1. 1 A relationship of accountability has five features Actors (principals) including clients, citizens, policy- makers Accountable actors (agents) including policy- makers, providers Enforcing Delegating Financing Performing Informing

2. 2 Public spending benefits the rich more than the poor -Benefit incidence analysis of public spending Money fails to reach frontline service providers -Captured by administrative layers or politicians -Public expenditure tracking surveys (PETS) Poor quality services -Quantitative Service Delivery Survey (QSDS) e.g., absenteeism Lack of demand by households How are services failing poor people?

3. 3 Policy framework Government program PRSP Sector strategies Budget allocation Outturn Timely disbursements in accordance with established policies and priorities OutputsImpactOutcomes The ideal situation…

4. 4 Policy framework Govt. program PRSP Sector strategies Budget allocation Outturn Timely disbursements in accordance with established policies and priorities Outputs Impact Outcomes PUBLIC EXPENDITURE TRACKING SURVEY (PETS) QUANTITATIVE SERVICE DELIVERY SURVEY (QSDS) A more typical situation… Lack of clarity about how resource allocation relates to policies and priorities - budget not comprehensive - classification system Political economy Nontransparent process - Poor reporting on execution - High level of aggregation - Discretion in allocation Weak service delivery - Accountability - Efficiency - Quality Inherently difficult to assess - Household surveys - Participatory approaches - Social Impact Assessment Unclear policy framework Weak management information systems - limited coverage - poor data quality - late and scattered reporting

5. 5 Public expenditure tracking surveys (PETS) Diagnostic tool to understand problems in budget execution Delays or predictability in funding leakages discretion in allocation of resources Micro data collected from different levels of government, including service delivery units Reliance on record reviews, but also facility managers and staff interviews Variation in design depending on perceived problems, country, and sector

6. 6 Nonwage funds not reaching schools: Evidence from PETS (percent) CountryMean Ghana 200049 Peru 200130 Papua NG 200128 Tanzania 199857 Uganda 199578 Zambia 2001 (discretion/rule) 76/10 Source: Ye and Canagarajah (2002) for Ghana; World Bank (2004) for PNG; Instituto Apoyo and World Bank (2002) for Peru; Price Waterhouse Coopers (1998) for Tanzania; Reinikka and Svensson 2002 for Uganda; Das et al. (2002) for Zambia.

7. 7 Quantitative service delivery surveys (QSDS) Focus on the frontline service unit and service provider behavior Inspired by micro-level household and firm surveys. Provides data on Resource flows (financial and in-kind) Inputs Service outputs and efficiency Quality of service Focus on dimensions of performance in service delivery Allows comparisons across ownership categories Increases observability of outputs and inputs

8. 8 Unannounced visits to primary schools and primary health centers in 6 countries Absence Rates in education and health by country Source: Chaudhury et al. (2006) Primary schools Primary health centers Bangladesh1635 Ecuador14-- India2540 Indonesia1940 Peru1125 Uganda2737 Unweighted average 1935 Absence rates (percent)

9. 9 Absence rates in education in India State Teacher absence (%) Maharashtra14.6 Gujarat17.0 Madhya Pradesh17.6 Kerala21.2 Himachal Pradesh21.2 Tamil Nadu21.3 Haryana21.7 Karnataka21.7 Orissa23.4 Rajasthan23.7 West Bengal24.7 Andhra Pradesh25.3 Uttar Pradesh26.3 Chhatisgarh30.6 Uttaranchal32.8 Assam33.8 Punjab34.4 Bihar37.8 Jharkhand41.9 Delhi- All India Weighted24.8%

10. 10 Role play: Nurse and patient reverse roles

11. 11 Thank you!