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Making Services Work for Poor People: Water and Sanitation

This study explores the challenges in providing water and sanitation services to poor communities, emphasizing the importance of institutional reforms and accountability frameworks. It discusses the significance of empowering poor people, monitoring service providers, and strengthening incentives for better service delivery. The analysis highlights the need to shift focus from mere pricing and subsidies to broader institutional relationships that enable efficient and sustainable service provision. Insights from past programs like Mexico's PRONASOL and NGO contracting models in Cambodia are examined to derive lessons for improving water and sanitation access for the marginalized population.

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Making Services Work for Poor People: Water and Sanitation

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  1. Making Services Work for Poor People: Water and Sanitation December 18, 2004 Junaid Ahmad OECD, Paris

  2. The Traditional Approach • Pricing services • Level • Chilean subsidy • Colombian subsidy • Johannesburg mechanism • Pricing services • Transition • Guinee-Conakry • Time path for price increase • Linked to service improvement • IDA financing • Access • Lower connection cost • welfare losses arising from higher utility tariffs triggered by the reform, are more than compensated for by the welfare gains associated with expanding access to services (McKenzie and Mookherjee, 2002). • But subsidy and access for what?

  3. Ground RealitySouth Asia as an example • Not one city or town in South Asia has 24 hour, 7 days a week water supply • Hyderabad and Karachi : 3 hours every two days • Delhi and Dhaka: 6-8 hours a day • Intermittent supply: health implications • Unaccounted for water: over 50% • Cities in South Asia: leaking bucket • Cost recovery: very low --- 20% of O&M • Sanitation • Open defecation • Little waste water treatment (less than 8-10%) • Decaying infrastructure: no O&M • Scale without sustainability • 30-40% not connected • Use of infrastructure for patronage and politics!!

  4. Re-defining the problem • The “ground realities” suggest that “pricing of services” is not the problem of making a system “pro-poor” • Making services work is essential to making services work for poor people • Going from 15-16 hoursof water a day to 24 hours (or increasing access by 10%) is a matter of money and technical solutions: it’s a managerialproblem • Going from 3 hours every other day to 24 hours (or increasing access by 40%) is not a matter of money and technical solutions, it is an institutional problem • Don’t fix the pipes, fix the institutions that fix the pipes

  5. Messages of the WDR • What kind of institutional reforms? Ones that ensure that the institutional relationships between key players in service delivery chain are such that they: • Empower poor people to • Monitor and discipline service providers • Raise their voice in policymaking • Strengthen incentives for service providers to serve the poor • Pricing/subsidies/access are the tails that wag the dog • So, what are these institutional relationships?

  6. A framework of relationships of accountability Poor people Providers Client power: short route of accountabilty

  7. A framework of relationships of accountability Long route of accountability Policymakers Poor people Providers

  8. A framework of relationships of accountability Policymakers voice Poor people Providers

  9. Mexico’s PRONASOL, 1989-94 • Large social assistance program (1.2 percent of GDP) • Water, sanitation, electricity and education construction to poor communities • Limited poverty impact • Reduced poverty by 3 percent • Even an untargeted, uniform per capita transfer would have reduced poverty by 13 percent

  10. PRONASOL expenditures according to party in municipal government Source: Estevez, Magaloni and Diaz-Cayeros 2002

  11. A framework of relationships of accountability Policymakers compact Poor people Providers

  12. Policymaker-provider:Contracting NGOs in Cambodia • Contracted out: NGO managed & could hire, fire, & transfer staff, set wages, procure drugs • Contracted in: NGO managed and could transfer but not hire and fire staff • Control group: Services run by government 12 districts randomly assigned to each category

  13. Contracting for Outcomes: health services in Cambodia Use of facilities by poor people ill in previous month Source: Bhushan, Keller and Schwartz 2002

  14. Applying the framework to water and sanitation

  15. Urban water networks: politics and patronage

  16. Strengthening the compact in urban water networks • Government owns assets, sets policy, regulates, delivers: judge and the jury are one and the same • For accountability: Separate the policy maker and the provider • Decentralize assets • Service and political jurisdictions fit each other better • Regulation & service delivery can be separated by tiers • Centre can use legislation & fiscal incentives to shape well-benchmarked local compacts and capacity growth • Freed of responsibility for service delivery, centre has incentives to ensure local service delivery works • Use private sector participation • Direct, powerful way of separating roles • But information, good regulation, parallel sector reform needed • Third-party regulation may be required • Multi-tiered government provides further opportunities • Information and benchmarking

  17. Strengthening client power in urban water networks • User charges: back to where we started • can increase accountability of providers • strengthen voice • Help separate policy maker and provider • Small independent providers can offer choice & competition • Legalize • No exclusive service contracts for formal providers • Enable contracting between formal provider and independent provider • Allow poor people to use subsidy to pay independent providers

  18. Rural areas: the problem

  19. Rural Areas Low density areas

  20. Rural Drinking Water Center/State Monitoring & Evaluation Society SRP LG Capacity Support Transition Costs Public Agency Communities

  21. Rural sanitation: A problem of demand price D1: Private demand D2: Optimal demand D2 D1 quantity

  22. Measure rural sanitation outcomes correctly • Usually measured as building latrines • Creates incentives to construct, not to use latrines • Outcome to measure: extent of open defecation • Orients accountability correctly

  23. What does a latrine subsidy do? • Sanitation is a community outcome • So, co-production of sanitation is key • Household subsidy distorts community participation and co-production • Paves the way for patronage

  24. How to create community outcomes and co-production? • Techniques and mechanisms of mobilization of communities • VERC in Bangladesh • NGO Forum and others • Reward the community and co-production • community subsidies for outcomes • Nirmal Gram Purashkar program in India • Use local governments to facilitate community participation

  25. Total sanitation National and Local policymakers Communities Poor people Providers

  26. Implications for urban sanitation • Supply of sanitation, not demand, the problem for networks • Property rights and regulation • Dar-es-salam cesspit cleaners • Orangi style co-production linked to networks • Community toilets in Pune

  27. Donors and service delivery Policymakers Project implementation units Global funds Poor people Providers Community driven development

  28. Services work for poor people when accountability is strong Policymakers Poor people Providers http://econ.worldbank.org/wdr/wdr2004

  29. Targeting Poor People: Minimum Service Delivery • Minimum standards and cost (India) • 40 lpcd – 120 lpcd • Choice of technology: hand-pumps to piped network • Target uncovered areas, special groups, 90 percent capital costs • Expenditure on basic services (Chile) • Below poverty level • Expenditure < than 5% • Through service provider • Monitored by Local Governments • Support to poor people (South Africa) • Grants to municipalities • Based on number of people below poverty level • Lump sump grants: service choice left to local governments In the context of India, poor people are better served by making services work: focus fiscal transfers on institutional reform rather than poverty targeting

  30. Reforming Institutions • Which path? • Through local governments: South Africa • Through the WSS: Chile • Which path for India?

  31. Reforming Through Local Government: South Africa State capital capacity incentives operating City towns towns towns Utilities, Departments, Regional systems

  32. State Reforming Through Utilities: Chile City Utility Regional Utility City towns towns consumers

  33. State Co-locating Reforms: 74th Amendment towns City Regional Utility City Utility towns consumers

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