Policymaking, trust, and the demand for public services: evidence from a mass sterilization campaign

Abstract

We study a large-scale family planning intervention in which more than 260,000 Peruvian women were sterilized. Many of these medical procedures are alleged to have been performed without patient consent. The subsequent disclosure of alleged illegal sterilizations caused reductions in the usage of contraceptive methods and prenatal and birth delivery services and, more generally, the demand for medical services in affected areas. As a result, child health worsened. The results persist for at least 17 years after the information disclosure and are driven by disappointed supporters of the implementing government. Learning about the government's malpractices undermined trust in institutions.

León-Ciliotta acknowledges financial support from the Spanish Ministry of Economy and Competitiveness, through the Severo Ochoa Programme for Centres of Excellence in R&D (Barcelona School of Economics CEX2019-000915-S), funded by grants MCIN/ AEI/10.13039/501100011033, RYC2017-23172, and PID2023-150768NB-I00.