Social Capital and Community Monitoring of Healthcare Services in Tajikistan

Although cross-country and cross-jurisdiction variation in the quality of services is a well-established fact, very little is known about whether and how individuals decide to complain about poor quality of services. This study contributes to this research area by identifying the mechanisms that affect individual decisions to complain about the quality of services in Tajikistan. The analysis is based on qualitative and quantitative data and seeks to understand why individuals are often unwilling to complain about poor quality of healthcare services. We show that the decision to complain is correlated with individual social capital and socioeconomic status. These results suggest that the correlates of whistleblowing are similar to other forms of political participation. Thus the design of bottom-up approaches to monitoring healthcare providers in developing countries should take into the account the sociocultural context in which they are implemented.