We use a randomized community development programme in rural Pakistan to assess the impact of citizen engagement on public service delivery and maternal and child health outcomes. The programme had a strong focus on ensuring the participation of women. Women in the study villages had also identified access to primary care as a critical need for them and their children at baseline. At midline, we find that the mobilization effort alone had a significant impact on the performance of village-based health providers. We detect economically large improvements in pregnancy and well-baby visits by Lady Health Workers, as well as increased utilization of pre- and post-natal care by pregnant women. In contrast, the quality of supra-village health services did not improve, underscoring the importance of community enforcement and monitoring capacity for improving service delivery.
public service delivery maternal and child health citizen engagement community development Pakistan Lady Health Workers