Fragile states

Service delivery and state-building

Page contents

Service delivery and state-building
Addressing social exclusion through service delivery
Non-state service providers in fragile states
Case studies and lessons learned

Service delivery and state-building

Donors are increasingly concerned with the relationship between service delivery and state-building. This encompasses two related elements: i) how the delivery of basic services can best support state responsiveness, state legitimacy and social cohesion and ii) how donors can support the development of state capacity to deliver or co-ordinate services. Underlying this is a belief that service delivery is ultimately the responsibility of the state, and an intuition that the visible presence of services extends the state’s reach and authority, supports state legitimacy and strengthens the social contract. Related to this, some argue that addressing the equitable delivery of services across disparate groups could help repair societal fractures. Nevertheless, little research has been done in this area to date, and much of it has been cautious about confirming any such causal links.

The state-building imperative encourages donors to consider the impact of their aid delivery mechanisms on the development of state capacity. Many call for donors to better manage the potential trade-offs between delivering services quickly through parallel structures that in some cases may bypass the state, and the long-term development of state capacity and accountability between service providers, government and citizens (rather than to donors).

Eldon, J., and Gunby, D., 2009, ‘States in Development: State-building and Service Delivery’, HLSP Institute, London
How, when and why do basic services matter for responsive state-building? This paper from HLSP uses cases studies from Cambodia, Nigeria, South Sudan and Zimbabwe to explore these questions as part of wider research on fragile states. The relationship between state responsiveness and service delivery is not straightforward. Fragility, violence, patronage, ethnicity and economic growth all play a part.
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Eldon J., 2008, 'Health System Reconstruction: Can it Contribute to State-building?', HLSP Institute, London
Can rebuilding health systems in fragile states strengthen the social contract and contribute to wider state-building? This study commissioned by the Health and Fragile States Network, which included fieldwork in Nigeria and Sierra Leone, finds that health sector strengthening can contribute to state-building in the health sector, but that its impact on wider state-building remains unclear. There may be more scope for wider state-building and the strengthening of the state-society compact through decentralised and 'bottom up' approaches. Context is the key influencer of potential for state-building, but is often inadequately understood.
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GSDRC, 2009, 'Service Delivery and Stabilisation', Helpdesk Research Report, GSDRC, Birmingham
The most commonly cited potential benefits of service delivery in post-conflict environments are that visible delivery enhances state legitimacy, strengthens the social contract and hence, promotes state-building. Delivery of services can also address underlying causes of conflict, i.e. social exclusion, and services such as health can be used as entry points for wider peace-building processes. In stabilisation contexts, a particular challenge is how, given that the state often lacks the capacity to ensure reliable services, provision by external actors and donors can enhance state legitimacy and not weaken it. In such a case, ensuring that the state’s role in service delivery is clearly communicated is key. The long-term commitment of donors is also important. Furthermore, given that the legitimacy of the state depends on much more than the delivery of services, it is often argued that stabilisation requires a multi-pronged and multi-layered approach.
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Addressing social exclusion through service delivery

There is increasing recognition that service delivery initiatives in fragile states should aim to ameliorate the negative effects of exclusion on certain groups over the long term. But issues of targeting and programming for marginalised and vulnerable groups in service delivery are highly complex and political.

Gardener, J. and Subrahmanian, R., 2006, 'Tackling Social Exclusion in Health and Education: Case Studies from South Asia', Report prepared for the Department for International Development, GHK International
In many Asian countries, poverty reduction is undermined by inequality and insecurity. Achieving the Millennium Development Goals in these countries requires effort from governments and development agencies to help excluded groups access health and education services. This paper from GHK International and the Institute of Development Studies uses examples from across Asia to identify ways of tackling social exclusion.
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Non-state service providers in fragile states

The absence or weakness of state services in fragile situations usually means the majority of services are delivered by non-state actors (including donors, international and local NGOs, traditional and commercial (small and large) service providers), particularly in the early recovery phase. Many recent studies have argued this results in the fragmented and uneven provision of services. In addition, many donors are concerned that the delivery of services through non-state providers negatively impacts on the development of state legitimacy and capacity. Recently, donors have become concerned with how states with weak capacity can effectively perform the indirect ‘stewardship’ roles of managing, co-ordinating and financing non-state providers of basic services. Related to this is the issue of transition from non-state to state provision, specifically, how non-state providers can support the development of state capacity for direct provision in the long-term.

GSDRC, 2009, 'Non-State Providers of Health Services in Fragile and Conflict-Affected States', Helpdesk Research Report, GSDRC, Birmingham
Most mechanisms that use NSPs to deliver services are only being applied at a very small scale in fragile states. There is some evidence that the most widely used mechanism - contracting - can increase service utilisation, increase service quality, improve efficiency, reduce service fragmentation, and support strengthening of national capacity. The basic package of health services (BPHS) contracting approach, in particular, is often cited as an effective mechanism for health service delivery in fragile states. However, some observers have voiced concern that contracting can promote precipitous decentralisation, erode NSP independence, and actually fragment the health system given that NSPs are seldom able to provide an overall framework in which to operate.
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GSDRC, 2009, 'Non-State Providers of Education Services in Fragile and Conflict-Affected States', Helpdesk Research Report, GSDRC, Birmingham
NSPs are generally viewed as key service providers and as more pragmatic, flexible and adaptable than state structures in fragile states. By allowing communities to identify their own priorities they are often seen as having the potential to empower communities, set up local governance structures and strengthen social accountability mechanisms. There are also drawbacks however. As NSPs often operate outside government regulation, there is a danger that some may be providing low-quality education. In addition, they can also be disconnected from policy development in the wider sphere. Gender issues – in terms of awareness of oppressive attitudes and exploitative employment practices – are also a concern.
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Batley, R., and Mcloughlin, C., 2009, ‘State Capacity and Non-state Service Provision in Fragile and Conflict Affected States’, Governance and Social Development Resource Centre, Birmingham
How can governments effectively engage with non-state providers (NSPs) of basic services where capacity is weak? This paper examines whether and how fragile and conflict affected states can co-ordinate, finance, and set and apply standards for the provision of basic services by NSPs. It explores ways of incrementally engaging the state, beginning with activities that are least likely to do harm to non-state provision.
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DFID commissioned a cross-country study of non-state provision of basic (primary) education, primary and community health-care, and water and sanitation in 2005. Findings, including lessons learned for donors for supporting non-state providers, are available on the website of the International Development Department at the University of Birmingham.

