Baseline Reciprocity Predictor of Real-World Absenteeism
RCTClinical Trial
Evaluating frontline health worker intrinsic motivation and predicting real-world work effort like absenteeism in developing countries is challenging. Traditional surveys often suffer from self-reporting bias and fail to reflect actual behavioral choices on the job.
Picture this
Imagine testing an employee's honesty in a simple coin-tossing game before hiring them. If their decisions in the game show high fairness, it reliably predicts whether they will actually show up on time and do their job diligently at work when nobody is watching.
What the evidence says
Health workers who were consistently reciprocal in the baseline Trust Game (always returning a returned-received ratio >= 1 regardless of amount received) were significantly less likely to be absent during unannounced visits (38% absence rate for high-reciprocity public workers vs. 61% for low-reciprocity workers, p < 0.05), proving that lab-in-the-field game choices mirror real-world workplace effort.
- Who was studied
- N = 94 health providers (re-visited out of 103 total workshop participants) from primary health facilities in Nairobi, Kenya.
- How
- Linking individual provider decision-making in a baseline Trust Game (measuring returned-received monetary ratios before reporting treatments) with unannounced follow-up facility visits conducted 1 week later to record actual worker attendance.
What to do
Utilize behavioral game exercises during public health workforce screening to identify candidate intrinsic prosociality and mitigate downstream employee absenteeism.
From the source
"Across all measures, health workers who are more reciprocal tend to be less absent during our unannounced visits, especially if working in the public sector."
e7b318f7-c10f-44ea-935a-6f4ab3cde66a-Health Workers’ Behavior, Patient Reporting and Reputational Concerns- Lab-in-the-Field Experimental Evidence from Kenya.pdf