Category Archives for public services

High-Frequency Data Using Mobile Phones: Incentives and Accountability

Great research note  [PDF] by Croke et al. (2012). Here’s the abstract:

As mobile phone ownership rates have risen dramatically in Africa, there has been increased interest in using mobile telephones as a data collection platform. This note draws on two largely successful pilot projects in Tanzania and South Sudan that used mobile phones for high-frequency data collection. Data were collected on a wide range of topics and in a manner that was cost-effective, flexible, and rapid. Once households were included in the survey, they tended to stick with it: respondent fatigue has not been a major issue. While attrition and nonresponse have been challenges in the Tanzania survey, these were due to design flaws in that particular survey, challenges that can be avoided in future similar projects. Ensuring use of the data to demand better service delivery and policy decisions turned out to be as challenging as collecting the high-quality data. Experiences in Tanzania suggest that good data can be translated into public accountability, but also demonstrate that just putting data out in the public domain is not enough. This note discusses lessons learned and offers suggestions for future applications of mobile phone surveys in developing countries, such as those planned for the World Bank’s “Listening to Africa” initiative.

Of particular interest to me is the fact that part of the design used financial incentives as a means to reduce nonresponse and attrition rates. In the technology and development world there has been lots of talk about “incentives to participate”, where the practical shortcut is often the provision of financial incentives. In Tanzania, for instance, the authors report that “respondents who successfully completed an interview were rewarded with an amount varying from $2 to $4″, not a negligible sum in the Tanzanian context.

Interestingly, in the working paper [PDF] from which this note is drawn, a footnote sheds some light on how effective these rewards were:

Remarkably in both Sudan and Tanzania the amount of the reward did not have a discernable impact on response rates.

But these findings are not as surprising as they may seem. Indeed, there is a good deal of evidence from behavioural economics pointing out that financial incentives might not work as well as traditional economics (and economists) would predict.

And a noteworthy excerpt on the limits of transparency and the role of existing institutions and actors:

One lesson is that  providing citizens with relevant, timely, and accurate data  about the actions of politicians, policy makers, and public service providers is not sufficient. For the data to have impact, they need to be accessible and disseminated widely, and in ways that allow them to be utilized by already existing institutions and actors.

This is an interesting point, although I am not sure to what extent existing institutions are enough. In the field of technology and governance, I believe that it has become quite clear that very little is achieved when technological solutions are not coupled with institutional innovations.

But that’s another story. In any case, a great read, and the type of effort that is badly needed in this space.

Local Environment and Monitoring of Public Health Service Delivery

picture by Dave Proffer on flickr

 

When is Community-Based Monitoring Effective? Evidence from a Randomized Experiment in Primary Health in Uganda 

By Martina Bjorkman and Jakob Svensson (2012)

Excerpts:

Access to quality services has been recognized as fundamental for wellbeing and economic development. However, in Africa and other developing countries, service delivery is often poor or nonexistent. Many argue that government bureaucracies may be ill equipped and lack incentives to improve the quality of public services. In response, development practitioners have started to experiment with involving beneficiaries in monitoring public service delivery and making service providers accountable to users. How best to design such interventions, and the impact of them, have been addressed in a handful of recent randomized field experiments. The results, to date, are mixed. While Banerjee et al. (2008) and Olken (2007) report minor or no effects on learning outcomes (in a project in primary education in India) and on corruption (in a road construction project in Indonesia), Bjorkman and Svensson (2009) and Duflo et al. (2009) report large positive improvements on average in a primary health intervention in Uganda and a primary schooling intervention in Kenya, respectively. What can explain these diverging findings? And more specifically, to what extent does the local sociopolitical environment influence users ability and willingness to monitor public service providers?

Using data from Bjorkman and Svensson (2009), linked to recently assembled data on ethnic and linguistic composition at the sub-national level for Uganda (Alesina and Zhuravskaya, 2008), and income data from the Uganda National Household Survey 2005 (UNHS, 2005), we test whether social heterogeneity, in income and ethnicity, can explain why some communities managed to push for better health service delivery while others were less successful. The results suggest that income inequality and, particularly, ethnic fractionalization adversely impact collective action for improved service provision.

***

As policymakers in developing countries search for ways to improve health and education for the poor, it is becoming clear that more is required than just additional funds. A key obstacle to better public services looks to be the weak incentives that providers face. Schools and health clinics are not open when they should be. Teachers and health workers are frequently absent from schools and clinics, and even when there, they spend significant time not serving the intended beneficiaries. Equipment, even when working, is not used. Drugs are misused, and public funds are expropriated. In response, a growing number of experts argue that more emphasis must be placed on strengthening beneficiary control that is, strengthening providers’ accountability to citizens/clients.

While there is evidence that such an approach can have large positive effects on service provision, there is also evidence of signiÖcant variation in outcomes. Using data from a randomized experiment in Uganda, we show that social heterogeneity, and specifically ethnic fractionalization, adversely impact collective action for improved service provision. As a result, the intervention resulted in a smaller increase in the quantity of primary health care provision in heterogeneous communities.

Our results have implications for both the design and evaluation of interventions aimed at strengthening beneficiary control in public service delivery programs. On program design, interventions should be adjusted to the local sociopolitical situation. As little is known about how this is to be done, our results open up an important agenda for research: How to enhance collective action in socially heterogeneous communities. On evaluation, ideally the researchers should design the evaluation protocol so as to be able to assess the impact conditional on the sociopolitical environments.

Read full study here [PDF].