Further resources on non-state providers can be found in the service delivery guide.

Case studies and lessons learned

The following case studies draw lessons from experience of delivering basic services in fragile contexts.

Federal Ministry for Economic Co-operation and Development, 2006, ‘Observations on Service Delivery in Fragile States and Situations – The German Perspective’, Special 145, Federal Ministry for Economic Cooperation and Development (BMZ), Germany
How can donors co-operate effectively with fragile states to secure basic services whilst improving governance? This paper from the German Federal Ministry for Economic Development and Co-operation (BMZ) assesses the state of service delivery in Eritrea, Cote d’Ivoire, Nepal, Guatemala and Yemen. It suggests that development agencies need to stay engaged even under poor conditions. When partnerships with the state are difficult, donors can co-operate with civil society and the private sector, while making contacts within the government to begin the process of state-building.
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Berry, C. et al., 2004, ‘Service Delivery in Difficult Environments: The Case of Nepal’, Nepal Country Office and Policy Division, Department for International Development, London
What are the challenges for service delivery in difficult environments? What lessons can be learnt from the conflict areas of Nepal? How effective are different strategies for delivering services to the poor and the vulnerable? This collaborative report from the DFID Nepal Office, Asia Policy Regional Policy Unit and DFID Policy Division (PD) describes the different approaches development agencies have used to support service delivery in Nepal and highlights key areas for future support.
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Moreno-Torres, M., 2005, ‘Service Delivery in a Difficult Environment: The Child-friendly Community Initiative in Sudan’, Department for International Development, London
The UNICEF-sponsored Child-Friendly Community Initiative (CFCI) represents an integrated, multi-sectoral and community-driven approach for the delivery of basic services to poor and vulnerable people in Sudan. What are the main achievements of CFCI? How does it differ from other donor interventions aiming to enhance service delivery? Compiled for the Department for International Development, this case study examines the effectiveness of the CFCI approach in Sudan and attempts to draw lessons for donors on service delivery in other fragile states.
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Green, C., 2008, ‘Strengthening Voice and Accountability in the Health Sector’, Nigeria Partnership for Transforming the Health Sector (PATHS), London
How can greater voice and accountability for citizens bring about improved health services? This Technical Brief from DFID reviews several voice and accountability initiatives supported by the Partnerships for Transforming Health Systems Programme (PATHS) in selected states in Nigeria. It concludes that the creation of formal mechanisms of voice and accountability can be effective in opening space for citizen-state accountability and improving service responsiveness. Further work is however needed from the government on strengthening accountability mechanisms for these initiatives to be fully successful.
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Zivetz, L., 2006, ‘Health Service Delivery in Early Recovery Fragile States: Lessons from Afghanistan, Cambodia, Mozambique, and Timor Leste’, Basic Support for Institutionalizing Child Survival (BASICS) for the United States Agency for International Development (USAID)
What are the impacts of foreign assistance on state stewardship of the health sector in early recovery fragile states? How can foreign aid encourage better state performance? This case study from USAID finds that donors have undermined state capacity to regulate service delivery by creating a two-track system. Promising approaches to support state stewardship include: contracting with NGOs; equity funds; civil service performance-based reform; sectoral plans; and budget support. Increased donor harmonisation is important.
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CECORE, REDROC, Saferworld, and YODEO, 2008, ‘Water and Conflict: Making Water Delivery Conflict-Sensitive in Uganda’, Saferworld, London
How can conflict-sensitive approaches (CSA) enhance development? This report from Saferworld documents how two water development projects in Uganda became more conflict-sensitive and, as a result, benefited recipient communities. CSA can deepen beneficiary participation and community ownership of development projects. More practical work is needed on implementing CSA within different sectors, and on understanding how best to adapt conflict-sensitive development to different levels and types of conflict.
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Lindemann, S., 2006, 'Addressing the Need for Water Service Delivery in Fragile States: The Case of German Involvement in Yemen', paper presented at the Berlin Conference on the Human Dimensions of Global Environmental Change 'Resource Policies, Effectiveness, Efficiency and Equity', 17-18th November, Berlin
Fragile states are often unable to provide water services to the majority of their people, especially the poor. So, how can international agencies work effectively in these environments to provide the infrastructure for safe drinking water? This study from Deutsche Gesellschaft für Technische Zusammenar-beit (GTZ) analyses the effectiveness of German donor involvement in the water sector of Yemen. Its success lies in the combination of support to sectoral reform at the national and regional level, and decentralised and commercialised services at the local level.
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