Accountability, the Last Mile on the Route to Quality Service Delivery : Evidence from Jordanian Schools and Primary Health Centers

In many developing countries, governments have invested substantial resources in the provision of basic services such as healthcare and education. These investments frequently yield minimal improvements in student learning and health outcomes,...

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Bibliographic Details
Main Author: World Bank
Format: Report
Language:English
en_US
Published: World Bank, Washington, DC 2016
Subjects:
Online Access:http://documents.worldbank.org/curated/en/365921477676848136/Accountabiliy-the-last-mile-on-the-route-to-quality-service-delivery-evidence-from-Jordanian-schools-and-primary-health-centers
http://hdl.handle.net/10986/25407
Description
Summary:In many developing countries, governments have invested substantial resources in the provision of basic services such as healthcare and education. These investments frequently yield minimal improvements in student learning and health outcomes, however. Promoting adequate provider effort necessitates accountability, including effective within-facility accountability is the focus of this report. Within the accountability framework, the role of supervisors in the facilities where service provision occurs has thus far been underemphasized. This report contributes to addressing this underemphasis, specifically focusing on the linkages between within-facility accountability and provider effort in the health and education sectors in Jordan. In the case of healthcare, a study was developed to generate novel insights from an original survey instrument. Notably, this is the first nationally representative study in Jordan to measure within-facility accountability and provider effort in primary health care facilities, and the first study in the Middle East and North Africa (MENA) region to investigate these linkages. The study relies on a nationally representative sample of 122 primary healthcare facilities where data are collected through patient exit interviews, and surveys administered to chief medical officers (CMO), doctors, and nurses who work at the centers, and where available, a representative of the community health committee. In the case of education, an empirical analysis was conducted, relying on existing data collected through principal, teacher, and student surveys, third-party classroom observations and school inventories, and math and reading student assessments from a nationally representative sample of 156 schools. The latter was complemented by a comparative case study of six Jordanian schools using statistical matching and a process-tracing procedure.