Framework Session: Improving the delivery of services

Framework session “Improving the Delivery of Services”

The framework session focused on four key questions, namely: (1) How can governments improve the systematic recruitment of public servants? (2) How can governments improve and incentivise the performance of public servants? (3) Are there ways to harness private monitoring efforts to improve public services? and (4) How can governments use private firms to spur service delivery?

The Session was chaired by Dr Richard Newfarmer and presentations were made by Professor Oriana Bandiera, Professor Andrew Zeitlin, Dr Rachel Glennerster, Mr Serge Kamuhinda and Mr. Chanchal Kumar.

The framework presentation was given by Professor Oriana Bandiera. She started by noting the importance of public sector for the provision of inputs to economic growth, including human capital (health and education), physical capital (infrastructure, transport), property rights and contract enforcement. She then discussed the available evidence on incentives effects on service delivery and whether such rewards improve performance. There are many successful examples of good performance resulting from measures that tie rewards to performance. At the same time, she continued, there are also examples of when such rewards create perverse incentives, namely (a) spurious improvements in performance measures that are not supported by actual improvements in performance; (b) improvements on measured dimensions produced at the expense of other measures and (c) crowding out of other sources of motivation or incentives.

Professor Bandiera then presented her study (co-authored) on how career incentives impact selection / recruitment of community health workers (CHW), as well as their performance during service. They collaborated with the Government of Zambia to experimentally vary the salience of career vs. social benefits to newly created health worker positions when recruiting agents nationally. The results showed that highlighting salient career incentives attracted more qualified applicants with strong career ambitions, without displacing pro-social preferences. Career incentives, far from selecting the “wrong” types, attract talented workers who delivered health services effectively.

Second speaker, Dr. Rachel Glennerster spoke about “Learning from research to improve health delivery: The case of Sierra Leone” – some of the important learning’s she highlighted were (a) incentivising demand for health services is cheaper than building more clinics; (b) provider accountability programming have failed to mitigate absenteeism; (c) hiring less-qualified staff to provide prevention technologies is an Intuitive idea, but still lacks evidentiary support; (d) recruiting the right people is more important than monitoring; and (e) community report cards can monitor disbursed health workers and improve health.

Professor Andrew Zeitlin then presented his study “Improving Services Delivery: An Assessment of Absenteeism Data”. The study found firstly that local monitoring improves teacher attendance, but only when the head teacher is responsible for monitoring and there are financial incentives for teachers at stake. Under this scheme, teacher presence is 11 percentage points higher than in the control group. Importantly, this design is also the most cost-effective since bonus payments were no larger than when parents were responsible for monitoring and secondly, although monitors report frequently, they understate teacher absenteeism. Head teachers report an average of 2.5 times per week and parents, encouraged to select a single reporting day, report on average once per week. Understatement of teacher absenteeism is substantial across all four schemes: the actual presence rate, as measured by independent surprise visits, is 14 percentage points lower than the reported presence rate. Parents generate significantly less reliable reports than head teachers. There is no evidence that reporting is less reliable when bonuses are paid. Further tests suggest that report quality is wanting because all monitors have a tendency to falsely report absent teachers as present. This is exacerbated under parent-led schemes, because parents opt to report on days when more teachers are present. Stricter reporting protocols under head-teacher-led schemes discourage head teachers from doing the same.

Mr Serge Kamuhinda and Mr. Chanchal Kumar spoke about the experiences from their own countries at the end of the session.

Summary written by Vikas Dimble, Country Economist – IGC, India Central