Public Expenditure Tracking and Service Delivery Surveys Qualidade do Gasto Publico no Brasil June 26-27, 2003 Ritva Reinikka Development Research Group, The World Bank

Public Expenditure Tracking and Service Delivery Surveys First Public Expenditure Tracking Survey (PETS) carried out in Uganda in 1996 First Public Expenditure Tracking Survey (PETS) carried out in Uganda in 1996 Since then, a large number of PETS and related surveys have been implemented Since then, a large number of PETS and related surveys have been implemented Scope and nature of surveys are differed, but common theme is link between public spending and outputs and/or development outcomes Scope and nature of surveys are differed, but common theme is link between public spending and outputs and/or development outcomes Surveys to date CompletedHondurasPeruAlbania Uganda (5) Tanzania (2) GhanaRwandaMozambiqueZambiaPNGBangladesh and more… OngoingBrazilEcuadorLaosIndiaIndonesiaEthiopiaNigeria

Benefits Government From policies and spending to benefits Outcomes We generally believe that providing financing and flexibility to countries with well-designed policies allows us to leverage good outcomes.

Individuals Government Providers Local Gov. Benefits Policy Information/M&E Capacity Institutional Incentives Household Behaviors Financing Leakage of Funds Policy Institutional Incentives Sub-optimal spending: High teacher salaries; Insufficient supply of textbooks Financing Capacity Information & Transparency Institutional Incentives Low quality instruction Capacity & Incentives Curriculum & Technology Lack of demand Financing Household Behaviors Community Norms Breakdowns on the way to achieving outcomes are due to gaps in… Outcomes

CORRUPTION The (missing) link between public spending and outcomes Broad allocation of resources Problems in budget execution Problems in service delivery Lack of demand for services Delays and lack of predictability (e.g. salaries, medicine stock-outs) Discretionary reallocation of resources (favoritism, lack of criteria or information, etc.) Leakage of financial or material resources Misappropriation of resources (e.g. theft of medicines) Absenteeism Overcharging Inefficiency, high cost, low quality PUBLIC EXPENDITURE TRACKING AND SERVICE DELIVERY SURVEYS

World Development Report 2004 Framework for service delivery

The Survey Approach Approach has varied considerably depending on context and focus Approach has varied considerably depending on context and focus Multilevel focus, but frontline providers (schools or health facilities) as main unit of observation Multilevel focus, but frontline providers (schools or health facilities) as main unit of observation Representative sample Representative sample Data collected through interviews and record reviews (financial records, stock cards for medicines, etc.) Data collected through interviews and record reviews (financial records, stock cards for medicines, etc.) Multi-angular approach for validation of data Multi-angular approach for validation of data Some surveys include detailed surveys of frontline provider, including availability/adequacy of inputs, quality, staff and user interviews, etc. Some surveys include detailed surveys of frontline provider, including availability/adequacy of inputs, quality, staff and user interviews, etc.

What have we learnt? Leakage Education sector in Uganda 1996 Education sector in Uganda 1996 Data from 250 schools and administrative units Data from 250 schools and administrative units Only 13 percent of intended capitation grant actually reached schools ( ). Only 13 percent of intended capitation grant actually reached schools ( ). Mass information campaign by Ministry of Finance (the press, posters) Mass information campaign by Ministry of Finance (the press, posters) Follow-up PETS to evaluate impact of the information campaign: Follow-up PETS to evaluate impact of the information campaign: 2/3 of reduction in leakage thanks to the campaign 2/3 of reduction in leakage thanks to the campaign In schools with newspapers leakage 12 percentage points lower than in schools without In schools with newspapers leakage 12 percentage points lower than in schools without High leakage has also been found in other countries (Tanzania, Ghana, Zambia, Peru) High leakage has also been found in other countries (Tanzania, Ghana, Zambia, Peru)

What have we learnt? Ghost workers and absenteeism Salary payments “leak” differently Salary payments “leak” differently Different measurement approaches: Different measurement approaches: PETS with data collection on payroll and staffing data (Honduras 2000, Peru 2002, Zambia 2002, Mozambique 2002, etc.) PETS with data collection on payroll and staffing data (Honduras 2000, Peru 2002, Zambia 2002, Mozambique 2002, etc.) Unannounced visits to schools and health facilities (absenteeism) Unannounced visits to schools and health facilities (absenteeism) HealthEducation Ghost workers Honduras5.0%8.3% Absenteeism Ecuador % Honduras27.0%14.0% Peru26.0%13.0% India43.0%23.0% Uganda35.0%26.0%

