DECENTRALIZED SERVICE DELIVERY FOR THE POOR EXECUTIVE...
Transcript of DECENTRALIZED SERVICE DELIVERY FOR THE POOR EXECUTIVE...
Decentralized Service Delivery for the Poor xi
DECENTRALIZED SERVICE DELIVERY FOR THE POOR
EXECUTIVE SUMMARY
Mexico has reorganized many of its government programs over the last dozen years, among others, by decentralizing them to states and municipalities, although that process is far from complete. Simultaneously, Mexico has achieved major expansion in the coverage of these social programs, especially for the poor. Currently, the biggest challenge is to improve program quality and accountability, which remain low by Organization for Economic Cooperation and Development (OECD) standards and about average for Latin America.
For this report—the third phase of a programmatic series of studies on poverty in Mexico—Mexico’s Social Cabinet requested that the Bank analyze service delivery of a specific list of programs that are essential to the government’s development strategy in the context of decentralization. The elements of the government’s strategy considered here—basic education, health care for the population without social security coverage, local social infrastructure, and local rural development—all aim directly or indirectly to reduce poverty. Both social and economic services shape the opportunities of poor people. Social services contribute to human capital formation and risk management, while economic services shape access to markets.
• Basic education includes preschool, primary school (grades 1–6), and lower‐secondary school (grades 7–9). Public schools account for 92 percent of enrollment in basic education. The Fondo de Aportaciones para la Educación Básica (FAEB, the Basic Education Fund), which is an earmarked transfer to the states, is the main source of funding for basic education. FAEB plus the federal programs considered in this report—the Programa de Escuelas de Calidad (PEC) and the Consejo Nacional de Fomento Educativo (CONAFE)—account for more than 15 percent of total public spending. FAEB and state spending cover mainly personnel costs. The PEC brings funds directly from the federal government to schools subject to certain conditions. CONAFE is a federal program that serves marginalized rural areas.
• Health for the population without social security coverage is provided by public programs that are principally directed to the poor; providers include the Ministry of Health (SSA), Instituto Mexicano de Seguro Social (IMSS)‐Oportunidades, and Seguro Popular. Spending for the population without social security coverage constitutes about 5 percent of total public spending. The Fondo de Aportaciones para los Servicios de Salud (FASSA, the Health Services Fund) transfers earmarked funds to the states for running the
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decentralized health care system. Ramo 12 is a federal item that supports SSA, the health component of Oportunidades, as well as all other federal health funding including Seguro Popular, the national health institutes, and federal hospitals.
• Local social infrastructure is provided through the Fondo de Aportaciones para la Infraestructura Social (FAIS), the third largest decentralized fund, which uses a transparent poverty‐weighted formula to distribute resources for investment to states and municipalities. The financial resources go initially to the state treasuries, with strict conditions to pass along the majority of the funds to municipalities, under the title Fondo para la Infraestructura Municipal (FISM). The rest of the resources remain at the state level under the title Fondo para la Infraestructura Social Estatal (FISE). FISM accounts for almost 2 percent of public spending. Federal and local governments are also able to spend more than the allotted distribution on local infrastructure provided that they have access to other financing resources. This occurs especially in wealthier municipalities.
• Local rural development is conducted through Alianza para el Campo, the large scale farm modernization program in Mexico. The Rural Development Program—a municipalized program of Alianza—provides funding to support rural productive investment. The Rural Development Program is targeted to farmers with small holdings. About 0.2 percent of the federal budget is allocated to the Rural Development Program. Participation varies greatly according to state, as does states’ own funding.
Some of the states and municipalities have independently developed their own programs that augment and, to some extent, fill in gaps for the federal programs reviewed here. There has been little or no coordination among these programs.
During the 1990s, Mexico made major policy changes that accelerated the decentralization of programs and financing; at the same time, democracy was taking root at all levels of government. Since then, decentralization of policies and programs has changed little. Although the decentralization agenda remains incomplete, some states and municipalities have made good progress in implementing the reforms of the previous decade and making improvements in the local practice. Many other states and municipalities, due to politics, weak administrative capacity, and socioeconomic conditions, have not taken the initiative to make creative improvements in the federalized programs. Rather, they remain agents to disburse federal money, struggling to deal with national unions and federal regulations. They do not implement the programs to their full potential which is necessary to address local problems such as development and poverty reduction. Since the wider trends in the national politics will continue to dictate the overall degree of decentralization (and probably not lead to significant changes in the near future), the way forward for improving the poverty‐
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reduction effects of these programs should focus on creating incentives for improving the quality of services, broadening access to these programs by the poor, and improving transparency with respect to inputs and results.
Even though the federal government favors decentralization, there is no unified strategy—the commitment to decentralization varies from ministry to ministry. Within each sector, different decentralization processes coexist.1 States and municipalities are attempting to fill in the blanks of the strategy, sometimes in an ad hoc manner, as their participation shapes the process in their own jurisdictions.
While there are often clear steps that would improve the quality of services, many of the national policies and organizational features needed to create more capacity and set better incentives to encourage the “right steps” are lacking. Decentralization can potentially bring benefits, but there are tradeoffs. On one hand, there are potential gains from local knowledge and greater responsiveness to local preferences. On the other hand, there are potential losses from lack of coordination, local capture, or higher inequality in the quality and coverage of services across jurisdictions.
