The quality of services delivered is an important determinant of people’s well-being for a given bundle of resources. Resources are critical to the delivery of services to clients. But resources are just only one, and sometimes a small component, of the performance factors that impact on the quality of service provision. Recent evidence shows that even when resources are allocated for provision of services, a large portion of the resources might not reach the intended clients. In some cases, services may not even be provided because frontline providers do not show up to work, resulting in poor delivery of services. The implication is that availability of resources does not guarantee that intended beneficiaries do in fact receive the benefits from the resources allocated.
This explains the often observed result of weak relationship between for example health expenditures and health outcomes in developing countries. In fact there are cases for which increased expenditures have been associated with decrease in health and other indicators of well-being. Such outcomes reflect weaknesses in the internal efficiency of the delivery mechanisms. Simply, budgetary allocation for a particular service may be only weakly related to what is delivered to clients.
The quality of service delivery is dependent on resource constraints--both financial and human. Provision of services requires tangible financial resources, and, given that many developing countries face severe resource constraints, quality of provision is likely to be poorer in these countries relative to more economically advanced countries. This is because the technology of delivery and the quality of service infrastructure is likely to vary across countries with different levels of income. Likewise, human resources in terms of knowhow and organizational capacity are an important determinant of service delivery. To the extent that these resources are relatively scarce in poor countries, then service delivery can also be expected to be considerably poorer.
While both human and financial resources are crucial determinants of service delivery, availability of resources does not guarantee efficient delivery. Institutions and institutional arrangements appear to be very important determinants of service delivery. The quality of institutions for service delivery can, therefore, be evaluated on the degree to which they promote accountability within the service delivery chain. Thus, linking institutions to service delivery requires a clear understanding of the factors that impact on service delivery and how those factors vary across institutions.
The chapters in this volume analyze Institutions and Service Delivery (ISD) in Africa. The book, after presenting the process of accountability in the provision of social services, provides a methodological framework, tools and techniques for studying / assessing institutions and service delivery. It also provides insights from past literature and initiatives institutions and service delivery reforms. The book is an outcome of the Collaborative research Project on “Institutions and Service Delivery in Africa”.
This book is available on the major bookshops near you.