We examine the effectiveness of accountability systems that rely on patient reporting in Kenyan health clinics. Patients and health care providers from public and private health clinics participate in a lab-in-the field experiment focusing on the relationship of trust between patient and provider. Patients decide whether to trust providers, providers have discretion over their reciprocity, and patients can complain. We compare the effectiveness of: (1) a client reporting system where patients’ complaints are disclosed to the providers’ professional peers, possibly leading to non-monetary penalties, (2) a system where complaints lead to monetary penalties, and (3) a system that, like a standard complaint box, attaches no tangible consequences to complaints. Overall, our findings suggest that citizen reporting systems that leverage peer pressure and reputational concerns can improve service delivery.

我们研究了肯尼亚卫生诊所依赖患者报告的问责制的有效性。来自公共和私人医疗诊所的患者和医疗保健提供者参与了一项实地实验室实验，重点是患者与提供者之间的信任关系。患者决定是否信任提供者，提供者对其互惠有自由裁量权，患者可以投诉。我们比较了以下效果：(1) 客户报告系统，在该系统中患者的投诉向提供者的专业同行披露，可能导致非金钱处罚，(2) 投诉导致金钱处罚的系统，以及 (3)一个系统，就像一个标准的投诉箱，不给投诉附加任何有形的后果。全面的，