three key relationships in the service delivery chain

The World Development Report means by accountability a relationship among actors that has five features: delegation, finance, performance, information about performance, and enforceability.

In buying a sandwich you ask for it (delegation) and pay for it (finance). The sandwich is made for you (performance). You eat the sandwich (which generates relevant information about its quality). And you then choose to buy or not buy a sandwich another day (enforceability), affecting the profits of the seller.

In a city the citizens choose an executive to manage the tasks of the municipality (delegation), including tax and budget decisions (finance). The executive acts, often in ways that involve the executive in relationships of accountability with others (performance). Voters then assess the executive’s performance based on their experience and information. And they act to control the executive — either politically or legally (enforceability).

The World Development Report states that to make services work for the poor, accountability has to be strengthened in three key relationships in the service delivery chain: between policymakers and poor people, between policymakers and providers, and between providers and their clients

Of politicians to citizens: voice and politics.

For poor people the only routine interaction with the state may be at the delivery point of services.

Public services often become the currency of political patronage and clientelism. Politicians give “phantom” jobs to teachers and doctors, or they build free public schools and clinics in areas where their supporters live.

The Report uses the term voice to express the complex relationships of accountability between citizens and politicians. The voice relationship includes formal political mechanisms (political parties and elections) and informal ones (advocacy groups and public information campaigns).

The citizen policymaker link is working either when citizens can hold policymakers accountable for public services that benefit the poor or when the policymaker cares about the health and education of poor people. These politics are “pro-poor.”

When elections are not enough to make services work for poor people, political pressure builds for new approaches that enable citizens to hold politicians and policymakers more directly accountable for services. The rapid growth of citizen initiatives has been described as a new accountability agenda.

Enthusiasm for direct citizen involvement comes from mounting frustration with the dominant mode of a national civil service delivering services that meet some technically predetermined “needs” of the population. Two separate trends are discernible in citizen voice initiatives: activities based on consultation, dialogue, and information sharing, and activities more direct and controversial, related to monitoring, compliance, and auditing.

One of the most powerful means of increasing the voice of poor citizens in policymaking is better information. Citizens need information about how actions of the state have promoted their well-being. But information is not enough. Accountability must have the quality of answerability (the right to receive relevant information and explanation for actions), and enforceability (the right to impose sanctions if the information or rationale is deemed inappropriate). Voice only is not sufficient for accountability; it may lead to answerability but it does not necessarily lead to enforceability. Citizens need some mechanism for enforceability, to make sure politicians and policymakers are rewarded for good actions and penalized for bad ones.

Voice is only one part of accountability. The impact on services depends also on the compact relationship between policymakers and providers. Even strong voice may fail to make basic services work for poor people because the compact is weak.

Of the organizational provider to the state: compacts.

The relationships between policymakers and service providers can be thought of as compacts: a broad agreement about a long-term relationship, whereby the provider agrees to deliver a service, in return for being rewarded or penalized depending on performance. Enforceability comes into play when the compact also specifies the rewards (and possibly the penalties) that depend on the service provider’s actions and outputs. The compact may be an explicit contract with a private or non-profit organization, or it could be implicit, as in the employment agreements of civil servants.

Since the contract cannot be fully specified, policymakers look to other means of eliciting pro-poor services from providers. One way is to choose appropriate providers who have an intrinsic motivation to serve the poor. Another way is to increase incentives to serve the poor or work in underserved areas. A third way is to solicit bids or services and use the competition in the bidding process to monitor and discipline providers

Generating and disseminating information are powerful ways of improving service delivery. Good information on the actions of providers and the outcomes of those actions must get to the policymaker. And remuneration must be tied as closely to these outcomes as possible. Separating the policymaker from the provider organization also helps to increase the accountability of providers.

Of the provider to the citizen-client: client power.

Because the policymaker cannot specify all actions of providers in the compact, or they just don’t care about the outcomes, citizens must reveal to providers their demand for services and monitor the providers’ provision of services. In systems that lack accountability relationships, public service jobs (teachers, policemen) are given as political favours. Services are allocated in ways that reward (or punish) communities for their political support. This system of clientelism creates a relationship not of accountability but of political obligation.

When services are failing the poor, clients can play two roles in strengthening service delivery.

First, for many services, clients can help tailor the service to their needs. Second, clients can be effective monitors of providers, since they are at the point of service delivery. Clients are usually in a better position to see what is going on than most supervisors in government hierarchies. Improvements in basic education have often depended on participation by parents. Although parents cannot monitor all aspects of education, they can monitor attendance by teachers and even illiterate parents can tell if their children are learning to read and write.

Public policy can help poor people acquire better services by expanding the choice of providers. Female patients who feel more comfortable with female doctors can go to one. The competition created by client choice also disciplines providers. When there is no choice of providers, increasing poor people’s participation in service provision can achieve similar results. Governments can expand consumer power by giving them the ability to monitor and discipline the provider and establishing procedures to make sure complaints are acted on.