Public Expenditure Public Expenditure TrackingTracking

andandService Delivery SurveysService Delivery Surveys

Qualidade do Gasto Publico no BrasilQualidade do Gasto Publico no BrasilJune 26-27, 2003June 26-27, 2003

Ritva ReinikkaRitva ReinikkaDevelopment Research Group, The World BankDevelopment Research Group, The World Bank

Public Expenditure Public Expenditure Tracking and Service Tracking and Service

Delivery SurveysDelivery Surveys First Public Expenditure First Public Expenditure Tracking Survey (PETS) Tracking Survey (PETS) carried out in Uganda in carried out in Uganda in 19961996

Since then, a large Since then, a large number of PETS and number of PETS and related surveys have been related surveys have been implementedimplemented

Scope and nature of Scope and nature of surveys are differed, but surveys are differed, but common theme is link common theme is link between public spending between public spending and outputs and/or and outputs and/or development outcomesdevelopment outcomes

Surveys to dateSurveys to dateCompletCompleteded

HondurasHondurasPeruPeruAlbaniaAlbaniaUganda Uganda (5)(5)Tanzania Tanzania (2)(2)GhanaGhanaRwandaRwandaMozambiqMozambiqueueZambiaZambiaPNGPNGBangladesBangladeshhand and more…more…

OngoinOngoingg

BrazilBrazilEcuadorEcuadorLaosLaosIndiaIndiaIndonesiIndonesiaaEthiopiaEthiopiaNigeriaNigeria

Benefi

ts

Govern

ment

From policies and spending to benefits

Outcomes

We generally believe We generally believe that providing that providing financing and financing and

flexibility to countries flexibility to countries with well-designed with well-designed

policiespolicies allows us to allows us to leverage good leverage good

outcomes.outcomes.

Indi

vidu

als

Government

Providers

Loca

l Gov

.Ben

efits

• Policy• Information/M&E• Capacity• Institutional Incentives• Household Behaviors• Financing

Leakage of Funds

PolicyInstitutional Incentives

Sub-optimal spending:High teacher salaries; Insufficient supply of textbooks

FinancingCapacityInformation & TransparencyInstitutional Incentives

Low quality instructionCapacity & IncentivesCurriculum & Technology

Lack of demandFinancingHousehold BehaviorsCommunity Norms

Breakdowns on the way to achieving outcomes are due to gaps in…

Outcomes

CORRUPTION

The (missing) link between The (missing) link between public spending and public spending and

outcomesoutcomesBroad allocation of resources

Problems in budget execution

Problems in service delivery

Lack of demand for services

Delays and lack of predictability (e.g. salaries, medicine stock-outs)

Discretionary reallocation of resources (favoritism, lack of criteria or information, etc.)

Leakage of financial or material resources

Misappropriation of resources (e.g. theft of medicines)

Absenteeism

Overcharging

Inefficiency, high cost, low quality

PU

BL

IC E

XP

EN

DIT

UR

E

TR

AC

KIN

G A

ND

SE

RV

ICE

D

EL

IVE

RY

SU

RV

EY

S

World Development Report World Development Report 20042004

Framework for service Framework for service deliverydelivery

Policymaker

Client Provider

The Survey ApproachThe Survey Approach Approach has varied considerably depending on Approach has varied considerably depending on

context and focuscontext and focus Multilevel focus, but frontline providers (schools Multilevel focus, but frontline providers (schools

or health facilities) as main unit of observationor health facilities) as main unit of observation Representative sampleRepresentative sample Data collected through interviews Data collected through interviews and and record record

reviews (financial records, stock cards for reviews (financial records, stock cards for medicines, etc.)medicines, etc.)

Multi-angular approach for validation of dataMulti-angular approach for validation of data Some surveys include detailed surveys of Some surveys include detailed surveys of

frontline provider, including frontline provider, including availability/adequacy of inputs, quality, staff and availability/adequacy of inputs, quality, staff and user interviews, etc.user interviews, etc.

