Decentralization and service delivery. The problem Disappointing health and education outcomes,...

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Decentralization and service delivery

Transcript of Decentralization and service delivery. The problem Disappointing health and education outcomes,...

Page 1: Decentralization and service delivery. The problem Disappointing health and education outcomes, especially for poor people.

Decentralization and service delivery

Page 2: Decentralization and service delivery. The problem Disappointing health and education outcomes, especially for poor people.

The problem

• Disappointing health and education outcomes, especially for poor people

Page 3: Decentralization and service delivery. The problem Disappointing health and education outcomes, especially for poor people.

Outcomes are worse for poor peopleDeaths per 1000 births

Source: Analysis of Demographic and Health Survey data

Page 4: Decentralization and service delivery. The problem Disappointing health and education outcomes, especially for poor people.

Outcomes are worse for poor peoplePercent aged 15 to 19 completing each grade or higher

Source: Analysis of Demographic and Health Survey data

Page 5: Decentralization and service delivery. The problem Disappointing health and education outcomes, especially for poor people.

The problem

• Disappointing health and education outcomes, especially for poor people

• Increasing public spending is not enough

Page 6: Decentralization and service delivery. The problem Disappointing health and education outcomes, especially for poor people.

Increasing public spending is not enough

* Percent deviation from rate predicted by GDP per capitaSource: Spending and GDP from World Development Indicators database. School completion from Bruns, Mingat and Rakatomalala 2003

Page 7: Decentralization and service delivery. The problem Disappointing health and education outcomes, especially for poor people.

Increasing public spending is not enough

* Percent deviation from rate predicted by GDP per capitaSource: Spending and GDP from World Development Indicators database. Under-5 mortality from Unicef 2002

Page 8: Decentralization and service delivery. The problem Disappointing health and education outcomes, especially for poor people.

The problem

• Disappointing health and education outcomes, especially for poor people

• Increasing public spending is not enough

• Services failing poor people at local levels

Page 9: Decentralization and service delivery. The problem Disappointing health and education outcomes, especially for poor people.

• Resources fail to reach frontline service providers

– Bulky state administrations soak up bulk of the resources

– Leakage: in Uganda, only 13 percent of non-wage recurrent spending on primary education reached primary schools

– Mismanagement: in Nigeria, community health workers often don’t get paid

The real problem for policy:Services failing poor people

Page 10: Decentralization and service delivery. The problem Disappointing health and education outcomes, especially for poor people.

The real problem for policy:Services failing poor people

• Service quality is low for poor people

– Bangladesh: Absenteeism rates for doctors in primary health care centers: 74 percent

– Zimbabwe: 13 percent of respondents gave as a reason for not delivering babies in public facilities that “nurses hit mothers during delivery”

– Guinea: 70 percent of government drugs disappeared

Page 11: Decentralization and service delivery. The problem Disappointing health and education outcomes, especially for poor people.

The solution: Decentralize?

• Increasing accountability for local services

• Decentralization to locally elected governments—analyzing potential impact within a framework of accountability

Page 12: Decentralization and service delivery. The problem Disappointing health and education outcomes, especially for poor people.

Poor people Providers

A framework of relationships of accountability

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Poor people Providers

Policymakers

A framework of relationships of accountability

Page 14: Decentralization and service delivery. The problem Disappointing health and education outcomes, especially for poor people.

Mexico’s PRONASOL, 1989-94

• Large social assistance program (1.2 percent of GDP)

• Water, sanitation, electricity and education construction to poor communities

• Limited poverty impact – Reduced poverty by 3 percent– If better targeted, could have reduced it by

64 percent

Page 15: Decentralization and service delivery. The problem Disappointing health and education outcomes, especially for poor people.

PRONASOL expenditures according to party in municipal government

Source: Estevez, Magaloni and Diaz-Cayeros 2002

Page 16: Decentralization and service delivery. The problem Disappointing health and education outcomes, especially for poor people.

Poor people Providers

Policymakers

A framework of relationships of accountability

Page 17: Decentralization and service delivery. The problem Disappointing health and education outcomes, especially for poor people.

