how these are addressed. Section 5 presents the results. Section 6 discusses implications for the theory of how clientelism translates into under-investment in pro-poor policy, and for institutions of accountability to remedy this. Section 7 concludes.

# **2. The institutional context, and sampling strategy in the Philippines**

The Philippines provides an institutional context particularly suited to empirically examining the policy consequences of clientelism. Municipal governments in the Philippines are responsible for delivering what can be characterized as a pro-poor public service: health programs for maternal and child well-being that are typically the only source for such services available to poor households.<sup>13</sup> At the same time, municipal governments are directly elected, with substantial variation in political characteristics across municipalities. This paper uses data from a unique survey that was purposefully designed to measure investments in public health services, the broad public service that local governments are responsible for delivering in the Philippines’ context, as well as a particularly salient practice of clientelism in the country: vote buying. The survey was fielded in February 2010.

The decentralization of service delivery and electoral competition in the Philippines provides opportunities to measure both variation in clientelist political strategies and service delivery at local levels. Such disaggregated measurement allows for establishing a correlation with health services of that part of the variation in vote buying that arises from idiosyncratic differences across municipalities. This enables the interpretation of the correlation as the policy consequence of vote buying politics, in the absence of any systematic variable that independently (and simultaneously) explains both vote buying and health service delivery.

The sampling strategy focused on gathering data from all municipalities in one province in the Philippines to enable cross-municipal comparisons while keeping province level characteristics fixed. The province of Isabela was selected for the study because it was sufficiently large to draw a sample of municipalities across which variation in service delivery could be examined.<sup>14</sup> Of the 35 municipalities in the province, 30 were selected for the study because cost considerations did not allow all to be covered.<sup>15</sup> That is, the overall criteria for the study design was to obtain, as cheaply and conveniently as possible, a set of municipalities 13 Health was described as the most important public service that Philippine municipalities could provide in the broad public interest, by the erstwhile Secretary of local government affairs in the Philippines, Mr. Jesse Robredo. Mr. Robredo provided this opinion when he was the Mayor of Naga City, in an interview with the author at the time of initiating this research, in October 2008. Mr. Robredo was a politician who had been widely feted as a reform champion. He met an untimely demise in a plane crash in August 2012.

14 An issue to contend with in the Philippines is the endogenous creation of new and small municipalities, possibly driven by considerations of facilitating patronage and clientelism (Khemani, 2011; World Bank, 2010). Too small and newly created municipalities may have lower capacity to deliver health services, and be characterized by clientelist practices. Isabela province is one of the few with a larger number of reasonably sized municipalities (most having a population greater than 20,000), among which the youngest was created in 1976, well before the more recent phenomenon of jurisdiction fragmentation.

15 The five municipalities to be dropped from the study were selected in consultation with the agency engaged to undertake the survey. First, three of the most remote municipalities-- Dinapigue, San Guillermo, and San Agustin— were dropped because the survey agency determined that the costs to reach them would be significantly higher than allowed within the task budget. Next, two additional municipalities—Gamu and Jones-- were dropped on the basis of available secondary data which suggested that these municipalities are similar in characteristics of political competition (the right hand side variables in our analysis) to their neighbors that would be included in the study.

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