The relevant dimensions of gain or loss from the decentralization processes analyzed here include, first, whether the decentralization processes improved performance, in terms of the quality and coverage of services for the poor; second, whether decentralization engendered greater local efforts to mobilize resources or to use them more efficiently; third, whether decentralization allowed or engendered better accommodation of programs to local conditions; and fourth, whether decentralization improved transparency and accountability of service providers to the government or to citizen‐beneficiaries. The second, third, and especially the fourth criterion not only are valued for their own sake, but also reflect the features of institutional design that are important determinants that influence the degree to which decentralization achieves its aims. Yet it should be noted, in most cases, there is not sufficient data to attribute specific outcomes to specific features of the decentralization processes. The most that one can report are the trends that occurred in the period since the decentralization processes started.
Institutional Conceptual Framework
To analyze how service‐delivery institutions may affect quality and efficiency, the report principally uses a framework developed in the 2004 World Development Report (WDR). This framework is adapted to the institutional context prevalent in the different sectors analyzed here, taking into account that each sector has gone through different stages in the decentralization process. In our basic conceptual framework, the
1 Administrative decentralization started around the 1990s. The main events for the purposes of this study are explained in the annexes to Volume I, mainly in the background notes on expenditure decentralization and poverty alleviation; see subsequent chapters for more detail.
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main actors in every country are the citizen‐beneficiaries and taxpayers (darkly shaded box at the bottom left of Figure 1), the government (darkly shaded box at the apex), and the service providers (darkly shaded box at the bottom right). The administrative process creates a compact—a structure of incentives, financial arrangements, and accountability mechanisms—between the government and the service providers who offer services and expect remuneration. The political process creates another compact between the government, which collects taxes, and their citizens, who expect benefits and hold the government accountable. One can then look at the chain of accountability from provider to government to citizens. Improving the effectiveness of this chain is one way to improve service outcomes. There is also a shorter potential route of accountability, from providers directly to citizen‐beneficiaries. Making this short route effective requires adequate local administrative autonomy to accommodate to local conditions, sufficient information for beneficiaries to evaluate service provider performance, and incentives for providers to respond to the influence of beneficiaries. For these programs to achieve their potential in poverty reduction, incentives are needed for targeting and efficiency, and local providers need to have authority and flexibility to respond to these incentives. Local authorities need to have or to develop institutional capacity to carry out these mandates.
Figure 1. Accountability Relationships with Political Parties, National Provider Organizations, and Subnational Governments
To adapt the framework to the decentralized institutional setting of service provision in Mexico, we need to add three actors—the three lighter boxes included in the diagram. The state and municipal governments add an extra step in the funding and
Families/ Citizens‐voters
Political Party
Political InfluenceTaxes/Resources Sectoral Policy and Operational Practices (including wage negotiations) Beneficiary voice: the Short Route of Accountability
Federal Government
Service Providers
State or Municipality
National Union
/
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accountability between the federal government and the service providers, but they might also allow a shorter long route of accountability if they take adequate control of the service provision and are responsive to the local citizenry.
The political parties in Mexico come in as separate actors because of their strong role in integrating the system (especially in the decades of one‐party rule) and in managing the careers of the politicians who run the governments. With no reelection allowed in Mexico, pleasing the party is the main currency used by officials (elected or appointed) to assure their future. An analysis of the political parties is beyond the scope of this report, except to note that they are important intermediaries in the system. To some extent they facilitate democratic communication from voters to leaders, and to some extent they represent their own interests in ways that hinder such communication. The national unions (teachers, health workers, farmers) and other national corporatist organizations (for example, the association of construction contractors) have a traditionally significant role in and strong links to the political parties in Mexico’s corporatist structure. This report does not analyze political parties, but rather the relationships among the state, providers, unions, and citizens or clients. Unions and corporatist organizations make a positive contribution in representing key stakeholders and in integrating the national development strategy. However, they also represent a private interest that may conflict with the public interest, and there is the possibility that they may disrupt the delegation of authority to subnational governments and the necessary accountability for service quality and efficiency.
Even the customized WDR framework cannot capture all of the important institutional dimensions. We must recognize, for instance, the need to develop and retain competent personnel at local levels, the need to consolidate federal programs and streamline their regulations so that local government can readily access them, and the need to create effective linkages among federal programs and between them and locally run programs.
Decentralization and Performance
In all sectors, coverage, equity, and targeting of services have improved, especially for the poor, and there is evidence of quality improvements in some cases. Quality generally remains low by OECD standards and remains roughly on par with Latin America. Service performance varies widely across the country, even after accounting for the correlation with the state income per capita, which indicates that other important factors are also influencing performance. Nonetheless, there is very little information at the state and municipal levels on the performance of the programs analyzed here, making it difficult to establish a link with decentralization.
