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Making Bricks from Straw: Resources and Productivity in Health Care

Edward N. Okeke

The American Economic Review2026https://doi.org/10.1257/aer.20241459article
FT50AJG 4*ABDC A*
Weight
0.50

Abstract

Why do health facilities in developing countries do so poorly? This paper examines the role of financial constraints. I describe an experiment in which we surprised health workers in randomly selected public health clinics in Nigeria with a N600,000 grant paid out in installments over one year. Its administration was left entirely to health workers. I show that the award led to large productivity gains. Using expenditure data combined with novel textual data I provide an explanation for these effects. I show that the award increased investments in physical and human capital, led to lower prices for patients and inspired health workers to do better.

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https://doi.org/https://doi.org/10.1257/aer.20241459

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@article{edward2026,
  title        = {{Making Bricks from Straw: Resources and Productivity in Health Care}},
  author       = {Edward N. Okeke},
  journal      = {The American Economic Review},
  year         = {2026},
  doi          = {https://doi.org/https://doi.org/10.1257/aer.20241459},
}

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Making Bricks from Straw: Resources and Productivity in Health Care

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Evidence weight

0.50

Balanced mode · F 0.40 / M 0.15 / V 0.05 / R 0.40

F · citation impact0.50 × 0.4 = 0.20
M · momentum0.50 × 0.15 = 0.07
V · venue signal0.50 × 0.05 = 0.03
R · text relevance †0.50 × 0.4 = 0.20

† Text relevance is estimated at 0.50 on the detail page — for your query’s actual relevance score, open this paper from a search result.