It could help improve ongoing efforts in the international development and aid community to build institutions of accountability for pro-poor policies.

A survey was designed to be able to correlate vote buying with the delivery of health services, taking advantage of an appropriate institutional context in the country of the Philippines.<sup>6</sup> The data come from a jurisdiction level where there is congruence between the political unit at which vote buying is measured, and the administrative unit at which a particularly broad and potentially pro-poor service is delivered. Directly elected municipal governments in the Philippines are responsible for delivering basic maternal and child services to villages within their jurisdiction. This allows for attributing the decision-making over political strategies, and over a pro-poor public service to the same political agents. Municipalities hire and manage nurses, midwives, and community or village health workers, the key health personnel that are supposed to deliver basic maternal and child health services to the poor.<sup>7</sup> The central finding is that in places where households report greater vote buying (in direct response to questions about offers of money in exchange for votes at the time of elections), municipal government records show lower investment in basic health services for mothers and children; and, possibly as a result of lower public investments or worse performance in delivering broad services, a higher proportion of children are under-weight.

The rich survey data allow for examining, and rejecting, various alternate explanations for the correlation that are outside of the channel of clientelism. For example, the incidence of poverty could be independently correlated with both vote buying and health services, driving a spurious correlation between the two. But the data do not support such alternate explanations. The disaggregated nature of the jurisdiction level, the municipality, facilitates a study design in which sources of variation in vote buying can be examined in detail. Almost the entire population of municipalities in one province of the Philippines was picked for this study to rely on within-province, and within-congressional-district variation in vote buying across municipalities. This allows for establishing a correlation with health services that arises out of idiosyncratic variation in vote buying across municipalities, controlling for a host of other explanatory variables.<sup>8</sup> The empirical specification addresses a measurement concern of unobserved factors driving household responses to sensitive questions (on vote buying) which could be independently correlated with health services. Household-level respondents were asked directly about the practice of vote buying in the municipality. These responses were then aggregated up to the village and municipal level, to focus on measuring variation across villages and municipalities in the percentage of respondents that reported vote buying. This amounts to “triangulating” household responses within a village or a municipality, rather than relying on variation in reports across individual households. The aggregated vote buying measure from the

> 6 These data were collected in February 2010 by the World Bank’s Philippines country team.

> 7 Households belonging to richer quintiles in the Philippines, and elsewhere, typically rely on services from higherlevel health professionals and facilities, such as doctors and hospitals (see, for eg., the evidence in Gwatkin et al, 2007).

> 8 This is not to say that variation in vote-buying is idiosyncratic in general. Rather, at the  level of disaggregation examined here, keeping provincial and district characteristics fixed, it is possible to examine the correlation with health services of only that part of the variation in vote buying that is likely driven by idiosyncratic differences across municipalities.

3