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Public Service Delivery

Why doctors leave their posts – problem-solving irregularities in the health sector with healthcare workers in Bangladesh

Mushtaq Khan's picture

It’s not often you get together the very people working on the frontline to sit down together and discuss why and how irregular practices occur in their sector – and what can be done about them. But that’s just what we did with a group of frontline health workers at a workshop in Bangladesh’s capital Dhaka in December 2017. We wanted to understand why corrupt and irregular practices occur in the health sector - what are the underlying incentives and processes? And what are some feasible and impactful ways to change these practices?

Many developing countries, including the three where our research consortium, the Anti-Corruption Evidence research consortium is working, Bangladesh, Nigeria and Tanzania, struggle to provide free or low-cost healthcare to all their citizens. Instead, citizens are often forced to buy services from the private sector at higher fees or worse, approach untrained or traditional healers. There is agreement in the literature that a large proportion of these inefficiencies occur due to corrupt practices (though there’s an active debate about whether using the c-word is helpful in this debate, which is why we talked about ‘irregularities’ during this workshop). Many of these practices are related to the way societies in developing countries are organized around patron-client relations, where tax resources are insufficient, and resources, jobs and promotions require lobbying powerful politicians.

How can we enhance competition in bus passenger urban transport?

Shomik Mehndiratta's picture
Photo: EMBARQ Brasil/Flickr

Também disponível em português.

While bus services are often planned and coordinated by public authorities, many cities delegate day-to-day operations to private companies under a concession contract. Local government agencies usually set fares and routes; private operators, on the other hand, are responsible for hiring drivers, running services, maintaining the bus fleet, etc. Within this general framework, the specific terms and scope of the contract vary widely depending on the local context.

Bus concessions are multimillion-dollar contracts that directly affect the lives of countless passengers every day. When done right, they can foster vigorous competition between bidders, improve services, lower costs, and generate a consistent cash flow. However, too often the concessions do not deliver on their promise and there is a perception across much of Latin America that authorities have been unable to manage these processes to maximize public benefits.

As several Latin American cities are getting ready to renew their bus concessions—including major urban centers like Bogotá, Santiago de Chile, and São Paulo—now is a good time to look back on what has worked, what has not, and think about ways to improve these arrangements going forward.

Burkina Faso’s digital ambition: transforming through eGovernment and digital platforms

Samia Melhem's picture

Burkina Faso has embarked on a journey to put public data infrastructure at the heart of social and economic development. But what does this mean? And why should ICT and digital data be a priority when a large segment of your population still cannot access to the internet? This is precisely the question that the upcoming World Bank-funded eBurkina project is meant to answer.

First Burkina Faso open data e-services realized with support from the World Bank

Burkina Faso, a low-income landlocked country in West Africa, has the ambition to reform public administration differently. More specifically, the country sees ICT and digital innovation as a key opportunity to accelerate development and meet the objectives of its national development strategy (PNDES). This approach is consistent with the World Development Report 2016 on Digital Dividends, which found that, when used properly and with adequate policy interventions, ICTs can be a powerful tool for social and economic development.

Speak up, citizens of La Paz! Barrios de Verdad is listening

Zoe Elena Trohanis's picture
Also available in: Spanish
Residents in La Paz use mobile phones to practice submitting feedback to their municipal government via the Barrio Digital tool.
Residents in La Paz use mobile phones to practice submitting feedback to their municipal government
via the Barrio Digital tool. (Photo: Barrios de Verdad team)
Information and communication technology (ICT) has expanded the frontiers of connectivity and communication. Nowadays, we don’t think twice before ordering an Uber or using Open 311 to report an issue to our municipality. In the developing world, the impact has been even greater. For example, in Latin America and the Caribbean, cellphone coverage increased from about 12 subscriptions per 100 people in 2000 to over 114 in 2014, and local governments are getting creative in using this technology to reach out to and engage with their citizens.

The city of La Paz in Bolivia is piloting a new tool called Barrio Digital—or Digital Neighborhood—to communicate more effectively and efficiently with citizens living in areas that fall within Barrios de Verdad, or PBCV, an urban upgrading program that provides better services and living conditions to people in poor neighborhoods.

The goals of Barrio Digital are to:
  1. Increase citizen participation for evidence-based decision-making,
  2. Reduce the cost of submitting a claim and shorten the amount of time it takes for the municipality to respond, and
  3. Strengthen the technical skills and capacity within the municipality to use ICT tools for citizen engagement. 

Enhancing government accountability can improve service delivery in Buenos Aires

Daniel Nogueira-Budny's picture

Also available in: Español

Young students in rural areas of Argentina. Photo: Nahuel Berger / World Bank

Public schools in the Province of Buenos Aires generally provide school books and other learning materials to students free of charge. This is important, as the poorest 40 percent of Argentina’s population relies disproportionately upon public services such as education. But, what happens when schools cannot purchase books for students?
Fixed expenditures, including personnel costs, generally leave limited space for other quality-enhancing education expenditures, such as school books and training materials. Faced with an unexpected pressure on such fixed expenditures in 2013, some schools were suddenly forced to cut down significantly on teacher training materials and other educational resources generally provided free of charge. As a result, a number of parents were suddenly forced to decide between purchasing learning materials for their children’s education, or paying bills.

