In a recent World Bank blog post, researchers Martina Björkman Nyqvist and Jakob Svensson address the importance that information dissemination has on social service provisioning in developing countries.
In developing countries, poor quality public service provisions are not uncommon. As a method to improve public service performance, the Community Drive Development (CDD) approach seeks to foster community participation in public services to strengthen demand-responsiveness and promote the accountability of public service providers. Though the World Bank has spent over 85 billion USD on CDD based projects, few have been rigorously evaluated or have impact evaluations with mixed results.
In one randomized field based in the primary health care sector in Uganda, researchers Martina and Jakob analyzed the effectiveness of community-based monitoring of public provisions in “Power to the People”, the intervention had two key components: the participation component, in which nongovernmental organizations held two rounds of village meetings to encourage community member’s involvement in the state of their local health services, including local health provider accountability, and an information based aspect of the intervention, in which community members were provided with a “report card” that detailed the quality of their local care facility and its performance as compared to national and regional standards. The information and participation components, coupled with a mutual action plan between community members and health staff on how to improve and monitor health provisions, led to an observed reduction in child mortality and increase in child weight a year into the treatment.
A parallel intervention was done with the long-run follow-up of the “participation and information” study, in which the participatory activities of three community meetings were the only aspect of the intervention, and information dissemination regarding the performance of local health facilities was excluded. Despite the fact that both interventions included similar data regarding meeting participation and had “action plans” between community members and health practitioners, the lack of information presented in the second treatment proved to have a profound effect of health outcomes: the participation and engagement component of the intervention was shown to have little impact on quality of care, health workers’ behavior, and health outcomes.
When information on health facility performance was provided to community members, they were more likely to focus locally on problems that either community members or health workers could address. When such information was not provided, it was decided that third-party actions were needed to solve local issues. With access to information, community members are able to distinguish and act upon local issues, monitor health providers to encourage higher effort, and ultimately improve health outcomes in the community.
Read the original post on the World Bank blog here: http://blogs.worldbank.org/impactevaluations/power-people-information-power