The Impact of Health Service Delivery on Political Support: Evidence from the Nigerian Subsidy Re-investment and Empowerment Programme

Sub-Saharan African governments need to make substantial investments to expand access to quality health services, necessitating research that examines the incentives before politicians to make these investments. This paper examined the implications of a national maternal and child health intervention in Nigeria for trust in the President and the ruling party in geographically-matched households and facilities using difference-in-difference models. We show that proximity to intervention health facilities led to increases in trust in the President and the ruling party. Our findings also indicate that the effect of service delivery on trust did not significantly interact with patronage relationships between the President and citizens. More broadly, our findings contribute to the evidence on positive returns to improving physical access to quality health services in similar contexts in Africa.