Improving Health Outcomes By Choosing Better Doctors: Evidence of Social Learning about Doctor Quality from Rural Tanzania.” working paper

Households in Africa and indeed almost everywhere, face a choice of health care providers with only limited information about the relative quality of these providers. Unlike households in developed counties, however, rural African households make choices among providers of highly variable quality for illnesses that are frequently severe and they must do so without access to formal sources of information or any insurance against the consequences of bad outcomes. In spite of—or because of—these difficulties, households in rural Tanzania do learn about and react to the quality of health care providers. In this paper, I examine a two year panel of health seeking behavior for over 500 households in rural Northern Tanzania where households face choices between forty modern health care providers. This paper shows (1) that house-holds change the way they visit new providers as they learn about quality, visiting better providers for marginally more severe illnesses and (2) households improve their outcomes as they learn about quality by choosing the appropriate doctors when they are sick. This findings have important implications for our understanding of the market for health care quality and the demand for health care more generally