Inter Press Service - September 21, 2003
Julio Godoy

"The world as a unit will probably halve the proportion of people living on less than one dollar per day due to the remarkable economic growth of India and the People's Republic of China," Shantayanan Devarajan, chief economist behind the World Bank's Human Development Report released Sunday told IPS in an interview in Paris. "But in other large parts of the world, as in Africa, and in several Latin American and Asian countries, this goal will hardly be reached."

Devarajan was in Paris last week to release the World Bank's World Development Report 2004. The report, officially presented this Sunday in Dubai at the general assembly of the World Bank, analyses the quality, quantity and efficiency of basic services such as education, healthcare, sanitation, running water, and electricity.

"Too often, basic services fail poor people," says the report, titled 'Making Services Work for Poor People'. "Freedom from illness, and freedom from illiteracy, two of the most important ways poor people can escape poverty, remain elusive."

The Millennium Development Goals agreed by the United Nations General Assembly in 1992 call for eradication of extreme poverty, hunger and child illiteracy, and for reduction of child mortality. They call for fighting gender inequality, for promoting girls' education, and the empowerment of women.

Other goals of the Millennium Development Agenda are improving maternal health by reducing maternal mortality by three quarters, reversing the spread of HIV and AIDS, ensuring environmental sustainability, raising official development assistance, and expanding access to world markets for the products of the poorest countries.

"Due to the failure to provide good basic services, the world is far from hitting the right path towards achieving universal primary education, towards eliminating the obstacles girls continue to face in education, and towards reducing child mortality," Devarajan says.

The World Bank did, however, find that "strong examples of good services, which prove that governments and citizens can do better than they have so far," Devarajan says.

Successful health, sanitation, and educational services have the empowerment of people in common, he says. "Whenever the clients of basic services, poor people that is, can influence service providers, and thus influence the services, they work better."

Devarajan cites a programme in Bangladesh for primary education of girls where bank accounts were opened in the girls' own name to allow them to manage their funds.

In addition, non-governmental organisations offered financial support to schools. The measures led to an improvement of services, such as enrolment of female teachers, and the construction of separate latrines for girls. "As a result, the rate of literacy has improved," Devarajan said.

The World Bank report underlines the importance of community-based services as provided in Cuba. "Even if the country has been experiencing a severe economic crisis for more than a decade, Cuba has been able to maintain lower levels of infant mortality than many industrial countries," Devarajan says.

The reason is the "sustained focus the Cuban political leadership has placed in health for more than 40 years now," he says. "The Cuban government sees the good of the people as a key performance indicator by itself."

To meet this commitment, the Cuban government has established a system of clinics, staffed by several specialists and nurses, Devarajan says. Additionally, the Cuban government has created a community health programme, with specialists looking after patients at clinics as well as at home, school or work.

The level of investment in a service is no guarantee that the service is working for poor people, Devarajan says. "Take the case of Senegal," he says. "Although it has been a peaceful, democratic country practically since independence 40 years ago, and has a fairly good system of superior education, its rate of primary school completion is only 40 percent of the child population. That is roughly equal to that of Congo Zaire, a country mired by dictatorship and extremely violent wars, and which practically has no public administration."

In such cases, the role of non-governmental organisations can be central in taking the place of state agencies in running basic services, Devarajan says.

The World Development Report 2004 places empowerment of people and their proximity to service providers at the centre of an analytical model that identifies how services are working towards meeting the Millennium goals.

This model, called the 'framework of accountability relationships' between poor people, policy makers and politicians, and service providers, indicates that clients of services often have little clout with politicians, and "that is why public services often become the currency of political patronage and clientelism."

A direct relationship between poor people and providers means that clients can help tailor the service to their needs, the report says. Also, clients can be effective monitors of providers, since they are at the point where services are delivered.

As a corollary of this analysis, the question whether a service is run by the government or by a private provider is no longer relevant, Devarajan says. "We have found that while there are frequent problems with public-run services, it would be wrong to conclude that government should give up and leave everything to the private sector," he says. "Experience shows that sometimes privatisation worsens the quality and efficiency of services." (END/IPS/WD/EU/ DV/JG/SS/03)

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