the 2008–2012 cohort. Second, we use a series of longitudinal surveys on the National Public Services (NPS) surveying over 6,000 households throughout Sierra Leone from 2005 to 2011 to measure changes in access and use of public services. The 2011 survey was designed to be longitudinal at the EA level, prompting us to aggregate household level variables to this unit of analysis. Our data include measures at the EA level from 2007, 2008, and 2011, which we describe in detail below. Our complete dataset includes 607 EA-level observations nested within 19 local council areas.

# **_Section 5.1: Dependent Variables_**

We operationalize our first outcome of interest as the provision of healthcare. During Sierra Leone’s protracted process of decentralization, a range of fiscal and administrative functions and responsibilities related to public service provisions were devolved to local councils. Of the 80 functions, health care was among the first and was fully devolved in law and in practice by 2005 (Casey 2009; Sacks and Larizza 2011, 10). The effects of fiscal decentralization on power-sharing relationships and public good provision therefore should be most observable in the use of public health services.<sup>7</sup> The NPS survey asks respondents about the level of heath care service in their communities, including what type of hospital or clinic they most often visit (government, private, NGO, traditional healer, etc.).<sup>8</sup> Our first dependent variable, therefore, is the percentage of respondents per EA that report using government-run health facilities in 2011.

As an additional indicator of health care provision we take a survey question from the 2011 NPS survey that directly asks respondents: “What do you think has happened to the quality of government health services in the last year?” Household respondents could report on a five-

> 7 In Sierra Leone, devolution of public service delivery to the local councils has largely meant the direct transfer of block grants to council accounts. These block grants cover basic maintenance of the programs and are used for the local implementation of public policies set at the ministry or central government level for that particular issue area. The LGA only guarantees that the annual grants are enough for basic maintenance of services. Therefore, other forms of local revenue stemming from local tax collection or mining revenue, or the precept that councils collect from Paramount Chiefs, are important components of local council budgets. The actual local council budgets in 2011 help verify this assumption, as many councils spend more, some much more, on health and education than the block grants that they receive from the central government.

> 8 There have been four rounds of the NPS surveys: 2005, 2007, 2008 and 2011. We use the 2008 and 2011 surveys, and we prefer the measure of self-reported distance to the nearest health center. The survey also asks how long it takes to get there in minutes. We choose not to use this measure because the time it takes to get to a health center could also be a function of infrastructure (i.e. if roads have improved in the area) and household wealth (i.e. if the respondent is now able to take a public bus rather than walk),

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