In education, the gap in primary education coverage between the poor and the rich states has narrowed since decentralization. Equity has improved, perhaps due to
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the cumulative effects of compensatory programs.2 However, efforts to increase lower‐secondary schooling for the poor confront significant challenges. Quality of education is low by international standards even after controlling for Mexico’s level of income. This is particularly true for the poor, which exacerbates the problems of access. The rapid expansion of the telesecundaria system is worrisome; although it has helped to improve access to school for the rural poor and accounts for 20 percent of total lower‐secondary enrollment (and a much higher share in rural areas), students in the telesecundaria have recorded low levels of achievement. Despite important institutional limitations in the decentralization process, local innovations have helped both rich and less wealthy states, improve their basic education systems. States that follow this pattern include Aguascalientes, Colima,3 Nuevo León, and Quintana Roo. The first three states plus the Distrito Federal rank at the top of the PISA scale, while the last state is around the national average. These states are working to improve learning achievement on several fronts, taking initiatives such as improving pedagogy practices, evaluation, and the hiring of teachers. In addition, some federal educational programs are stimulating discussion about how to improve school management and learning achievement.
In the area of health, indicators of outcome, such as life expectancy and infant mortality, have improved in the last decade, due in part to the success of centralized programs, such as the vaccination program. However, maternal mortality has remained at very high levels according to international standards. The Millennium Development Goal on maternal health proposed to reduce maternal mortality by two‐thirds from 1990 to 2015. However, with a reduction of only 30 percent in the last 15 years, it is unlikely that Mexico will be able to achieve this Millennium Development Goal. There are a lot of data about the overall population, but the existence of several different public systems of provision (IMSS, SSA, ISSSTE, IMSS‐Oportunidades, and state health systems) make it difficult to establish a relationship between systems and outcomes. The following results are from a health analysis based on a sample of six states (Arredondo 2005). First, across states, there seem to be important differences in health outcomes and indicators, and the differentiation is not necessarily between the poor and the rich states. Second, in high‐ to medium‐income states such as Baja California Sur, Jalisco, and Tabasco, the evolution of health performance has been neither even nor significantly better than in the rest of the country. Third, these states that seem to be far advanced in the decentralization process are investing considerable resources in their health systems, and have been able to reallocate resources relatively effectively (preventive versus curative expenditures). More data and analysis are necessary to assess the progress of decentralization and its effects in these states and in others. A new federal program—
2 The Ministry of Education’s compensatory education interventions target schools in disadvantaged rural areas and increase resource allocations for those schools to give students more equal opportunities. Compensatory education programs tend to decrease dispersion in scores. Perhaps the cumulative impact of compensatory education from basic education is carried over to lower‐secondary schools and explains, in part, the high degree of equity observed in PISA results. 3 Colima is the best performer but only ranks 14th in GDP per capita.
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Seguro Popular—distributes funds to states based on the location of patients who choose to affiliate and is helping to expand coverage among the population without social security coverage and to reduce catastrophic health expenditures.
Coverage of social infrastructure has improved, although it continues to be low for the poor. FAIS is an important source of financing for local social infrastructure investment in the poorest municipalities, and it is, in general, well targeted according to the level of marginality. However, the significance of FAIS in the overall availability of municipal financial resources varies by sector and size of municipality. The sectoral allocation of the FAIS investment (water versus roads versus housing upgrading and so forth) is not generally correlated with lack of coverage in that sector, although this finding varies by state and sector. A potential explanation is that municipalities have several sources of funds for investment in social infrastructure in addition to FAIS. Another explanation is that FAIS institutional arrangements vary from state to state.
In production‐oriented programs in rural areas, investment is high but not notably effective. This is due to the proliferation of segmented federal programs with no coordination, the lack of clear political accountability for rural development because responsibilities are diffused among various federal Secretarías and state governments, and a host of problems in program design and implementation. Additionally, the poverty impact of these programs, and its impact on rural development, is difficult to assess because much of it is indirect, depending on its effect on employment and wages.
There is evidence for Mexico and other Latin American and Caribbean countries that agricultural growth has a strong effect in reducing rural poverty, and there is also evidence that the rural poor in Mexico derive a large part of their income from non‐farm sources. Therefore, programs oriented to increasing employment and income opportunities in the farm and rural non‐farm sectors are, in principle, pro‐rural poor, but the targeting of these programs may be problematic. Thus, a problem with Alianza’s Rural Development Program is that it concentrates on small farmers, that is, on producers who already have access to at least some productive assets and in turn are wealthier than the poorest in rural Mexico. As a consequence, even if the targeting of the program is good in terms of “farmers” (80 percent of beneficiaries belong to the two smallest categories of the five types of farmers considered by the Food and Agriculture Organization), it is not designed to reach the poorest rural families.
Funding, Equity, and Performance
The incentive for raising revenues or using transfers efficiently at the state or local level is driven by the current arrangements for taxes and transfers between the states and the central government.4 The system has its foundations in the early 1990s
4 The two main categories of transfers to the states are participaciones and aportaciones. Participaciones were originally state and municipality revenues whose collection was delegated to the federal level in the Fiscal
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and earlier (Fiscal Coordination Law), when the interinstitutional relationships described above were heavily dominated by the power of one political party that controlled the federal and almost all state governments and drew its power base from various organized interests, including public employee labor unions. States and municipalities are heavily dependent on transfers from the center. A standard result from the literature on fiscal decentralization is that the dependence on transfers reduces the direct accountability between subnational governments and their citizen‐clients. This lack of accountability can result in less effort to mobilize local revenues or to use transfers efficiently.
