Making Services Work for Poor People Shanta Devarajan World Bank.

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Presentation transcript:

Making Services Work for Poor People Shanta Devarajan World Bank

Services are failing poor people: MDGs—Global Aggregates Eradicate Poverty & Hunger Universal Primary Education

Services are failing poor people: MDGs—Global Aggregates Promote Gender EqualityReduce Child Mortality Ratio of girls to boys in primary and secondary school (%)

Growth is not enough Poverty Headcount Primary Education Enrollment % Infant Mortality per 1000 Target 2015 Growth alone Target 2015 Growth alone Target 2015 Growth alone EAST ASIA ECA LAC MENA SA AFRICA Source: Global Economic Prospects 2001, p.42 base case; Devarajan (2002)

Why are services failing? Governments spend on the wrong goods and people

Benefit Incidence of Public Spending

Why are services failing? Governments spend on the wrong goods and people Resources fail to reach the service provider (Uganda tracking study) Weak incentives for effective service delivery

Examples of ineffective service delivery India: Teachers arriving drunk regularly, high levels of absenteeism. Zimbabwe: 13% of respondents gave as a reason for not delivering babies in public facilities that “nurses hit mothers during delivery”. Guinea: In 1984, 70% of government drugs disappeared. Costa Rica: absenteeism rate is 30% in public health facilities.

Why are services failing? Governments spend on the wrong goods and people Resources fail to reach the service provider (Uganda tracking study) Weak incentives for effective service delivery Demand-side constraints

Donors Making services work for poor people

Relationships

Policymaker-Provider: Contracting NGOs in Cambodia Contracting out (CO): NGO can hire and fire, transfer staff, set wages, procure drugs, etc. Contracting in (CI): NGO manages district, cannot hire and fire (but can transfer staff), $0.25 per capita budget supplement Control/Comparison (CC): Services run by government 12 districts randomly assigned to CC, CI or CO

Utilization of Facilities by Poor People Sick in last month, %

Relationships

Client-Provider: EDUCO Program in El Salvador Parents’ associations –Hire and fire teachers –Visit schools on regular basis –Contract with Ministry of Education to deliver primary education

%Effect of 1 more class visit by ACE on math and language score

EDUCO Effect: School days missed due to teacher absence Avg # of days missed: 1.34

Relationships

FSSAP Bangladesh Criteria: –Attendance in school –Passing grade –Unmarried Girls to receive scholarship deposited to account set up in her name School to receive support based on # of girls

Donors Relationships