Diana Dakhlallah
PhD, Sociology, Stanford University, USA
BA, Neuroscience and Behavior, Barnard College, USA
By Appointment
Diana Dakhlallah is an Assistant Professor of Organizational Behaviour. She joined Desautels in 2018 after completing her PhD at Stanford University.
Her research interests include economic sociology, political economy, healthcare markets, global health, bribery, development, social incentives, organizations, and morally and socially contentious markets
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 organizations 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 institutionalization of unsanctioned transactions within organizations and at the societal level.
Three papers are linked to this research:
D. Dakhlallah. A Field Experiment on Reputational Incentives and Bribe Exchange. [Expand for Abstract]
(Under Review) I investigate whether group-level reputational incentives amongst work groups in the workplace reduce bribe exchanges. I designed and implemented a field experiment in the maternity services of Moroccan public hospitals, where healthcare providers take bribes from patients in return for improving on the quality of care. This study gives us the first direct evidence of the effect that group-level reputational incentives can have on reducing bribery inside a real-world organization. I find the effectiveness of group-level reputational incentives depends on baseline prevalence levels: healthcare providers in higher-bribery services reduce their bribe-taking behavior, while providers in lower-bribery services do not. I argue that providers have a tolerance threshold for allowable levels of misbehavior—the mechanism that sets their reputational consequences for bribes. Field observational, provider-level survey and organization-level data support this conclusion. The results demonstrate that coarser-level revelations about a practice that group members engage in but prefer to keep private can deter them—conditional on prevalence. This study adjudicates between two long-held theoretical predictions about the social-influence dynamics of bribery inside organizations (free-rider vs. normative-pressure arguments), and suggests that future research should explore the full import of a threshold model of social-influence in the study of bribery and misbehavior. On a policy level, these findings indicate that coarse information-based revelations about bribery can be an effective policy lever and also give us a close-up example of the kinds of tradeoffs that policymakers should be aware of when considering the welfare effects of image-induced behavior change on providers and beneficiaries.
D. Dakhlallah. Making the Right Move: How Effective Matching on the Frontlines Maintains the Market for Bribes. [Expand for Abstract]
(Under Review) 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 neutralizes conflict in bribe exchange. I theoretically develop “first moves": how invitations into bribe transactions are extended and by whom. Using unique microsurvey 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.
D. Dakhlallah. Bribery: Unlearning Certitudes and Shifting Perspective. [Expand for Abstract]
(Working Paper) In this article, 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 organization). I interrogate the assumptions and corresponding inferences that underlie our theories of bribe exchange in an evidence-based manner. For evidence, I draw on behavioral field studies, which include ethnographies, fieldwork, field experiments and micro-survey data. I start with the staple principal-agent model that informs the theoretical intuitions of scholars and policymakers alike, and evaluate it against the evidence. Moving beyond the agency model, I focus on four core and under-addressed themes in the study of bribe exchange: the underlying assumptions of collusive dynamics (between principals and agents, amongst agents, and between beneficiaries and agents), the beneficiary-agent interaction, the institutionalization of bribery within organizations, and the role of social incentives vis-à-vis bribery within organizations. My treatment of bribery in this paper emphasizes two points (1) the dynamic of the beneficiary-agent interaction is the access point for understanding the incentive space that governs bribe exchange and (2) bribe exchange should be studied at the level of the organization (e.g. the hospital) or relevant organizational form (e.g. along a trucking route). Both of which bring us closer to “where the action is" with minimal assumptions. I also introduce a range of metrics and measures to capture the dynamics of the bribe exchange space. Through some illustrative applications I demonstrate how they can be used to shed light on important analysis end points, such as the institutional and cultural contexts of bribery which are features of the exchange space that are otherwise unobservable to us. The various themes explored in this paper converge on the idea that social incentives within organizations are a missing and key feature for achieving a better understanding of bribe exchange and identification of the promising deployable policy levers for addressing this phenomenon during pubic services provision.
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.