What have we learnt? Allocation and budget execution Leakage sometimes difficult to assess due to lack of explicit allocations or entitlements Leakage sometimes difficult to assess due to lack of explicit allocations or entitlements But surveys can shed light on other important allocation and budget execution issues But surveys can shed light on other important allocation and budget execution issues Primary health care in Mozambique: Primary health care in Mozambique: Very large variation across districts and facilities in non-wage recurrent spending, staffing, and distribution of medicines Very large variation across districts and facilities in non-wage recurrent spending, staffing, and distribution of medicines Severe problems in budget execution, with late first transfers and slow processing of accounts, resulting in low predictability Severe problems in budget execution, with late first transfers and slow processing of accounts, resulting in low predictability Weak record keeping at provincial, district, and facility levels, often with large discrepancies between levels Weak record keeping at provincial, district, and facility levels, often with large discrepancies between levels

The strengths of the approach Useful tool for diagnosing and understanding problems in budget execution and service delivery, including corruption Useful tool for diagnosing and understanding problems in budget execution and service delivery, including corruption Multilevel perspective important and not achieved from simple school or facility surveys Multilevel perspective important and not achieved from simple school or facility surveys District and frontline provider perspective often forgotten at central level District and frontline provider perspective often forgotten at central level Representative sample provides credibility not achieved through small- sample studies or institutional reviews Representative sample provides credibility not achieved through small- sample studies or institutional reviews Validation of administrative data (financial and output) Validation of administrative data (financial and output) Can provide basis for monitoring of changes over time Can provide basis for monitoring of changes over time Surveys provide data for research that can improve our understanding of the determinants of corruption or poor service delivery Surveys provide data for research that can improve our understanding of the determinants of corruption or poor service delivery Process of designing and implementing survey is useful for understanding institutional and procedural arrangements for budget execution and service delivery Process of designing and implementing survey is useful for understanding institutional and procedural arrangements for budget execution and service delivery

Survey Design: Surveying what? Why? What are the problems? Are there important gaps in our understanding of the nature, extent, and source of problems? What are the problems? Are there important gaps in our understanding of the nature, extent, and source of problems? Is a survey the appropriate tool? Stand-alone or as a complement? Worth the cost? Is a survey the appropriate tool? Stand-alone or as a complement? Worth the cost? Is it feasible? How is the budget structured and implemented? Is it feasible? How is the budget structured and implemented? Who is the audience and is there a likely impact? Is there a political demand? Who is the audience and is there a likely impact? Is there a political demand? Will the information be used? By whom? Will the information be used? By whom?

Implementation issues: Who? How? Requires skills like any other micro survey Requires skills like any other micro survey Steps in implementation Steps in implementationConcept Buy-in across the board Questionnaire design Identify (and contract) implementing agency Pilot Enumerator training Field work (including quality control and data entry) Analysis and dissemination

Some limitations Surveys only provide part of the answer Surveys only provide part of the answer What about inter- and intra-sectoral allocations? What about inter- and intra-sectoral allocations? Link with outcomes? Link with outcomes? => Budget analysis and social impact analysis (with household data or through participatory approaches) are still important => Budget analysis and social impact analysis (with household data or through participatory approaches) are still important Surveys should supplement rather than supplant routine information, control, and integrity systems Surveys should supplement rather than supplant routine information, control, and integrity systems Surveys provide information but don’t necessarily result in change Surveys provide information but don’t necessarily result in change A lack of information about the scope and nature of problems is not always the primary constraint to improving PEM and service delivery A lack of information about the scope and nature of problems is not always the primary constraint to improving PEM and service delivery Continuity and link with efforts at strengthening institutions and routine PEM systems important Continuity and link with efforts at strengthening institutions and routine PEM systems important Link with community and other local stakeholders can be difficult to achieve – important to use findings to strengthen local transparency and accountability mechanisms Link with community and other local stakeholders can be difficult to achieve – important to use findings to strengthen local transparency and accountability mechanisms

Finding out more… Survey reports, instruments, and documentation on: Survey reports, instruments, and documentation on: Some references: Some references: Dehn, Reinikka, and Svensson “Survey Tools for Assessing Performance in Service Delivery.” In Bourguignon and Pereira da Silva, eds. Evaluating the Poverty and Distributional Impact of Economic Policies. Oxford University Press and the World Bank. Forthcoming Dehn, Reinikka, and Svensson “Survey Tools for Assessing Performance in Service Delivery.” In Bourguignon and Pereira da Silva, eds. Evaluating the Poverty and Distributional Impact of Economic Policies. Oxford University Press and the World Bank. Forthcoming Reinikka and Svensson Measuring and understanding corruption at the micro level. In Della Porta and Rose-Ackerman, eds. Corrupt Exchanges: Empirical Themes in the Politics and Political Economy of Corruption. Nomos Verlagsgesellshaft. Reinikka and Svensson Measuring and understanding corruption at the micro level. In Della Porta and Rose-Ackerman, eds. Corrupt Exchanges: Empirical Themes in the Politics and Political Economy of Corruption. Nomos Verlagsgesellshaft. Lindelow and Wagstaff “Health Facility Surveys: An Introduction.” Policy Research Working Paper Development Research Group, World Bank., Washington, D.C. Lindelow and Wagstaff “Health Facility Surveys: An Introduction.” Policy Research Working Paper Development Research Group, World Bank., Washington, D.C.