A negative effect of decentralization over the past decade seems to be a reduced tax effort by municipal governments, which declined from 0.17 percent of GDP in 1990 to 0.07 percent of GDP in 2004. The amount of transfers to municipalities has grown strongly, but the resources are coming to them with less discretion and more by formula. Since the participaciones formula gives a slight reward for local fiscal effort, and state‐debt bailouts and discretionary transfers from the president virtually ended after 1998, the marginal incentives for local fiscal effort have improved. But the big increase in total federal transfers to municipalities has had an apparently negative effect on the total tax effort. States have not changed their tax effort appreciably, perhaps because the law does not give them much scope to collect their own revenue.
Even though no claims of causality can be made, it is illustrative to report key trends in efficiency observed since the beginning of the decentralization. In resource use, there is little evidence of greater efficiency as a result of decentralization, but it varies by sector. For instance, the bulk of education spending is budgeted and distributed “inertially,” based on the stock of physical capital and employees belonging to the federal system before decentralization. This allocation does not consider the demand of clients, the productivity of suppliers, or poverty. Moreover, the expansion of enrollment nationally has been proportionately less than the increase in the number of teachers and schools and slower than the increase in spending. This increase in spending per student since decentralization is explained mainly by the increase in teachers’ salaries.5 Cross‐sectional data show that teacher salaries are not correlated with student achievement.6 Therefore, it is likely that this higher expenditure has not
Pact for tax efficiency reasons. Most of these transfers are distributed under Ramo 28. Aportaciones were conceived as federal money earmarked to pay for (formerly) federal commitments and transferred to the states and municipalities together with those commitments (for example, education and health). These funds, formerly under Ramo 26, now go out under Ramo 33. For an extensive review see World Bank (2004a; 2001a; 2001b). 5 International comparisons suggest that higher shares of non‐salary spending are associated with better performance. An area for future research is to obtain data on non‐salary spending by state, in order to assess whether spending is correlated with performance. 6 The subnational governments received transfers equal to about twice as much per capita in real terms in 2004 as in 1992, before the major sectors began to be decentralized (1993) and the last main revision of the participaciones formula was finalized (1994).
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affected performance. Moreover, standardized educational testing results across states are not at all correlated with spending per student (see Figure 2).7
Figure 2. Math and Reading Test Results and Expenditures per Student, 2001
Source: SEP.
In health, one cannot attribute evidence of improvements in outcome indicators to decentralization: performance varies greatly across states, particularly among those states that have gone farthest with decentralization, and there is little information at the state level on the non‐fiscal factors that might influence performance. With respect to spending, health expenditures have been increasing in real terms at a rate of 9.6 percent a year. Federal transfers (FASSA) and federal spending (Ramo 12) have increased from MxP$1,186 per capita for the population without social security coverage in 1992 to MxP$2,319 per capita for the population without social security coverage in 2004. In the mid‐1990s, during the 1994 crisis and shortly after, there was a substantial drop in spending, followed by a recovery. As in the case of education, the bulk of spending is budgeted and distributed “inertially” across states, based on the stock of physical capital and employees belonging to the federal system before decentralization. This leads to inequity, because states that are well endowed receive large portions of FASSA funds. Although 20 percent of FASSA is allocated through a formula that takes into account state deficits or surpluses in health care, this does not compensate fully for the unequal distribution of services, nor does it give incentives for states to improve the efficiency of their systems. Recent initiatives are trying to reverse these inequities and inefficiencies.
In social infrastructure, there are some indications of improved efficiency since decentralization. Most states have developed their own planning and implementing 7 The tests were not given in the years prior to decentralization, so we do not know how changes in spending over time correlate with test results. More statistically sophisticated analysis, taking account of the local socioeconomic conditions and the basic organizational features of the states, confirms the insignificance of per capita funding levels for explaining variation in test performance across states. See the discussion in the education chapter in Volume II and Quality of Education, World Bank, 2006b.
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models for FAIS, which require careful analysis in order to identify and disseminate best practices.
In rural development, there are no clear standards for output and thus no concrete indicators of efficiency. Most public spending for agriculture and rural development is not efficient in terms of its direct effects on poverty, since most public spending does not go to the poorest rural citizens. According to targeting criteria based on state marginality, the decentralized funding of Alianza is regressive. Whether it is effective for developing agriculture is beyond the scope of this report.
Although the variance in performance typically is not correlated with the variance in federal or total funding levels (as mentioned in the context of efficiency), the geographic variation across states and municipalities in funding per capita or per user is substantial (usually by more than a factor of two from lowest to highest). This variance in funding may potentially generate differences in coverage and quality.
The best program in this regard is FAIS, whose distribution follows a transparent formula based on population and the marginality index. There is still room for improvement because the municipalities do not necessarily distribute the projects to benefit their poorest communities and because some states apply an alternative formula to the one used by the federal government to distribute FAIS resources to their municipalities, with the result that some municipalities with similar degrees of poverty in different states do not receive a similar level of funding thru FAIS.
In basic education and health for the population without social security coverage, the bulk of the distribution (FAEB and FASSA in Ramo 33) is done according to the distribution of teachers, doctors, and nurses in the federal facilities before the decentralization.8 While this was a practical starting point for the national agreements and the transition, it has led to widely varying funding levels per student and per population without social security coverage, disparities that have increased over time. The disparities are not correlated with poverty levels, but rather with the absolute state population (larger states get less per capita) and with the size of the states’ own systems before decentralization. States that had—and made the fiscal effort to pay for—larger systems of their own usually had small federal systems per capita before, and so have received less federal financing since decentralization.
