Policymaking, Trust, and the Demand for Public Services: Evidence from a Mass Sterilization Campaign

• Authors: Fernando Fernandez, Gianmarco León-Ciliotta and Dijana Zejcirovic.
• American Economic Journal: Economic Policy, Vol. 17, No. 1, 181–215, February 2025.

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.