:eyes:
What they're REALLY saying :
World Bank report from 2002 . . .
Why does public expenditure on average have such a limited effect on health and
education outcomes? We can break the problem down into at least four components.
First, governments may be spending on the wrong goods or the wrong people. A large
portion of public spending on health and education is devoted to private goods—ones3
where government spending is likely to crowd out private spending (Hammer, Nabi and
Cercone 1995).
Furthermore, most studies of the incidence of public spending in health
and education show that the benefits accrue largely to the rich and middle-class; the share
going to the poorest twenty percent (where it can make a difference) is always less than
20 percent (Table 2).
Second, even when governments spend on the right goods or the right people, the
money fails to reach the frontline service provider. In Uganda in the early 1990s, the
share of nonwage recurrent expend itures for primary education actually reaching the
primary school was only 13 percent (Reinikka and Svensson 2001).
There was
considerable variation in grants received across schools but larger schools and schools
with wealthier parents received a larger share of the intended funds (per student), while
schools with a higher share of unqualified teachers received less. These findings are
comparable to similar studies in Ghana and Tanzania (for a review see Reinikka and
Svensson 2002).
Third, even when the money reaches the primary school or health clinic, the
incentives to provide the service are often very weak. The service providers may be
poorly paid and hardly ever monitored. They respond to incentives from the central government
bureaucracy, which is mostly concerned with inputs rather than outputs.
The
“clients”, meanwhile, be they schoolchildren, parents, patients or expectant mothers, have
limited knowledge and even less power to hold the service provider accountable.Fourth, even if the services are effectively provided, households may not take advantage of them. For economic and other reasons, parents pull their children out of school or fail to take them to the clinic. This “demand-side” failure often interacts with the supply-side failures to generate a low-level of public services and outcomes among
the poor.
The World Development Report 2004 is aimed at
making services work for poor people, so that we can make greater progress toward the MDGs. This paper is an introduction to that report. In section II, we examine cases where policies have resulted in better service delivery, as well as the reasons why in other situations they have not. In section III, we use these examples to develop a framework for identifying public actions 4 that could result in better service-delivery outcomes. We describe what research has to
say about the different elements of the framework. Finally, in section IV, we highlight some of the critical, unanswered questions in this area. Throughout the paper (and the
report), our focus will be on health, education and water services, because they are critical to achieving the human-development MDGs. While other inputs, such as roads
and electricity, can have a significant effect on health and education outcomes, we focus on those services that are transactions- intensive, where the problem of organizing and
delivering the service is crucial. Many of the lessons obtained from frontline service delivery in health, education, and water are, however, applicable to other services as well.
Maybe you should READ IT!
http://siteresources.worldbank.org/INTWDR2004/Resources/17976_ReinikkaShantaInitialFramework.pdfWorld Report from 2009:
". . . Opening options for migration stimulates
greater human capital investments:
people consider not only the local returns to
education but also the returns in other locations.
If schooling options are available in
poor areas, potential migrants will invest in
additional human capital, anticipating that
jobs in leading areas require higher skills.
Employers in those areas are likely to favor
educated workers who signal themselves as
more “able” than other workers from lagging
areas.
. . . Government programs, such as that for
the universal primary education in Uganda,
often refl ect national priorities. Uganda’s
program increased enrollments in the
north—the country’s poorest area (see box
8.7). But more effort is needed to improve
education quality because of the higher
costs of delivering services in the northern
region. With poor implementation capacity
and underspending in lagging areas, the gap
between “regional needs” and allocations
from higher levels of government becomes
even wider. Although this could be seen
as spatial targeting of public spending, an
outcome-oriented policy framework would
regard such efforts as spatially blind.
Transfer mechanisms for public services.
Redistributive transfers from higher levels
of government can reduce disparities in fi scal
capacity and public service provision
across subnational jurisdictions. At least
three criteria motivate their allocation:
• Need. Areas with lower incomes would
receive more investment, but richer
areas may also demand more resources
to meet the needs of population growth
and congestion.
• Effi ciency. Areas with higher returns
to investment would receive more
allocations.
• Equality. Spending is equalized across
locations, so that public investments do
not give an advantage to any single area.
Need-based transfers can improve public
service delivery in lagging areas, because
local tax bases may be inadequate to generate
enough revenues. Intergovernmental
transfers can help provide similar access to
public services for residents anywhere in
the country. Such transfers are particularly important for subnational governments
that depend heavily on federal transfers
to cover spending. They fi nance about 60
percent of subnational spending in developing
countries and transition economies,
compared with about a third in member
countries of the Organisation for Economic
Co-operation and Development
(OECD).
. . . Basing education transfers purely on
enrollments favors states that already have
education infrastructure and teachers,
penalizing those that do not. Basing health
transfers purely on hospital beds similarly
supports better-off states that have the
resources to build more hospitals.