A two-day policy seminar was held in Nairobi to deliberate the Service Delivery Indicators (SDI) project, part of a large-scale research project conducted by AERC in partnership with the World Bank.
Dubbed the Institutions and Service Delivery project, it started in the mid-2000s and later incorporated the William and Flora Hewlett Foundation and the African Development Bank (AfDB). The project was initiated to review the quality of service delivery in primary education and basic health services and provide measures for benchmarking service delivery performance in Africa.
The SDIs examine the efforts (what providers do) and abilities (what providers know) of health providers and educators and the education and health facilities’ resources that contribute to a functioning school or health facility. In education, providers’ ability is measured by teachers’ minimum knowledge to master the curriculum and quality of instruction they offer while in health, it is measured by health workers’ diagnostic accuracy, adherence to clinical guidelines and management of maternal/neonatal complications.
Providers’ effort in education is measured in terms of teachers’ absence from school, absence from classroom and time they spend teaching while in health, it is measured in terms of health workers’ absence from facility and caseload per provider. Finally, inputs in schools are measured by assessing availability of teaching equipment, infrastructure, student-teacher ratio and students per textbook while in health facilities, it is measured by availability of equipment, drugs and infrastructure.
In the three countries of focus, namely Kenya, Nigeria and Tanzania, the key findings from the surveys were:
· there was fairly high absenteeism rates both in schools and health facilities across countries;
· there were low rates of correct diagnosis by public health providers of at least 4 out of 5 very common conditions – suggesting either existence of knowledge gaps or failure to adhere to professional guidelines (or both); and
· a significant proportion of primary school teachers do not exhibit mastery of the curriculum they teach.
Since the launch of the SDI country reports, further research has been undertaken by AERC, with support from the World Bank, to better understand and exploit this rich data set in order to inform policy making in Africa. The research in question has focused on understanding service delivery in health and education in three countries, names, Kenya, Tanzania and Nigeria.
The seminars also involved media and civil society organizations in Kenya, Tanzania and Nigeria. With increased discussions and use of SDIs, it is expected that findings of SDIs will become integrated into education and health policymaking processes for improved service delivery, performance and accountability in the two countries.