This paper presents the results of two field experiments on
local accountability in primary health care in Uganda. Efforts
to stimulate beneficiary control, coupled with the provision
of report cards on staff performance, resulted in significant
improvements in health care delivery and health outcomes
in both the short and the longer run. Efforts to stimulate
beneficiary control without providing information on
performance had no impact on quality of care or health outcomes.
The paper shows that informed users are more likely
to identify and challenge (mis)behavior by providers and as a
result turn their focus to issues that they can manage locally.