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Making Services Work for Poor People: World Development Report 2004

Author: The World Bank
Date: 2003
Size: 288 pages (4026 KB)

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Summary

How can countries accelerate progress towards the Millennium Development Goals by making services work for poor people? How does the integration of poor people into determining the quality and quantity of services they receive ensure higher success rates? The 2004 World Development Report from The World Bank looks at successful innovations and failures to guide policymakers on improving the delivery of basic services.

Broad improvements in human welfare will not occur unless poor people receive wider access to affordable, better quality services in health, education, water, sanitation and electricity. Without such improvements in services, freedom from illness and illiteracy - two of the most important ways poor people can escape poverty - will remain elusive to many.

Key services fail poor people in access, quantity and quality. The main difference in the success of efforts by developing countries is the degree to which poor people themselves are involved in determining the services they receive. The report documents three ways in which services can be improved:

• Increasing choice and participation in service delivery by the poor so they can monitor and discipline providers. School voucher schemes increase clients’ power over providers and increase enrolment rates.
• Raising poor citizens voice through the ballot box and making information widely available can make poor people more aware of the standard of service they are receiving and increase demand for change.
• Rewarding the effective and penalising the ineffective delivery of services to poor people. Examples of paying primary heath providers based on the health of households improved health indicators as well as use of the services.

The varied experience with traditional and innovative modes of service delivery clearly shows that no single solution fits all services in all countries. Completing a series of questions and examining different combinations of characteristics suggests more specific solutions. Eight options have been put forward to see which service delivery arrangement would suit specific cases. Some of the options are:

• Central government financing with contracting. In a favourable political context, with agreement on government action, an easy to monitor service such as immunization could be delivered or financed by the public sector and contracted out to the private or non-profit sector.
• Central government provision. When the service is difficult to monitor but the politics are pro-poor and clients homogeneous, the traditional centralised public sector is the appropriate delivery system.
• Local government financing with contracting. With heterogeneous preferences, local governments should be involved in services. When local politics are pro-poor, local governments could be more reliable financiers of services.
• Local government provision. For difficult to monitor activities, such as education, management responsibility might be ceded to parent groups when the politics are conducive.
• Client power. When publicly financed services are subject to capture, the politics are not pro-poor. The best action is to strengthen the clients’ power.

Access full text: available online

Source: World Bank, 2003, 'Making Services Work for Poor People, World Development Report 2004', World Bank, Washington D.C
Author: Sarah Bennett , sara_bennett@abtassoc.com