Employee absence as an indicator of patronage

I attended an interesting presentation recently by Michael Callen (UCSD) on the political economy of public employee absence in Pakistan (PDF).  In an observational study of doctors at public clinics in Pakistan’s Punjab region, he and his co-authors found that doctors who personally knew their MPs were almost twice as likely to be absent as those who did not.  Furthermore, doctors in districts which were less politically competitive, and where their sponsoring MPs would thus face less risk of public backlash over poor service provision, were more more likely to be absent than those in competitive districts.  The idea here is that MPs face two conflicting incentives: it’s cheaper to them to provide patronage goods (like jobs in the public health service) to individuals in exchange for votes, but if they face political competition, they instead have an incentive to try to provide higher quality goods to more voters.