The Rural Development Program is allocated to states according to a complex formula that includes variables such as rural population, agricultural GDP, harvested land, irrigated land, number of production units, and state contribution. State trust funds are responsible for the financial management and, through technical committees, for the approval of farmers’ proposals. Since 2003, part of the funding of the Rural
8 The federal government has been allocating resources to compensate for inequities through the CONAFE and PEC programs in education and the Seguro Popular program in health.
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Development Program started going to municipal authorities. States generally complain that excessive rules and regulations hinder the implementation and adaptability of the program.
Accommodation to Local Conditions
The decentralization process in Mexico is far from complete. One root of this is the continued near monopoly of the federal government in raising taxes. Second, even though around half of programmable public sector funds pass through the state and municipal governments, the federal government retains a dominant role in directing how the decentralized resources are used. The means of influence differ, but much of the underlying political economy is similar. Powerful interests, such as some unions, have a close relationship to the federal government, built up during the 20th century under a corporatist single‐party state, and they prefer to avoid dealing with the independent and politically competitive governments of the 32 states.9
In the education and health sectors, the unions for teachers, doctors, and nurses negotiate the salaries and rules for personnel with the federal government, and then the federal government transfers the money to states to pay these workers. States have little power to manage personnel which seriously limits their options for managing the sector or for accommodating to local circumstances.
In the decentralized programs for municipal infrastructure and rural development, there is little ex ante earmarking of funds to be devolved to municipalities; in most areas where such funds could be used, they are dominated by other federal programs in water, electrification, roads, and agricultural investment. To some extent, the municipal programs allow the local governments to put money where they feel the federal government has missed an opportunity, but some of the devolved funds come back under federal control as required counterpart funds to the federal programs.
The central government has imposed many restrictions and rigidities on the implementation of municipalized rural development programs, making it difficult for the local governments to operate. Furthermore, it is difficult to design strategically sound rural development programs with investments clustered around local development axes.
Incentive for Local Performance
International experience shows a variety of incentive mechanisms for improving local performance. Unfortunately, most of them are absent in the decentralization arrangements in Mexico.
9 The leadership of the national teachers union has opposed decentralization of the union as a potential threat to its influence and importance.
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At the aggregate political level, in most other countries local politicians have the incentive of reelection, which makes them accountable to local voters. There have been proposals, but no actions, to allow reelection at the municipal level in Mexico where the single three‐year term discourages projects with longer‐term benefits. Coahuila is the one exception to this rule. At the aggregate fiscal level, locally raising a substantial share of fiscal resources for local spending, as is the case in Brazil (Southern states), Canada, and the United States, creates another accountability relationship with local taxpayer voters. In some larger cities of Mexico, local revenue generation occurs, with beneficial incentives for efficiency and accountability. However, smaller municipalities lack the capacity and states lack the fiscal space to replicate this effort. Additionally, the growth of federal largess with transfers has further undercut the incentive for local fiscal efforts. Providing technical assistance and legal tax authority (to states) as a substitute for increased federal transfers would help improve incentives.
In education and health, many countries have formulas whereby the funding follows the location of students’ attendance or patients’ use of services, with perhaps some simple rule‐based adjustments to account for demographic characteristics, like age and geographic dispersion. Such arrangements create beneficial incentives in several dimensions. First, there is an incentive for equity, as the formula for distributing national resources creates an expectation for similar methods of distribution locally—for example by facility. Second, such formulas create incentives and space for local governments to choose more efficient combinations of inputs. Third, the formulas reward facilities and local governments that improve school attendance and make their health services more attractive. Box 2.2 in Chapter 2 describes how Colombia has converted its basic education transfers to a capitation basis, after starting from a distribution based on the historical location of teachers and health workers, as Mexico has.
Accountability and Transparency
Since the beginning of the decentralization process, institutional change in these programs has allowed for an improvement of the accountability mechanisms in two ways—first, by forging shorter routes of accountability through some of the state and municipal governments that have responsibility for managing service delivery in education, health, and municipal infrastructure services and, second, by forging direct links of accountability between clients and providers in some schools, health facilities, and municipal service agencies. Although it is hard to prove definitively, anecdotal evidence supports the presumption of this report that more transparency and accountability will lead to better social services and infrastructure for the poor.
The challenge of improving the transparency of the decentralized programs has two aspects: clarity on the allocation of resources and evidence of the results. The allocation of resources for the sectors under consideration is certainly more transparent than it was 12 years ago when most of the decentralization began. A politically more
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independent national Congress leaves much less of the budget to executive discretion. The budget—proposed and approved—and the various reports from the executive branch now provide detailed public information about distribution of resources across programs and geographic areas. Some resources, including the funds for social infrastructure and rural development considered here, are distributed by formula to states and within states to municipalities. People can see where the money is going geographically and debate the pros and cons of the formula. On local decisions regarding the use of financial resources, transparency varies, but at least some places are utilizing participatory platforms to choose projects. Among them are the Municipal Planning Councils (COPLADEMUN) for social infrastructure and the Municipal Councils for Sustainable Rural Development (CMDRS) for agricultural and rural development. The electoral democracy at the local level could be mutually reinforcing of these institutions, if they facilitate the attainment of technically sound and popularly supported spending decisions and avoid being captured by local elites.
