Thumbs up: Reducing health worker absenteeism with fingerprinting technology


$173,000 I Stage 2: Testing at Scale I Global Health


The problem: High rates of health worker absenteeism

On average across India, health workers are absent 43% of the time, and previous government efforts to encourage attendance have largely failed. Mobile phones can be used to reduce health professional absenteeism while providing real-time rural disease and health data.

The solution: Mobile monitoring of attendance and emerging health threats

To reduce health worker absenteeism, the State Government of Karnataka, Harvard, and the Jameel Poverty Action Lab South Asia at the Institute for Financial Management and Research, in Chennai, will use smart phones to capture thumb impressions of health staff as a monitor of daily attendance. The project will also facilitate faster response to emerging health threats by transmitting real time epidemiological data from rural areas to state-level health authorities. A randomized control trial will measure the cost-effectiveness of this program, which, if proven successful, will inform the Government of Karnataka's expressed interest in scaling to the entire state. This project leverages more than $119,844 in other funding and additional in-kind resources.  


The potential: Cost effectiveness, impacts, and implications

The intervention, with 4.5 million beneficiaries in the treatment group, is designed to reduce health worker and doctor absenteeism below baseline levels (51% for health workers and 61% for doctors). If successful, the Government of Karnataka plans to scale the program across the state (population 52 million). The effects may parallel that of a prior study, which found that when teachers were required to take time-stamped photographs in their classrooms to receive their pay, teacher absenteeism fell by 21 percentage points relative to the control group, and children's test scores increased by 0.17 standard deviations.

Last updated: August 28, 2015

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