Intrinsic Incentives: A Field Experiment on Leveraging Intrinsic Motivation in Public Service Delivery

Although extrinsic and intrinsic motivation likely jointly explain the effort of many agents engaged in public service delivery, incentives typically only appeal to the former. In the context of a rural health worker program in India, I develop and test a novel mobile phone app designed to increase agents’ intrinsic returns to effort. At one year of follow-up, the self-tracking app leads to a 24% increase in performance as measured by the main job task (home visits). Moreover, the app is most effective when it leverages pre-existing intrinsic motivation: it produces a 41% increase in performance in the top tercile of intrinsically motivated workers, but no improvement in the bottom tercile. This treatment effect persists over time for the most intrinsically motivated workers, whereas early improvements decay among the least motivated workers. Supplementary evidence suggests that the treatment effect on performance is mediated primarily by making effort more intrinsically rewarding, and not by other mechanisms such as the provision of implicit extrinsic incentives. Despite these effects on worker performance, I find no effect on health outcomes. ∗Harvard Medical School and Brigham and Women’s Hospital, [email protected]. I thank the Chief Medical Office of Kaushambi District, Dr. Nandini Sharma/Maulana Azad Medical College, and Dimagi, Inc. for hosting this research; Brian DeRenzi, Andrew Ellner, and Neal Lesh for ongoing collaboration as co-Investigators; and Sapana Gandhi, Sangya Kaphle, Sugandha Nagpal, Robert Racadio, and Jeremy Wacksman for excellent research assistance. I am grateful to Nava Ashraf, Oriana Bandiera, Iqbal Dhaliwal, Paul Farmer, Rema Hanna, Michael Kremer, Matthew Rabin, Andrew Weiss, and seminar participants at Harvard Business School, Harvard Department of Economics, and Harvard Medical School for helpful comments. Generous financial support has been provided by the Massachusetts General Hospital Consortium for Affordable Medical Technologies, Child Relief International, and the Harvard Business School Doctoral Program.