Absence rate among teachers

Country Rate (percent)

Ecuador 16

India 25

Indonesia 18

Papua New Guinea 15

Peru 13

Zambia 17

Uganda 26

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Poor people Providers

National policymakers

Decentralized service delivery

Local policymakers

Page 19: Decentralization and service delivery. The problem Disappointing health and education outcomes, especially for poor people.

Poor people Providers

National policymakers

Fiscal issues

Local policymakers

Page 20: Decentralization and service delivery. The problem Disappointing health and education outcomes, especially for poor people.

Fiscal Issues

• Expenditure assignments– Loss of economies of scale

– Concurrent responsibilities can lead to duplication, confusion, and evasion

• Financing—tax assignments, intergovernmental transfers, borrowing– Soft budget constraints

– Tax inefficiencies and inequities

– Political distortions in resource distribution

Page 21: Decentralization and service delivery. The problem Disappointing health and education outcomes, especially for poor people.

Poor people Providers

National policymakers

Administrative responsibilities

Local policymakers

Page 22: Decentralization and service delivery. The problem Disappointing health and education outcomes, especially for poor people.

Poor people Providers

National policymakers

Capacity constraints

Local policymakers

Page 23: Decentralization and service delivery. The problem Disappointing health and education outcomes, especially for poor people.

Poor people Providers

National policymakers

Political issues

Local policymakers

Page 24: Decentralization and service delivery. The problem Disappointing health and education outcomes, especially for poor people.

Political Issues

• Why do services fail poor people even in democracies where politicians depend upon their support to gain and remain in office?

• Political market imperfections

– Information constraints

– Social polarization

– Credibility of political promises

Page 25: Decentralization and service delivery. The problem Disappointing health and education outcomes, especially for poor people.

Do information problems improve with decentralization?

• Voters better informed about local public goods

• Easier to monitor local services

• Easier to coordinate rewards/ punishments when policy dimensionality is reduced

• In Uganda and the Philippines, voters rely on local social networks for information about local govts., and on national newspapers for national govts.

• In Nigeria, uncertainty about fiscal resources available to local govts.

• In India, voters hold state governments responsible for local services

Page 26: Decentralization and service delivery. The problem Disappointing health and education outcomes, especially for poor people.

Does social polarization reduce with decentralization?

• Decentralized units more homogeneous

• Some local communities even more polarized (within-village inequality in India very high)

• Local elites find it easier to mobilize and “capture” public resources

Page 27: Decentralization and service delivery. The problem Disappointing health and education outcomes, especially for poor people.

Does political credibility increase with decentralization?

• Proximity and reputation breed credibility

• In young democracies, politicians build credibility by targeting their “clients”

• Combination of social polarization and young democracy make local politics particularly “clientelistic”

Page 28: Decentralization and service delivery. The problem Disappointing health and education outcomes, especially for poor people.

Political Issues

• Why do services fail poor people even in democracies where politicians depend upon their support to gain and remain in office?

• Political market imperfections– Information constraints

– Social polarization

– Credibility of political promises

• Political Institutions and Electoral Rules

Page 29: Decentralization and service delivery. The problem Disappointing health and education outcomes, especially for poor people.

Political Institutions and Electoral Rules

• Non-pivotal/non-swing voters get neglected under centralization (Eg. Bolivia)

• Lower barriers to entry increases political competition

• National political parties determine objectives and incentives of local governments

• Proportional representation and district magnitude more significant determinants of service delivery incentives

Page 30: Decentralization and service delivery. The problem Disappointing health and education outcomes, especially for poor people.

Poor people Providers

National policymakers

Transition dilemmas

Local policymakers

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EDUCO Program in El Salvador

• Parents’ associations (ACEs)– Hire and fire teachers– Visit schools on regular basis– Contract with Ministry of Education to

deliver primary education

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EDUCO promoted parental involvement…

Source: Adapted from Jimenez and Sawada 1999

…which boosts student performance

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Conclusion

• Services fail when accountability breaks down

• Decentralization can overcome or exacerbate accountability failures

• Institutional design should address political market imperfections:-- provide more relevant information-- de-emphasize social polarization-- build credibility for public services