In health and especially education, the national unions strongly assert their own interests, sometimes at the expense of service quality and other citizen‐beneficiary interests. Nonetheless, the variety of state‐level experience in Mexico shows the potential, partially achieved in some states, to make incremental improvements through negotiation with the unions. As states achieve more fiscal autonomy by raising revenues locally, they have more flexibility to negotiate such agreements.
Transparency about results is also improving, although information is still scarcer than for resource allocation. In education, Mexico now uses the international standard PISA test, which provides information on individual student achievement, along with data on socioeconomic and geographic background. Identification of the policies and innovations in states with high average scores and low dispersion could be valuable knowledge for the others. (See the sectoral piece on education in Volume II and World Bank, 2006b.)
Available analysis also shows that the special federal programs in education that build local accountability of schools to the parents and community—Apoyos a la Gestión Escolar (AGEs of CONAFE) and perhaps PEC—are associated with higher school achievement, even after controlling for socioeconomic factors. These programs do not create new schools; rather, they increase the resources and transform the incentives in schools that remain in the traditional framework of state management and federal funding for teachers’ salaries.
In health, making each provider accountable for outcomes will require information on the health outcomes in each of the client populations—information that is still missing. SSA has begun collecting key data on the quality of health care with three evaluations, in 2003, 2004 and 2005, which will be published in August 2006, on issues such as whether facilities are opened and staffed on schedule, how long patients
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have to wait for procedures, what procedures are performed, what share of procedures are successful, and whether medicines are available.
Some evidence suggests that the IMSS‐Oportunidades health system, which is still operated centrally, but only in about half of the states, provides better service than the state‐run SSA programs. Some states have combined the management of the two programs: Campeche, Chiapas, Oaxaca, Yucatán, and partially Veracruz.
Seguro Popular is the major recent innovation in the health sector institutions. The program has recorded success in shielding families, especially the poor, from catastrophic health expenditures. Participation has grown quickly since 2003 and is slightly more progressive than participation in SSA (which is already pro‐poor), but less progressive than in other programs such as Oportunidades. With the goal of having funds follow the patient; the program has been successful in assigning funds according to the number of beneficiaries. The next step is to direct funding to the facility where the patient goes, a change that is scheduled for 2010. The states have to contribute a share of the costs, which gives them incentives for efficient management. Much of the expenditure under the program goes for medicines, and the part used for personnel has been used to hire short‐term contract workers, which should give administrators some leeway in managing the facility.
To improve monitoring and influence the quality of service, Seguro Popular has a federal accreditation program for states and facilities; there is not yet evidence on how well this works. No progress has been made on creating a culture of prepayment, as the states are listing almost all of the registrants as the extreme poor, so that they make no payment. Some states with IMSS‐Oportunidades facilities have started to fund them with Seguro Popular as well, which has the potential to create an effective bridge with the state SSA system.
For local infrastructure, almost all municipalities report what they do with the resources from FISM to state governments, however only some states report this information or information on FISE funds to the federal government, as required by law. The lists of investments undertaken appear reasonable—water and sanitation, local roads, and water appear to be most common. FAIS allocations in the water and electricity sectors appear to be correlated with lack of access to these services, although a similar correlation was not found in the case of sanitation investments. Many other programs (mostly federal, some local) also fund such infrastructure. So, without knowing the total array of investments coming into each locality (which no one keeps a record of), it is not possible to assess whether the resources from FISM (generally a minority of the total) are being well allocated.
For municipal investment in rural development, information is even scarcer about both the local needs and the actual allocation of investments. The detailed and usually delayed federal regulations on the use of funds seem to have the primary effect
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of making project execution difficult and inefficient. The complexity also makes it unnecessarily difficult for municipal rural councils to understand and implement the program.
Policy Challenges and Options for the Future
To date, decentralization in Mexico has been haphazard. Fiscal decentralization of transfers and spending has gone quickly, for political reasons, while taxation has remained centralized. Although local governments write the check, they have insufficient authority to manage the sectors for results. In education and health, most of the money goes to workers whose contracts are set at the national level. In rural development, complex national rules constrain local programming, and in municipal infrastructure as well as rural development, the much larger direct federal programs often overshadow any results produced by the local programs. For these and other reasons, institutions and incentives for accountability have remained weak in all the program areas examined here. True accountability is not possible without adequate authority.
Decentralization has worked better in those services, states, and municipalities where there was effective (efficient, pro‐poor) filling of the gaps in the federal programs. This implies a need both for systematic shifts to a more rational decentralization process and for a process of learning from successes and failures, in particular whether successes are products of good design or local context. Some well‐developed states such as Aguascalientes do well in all services, but other states with comparable income levels do well in a few sectors, but not in others. The differences in their reactions to the decentralization challenge provide scope for learning from good and bad experiences.