What have we learnt? What have we learnt? LeakageLeakage

Education sector in Uganda 1996Education sector in Uganda 1996 Data from 250 schools and administrative Data from 250 schools and administrative

unitsunits Only 13 percent of intended capitation Only 13 percent of intended capitation

grant actually reached schools (1991-95).grant actually reached schools (1991-95). Mass information campaign by Ministry of Mass information campaign by Ministry of

Finance (the press, posters)Finance (the press, posters) Follow-up PETS to evaluate impact of the Follow-up PETS to evaluate impact of the

information campaign:information campaign: 2/3 of reduction in leakage thanks to the 2/3 of reduction in leakage thanks to the

campaigncampaign In schools with newspapers leakage 12 In schools with newspapers leakage 12

percentage points lower than in schools withoutpercentage points lower than in schools without High leakage has also been found in High leakage has also been found in

other countries (Tanzania, Ghana, other countries (Tanzania, Ghana, Zambia, Peru)Zambia, Peru)

Leakage of non-wage capitation grant to schools

0%

20%

40%

60%

80%

100%

1991-1995 2001

What have we learnt? What have we learnt? Ghost workers and absenteeismGhost workers and absenteeism

Salary payments “leak” Salary payments “leak” differentlydifferently

Different measurement Different measurement approaches:approaches: PETS with data collection PETS with data collection

on payroll and staffing on payroll and staffing data (Honduras 2000, data (Honduras 2000, Peru 2002, Zambia 2002, Peru 2002, Zambia 2002, Mozambique 2002, etc.)Mozambique 2002, etc.)

Unannounced visits to Unannounced visits to schools and health schools and health facilities (absenteeism)facilities (absenteeism)

  Health Education

Ghost workers

Honduras 5.0% 8.3%

Absenteeism

Ecuador - 16.0%

Honduras 27.0% 14.0%

Peru 26.0% 13.0%

India 43.0% 23.0%

Uganda 35.0% 26.0%

0

1000

2000

3000

4000

0 1000 2000 3000 4000

Outpatients - facility data

Outp

atie

nts

- dis

tric

t dat

a

C a n w e t r u s t a d m i n i s t r a t i v e r e c o r d s ?Q S D S U g a n d a

What have we learnt? What have we learnt? Allocation and budget executionAllocation and budget execution

Leakage sometimes difficult to assess due to lack Leakage sometimes difficult to assess due to lack of explicit allocations or entitlementsof explicit allocations or entitlements

But surveys can shed light on other important But surveys can shed light on other important allocation and budget execution issuesallocation and budget execution issues

Primary health care in Mozambique:Primary health care in Mozambique: Very large variation across districts and facilities in Very large variation across districts and facilities in

non-wage recurrent spending, staffing, and distribution non-wage recurrent spending, staffing, and distribution of medicinesof medicines

Severe problems in budget execution, with late first Severe problems in budget execution, with late first transfers and slow processing of accounts, resulting in transfers and slow processing of accounts, resulting in low predictabilitylow predictability

Weak record keeping at provincial, district, and facility Weak record keeping at provincial, district, and facility levels, often with large discrepancies between levelslevels, often with large discrepancies between levels

The strengths of the The strengths of the approachapproach

Useful tool for diagnosing and understanding problems Useful tool for diagnosing and understanding problems in budget execution and service delivery, including in budget execution and service delivery, including corruptioncorruption Multilevel perspective important and not achieved from simple Multilevel perspective important and not achieved from simple

school or facility surveysschool or facility surveys District and frontline provider perspective often forgotten at District and frontline provider perspective often forgotten at

central levelcentral level Representative sample provides credibility not achieved Representative sample provides credibility not achieved

through small-sample studies or institutional reviewsthrough small-sample studies or institutional reviews Validation of administrative data (financial and output)Validation of administrative data (financial and output) Can provide basis for monitoring of changes over timeCan provide basis for monitoring of changes over time Surveys provide data for research that can improve our Surveys provide data for research that can improve our

understanding of the determinants of corruption or understanding of the determinants of corruption or poor service deliverypoor service delivery

Process of designing and implementing survey is useful Process of designing and implementing survey is useful for understanding institutional and procedural for understanding institutional and procedural arrangements for budget execution and service deliveryarrangements for budget execution and service delivery

Survey Design: Surveying Survey Design: Surveying what? Why?what? Why?

