Diana Dakhlallah
PhD, Sociology, Stanford University, USA
BA, Neuroscience and Behaviour, Barnard College, USA
By Appointment
Diana Dakhlallah is an Assistant Professor of Organisational Behaviour. She joined Desautels in 2018 after completing her PhD at Stanford University.
Her research interests include economic sociology, organisational theory, political economy, healthcare markets, global health, bribery, and development.
Prof. Dakhlallah has two broad streams of research:
STREAM 1 Her most recent work falls at the intersection of the political economy of service provision in public sector organisations and global health.
She has combined in-depth field work, survey methods, field experimental methods, and behavioural interventions to examine the dynamics of bribe exchange and care between frontline providers and beneficiaries during service provision in public healthcare establishments. In particular, she leverages these methods to explore the role that social incentives play in structuring the nature and quality of interactions between healthcare providers and healthcare seekers to both understand and mitigate governance issues. This work is conducted in the context of the MENA region.
The lessons from her recent work shed light on questions related to the interpretation, measurement, scaling, social-influence dynamics, and institutionalisation of unsanctioned transactions inside organisations and at the societal level.
Three papers are linked to this research:
D. Dakhlallah. Collective Reputation and Bribe Exchange: A Field Experiment. [Expand for Abstract]
(R&R) I investigate whether collective reputation threat incentivises healthcare providers to stop taking bribes. I designed and implemented a field experiment in the maternity wards of Moroccan public hospitals, where healthcare providers take bribes from patients in return for improving on the quality of care. This study gives the first direct test of the impact of collective reputational incentives on bribery reduction inside a real-world organisation. I find that bribery levels decrease in high-prevalence wards, but remain the same in low-prevalence wards. This circumscribed effectiveness is due to a tolerance threshold, defined as a prevalence level above which providers experience the reputational costs of being associated with bribery, and below which they do not. Field observational, provider-level survey and organisation-level data support this conclusion. Theoretically, this work adjudicates on two social-influence theories of misconduct inside organisations. I provide evidence in favour of the normative-pressures over the free-rider account, and suggest future research explore the full import of threshold dynamics. On a policy level, these findings indicate that collective reputation threat is an effective policy lever in harder hit environments. This is good news because it is in such settings that policy finds itself at a loss. This study gives a close-up example of the kinds of tradeoffs that policymakers should be aware of when considering the welfare effects of image-induced behaviour change.
D. Dakhlallah. Making the Right Move: How Effective Matching on the Frontlines Maintains the Market for Bribes. [Expand for Abstract]
(Forthcoming) If individuals don’t like bribery, and the reality is it’s widespread, then how does bribery happen? Even in places where bribery is prevalent, people find it distasteful and risky. While individuals can identify a type of person who might be receptive, variance in types is still significant enough that in expected value terms, bribery would not occur. The question of how people choose to engage in bribery–-and what their choices imply for individuals and for the market for bribes–-remains unanswered. I demonstrate that effectively matching first moves to the socioeconomic status of transacting parties is a decisive micro-mechanism that neutralises conflict in bribe exchange. I theoretically develop “first moves": how invitations into bribe transactions are extended and by whom. Using unique micro-survey data on bribe flows in the Moroccan healthcare sector, I analyse how status dynamics between providers and clients condition the choice of first moves. The probability of extortion decreases as client status increases and that of offers increases with client status; indirect demands are less status-sensitive. For individuals, status-sensitive first moves create the accommodating exchange partners providers want. This explains how bribery can be simultaneously distasteful, risky and scalable. For the market, they explain the low reporting rates by clients. This muting keeps bribery under principals’ radar and makes bribery sticky. Attention to how bribery happens reveals the use-value of a new outcome: first moves. It calls into question standard interpretations of prevalence rates and provides analytical tools to (re) consider existing and new policy approaches to bribery.
Dakhlallah, D. (Forthcoming, 2021). "Making the right move: How effective matching on the frontlines maintains the market for bribes." In Economies, institutions, and territories: Dissecting nexuses in a changing world, edited by Luca Storti, Giulia Urso and Neil Reid. Routledge: Dynamics of Economic Space Series.
D. Dakhlallah. The Social Dynamics of Bribery Inside Organisations. [Expand for Abstract]
(Working Paper) I focus on bribery during public services provision. The provision of public services involves three parties–the beneficiary (service seeker), the agent (service provider) and the principal (public sector organisation). I interrogate the assumptions and inferences of dominant theories used to analyse bribery. For evidence, I draw on behavioural field studies, which include ethnographies, field experiments, and micro-survey data. I analyse three core and under-addressed themes in the study of bribe exchange: the assumptions of collusive dynamics (between principals and agents, among agents, and between beneficiaries and agents), the beneficiary-agent interaction and the institutionalisation of bribery inside organisations. This paper emphasises two points: (1) the beneficiary-agent interaction is the access point for understanding the incentive space that governs bribe exchange and (2) bribery is best studied at the level of the organisation. I show how social dynamics hinder collusive behaviour and the institutionalisation of bribery inside organisations--traditionally overestimated features of bribe markets—and how they inspire measures that deliver a more textured account of bribery in a given context, improving comparative work and policy design.
Current Extensions
Building on one of the main findings from this stream of work, she is now designing a series of experiments to develop a more precise understanding of the micro mechanisms that underlie behavioural thresholds.
It appears that in the context of work groups, the ability of social incentives to induce corrective and constructive change in group members’ behaviour depends on the prevalence of transgressive behaviour at the group-level. Above a certain prevalence level, social-incentive effects are activated leading to behaviour change and below this “threshold level” they are muted.
This raises a series of how, when and why questions that Prof. Dakhlallah is working on addressing.
STREAM 2 She recently launched a new research agenda which is focused on the political economy of drug development processes—in particular, global clinical trials (GCTs) and precision medicine (PM). The goal is to develop a deeper understanding of the roles of industry and government actors in driving and co-shaping the markets for GCTs and PM. This has implications for end-users, knowledge production and transfer, the development and regulation of pharmaceuticals, and the political economy of health. Data collection for this project covers various geographic locations.
