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

Approaches to Improving the Delivery of Social Services in Difficult Environmentshumanitarian law and seeking to get monitoring missions on the ground tohold state and non-state forces accountable for their actions.49. Reduce the costs of accessing services: one challenge for the poor indifficult environments (in common with the poor across most developingcountries) is meeting the cost of accessing services, both direct andindirect. A full review of all the possible approaches and responses isbeyond the scope of this paper, but it is worth focusing here on user fees.There are strong advocates for the removal of user fees in the health andeducation sectors, but this may not be feasible in many difficultenvironments where non-state actors are a major provider of services, andlack of government capacity makes effective regulation virtuallyimpossible. More promising may be efforts to increase the amount ofdisposable income that the poor have access to. One way to do this isthrough cash for work programmes. Other social protection 58 initiativesthat may have the potential to offer a safety net for the poor and enablethem to access services include conditional cash transfers, nutritionsupport services, and fee exemptions 59 . The latter have also been used totarget orphans and vulnerable children in countries heavily affected by HIVand AIDS and thereby assist them in accessing services, particularlyeducation. Alternatively, incentives for attendance can be built into theservices themselves. School feeding programmes, for example, have hadsome success in increasing access to school in difficult environments.58 Defined here as a range of measures that aim to prevent shocks and stresses (including long-termsevere poverty) having a harmful effect on wellbeing.59 Marcus, R. with Piron, L.H. and Slaymaker, T. (July 2004).This working paper is intended to stimulate public discussion. It is not necessarily DFID orUK Government policy24