Approaches to Improving the Delivery of Social Services in Difficult ...

Approaches to Improving the Delivery of Social Services in Difficult Environmentscoordinating aid efforts in certain difficult environments. There aredrawbacks to these interventions in certain contexts, for instance wherethe World Bank is seen to represent ‘external interests’ or where the UNagencies are inefficient 35 or do not have enough experience on the groundto fulfil the role of policy coordinators. Effective coordination may also beundermined by the motivations of different agencies, and the lack of ‘teeth’in coordination mechanisms to ensure that all agencies participate 36 .34. Reduce the risk of undermining the state. Where possible, even ifalternative mechanisms are used, relationships with the government andwith state structures should be maintained in order to facilitate possiblehandover back to full state oversight. Otherwise there is a danger ofcreating completely parallel structures that undermine the state’s ultimateresponsibility for service delivery. Social funds, for example have beencriticised on the grounds that they sometimes fail to build local and centralgovernment capacity and they may have poor coordination in the targetingof service delivery interventions 37 . The risk of undermining the state can bereduced by aligning donors systems with government financial systems(for example keeping expenditure ‘on budget’ and in accordance withgovernment financial cycles), by sharing a common policy framework asfar as possible, and by not unnecessarily weakening state capacity thoughdrawing away key human resources.IV.2 Building capacity of service providers35. Service providers include organisational providers (health departments,education departments, water and sanitation departments), frontlineprofessionals (doctors, nurses, teachers, engineers) and the organisationsthat support these professionals (training colleges, for example). In difficultenvironments, the capacity of providers may be weak in terms ofinfrastructure, human and financial resources, and responsiveness to thepoor.36. Build capacity of state providers: in situations where there is somewillingness and capacity, state providers should be considered as an entrypoint for strengthening service delivery. This is for two reasons. First, itcan be an effective way of building state accountability for public services,and second it is less likely to undermine an already fragile state (seecomments above). The key challenge is to work with the state to find waysto make limited human and financial resources extend the reach ofservices to the poor.37. Many countries, particularly across sub-Saharan Africa, are facing agrowing crisis of human resource capacity, which is significantly impactingon their ability to deliver vital public services. The problem is particularlystark in difficult environments where, for example, conflict may exacerbateoverall shortages of personnel, teachers and health personnel may be35 Jones, B. (2004).36 Sommers, M. (2004)37 Rawlings, L., Sherburne-Benz, L., Van Domelen, J. (2004).This working paper is intended to stimulate public discussion. It is not necessarily DFID orUK Government policy18