Global Services

1. Global Services Lesson 4: Delivery of Public Services

2. Governments and Services • Governments are usually the main provider of public services. • Governments are often ill-suited to provide social services because 1) monopoly provides few incentives to cut costs and increase quality of service and 2) bureaucracy/lack of flexibility • Other problems noted in the literature for sanitation and water delivery, include bad financial management, low funding priority, lack of staff experience and qualifications, absent or weak customer service orientation, political interference, little or no independent regulation and an absence of civil society consultation. • Many countries around the world subscribed to concept of a welfare state – especially in Europe and in former European colonies, such as India. Government services to those in need – disabled, elderly, poor – would be paid through taxation, but provided to recipients for low or now cost. • Because governments cannot actually afford to provide all the necessary services – NGOs and voluntary organizations often fill the gaps.

3. NGOs as Education Provider • NGOs play many roles in supporting education service delivery • Advocacy to governments to fulfill demands of the UN’s Education for All initiative • Provide support to improve the quality of government provision through school adoption programs (i.e. International Studies Schools Network of the Asia Society) • Direct Services: provide educationalopportunities to those excluded fromgovernment schooling – such as street children, orphans, child soldiers, indigenous children, minority group children, disabled children, refugees, etc. • Often NGO programs only reaches a small amount of all children in any given country. Government usually remains the primary provider. • Assessment data of teachers is not always available. External monitoring not always present, as found in many government schools.

4. Private Sector: water and sanitation services In Developing World • Millions die every year from lack of access to safe water and adequate sanitation. • In developing countries, there is often weak government capacity, especially in urban and rural environments. • Private sector participation (PSP) does not tackle the underlying causes of lack of utility access. Problems exist in capacity building, community participation, finance and institutional reform. • There is often no provision to take back service delivery if the private sector fails or when contracts end-> irreversible dependence on private providers • Government capacity must be addressed. In PSP, local and central governments’ role is to facilitate, monitor and regulate. When decentralizing delivery, local government capacity needs to be built up to ensure responsiveness to local needs and the provision of quality services. • Poor need to be seen as contributors, not just recipients of services. Social mobilization and community participation is key for sustainable development. Poor often do not receive services because of the need for cost recovery. • Private sector has a role, but it cannot be realized if there is corruption or political resistance to serving the poor. • Stable rules, political commitment to address the underlying causes, good governance and an informed and active citizenry are needed for successful PSP.

5. NGOs: Not-for-Profit Health Care in India • In India, health servicesusually provided by government or private sector. Private sector careis delivered either by for-profit or not-for-profit providers • Individual practitioners provide most of the care in the for-profit health sector • Initially, not-for-profit health sector was hospital-based butit later expanded to include community health doctors in development projects. Now, the NGO role in health care is varied: advocacy, awareness and education, research, and actual provisioning of services • Indian government provides grants and subsidies to NGOs to assist the state in health programs, such as tuberculosis, leprosy and family planning programs. • There is no official count of number of NGOs in health care. Some studies list 7000 NGOs in health-related services as of 1997