Politics shape services; and services shape politics

28 May 2014
Comment


Politics matter for development and shape how services are provided.

Some political economy analysis has found similar requirements for good performance in service delivery, including good monitoring, effective sanctions, strong systems of local accountability, and political incentives to see the project through.

But for workers in health, education, water or sanitation, the political challenges and opportunities they face can look very different and more specific. How to work with district education officers who face political pressures? How to coordinate health and waste management departments that don’t speak to each other? Why do mothers use traditional birth attendants rather than hospitals - despite targeted information campaigns?

Research by ODI and the International Development Department (IDD) of the University of Birmingham suggests that services do indeed have their own unique political character which affects how they perform.

In a hospital, for example, patients place themselves individually into the care of doctors and nurses. They know little about the treatment they are undergoing, and are not empowered to dispute it.

By contrast water-users know better what they should expect from the supplier, share their experience of the service with other users, and can have their say at a neighbourhood level.

These differences are political. They affect power relations between politicians, providers and health care users face bigger challenges than water users when making demands or questioning providers.

These factors shape the behaviour of politicians, policy-makers, and the people who provide and use the services. ODI and IDD have drawn up a framework for piecing together the evidence on the political effects of 'service characteristics’ – that is, the features that can be used to distinguish between services.

For example, services that are privately consumed, like household water connections rather than mains sewers, will enhance opportunities for political patronage while visible aspects of services, such as building clinics rather than training staff, are likely to be a greater priority for politicians.

Being a monopoly as in piped water supply, or having a high degree of professional knowledge - as in healthcare - can strengthen service providers over users.

On the other hand, regular use of a local service - like a school - enables communities to organise and make demands.

Identifying these differences can generate specific options for policy responses and organisational reforms that take into account the particular dynamics that may have been holding back improvements.

This research takes thinking on political economy out of its ‘governance silo’ and roots it more in the knowledge of specialists in health, education, water and sanitation.

It gives us a much fuller picture of how to bring together technical and political skills to enhance development.