Miri Stryjan

Abstract:

We examine how local institutions can enhance policy Implementation through bottom-up monitoring and top-down control mechanisms. Specifically, we assess the impact of state-controlled community meetings – guided by local leaders – on Rwanda’s rapid progress in family planning in the early 2000’s. We study the impact of community meetings on contraceptive adoption, using rainfall variation to introduce exogenous variation in meeting participation. Our analysis covers periods before and after a policy reform that incentivized local leaders to boost contraceptive adoption. We find that meetings significantly influenced adoption only after the reform, indicating that top-down monitoring was a key factor in how meetings affected adoption. Specifically, after the reform, non-rainy Saturdays, indicative of well-attended meetings, increase the likelihood of contraceptive adoption by 18% in the same month, while rainfall before the reform or on other days show no effect. Results are robust to another incentivized outcome as well as to different rainfall thresholds. We also present suggestive evidence that adoption was partly involuntary. Our findings shed new light on Rwanda’s remarkable health development indicators and challenge the view that local institutions predominantly influence development outcomes through enabling bottom-up pressure, instead emphasizing their role in facilitating top-down monitoring.