Equity in Public Services in Tanzania and Uganda
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Washington, DC
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The context of this note is the concern
in both Uganda and Tanzania that the distribution of public
servants in both countries has been uneven, leading to
inequity in the delivery of public services, with lower
quality services linked to persistent poverty in certain
underserved or hard-to-reach and stay (HTRS) areas. The note
looks in detail at the nature of the problem as it affects
education and health services, assesses measures already in
place to tackle inequity, and makes recommendations to
address the problem in the immediate as well as the
long-term. In focus in this note are those areas that suffer
from having far below average numbers of public servants,
and consequently far below average public services. In
Tanzania such areas are more commonly referred to as
under-served and again additional resources have been
allocated to them. Governments have so far responded with
relatively conventional measures, such as financial
incentives for staff and improved living conditions. While
both of these are important, the scope and depth of the
issue requires a more radical approach. A range of ideas is
offered for each country, and these are then presented in a
matrix. Three priorities needs emerge for both countries: 1)
to consider demand as well as supply-side measures, in
particular to strengthen Government accountability; 2) to
address fiscal constraints by changing policies on
allowances which currently favor those at the centre of
government, and by giving HTRS areas greater financial
management flexibility; and 3) to put a time limit on the
assessment of measures to fix the state, leaving open the
possibility that market mechanisms might eventually present
the best option in dealing with inequity in public services.
Palabras clave
ABSENTEEISM, ACCESS TO HEALTH CARE, ACCOUNTABILITY, ACCOUNTABILITY FRAMEWORK, ADMINISTRATION COSTS, ALLOCATION, ALLOCATION OF FUNDS, ARTICLE, AUDIT OFFICE, AUDITOR GENERAL, BASIC EDUCATION, BUDGET ALLOCATION, BUDGET RESOURCES, BUDGET YEAR, CAPACITY BUILDING, CENTRAL GOVERNMENT, CITIZENS, CIVIL SERVANTS, CIVIL SERVICE, CIVIL SERVICE REFORM, CLASSROOMS, CLINICS, COMMUNITIES, COMMUNITY HEALTH, COMPLETION RATES, DATA COLLECTION, DECISION MAKING, DEVELOPING COUNTRIES, DEVELOPMENT GOALS, DISCRETIONARY ALLOCATIONS, DISCRETIONARY ALLOWANCES, DISTRICTS, DRUGS, ECONOMIC DEVELOPMENT, EDUCATION SECTOR, EDUCATION SERVICES, EDUCATION SPENDING, EDUCATION SYSTEMS, EFFECTIVENESS OF SERVICE DELIVERY, ENROLMENT RATE, EPIDEMIC, EQUALITY, EQUITY ISSUES, EXAM, EXAMS, FEMALE, FEMALE TEACHERS, FINANCIAL CONSTRAINTS, FINANCIAL MANAGEMENT, FINANCIAL RESOURCES, FISCAL CONSTRAINTS, FISCAL POLICY, FOOD SUPPLIES, GENERAL BUDGET SUPPORT, GLOBAL HEALTH, GROSS ENROLMENT, HEAD TEACHER, HEAD TEACHERS, HEALTH CENTERS, HEALTH CENTRE, HEALTH CENTRES, HEALTH EDUCATION, HEALTH FACILITIES, HEALTH INDICATORS, HEALTH MANAGEMENT, HEALTH SECTOR, HEALTH SERVICES, HEALTH SPENDING, HEALTH WORKERS, HIV, HOSPITAL, HOSPITALS, HOUSING, HOUSING CENSUS, HOUSING FOR TEACHERS, HUMAN RESOURCE MANAGEMENT, IMMUNODEFICIENCY, INEQUITABLE DISTRIBUTION, INEQUITIES, INTERVENTION, INTERVENTIONS, IRON, LEADERSHIP, LEARNING, LEARNING OUTCOMES, LIMITED RESOURCES, LIVING CONDITIONS, LOCAL AUTHORITIES, LOCAL COMMUNITIES, LOCAL GOVERNMENTS, LOW-INCOME COUNTRIES, MANAGEMENT SYSTEMS, MARKET MECHANISMS, MATERNITY LEAVE, MIDWIVES, MINISTRY OF FINANCE, MINISTRY OF HEALTH, MOBILITY, MOBILITY OF PEOPLE, MONITOR PERFORMANCE, MUNICIPALITIES, NATIONAL AUDIT, NATIONAL LEVEL, NET INTAKE, NET INTAKE RATES, NUMBER OF CHILDREN, NURSES, NURSING, OUTCOME DATA, OUTCOME INDICATORS, PANDEMIC, PATIENT, PATIENTS, PERFORMANCE ACCOUNTABILITY, PERFORMANCE AUDIT, PERFORMANCE MANAGEMENT, PERFORMANCE MANAGEMENT SYSTEM, PERSISTENT POVERTY, PERSONNEL EMOLUMENTS, PERSONNEL MANAGEMENT, PHARMACISTS, POLICY RESEARCH, POLICY RESEARCH WORKING PAPER, POVERTY REDUCTION, POVERTY REDUCTION STRATEGY, PRIMARY EDUCATION DEVELOPMENT, PRIMARY EDUCATION DEVELOPMENT PROGRAM, PRIMARY HEALTH CARE, PRIMARY HEALTH SERVICES, PRIMARY SCHOOL, PRIMARY SCHOOL TEACHERS, PRIMARY SCHOOLS, PUBLIC EDUCATION, PUBLIC EXPENDITURE, PUBLIC EXPENDITURE REVIEW, PUBLIC EXPENDITURE TRACKING, PUBLIC SECTOR, PUBLIC SECTOR REFORM, PUBLIC SECTOR SPECIALIST, PUBLIC SERVICE, PUBLIC SERVICE MANAGEMENT, PUBLIC SERVICES, PUPIL ATTENDANCE, PUPIL TEACHER RATIO, PUPIL TEACHER RATIOS, PUSH FACTORS, QUALITY EDUCATION, QUALITY OF EDUCATION, QUALITY OF SERVICES, QUALITY SERVICES, REFORM STRATEGY, REGIONAL ADMINISTRATION, RESOURCE ALLOCATION, RESOURCES FOR EDUCATION, RESPECT, RURAL AREA, RURAL AREAS, RURAL SCHOOLS, SAFE WATER, SANITATION, SCHOOL TEACHERS, SCHOOL VISITS, SCHOOLING, SCHOOLING QUALITY, SECONDARY EDUCATION, SECONDARY SCHOOL, SECTOR MINISTRIES, SECTOR MINISTRY, SECTOR POLICIES, SERVICE DELIVERY, SERVICE DELIVERY FUNCTIONS, SERVICE EMPLOYMENT, SERVICE PROVISION, SERVICE QUALITY, SERVICE UTILIZATION, SOCIAL RESEARCH, SOCIAL SECTORS, SPATIAL DISTRIBUTION, SPOUSE, TEACHER ABSENTEEISM, TEACHERS, TEACHING, TERTIARY EDUCATION, TETANUS, TOLERANCE, TOWNS, TRAINING INSTITUTES, TRANSPORTATION, UNIVERSAL PRIMARY EDUCATION, UPE, URBAN AREA, URBAN AREAS, VACCINATION, VICIOUS CYCLE, WAR, WHOOPING COUGH, WORKERS, WORKFORCE