While the variety of circumstances and results precludes a uniform conclusion about decentralization, part of the way forward towards improved service delivery seems to entail loosening of regulations about what the local governments do and giving the federal government a stronger role in setting standards of outcomes (for example, core curricula, engineering standards), undertaking monitoring and evaluation, and requiring that the local governments disclose to their citizens the financial arrangements and outcomes of the sectors and programs they manage. While looser regulation means less earmarking and direction within each sector, international experience in Canada and Europe shows that sectoral earmarking can be loosened (without leading to underfunding) as the citizens develop clear expectations that the local government has the responsibility for providing the service. This phenomenon is starting to happen in Mexico, most clearly with FAIS, which never had tight earmarking. It also has occurred in education and health, such as when people
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complain to their governor about a rise in maternal mortality or a problem with schools.
Concerning incentives created by the fiscal system, international experience suggests a number of policy options for improving the mobilization of local resources, efficiency of resource use, and distribution across jurisdictions:
• Incentives for local revenue generation appear to be weak in Mexico: own‐revenues are low and have declined since the increase in federal transfers during the past decade. At the municipal level, the mayors in poor municipalities have incentives mainly to “bring resources down” by influencing federal‐ and state‐level resources, instead of mobilizing local revenues (Grindle, 2004). This is bad for overall revenue mobilization and for strengthening the local tax contract. The situation of the states is no better. The increasing role of Congress has tended to magnify this: while the Support Program for the Strengthening of the States (PAFEF) is still relatively small, it adds another incentive for states to look “up” for resources rather than to generate revenues locally.
• Despite the shift to a more formula‐driven allocation of resources for municipal investment, with greater automaticity of federal resources (which improves incentives at the margin), the wealth effect of the large increase in the volume of (inframarginal) resources has decreased the incentives for mobilizing local revenue in many places.
• For both states and municipalities, the federal government would do well to slow, if not reverse, the growth of total transfers, using them selectively to motivate nationally desirable practices, to compensate poor areas, and to encourage local revenue efforts as a way to find additional resources for public purposes, including the poverty‐reducing programs discussed here.
• For municipalities, which have a good potential tax base (property tax), the federal government could support technical assistance to strengthen the cadastres, property registries, and collection of property taxes. The Ministry of Finance was considering such a project in 2005 and should return to this idea.
• For states, which lack a good tax base, the government several times has proposed allowing them to have a final sales tax on the same base as the federal value added tax (VAT). The Convención Nacional Hacendaria (CNH, National Fiscal Convention) also has recommended it, but agreement has never been reached about how the VAT and the tax participation system would be adjusted, in order to accommodate the proposal. Perhaps the next government will take up a similar idea.
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• Implementing the CNH recommendation to expand the tax base of the state governments would give states’ fiscal authority to respond to citizen demands for improved services and give citizens more interest in monitoring the efficient use of the taxes they pay.
• The CNH in 2004 recommended moving to a distribution formula for federal resources (aportaciones) based on the number students or clients. Implementing the CNH recommendation to distribute education and health resources, at least at the margin, based on the location of students and clients, respectively, would contribute both to improved equity and to citizens’ understanding that resources come to a state in response to the needs of their citizens rather than the bargaining power of a national union.
• Further fixes to the FAIS formula should take careful consideration of how much the rich states should be expected to help their own poor.10
Better and more efficient services are in many instances related to the flexibility and authority that local governments have to adapt programs to local needs and to take other steps to improve efficiency and quality. International experience shows the importance of this (World Bank 2004c). A number of specific actions would allow greater accommodation to local conditions. In some cases, they involve changing the intergovernmental compact, so that state or local governments have more freedom to respond to local citizens. In other cases, citizens would gain more scope for expressing their preferences from having more freedom to choose their service provider (for example, Seguro Popular).
• Programs like AGEs and PEC and other measures to strengthen accountability of schools to parents have the potential to help improve the quality of Mexico’s basic education and thus to reduce poverty. Further analysis needs to identify what aspects of these programs have the beneficial impact and how this could expand to a wider circle of schools. It is important to promote educational models that improve pedagogical practices, evaluation at the local level, and accountability, so that resources are allocated based on performance.
• In education and health, the federal government could encourage states to take the initiative in the negotiations with the union by setting the standards of quality without specifying details of method, by allowing more state discretion to improve such things as school curriculum and health payment
10 We do not know how much rich states are allocating their untied (non‐FISM) resources to help their own poor. The question we pose here is how much they should be allocating. Do they ever graduate from needing federal assistance to helping their own poorer regions?
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systems, by promoting general fiscal autonomy, and by disseminating information on best practices.
• SSA should allow greater flexibility for management of health units at the local level, so that they can respond to local needs and make the best use of the decentralization process. Accountability, both upward and downward, should continue to be fostered to ensure that the flow of resources to the states is based on performance and to strengthen the hand of citizens in exerting constructive political influence on their local governments.
While these measures do not guarantee that the local governments will respond appropriately to citizens’ recommendations, they should help strengthen the accountability relationship that arises out of the democratic process.
• An attractive option for reform in the health sector, with its multiplicity of programs and providers, would be to have the affiliation of each client indicate the source of funding that she or he could then take to the most suitable provider.11 Seguro Popular aims to have portability of funding in the near future, and the other programs could arrange similar portability as well. Having funding follow the client would, based on international experience, enhance the power of the clients and the accountability of the providers.
• As clients gain flexibility to seek the best provider, the providers—hospitals and clinics—will need and demand more flexibility and authority to improve their services.
