Among these different measures of village health service delivery, while two are more direct measures of municipal actions (placement of health workers and projects), the third plays the role of an important summary measure of service delivery performance—percentage of children characterized as being severely below normal weight. This measure can be particularly helpful in discerning the equilibrium policy consequences of clientelism. Other work has shown that even primary health services can be subject to clientelist targeting (Chen and Cammett, 2012; Nichter, 2011). That is, it is difficult to find a measure of broadly delivered services that are not subject to the _quid pro quo_ of clientelism. The data on child health outcomes that are available in the Philippines are particularly helpful in this regard, serving as a measure of government performance in delivering broad welfare to its most vulnerable citizens.

In different specifications, the vector Wijkcontains relevant characteristics of the barangay in which the household resides: poverty, population, location (distance from centro), and quality of roads. The survey team recorded direct-observation data on the quality of barangay roads. The percentage of household respondents reporting participation in bayanihan activities is used as a barangay-level measure of social capital. All of these variables were used in the previous section to examine correlation with vote buying; none were robustly correlated with vote buying.

The vector Zjk across different specifications contains municipal political variables that might be correlated with health services in their own right, or be mediating the correlation with vote buying: whether key informants indicate that the mayor’s family is a major landowner or employer of labor; whether a political clan has been entrenched in power; other available measures of electoral competition such as number of candidates and the margin of victory. The vector Zjkalso includes indicators of municipal fiscal capacity—the share of own revenues (or alternately, the share of transfers from above), and the total per capita revenues.

The following specification is estimated to assess the correlation of vote buying measured at the municipal-level (percentage of household respondents in a municipality reporting vote buying), with municipal allocation of spending to health services in recent years (averaged over 2007 and 2008, the two years since the last elections of 2007 for which data is available for all municipalities in the sample). Data on the expenditure composition of municipal budgets was gathered from official statements of expenditures provided by the municipal accountant.

MunicipalHealthSpending ( ~~)~~ ij = γ0 + γ1VoteBuyingij + Vijγm + μj + εij (3) TotalSpending For municipality _i_ in congressional district _j_ , the vote buying variable measures the percentage of affirmative responses from 40 households in the two sampled villages to the vote buying questions. Municipal-level controls included in the vector Vij , are municipal estimates of poverty, municipal population, and different measures of municipal fiscal capacity (dependency on national revenue shares, share of own revenues in total income, and per capita total revenues). Congressional district fixed effects, μj, are included.

The main argument for why the estimates for β1in equation (2) and the estimates for γ1 in equation (3) are likely to reflect the equilibrium policy consequence of vote buying politics is that the variation in vote buying in this sample is exogenous to other factors that could influence 16