Weekly wire: The global forum

Roxanne Bauer's picture

World of NewsThese are some of the views and reports relevant to our readers that caught our attention this week.

This paper suggests that reform-minded public officials can improve development results by using citizen engagement in a variety of ways: to elicit information and ideas, support public service improvements, defend the public interest from ‘capture’ and clientelism, strengthen the legitimacy of the state in the eyes of citizens and bolster accountability and governance in the public sector.  Based on analysis of five case studies exploring recent citizen engagement initiatives in different parts of the world this paper posits that there are no blueprints for the design and implementation of such initiatives or standardised and replicable tools. Instead it suggests that successful and sustainable citizen engagement is ideally developed through “a process of confrontation, accommodation, trial and error in which participants discover what works and gain a sense of self-confidence and empowerment”.
The Guardian
As a reporter in the Bosnian war, in 1993 I went to Belgrade to visit Vuk Drašković, the Serb nationalist politician and writer who was then leading the mass opposition against the Slobodan Milošević regime. Drašković had drawn liberal as well as ultra-nationalist support in Serbia for his cause. As I was leaving his office, one of Drašković’s young aides pressed a folded bit of paper into my hand. It turned out to be blank except for a date: 1453 – the year Orthodox Constantinople fell to the Muslim Ottomans. Friends of mine who had worked in the former Yugoslavia during the Croatian and Bosnian wars had similar experiences in Zagreb and Sarajevo, though the dates in question were different. It seemed as if the “sores of history”, as the Irish writer Hubert Butler once called them, remained unhealed more than half a millennium later – at least in the desperate, degraded atmosphere of that time and place. And yet, while alert to the possibility that history can be abused, as it unquestionably was in the Balkans in the 1990s, most decent people still endorse George Santayana’s celebrated dictum: “Those who cannot remember the past are condemned to repeat it.” 

An office on four wheels brings land administration services to isolated populations

Victoria Stanley's picture
 State Committee on Property Issues of Azerbaijan Republic
Photo: State Committee on Property Issues of Azerbaijan Republic
I recently had the opportunity to see the mobile offices run by the State Service for the Registration of Real Estate (SSRRE) of the Republic of Azerbaijan.  These mobile offices provide the same services any citizen can receive in a physical SSRRE office, but they literally come to you.

Property registration is a very important activity in Azerbaijan which has transformed from a planned economy to a market economy over the past decade. For most citizens their property is the largest asset they own, so being able to register that property in a secure real estate registry is very important. However, there are many reasons that can prevent property owners from visiting an office, whether it be distance, old age, or disability. That’s why SSRRE decided to take the office out on the road. 

Pushing the frontier of e-government procurement in Africa with the open contracting standard

Lindsey Marchessault's picture

Public procurement is a linchpin for good governance and effective public service delivery, both of which are critical to the sustainable development of Africa. In many countries throughout the region, strengthening procurement to address weaknesses in public sector governance has become a priority. 

Innovation and collaboration for rapid results in public procurement

Sarah Lavin's picture

The World Bank’s Governance Global Practice (GGP) is integrating its approach to address technical and political constraints to effective public procurement in Cameroon.
In efforts to boost efficiency and integrity in public spending, the Government of Cameroon created the Ministry of Public Procurement (MINMAP), the first of its kind in the world, to take responsibility for providing oversight to public contract procurement and management. It is also in charge of executing high value contracts on behalf of all sector ministries and designing public procurement policies and capacity development strategies in partnership with the pre-existing public procurement regulatory body (ARMP).

What is the secret of success in social inclusion? An example from Himachal Pradesh

Soumya Kapoor Mehta's picture
We started with a standard warm-up question as Gangi Devi, our first respondent, sat in anticipation. “Tell me a little bit about your society. What is distinctive about the Himachali way of life?” A smile lined up a face creased otherwise with wrinkles. “We are a peaceful society,” she said after thinking a little. “People here are good to one another, we stand by each other.” A person sitting next to her added for good measure, “We Himachalis are very innocent people.”
For those working in the development space in India, the state of  Himachal Pradesh, a small state ensconced in the Himalayas with a population of 7 million, is an outlier for many reasons, not least of which is Gangi Devi’s near puritan response.
Gangi Devi lives near a tourist centre close to Shimla, the state capital, which has seen increasing tourist footfall in recent years. Even as her community is debating the costs and benefits of increased activity around their village, Gangi Devi and her neighbours trust that the state government would keep people’s interests in mind and address adverse impacts, if any, of increased tourism on the environment.
Their belief in the government is supported by real actions. Himachal Pradesh is the first state in India to ban the use of plastic bags. Smoking in public spaces in the city of Shimla is punishable by law.
Governance in Himachal Pradesh looks doubly impressive when considered against an enviable development record