter recipients from actualising better outcomes from the time and effort of those who are trying to help them.
In an effort to better understand how best to deliver aid, 400 doctors, nurses and midwives in rural Burkina Faso participated in a “lab-in-the-field” experiment to illuminate these issues. The experiment underlined the importance for public policy of accounting for both the extra effort needed to serve the poor and the pro-poorness of the service providers themselves. Health workers who received equal bonuses to serve poor and non-poor patients saw fewer poor patients than workers who received only a flat salary. This is due to the fact that, in the presence of pecuniary incentives to serve the non-poor, it was the pro-poor who most reduced their load of poor patients because, in their absence, it is largely the pro-poor who choose to see poor patients. The presence of pro-poor service providers can substitute for pecuniary bonuses to serve the poor, but on the other hand, pro-poor individuals recognise that pecuniary incentives might reduce the attention that they give to poor patients. Therefore, while designing pro-poor policies, it is vital to understand the different incentives and motivation of service providers can differ in providing for the poor.