Service delivery

User involvement and accountability

There is a general consensus that improving user involvement and increasing the accountability of service providers to their clients is a good way to improve service delivery outcomes. But what is the best way to involve users in the design, monitoring and evaluation of services? What are the barriers to participation, particularly amongst the poorest?

Page contents:

• User involvement and voice
• Mechanisms for user involvement
• Understanding rights and entitlements
• Accountability

User involvement and voice

Recent research argues that community participation in service delivery significantly enhances the responsiveness and accountability of service providers to users. However, communities should not be thought of as homogenous, as power hierarchies exist in all communities, meaning that some groups do not have the ability to voice their views. How can service provision be designed and delivered in a way that ensures the opinions of the users, socially excluded groups and the voices of the poor are heard and represented? Client voice is affected by various factors, including social status, education and geographical position. Citizens need to be more involved in service delivery, but getting their voices heard can be constrained by low awareness of rights, government resistance, poor access to information and complex laws and procedures for involvement in local decision-making. It is important to recognise that the poor face particular barriers to participation, for example, illiteracy, lack of time and an inability to travel long distances.

The resources below call for user involvement to move beyond mere consultation to ongoing influence in policy development.

Commins, S., 2007, ‘Community Participation in Service Delivery and Accountability, OECD-DAC, Paris
How can citizens affect service delivery and accountability? This paper, from the University of Los Angeles, provides an overview of issues and experiences with diverse forms of community participation in the provision of services. Service provision arrangements linked to various forms of community participation may improve MDG-related outcomes. Community participation also affects public sector accountability at local, regional and national levels.
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Standing, H., 2004, 'Understanding the Demand Side in Service Delivery: Definitions, Frameworks and Tools for the Health Sector', DFID Health Systems Resource Centre, Department for International Development, London
Can the active engagement of primary stakeholders in service provision contribute to improving the quality of health care? If so, what role should government and development agencies play in this process? This document by DFID's Health Systems Resource Centre explores the different uses of the 'demand side' concept, the challenges that demand side approaches pose to service delivery in the health sector of low income and transitional countries and the implications of these differences for policy actors, particularly international agencies.
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Goetz, A.M. and Gaventa, J. et al. 2000, 'Bringing Citizen Voice and Client Focus into Service Delivery,' IDS Working Paper no. 138, Institute of Development Studies, Brighton.
This study examines current public sector reforms across the world in both developed and developing countries. It assesses their attempts to focus more on the needs of users. It also looks at how effectively civil society can voice its demand for improved services.
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Rakodi, C. and O'Connell, H., 2002, ‘Influences and Accountability: Citizen Voices, Responsiveness and Accountability in Service Delivery’, One World Action, London
How can citizens exercise their right to participate meaningfully in ensuring basic service delivery? How can the public sector’s willingness and ability to respond and deliver those services in an accountable and sustainable way be increased? This report synthesises the proceedings of a seminar held by One World Action to discuss these two issues. It suggests how politics could be made more democratic with the goal of improving local service delivery.
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Mechanisms for user involvement

There are various mechanisms designed to improve participation and accountability of services, for example user groups and committees. But what makes a mechanism successful? What are the incentives to encourage a user to engage? Often these mechanisms suffer from poor credibility and elite capture.  Research has revealed that despite their aims, they can become politicised, with undemocratic and non-inclusive practices and limited powers.

Manor, J., 2004, ‘User Committees: A Potentially Damaging Second Wave of Decentralization’, European Journal of Development Research, Vol 16, no.1
Since the mid-1990s, ‘user committees’ have proliferated in less-developed countries. They are intended to give ordinary people the opportunity to influence development programmes and projects. In some cases, they have had a positive impact. However, this article, published in the European Journal of Development Research, argues that they may be having a damaging effect on decentralisation and participation.
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Singh J., and Shah P, 2003, 'Making Services Work for Poor People - The Role of Participatory Public Expenditure Management (PPEM'), Social Development Notes No. 81, World Bank, Washington D.C
How can services be made to work for poor people? What reforms are needed? This study from the World Bank puts forward the case for participatory public expenditure management (PPEM) to improve service delivery in developing countries.
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Understanding rights and entitlements

Often, people who do not have access to basic services are not able to demand better service from providers. This can be as a direct result of their lack of services, for example because they are illiterate, under-educated or unwell. Providing information is the first step to improving accountability amongst excluded groups – information helps people to understand the services they are entitled to, and the mechanisms available to them to demand this level of service. 

For a fuller discussion of rights-based approaches to service delivery, please see relevant sections of the GSDRC Topic Guide on Human Rights.

Banerjee, A., et al., 2006, 'Can Information Campaigns Spark Local Participation and Improve Outcomes? A Study of Primary Education in Uttar Pradesh, India', World Bank Policy Research Working Paper 3967, World Bank, Washington D.C.
What role can local community participation in basic service delivery play in promoting development outcomes? This World Bank working paper considers the participation of Village Education Committees (VECs) in improving primary education services in Uttar Pradesh, India. It reports findings from a survey of public schools, households and VEC members on the state of education services and the extent of community participation in delivering such services. Findings suggest that local participation might be constrained by lack of information regarding VECs and that substantial apathy exists towards education as an area for public action.
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Accountability

Accountability failures are a key cause of weak service delivery. Accountability is needed between policy-makers, service providers and service users, with the key relationship being direct accountability between providers and users. In developing countries this accountability relationship is often missing. Traditionally accountability mechanisms have been divided into ‘vertical’, where external systems are used by non-state actors to hold the state to account, or ‘horizontal’, where internal checks and balances are in operation. New types of accountability are now emerging which tend to be more informal and utilise new sites of engagement, for example online complaints forums. 

World Bank, 2003, ‘Making Services Work for Poor People’, World Development Report 2004, World Bank, Washington D.C. 
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.
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Asha, G., 2003, ‘Accountability in Health Services: Transforming Relationships and Contexts’, Working Paper Series, Vol. 13, no. 1, Harvard Centre for Population and Development Studies, Boston
Accountability mechanisms are increasingly being used in health programmes around the world, but to what effect? In this working paper from the Harvard Centre for Population and Development Studies, the author argues that accountability mechanisms may not always respond to the needs of marginalised groups in society and that attention needs to be paid to the social and institutional context in which they are placed. To be successful, accountability mechanisms need to emphasise building broad and democratic constituencies to support social change.
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