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Social Development

The politics of service delivery

Shanta Devarajan's picture

Teachers in Tanzania are absent 23 percent of the time; doctors in Senegal spend an average of 39 minutes a day seeing patients; in Chad, 99 percent of non-wage public spending in health disappears before reaching the clinics.

These and other service delivery failures have been widely documented since the 2004 World Development Report, Making Services Work for Poor People.

But why do these failures persist?  Because they represent a political equilibrium where politicians and service providers (teachers, doctors, bureaucrats) benefit from the status quo and will therefore resist attempts at improving services.  For instance, teachers are often the campaign managers for local politicians.  They work to get the politician elected, in return for which they get a job from which they can be absent. Powerful medical unions ensure that their members can work in the private sector and neglect their salaried government jobs.  The losers are the poor, whose children don't learn to read and write, or get sick and die because the public clinic is empty.

Rewarding safe sex

Damien de Walque's picture

Prevention strategies have had limited impact on the trajectory of the HIV/AIDS epidemic. New, innovative approaches to behavioral change are needed to stem the epidemic.

In a joint effort with many colleagues, and in collaboration with the Ifakara Health Institute in Tanzania and, the University of California at Berkeley, we launched a study with the acronym RESPECT (“Rewarding STI Prevention and Control in Tanzania”).

We started with an observation:  Conditional cash transfers (CCTs) have been used successfully to promote activities that are beneficial to the participants such as school attendance  and health check-ups for children.  The Tanzanian experiment asks whether CCTs can be used to prevent people from engaging in activities that are harmful to themselves and others, such as unsafe sex. This is a controversial idea.

Creating a level playing field

Wolfgang Fengler's picture

Throughout the slums of this world, poor children are dreaming of becoming football stars and playing in the World Cup. Some of them from Kibera—Kenya’s largest slum—had a shot last weekend, when the International School of Kenya hosted the third “Mini World Cup”.

The event involved more than sixty teams made-up of Kenyan and international children from all walks of life. Two teams from Kibera made it to the top eight teams of the tournament, keeping their dream alive to win the “Cup” in one of the next years. The great thing about football is that all teams, no matter what their social background, have an equal opportunity to win. They start on a level playing field, and they all play by the same rules. When the final whistle blows, there is no reason why one of the teams from Kibera should not lift the Mini World Cup next time, just as Ghana’s Black Stars overcame Team USA in the 2010 World Cup, despite the huge disparity in wealth between the two nations.

In economic development, the equivalent of having a level playing field is equality of access to basic services.

Raising the Volume on 'Quiet Corruption'

Shanta Devarajan's picture

 
Photo: Arne Hoel

In Uganda, teachers in public primary schools are absent 27 percent of the time. In Chad, less than one percent of the non-wage recurrent expenditures reaches primary health clinics.  In West Africa, about half the fertilizer is diluted before it reaches the farmer. 

Les Réussites Africaines

Shanta Devarajan's picture

Ces dernières années, de nombreux pays africains ont commencé à faire preuve d’un dynamisme remarquable.

Le taux de croissance  enregistré au Mozambique est fulgurant, affichant une moyenne annuelle de 8 % sur plus de dix ans. Le Kenya est devenu l'un des plus importants fournisseurs mondiaux de fleurs coupées. Le service M-Pesa, qui permet d’effectuer des transferts d’argent à partir d’un téléphone mobile, rencontre un succès grandissant tandis que le programme KickStart aide les petits agriculteurs à irriguer leurs cultures à moindre coût. Le tourisme rwandais fleurit depuis qu’il s’est axé sur la vie des gorilles et dans la ville de Lagos au Nigéria, les nouvelles infrastructures du BRT (réseau de transport rapide par bus) facilite un développement urbain plus efficace. En deux mots, l’Afrique est en train de vivre une réelle transformation.

What AIDS Leaves Behind: A Heavy Burden on African Women

Kathleen Beegle's picture

Unlike other diseases in Africa (malaria, tuberculosis, intestinal worms, etc.), which mainly affect the young and the old, HIV/AIDS takes its toll on prime-age adults during the most productive years of their lives. The death of an adult family member can have large consequences for the surviving family. Given prevailing social norms in many African societies, the burden may likely be heaviest for women.

Most studies focus on the consequences for orphaned children – their schooling and health. We know less about how older adults are impacted.  In our study, we track individuals and their households in northwest Tanzania, an area of high HIV prevalence in the 1990s, over a 13-year period.

We find that, when a family member dies, women (even old women) end up working more on the farm; men do too, but not as much.  Having an asset such as goats enables them to work less. 

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