Improving Basic Services for the Bottom Forty Percent: Lessons from Ethiopia

Improving Basic Services for the Bottom Forty Percent: Lessons from Ethiopia


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Improving Basic Services for the Bottom Forty Percent: Lessons from Ethiopia by World Bank, Jean-Paul Faguet, Christopher Gaukler, Wendmsyamregne Mekasha

Ethiopia's model for delivering basic services appears to be succeeding and to confirm that services improve when service providers are more accountable to citizens. As discussed in the World Development Report 2004, accountability for delivering basic services can take an indirect, long route, in which citizens influence service providers through government, or a more direct, short route between service providers and citizens. When the long, indirect route of accountability is ineffective, service delivery can suffer, especially among poor or marginalized citizens who find it challenging to express their views to policymakers. In Ethiopia, the indirect route of accountability works well precisely because of decentralization. Service providers are strictly accountable to local governments for producing results, but in turn, the local authorities are held accountable by the regional and federal governments. A degree of local competition for power and influence helps to induce local authorities and service provides to remain open to feedback from citizens and take responsibility for results. The direct route of accountability has been reinforced by measures to strengthen financial transparency and accountability (educating citizens on local budgets and publicly providing information on budgets and service delivery goals), social accountability (improving citizens' opportunities to provide feedback directly to local administrators and service providers), and impartial procedures to redress grievances.Woreda-level (district) spending has been a very effective strategy for Ethiopia to attain its Millennium Development Goals (MDGs). Woreda health and education goes to pay for health extension workers (HEWs) and teachers. This study finds evidence that woreda-level spending in health and education is effective. Owing to the intervention of HEWs, the use of health services has increased, especially among the poorest quintiles. Finally, the effect of woreda-level spending on agricultural extension workers is associated with higher yields for major crops. Spending on agricultural extension workers increases the probability that farmers, regardless of the size of their plots, will use improved farming techniques. Education, health, and agriculture account for 97 percent of woreda spending. This is complemented by support for capacity building and citizen voice. Clearly, spending efficiency is improved through better capacity, more transparency, and greater accountability to citizens.

Product Details

ISBN-13: 9781464803314
Publisher: Bernan Distribution
Publication date: 07/31/2014
Series: World Bank Studies
Pages: 108
Product dimensions: 6.90(w) x 9.90(h) x 0.50(d)

Table of Contents

Foreword xi

Acknowledgments xiii

About the Authors xv

Executive Summary xvii

Abbreviations xxiii

Introduction and Background 1

Context and Structure of This Book 3

The Promoting Basic Services Program 3

Notes 8

Chapter 1 Conceptual Framework and Methodology 9

Notes 13

Chapter 2 Citizen Direct Voice and Accountability 15

Decentralization and the Quality and Appropriateness of Local Services 16

Financial Transparency and Accountability 17

Social Accountability 18

Grievance Redress Mechanisms 18

Notes 19

Chapter 3 Effectiveness of Woreda Block Grant Spending on Education, Health, and Agriculture 21

A Positive Association between Woreda Block Spending and Results in Education 21

A Positive Association between Woreda Block Grant Spending and Results in Health 22

A Positive Association between Woreda Block Grant Spending and Results in Agriculture 25

Notes 28

Chapter 4 How Equitable Is Decentralized Spending at the Woreda Level? 29

Woreda Block Grant Spending on Health Improves Outcomes, Especially for the Rural Poor 29

Incidence Analysis of Woreda Block Grant Spending on Health and Education 32

Catalytic Effect of Spending on Extension Services by Plot Size 33

Gender Equity Analysis for Woreda Block Grant Spending 33

Notes 35

Chapter 5 The Federal System's Role in Helping Lagging Areas and Groups 37

Regionally Disaggregated Analysis of Woreda Block Grant Spending 37

Ethnically Disaggregated Analysis of Woreda Block Grant Spending 39

Notes 41

Conclusions and Recommendations 43

Appendix A Detailed Methodology and Data Sources 45

Appendix B Financial Transparency and Social Accountability under the PBS Program 53

Appendix C The Center and the Periphery in Ethiopia: The, Evolution of Today's Federal State 55

Appendix D Detailed Regression Results 59

Bibliography 105


1.1 The Indirect Route of Accountability Through Policy Makers to Service Providers 5

1.1 Some Caveats on Interpreting the Results of This Study 10

2.1 The Direct Route of Accountability-Citizen Direct Voice and Accountability Models in Ethiopia 15

3.1 Ethiopia's Health Extension Program and Health Extension Workers 22

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