Wealth-Differentiated Sanction Sensitivity in Reporting
RCTClinical Trial
Citizen-driven accountability mechanisms rely on equal civic participation, but socioeconomic inequalities can distort who uses reporting tools. Poorer citizens often face higher social or economic costs when filing grievances against high-status public service providers.
Picture this
Imagine a customer service hotline that levies small court fees for formal disputes. A wealthy customer comfortably pays the fee and submits a claim, whereas a low-income customer fears potential financial risks or backlash from powerful staff and chooses to stay silent.
What the evidence says
Wealthier patients were significantly more willing to file complaints when reports generated monetary penalties for providers compared to poorer patients (interaction coefficient = +0.076, p = 0.045), whereas lower-wealth patients showed heightened reticence when complaints carried tangible consequences.
- Who was studied
- N = 164 trusting patients evaluated across strategy-elicited complaint scenarios in Nairobi, Kenya.
- How
- OLS linear probability modeling interacting patient asset wealth index (constructed via factor analysis over six household assets) with treatment conditions to predict complaint filing probability.
What to do
Provide legal protections, low-barrier reporting tools, and zero-cost submission mechanisms to prevent socioeconomic bias from suppressing complaint volume among low-income service recipients.
From the source
"Focusing on the coefficients of the interaction between wealth and the treatments, we find that wealthier patients (relative to poorer patients) are more likely to complain if reports lead to monetary penalties (MP) than if it leads to no consequences for the providers."
e7b318f7-c10f-44ea-935a-6f4ab3cde66a-Health Workers’ Behavior, Patient Reporting and Reputational Concerns- Lab-in-the-Field Experimental Evidence from Kenya.pdf