• For FAIS and FISM, some states, like Puebla and Zacatecas, have instituted their own rules to assure that poor communities receive adequate consideration within their municipalities. These experiences should be studied in more depth, and best practices should be disseminated.
• In some sectors, FAIS resources seem to be well targeted according to the needs of the municipalities. However, an analysis of the efficiency of FAIS would require knowledge of local needs, conditions, and resources. In any case, allowing reelection of mayors, as recommended by CNH in 2004, would improve continuity and probably contribute to more efficient investment plans with a longer time horizon.
11 Initially, the portability of Seguro Popular funding might be limited to SSA and IMSS‐Oportunidades facilities, since access to the insurance (without social security coverage)‐based facilities (for example, regular IMSS, ISSSTE) is now linked to employment status. While virtually all the other reform options discussed here could go with or without the others, separating the provider from the financing source would affect the design of some of the other proposed reforms.
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• For rural development programs, as an alternative to municipalization, Mexico might consider consolidating most rural development productive programs at the state level, as places like Germany, Italy, and Spain do successfully. In this model, federal regulation of local program design would be relaxed, focusing instead on the transparency of information to the local population.
Transparency of information is a key factor for improving accountability in each program. Many states and some municipalities have followed, and some even have surpassed, the federal example of enacting the Federal Law of Access to Information and setting up an agency to implement it. Federal actions in the areas discussed here should support this trend. Below is a list of specific suggestions, which includes both improved information on resource allocation and improved measurement of performance. For example, the specific transfer programs might include disclosure of information as a condition for receiving at least some of the funds.
• In education, the government should make the data available publicly down to the school level. Information for each school on the budget and staffing levels and the attendance of students and staff should also be made available to the local community and thus to the wider public.
• SSA should continue its programs to improve information about health, making publications more prompt and providing clearer information on the linkages between outcomes and the agencies responsible for each segment of the population.
• To strengthen capacity and accountability of the COPLADEMUN and the CMDRS, a combination of fiscal incentives for transparency (like increments to transfers being conditional on timely publication of information), technical assistance to build capacity, and budget flexibility to build and implement a medium‐term program at the municipal level is needed. The federal government should disseminate information on the best practices in terms of planning and allocation of FAIS resources.
• Relying on the judgment of the local citizenry, enhancing the information available to them, and strengthening the capacity of local government to respond could help to improve the choice of local social infrastructure. Major improvement will require more than simple transparency measures, however, such as more incentives for raising local revenue, as mentioned above.
• If the government decides to pursue the strategy of support for small and medium farmers via local governments—states or municipalities—the most viable option is to shift the regulatory emphasis on disclosure of information.
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For instance, one option is to make the money for each year available once the municipality has fully disclosed the information on the program in the previous year (eventually including performance‐monitoring data) and has made public its plan for investment in the current year.
Some beneficial changes in program design or sectoral management are not specific to the institutional arrangements of decentralization. For example:
• For the rural development program, expanding the access for landless rural families would improve the probable impact on poverty reduction. This could be done either by facilitating the access of landless farmers to land (as in the program for young landless farmers recently started by the Secretaría de la Reforma Agraria, SRA) or through much more support for rural non‐farm activities.
• In education, experience internationally and within Mexico indicates the benefit of improving (a) the pedagogical process (the content of textbooks, teaching process, and use of didactic material, for example); (b) the hiring, assignment, and reassignment of personnel (for example, to avoid transferring teachers during the school year); and (c) the testing and monitoring of results.
Looking across all programs and states, time is a factor leading to improvement in federal programs such as AGEs in CONAFE. The longer a state is running a program, the better the results will be on average. Thus patience is needed:
• As long as a program is showing some improvement, even if it has not yet achieved full expectations in a couple of years, it should not be scrapped or allowed to die with the change of administrations. It would be better to continue with it and make marginal improvements in design, while the local and federal authorities learn how to operate it better.
Whatever the benefits of the individual programs in this report, one must also consider the context of overall public spending and the pattern of earmarking so many resources for particular uses by subnational governments. As these commitments become politically, if not legally, inflexible, few resources are left for any government to implement a broad economic development plan. The social programs that benefit the poor directly will work best to reduce poverty when they are in the context of overall strong economic growth.
Any wholesale reversal of decentralization in Mexico seems politically unlikely. The increased democracy of state and municipal levels has contributed to the decentralization and seems likely to sustain it politically. So trusting more in local
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democracy may help to improve the performance of decentralized service delivery. Ideas for reasserting central control run up against the evident failure of this strategy in rural development where detailed rules for decentralized federal programs have made local implementation administratively difficult. Moreover, the federal authorities lack the information and political mandate to positively influence the substance of what the local governments are doing. Further improvements to decentralization in Mexico seem to be more about increasing the transparency of both resource allocation and intergovernmental division of responsibilities, along with the overall task of deepening democracy and strengthening government‐society links.
The analysis presented in this report does not pretend to be exhaustive of decentralized service delivery for the poor. Important areas for future research include the following: (i) analysis of the compliance of the law or of the detail regulations in programs; (ii) systematic comparisons of state interventions in the sectors analyzed in this report; (iii) analysis of the implications and requirements to implement per capita funding in health and education, and freedom to choose providers; and (iv) systematic compilation of information at the state and municipal level on the performance of the programs.
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