Devolution, Accountability, and Service Delivery: Some Insights from Pakistan


Book Description

Abstract: This paper studies the relationship between devolution, accountability, and service delivery in Pakistan. It examines the degree of accessibility of local policy-makers and the level of competition in local elections, the expenditure patterns of local governments to gauge their sector priorities, and the extent to which local governments are focused on patronage or the provision of targeted benefits to a few as opposed to providing public goods. The main findings of the paper are three-fold. First, the accessibility of policy-makers to citizens in Pakistan is unequivocally greater after devolution, and local government elections are, with some notable exceptions, as competitive as national and provincial elections. Second, local government sector priorities are heavily tilted toward the provision of physical infrastructure - specifically, roads, water and sanitation, and rural electrification - at the expense of education and health. Third, this sector prioritization is in part a dutiful response to the relatively greater citizen demands for physical infrastructure; in part a reflection of the local government electoral structure that gives primacy to village and neighborhood-specific issues, and in part a reaction to provincial initiatives in education and health that have taken the political space away from local governments in the social sectors, thereby encouraging them to focus more toward physical infrastructure.




Devolution, Accountability, and Service Delivery


Book Description

This paper studies the relationship between devolution, accountability, and service delivery in Pakistan. It examines the degree of accessibility of local policy-makers and the level of competition in local elections, the expenditure patterns of local governments to gauge their sector priorities, and the extent to which local governments are focused on patronage or the provision of targeted benefits to a few as opposed to providing public goods. The main findings of the paper are three-fold. First, the accessibility of policy-makers to citizens in Pakistan is unequivocally greater after devolution, and local government elections are, with some notable exceptions, as competitive as national and provincial elections. Second, local government sector priorities are heavily tilted toward the provision of physical infrastructure - specifically, roads, water and sanitation, and rural electrification - at the expense of education and health. Third, this sector prioritization is in part a dutiful response to the relatively greater citizen demands for physical infrastructure; in part a reflection of the local government electoral structure that gives primacy to village and neighborhood-specific issues, and in part a reaction to provincial initiatives in education and health that have taken the political space away from local governments in the social sectors, thereby encouraging them to focus more toward physical infrastructure.




Decentralization and Service Delivery


Book Description

Dissatisfied with centralized approaches to delivering local public services, a large number of countries are decentralizing responsibility for these services to lower-level, locally elected governments. The results have been mixed. The paper provides a framework for evaluating the benefits and costs, in terms of service delivery, of different approaches to decentralization, based on relationships of accountability between different actors in the delivery chain. Moving from a model of central provision to that of decentralization to local governments introduces a new relationship of accountability-between national and local policymakers-while altering existing relationships, such as that between citizens and elected politicians. Only by examining how these relationships change can we understand why decentralization can, and sometimes cannot, lead to better service delivery. In particular, the various instruments of decentralization-fiscal, administrative, regulatory, market, and financial-can affect the incentives facing service providers, even though they relate only to local policymakers. Likewise, and perhaps more significantly, the incentives facing local and national politicians can have a profound effect on the provision of local services. Finally, the process of implementing decentralization can be as important as the design of the system in influencing service delivery outcomes.




Pakistan


Book Description

The authors exposit likely developments in Pakistan's internal and external security environment over the coming decade; assess Pakistan's national will and capacity to solve its problems, especially those relating to security; describe U.S. interests in Pakistan; and suggest policies for the U.S. government to pursue in order to secure those interests.




Providing Affordable, Quality Health Care in Owerri


Book Description

Leaders and those aspiring to direct the welfare of a nation need to understand how citizens perceive the institutions of nation. When the publicly sponsored institution administering the welfare of a nation via health care policies falls into crisis, its leaders must understand the nature of the crisis and influence upon the health of citizens. The adage, reality is perception remains true during such a crisis as leaders ask how to coordinate the resources of a nation as to address a health crisis. This study frames a crisis of health care services delivery within the city of Owerri located within the state of Imo, Nigeria. The goal of this study is to richly illustrate and research the failure of government institutions within Owerri as to understand the problems facing the Nigerian health care sector.




Waiting for Democracy


Book Description

References pp. 115-132.




The Political Economy of Democratic Decentralization


Book Description

Nearly all countries worldwide are now experimenting with decentralization. Their motivation are diverse. Many countries are decentralizing because they believe this can help stimulate economic growth or reduce rural poverty, goals central government interventions have failed to achieve. Some countries see it as a way to strengthen civil society and deepen democracy. Some perceive it as a way to off-load expensive responsibilities onto lower level governments. Thus, decentralization is seen as a solution to many different kinds of problems. This report examines the origins and implications decentralization from a political economy perspective, with a focus on its promise and limitations. It explores why countries have often chosen not to decentralize, even when evidence suggests that doing so would be in the interests of the government. It seeks to explain why since the early 1980s many countries have undertaken some form of decentralization. This report also evaluates the evidence to understand where decentralization has considerable promise and where it does not. It identifies conditions needed for decentralization to succeed. It identifies the ways in which decentralization can promote rural development. And it names the goals which decentralization will probably not help achieve.







Governance in Developing Asia


Book Description

Governance in Developing Asia is one of the first books of its kind to provide an overview of the role that better governance and citizen empowerment can play in improving public service delivery in developing Asia. The World Development Report 2004 se




Local Governments and the Public Health Delivery System in Kerala


Book Description

This book discusses the significance of local governments in public healthcare systems in developing countries, particularly India. It considers a new model of public health delivery system in the Indian state of Kerala, which is unique in achieving a fairly high level of human and social development with a relatively low level of economic development. Unlike most Indian states, Kerala has devolved the control of health service management to local governments, though the state government still has administrative powers, resulting in a system of dual responsibilities. Transfer of public health control from state government to local governments has seen an increase in the participation of the local community in public health delivery management. Based on a field study conducted in Keralan districts, this book explains the scope for mobilising local resources for the implementation of public health projects under local government, discussing a unique model of co-production between the government and civil society that can improve health services, efficiency and equity, leading to better health outcomes. As such, this study will be of interest to scholars and practitioners in the areas of health, local governance and decentralised planning.