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Public Expenditure Tracking and Service Delivery Surveys

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					Public Expenditure Tracking &
   Service Delivery Surveys

     The 2003 ICGFM-WBI Workshop
                  Washington, DC
                  November, 2003

              Magnus Lindelow
       Development Research Group, The World Bank
         The presentation
1.   Why new tools for public expenditure
     analysis?
2.   What are Public Expenditure Tracking
     Surveys (PETS)?
3.   Examples (Uganda, Mozambique, and
     more)
4.   Strengths and limitations of PETS
     Why new tools to analyze public
     spending and service delivery?
   Limited impact of public spending and external aid on
    growth and human development (WDR 2004)
       Inappropriate allocation of resources
       Resources do not reach service delivery units
       Poor quality of service delivery
       Services are not used by the population
   New approaches to aid delivery (budget support,
    PRSCs, etc) => fiduciary and accountability concerns
       Are budget allocations pro-poor?
       Are budget outturns consistent with allocations?
       Do expenditures result in intended outputs and outcomes?
   Lack of reliable data in many developing countries
     Public Expenditure Tracking and
         Service Delivery Surveys
   First Public Expenditure             Surveys to date
    Tracking Survey (PETS)          Completed      Ongoing
    carried out in Uganda in 1996   Uganda (3)     Ethiopia
   Since then, a large number of   Tanzania (2)   Nigeria
    PETS and related surveys        Ghana          Brazil
                                    Rwanda         Laos
    have been implemented           Mozambique
   Scope and nature of surveys     Zambia
                                    PNG
    have differed, but common       Honduras
    theme is link between public    Peru
    spending and development        Bangladesh
    outcomes                        and more…
                      The Approach
   Approach has varied considerably depending on context and focus

   Multilevel focus, but frontline providers (schools or health
    facilities) as main unit of observation
   Multi-angular approach for validation of data
   Representative sample
   Data collected through interviews and record reviews
   Some surveys include detailed surveys of frontline
    provider, including availability/adequacy of inputs, quality,
    staff and user interviews, etc.
    What a PETS can and cannot do
Resource flow                               Issues that PETS can address
   Money        Central
   Drugs                                    - Outturn consistent with
 Equipment                                  allocation (leakage?)
Schoolbooks
                                            - Consistency of records between
    etc.
                Province                    different levels (leakage?)
                             “Paper
                              trail”      - Actual allocation of resources
                                          across districts and facilities
                           Budget records (equity and efficiency?)
                District
Fee revenues                Stock cards
                              Payrolls      - Delays in financial transfers or
                            Student lists   distribution of material
                                etc.
                School /
                Facility
                                            Issues that PETS can’t address
                                            “Cooked” books
                Services
        Uganda Education PETS (1995)
                                                           Leakage of non-wage
   Education sector                                     capitation grant to schools

   Data from 250 schools and administrative units    100%
   Only 13 percent of capitation grant entitlement
                                                      80%
    actually reached schools (1991-95).
   Mass information campaign by Ministry of          60%

    Finance (the press, posters)                      40%
   Follow-up surveys (PETS, provider surveys,
                                                      20%
    integrity surveys, etc.)
                                                       0%
                                                              1991-1995        2001
   High leakage has also been found in other
    countries (Tanzania, Ghana, Zambia, Peru)
Mozambique Health ETSDS (2002)
   No budget allocations to individual primary
    health facilities => focus on:
     Consistency of records between different levels
     Equity and efficiency in allocation of resources

     Timeliness of resource transfers

     Perceptions of staff and users

   Sampled 90 health facilities in 35 districts
    nationwide
    Mozambique ETSDS findings
   Weak record keeping and “leakage”
       District-level financial records for recurrent budget
        inconsistent with province-level records for 75% of districts,
        but no systematic pattern
       Discrepancies in drug records and some evidence of leakage
       Inconsistent HR records (provincial admin., district admin,
        facilities)
       Facility reporting of user fee revenues approx. 70% of
        expected amounts
   Considerable inequities in allocation of resources
    (recurrent budget, drugs, HR, etc) across districts and
    facilities
Inequality in drug distribution (Moz.)
                         Min      Mean    Max

     Number of tablets per outpatient
                                    4.6
     Aspirina              1.1            16.8
                                    4.1
     Cloroquina            1.2            12.9
                                    2.7
     Cotrimoxazol          0.0             7.8
                                    1.6
     Mebendazol            0.5             6.2
                                    0.8
     Metronidazole         0.0             3.3
                                    2.6
     Paracetamol           0.0             7.8
Delays in budget transfers (Moz.)
100%
 90%
 80%
 70%
 60%
 50%
 40%
 30%
 20%
 10%
 0%
  01-Jan        31-Jan     02-Mar      01-Apr     01-May     31-May      30-Jun      30-Jul
       Cumulative percentage of districts that have received first budget transfer (2002)
     Ghost workers and absenteeism

   Salary payments “leak”                              Health   Educ.
    differently                         Ghost workers
   Different measurement               Honduras        5.0%     8.3%
                                        Absenteeism
    approaches:
                                        Bangladesh       35%       -
       PETS with data collection
                                        Honduras         27%      14%
        on payroll and staffing data
                                        India            43%      25%
       Unannounced visits to
                                        Peru             26%      13%
        schools and health facilities
                                        Indonesia        42%      18%
                                        Ecuador           -       16%
                                        Uganda           35%      26%
    The strengths of the approach
   Useful tool for diagnosing and understanding problems
    in budget execution and service delivery
       District and frontline provider perspective often forgotten at
        central level
       Representative sample provides credibility not achieved
        through small-sample studies or institutional reviews
   Validation of administrative data (financial and output)
   Can provide basis for monitoring of changes over time
   Surveys provide data for research that can improve our
    understanding of the determinants of poor service
    delivery
   Process of designing and implementing survey is useful
    for understanding PEM and service delivery system
                    Some limitations
   Surveys only provide part of the answer
       What about inter- and intra-sectoral allocations?
       Link with outcomes?
   Surveys should supplement rather than supplant routine
    information, control, and integrity systems
   Surveys are not audits
       Enumerators do not have appropriate skills
       Too time consuming for large sample
       Focus on system-diagnostic rather than particular districts or facilities
   Surveys provide information but don’t necessarily result
    in change
       A lack of information may not be primary constraint to improving
        PEM and service delivery – findings need to be used strategically
                  Finding out more…
   Survey reports, instruments, and documentation on:
    www.publicspending.org
   http://www1.worldbank.org/publicsector/pe/trackingsurveys.h
    tm
   Some references:
       Dehn, Reinikka, and Svensson. 2003. “Survey Tools for Assessing Performance in
        Service Delivery.” In Bourguignon and Pereira da Silva, eds. Evaluating the Poverty
        and Distributional Impact of Economic Policies. Oxford University Press and the World
        Bank. Forthcoming
       Reinikka and Svensson. 2002. Measuring and understanding corruption at the
        micro level. In Della Porta and Rose-Ackerman, eds. Corrupt Exchanges: Empirical
        Themes in the Politics and Political Economy of Corruption. Nomos Verlagsgesellshaft.
       Lindelow and Wagstaff. 2002. “Health Facility Surveys: An Introduction.” Policy
        Research Working Paper 2953. The World Bank.
   Email: mlindelow@worldbank.org

				
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