Management, Supervision, and Health Care: A Field Experiment

Abstract

We used a randomized management consulting intervention with 80 public-sector healthcare facilities in Nigeria to study the role of information, training, and supervision on the adoption of improved organizational practices. Facilities that received detailed improvement plans and nine months of implementation support—including regular visits to monitor progress and set intermediate goals related to the plans—showed large, significant short-term effects on the adoption of practices that were under the responsibility of facility staff. Facilities that received general improvement advice but no implementation support showed no change in practices. Implementation support appears crucial for improvements, especially in contexts without market incentives for the adoption of effective managerial practices.