What are the problems? Are there important What are the problems? Are there important gaps in our understanding of the nature, gaps in our understanding of the nature, extent, and source of problems?extent, and source of problems?

Is a survey the appropriate tool? Stand-alone Is a survey the appropriate tool? Stand-alone or as a complement? Worth the cost?or as a complement? Worth the cost?

Is it feasible? How is the budget structured Is it feasible? How is the budget structured and implemented?and implemented?

Who is the audience and is there a likely Who is the audience and is there a likely impact? Is there a political demand?impact? Is there a political demand?

Will the information be used? By whom?Will the information be used? By whom?

Implementation issues: Implementation issues: Who? How?Who? How?

Requires skills like any other micro surveyRequires skills like any other micro survey Steps in implementationSteps in implementation

ConceptConceptBuy-in across the boardBuy-in across the boardQuestionnaire designQuestionnaire designIdentify (and contract) implementing agencyIdentify (and contract) implementing agencyPilotPilotEnumerator trainingEnumerator trainingField work (including quality control and data Field work (including quality control and data entry)entry)Analysis and disseminationAnalysis and dissemination

Some limitationsSome limitations Surveys only provide part of the answerSurveys only provide part of the answer

What about inter- and intra-sectoral allocations? What about inter- and intra-sectoral allocations? Link with outcomes?Link with outcomes? => Budget analysis and social impact analysis (with household => Budget analysis and social impact analysis (with household

data or through participatory approaches) are still importantdata or through participatory approaches) are still important Surveys should supplement rather than supplant Surveys should supplement rather than supplant

routine information, control, and integrity systemsroutine information, control, and integrity systems Surveys provide information but don’t necessarily Surveys provide information but don’t necessarily

result in changeresult in change A lack of information about the scope and nature of problems is A lack of information about the scope and nature of problems is

not always the primary constraint to improving PEM and not always the primary constraint to improving PEM and service deliveryservice delivery

Continuity and link with efforts at strengthening institutions Continuity and link with efforts at strengthening institutions and routine PEM systems importantand routine PEM systems important

Link with community and other local stakeholders can be Link with community and other local stakeholders can be difficult to achieve – important to use findings to strengthen difficult to achieve – important to use findings to strengthen local transparency and accountability mechanismslocal transparency and accountability mechanisms

Finding out more…Finding out more… Survey reports, instruments, and documentation Survey reports, instruments, and documentation

on: on: www.www.publicspendingpublicspending.org.org http://www1.worldbank.org/publicsector/pe/trackingsurveyshttp://www1.worldbank.org/publicsector/pe/trackingsurveys

.htm.htm Some references:Some references:

Dehn, Reinikka, and Svensson. 2003. “Survey Tools for Dehn, Reinikka, and Svensson. 2003. “Survey Tools for Assessing Performance in Service Delivery.” In Bourguignon Assessing Performance in Service Delivery.” In Bourguignon and Pereira da Silva, eds. and Pereira da Silva, eds. Evaluating the Poverty and Evaluating the Poverty and Distributional Impact of Economic Policies. Distributional Impact of Economic Policies. Oxford University Oxford University Press and the World Bank. ForthcomingPress and the World Bank. Forthcoming

Reinikka and Svensson. 2002. Measuring and understanding Reinikka and Svensson. 2002. Measuring and understanding corruption at the micro level. In Della Porta and Rose-corruption at the micro level. In Della Porta and Rose-Ackerman, eds. Ackerman, eds. Corrupt Exchanges: Empirical Themes in the Corrupt Exchanges: Empirical Themes in the Politics and Political Economy of Corruption. Politics and Political Economy of Corruption. Nomos Nomos Verlagsgesellshaft.Verlagsgesellshaft.

Lindelow and Wagstaff. 2002. “Health Facility Surveys: An Lindelow and Wagstaff. 2002. “Health Facility Surveys: An Introduction.” Policy Research Working Paper 2953. Introduction.” Policy Research Working Paper 2953. Development Research Group, World Bank., Washington, D.C.Development Research Group, World Bank., Washington, D.C.

Email: Email: rreinikkarreinikka@worldbank.org@worldbank.org