Many African countries have implemented large donor funded public health programs
in the past decade targeting major diseases such as HIV/AIDS and malaria. There is
a large literature which examines the effect of these programs on health outcomes,
but little is known about their effect on politics. Do politicians gain popularity as a
result of these programs? If so, it could suggest the potential for a positive, mutually
reinforcing equilibrium, whereby politicians would see delivery of health services as a
key way to maintain public support. I exploit the fact that two national bed net distribution
campaigns in Tanzania (in 2008-09 and 2010-11) took place at approximately
the same time as the 2008-09 and 2010-11 National Panel Surveys. This enables a
regression discontinuity design based on survey interview date to estimate the effect
of these programs on the approval ratings of local politicians. I find that bed net distribution
results in large and statistically significant improvements in the approval levels
of a broad range of political leaders. However, this is only true for the 2010 campaign,
when all household members (rather than children under 5) were the primary benefi-
ciaries. Moreover, the effect is driven by respondents living in opposition-dominated
villages, and by nets delivered in the rainy season, when malaria is a particularly salient
problem. Taken together, these findings suggest that citizens are prepared to update
their evaluation of their political leaders, especially when they deliver services that are
salient and visible, and when this service delivery provides information about the capability
of actors, such as opposition party officials, about whom there is limited prior
knowledge.