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Improving Service Delivery for Children

Improving Service Delivery for Children. Key areas identified for improving availability and quality of Services:. Pre-natal Care Immunization Responsive feeding and caring Pre-school education Primary education

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Improving Service Delivery for Children

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  1. Improving Service Delivery for Children

  2. Key areas identified for improving availability and quality of Services: Pre-natal Care Immunization Responsive feeding and caring Pre-school education Primary education Despite improvements during past few decades, many of these services fail to reach the Poorest

  3. Why are services failing to reach the poor ? Demand Knowledge Empowerment Affordability Social Barriers Physical access Human Resources Supply Availability of Consumables Resource Allocation Governance

  4. The Challenges • Weak implementation capacity • Inadequate program monitoring • Over centralization and lack of flexibility in design • Lack of accountability

  5. Services can improve by strengthening accountability mechanisms. Policy Maker Indirect Voice Indirect Compact Client Provider Direct Client Power

  6. But, services can still work by Strengthening Client Power. Empowering the poor to monitor and discipline Citizen’s Report Cards in Bangalore Co-producing health and nutrition services Mid Day Meal Program in Tamil Nadu User associations hire and pay health staff in Mali Co-operative Pharmacies in Haiti, Singapore.

  7. Services can improve by Strengthening incentives to providers to serve the poor • Buying Results. The Government as active purchaser of health services thru performance based contracts directly with health providers or with intermediaries • Urban Slums Project in 74 municipalites in AP • Contracting our nutrition Services in Senegal & Madagascar • Incentives for working in underserved areas. • Hardship allowances • Quota for higher education

  8. Services can improve by sharing information and giving voice to the poor • Display of funds devolved to schools in DPEP • Publishing education grants to schools in Uganda • Sharing information relevant for local context • Ma-beti melas in DPEP/Mahila Samakhya • Meena by UNICEF • Polio Campaign • Informing facts and figures to generate informed debate • Child labor and Schooling

  9. Services can improve by strengthening accountability mechanisms. • Immunization Services in Tamil Nadu • Enhancing collective accountability – Madhya Pradesh in education

  10. Services can improve by offering demand side financing • Educational scholarships for Girls in Bangladesh • Conditional Cash Transfers in PROGRESSA, Mexico

  11. None of these solutions are fast are easy. But, success is clearly possible. “It does not matter how slowly you go so long as you do not stop” Confucius WDR 2004

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