Decentralization and Accountability for District Service Delivery in Madagascar
TABLES
Derick W. Brinkerhoff
Research Triangle Institute
Presentation for:
Conference on Governance and Accountability in Social Sector Decentralization
World Bank
Washington, DC
February 18-19, 2004
Acronyms
CEG Secondary school
CHD District hospital
CISCO District education office
CSB Primary health care center
DIRESEB Regional office, Ministry of Education
DIRSAN Regional office, Ministry of Health
EPP Public primary school
FAF Parents-school partnership association
FID Social investment fund
FRAM Association of parents of students
MINISEB Ministry of Education
MINSAN Ministry of Health
PFU User-fee pharmaceutical cost-recovery program
PhaGCom Community pharmacy
SSD District health office
ZAP Administrative and pedagogical zone
Accountability Categories, Activities, and Purposes
Financial / · Tracking and reporting on allocation, disbursement, and utilization of financial resources
· Cost accounting/budgeting for: personnel, operations, equipment/supplies / · Purpose is to comply with prescribed procedural standards; cost control; resource efficiency measures; elimination of waste, fraud, and corruption.
Performance / · Demonstrating and reporting on activities, achievements, results, and outcomes.
· Assessing quality of service provision.
· Monitoring service provider behavior. / · To assure that that service delivery adheres to the legal, regulatory, and policy framework; that services are delivered according to quality norms, standards and values.
· To improve performance by comparing with best practices and evaluating against them.
Political/democratic / · Assuring service delivery equity/fairness.
· Disseminating information and notifying citizens of rights and responsibilities (transparency).
· Responding to citizens’ needs and demands, either directly or through elected representatives.
· Building citizen and service user trust.
· Mediating/resolving disputes. / · To ensure that taxpayer funds are used legally and that they are used to address the distribution of services in a manner consistent with stated policies.
· To allow citizens to monitor the performance of elected officials.
Health Functions by Level
MINSAN / · Develops national health policy and regulations.
· Prepares the budget.
· Manages personnel according to civil service regulations, including hiring, promotions, and firing; assigns doctors to posts.
· Undertakes collection, monitoring, reporting, and analysis of national health data and statistics.
· Carries out technical and financial oversight of the administrative units, laboratories, and health facilities under its jurisdiction.
DIRSAN / · Provides technical and financial oversight of the districts in the province.
· Does province-level health planning to implement national policy, including preparation of an annual plan for the province.
· Implements civil service personnel policy, including some health staff assignment to posts within the province.
· Serves as the collection and transmission point for provincial health data.
SSD / · Provides supervision and quality control and training for service delivery of the primary care health posts (CSB1, CSB2), and one category of local hospital (CHD1).
· Allocates staff among posts within the district (except for doctors).
· Prepares an annual district workplan.
· Executes the non-salary portion of the recurrent expenditure budget, and distributes supplies among the health posts.
· Compiles and reports on health statistics for the district.
CSB (1 & 2) / · Provides basic health services, undertakes community outreach and vaccination campaigns.
· Collects and reports on health statistics.
· Manages drugs and equipment allocated to them by the SSD.
· Prepares annual workplans (new function– not yet in place)
Degree of Formal Decision-Making Discretion: SSD and CSB
Planning
q Policy formulation
q Program/project design / SSD: Limited
CSB: Minimal to None / No role in policy, sets district priorities in line with MINSAN and donor sectoral policies, prepares annual district workplan. / No role in policy, new for 2003 is a facility-level annual workplan.
Finance
q Revenue collection
q Budgeting, revenue allocation
q Expenditure management and accounting
q Financial audit / SSD and CSB: Minimal to None / Oversees PFU accounts, prepares annual operating budget, executes budget according to official procedures, reports on spending, audits CSBs / Collects PFU funds.
Human Resources
q Staffing (planning, hiring, firing, evaluation)
q Salaries and benefits
q Training / SSD: Medium
CSB: Minimal to None / Submits staffing needs to DIRSAN and MINSAN. Assigns staff, other than doctors, to posts. Provides input to personnel files. Distributes salaries; no role in setting pay rates or benefits. Provides some training to CSB staff. / Submits staffing needs to SSD. Attends training sessions. Chef-CSB supervises other CSB staff.
Service Delivery
q Defining service packages
q Targeting service delivery
q Setting norms, standards, regulations
q Monitoring and oversight of service providers
q User participation
q Contracting / SSD: Medium
CSB: Limited / Contributes to service package definition and targeting within MINSAN and donor guidelines, applies national norms and regulations, monitors and supervises CSBs in district. / Implements service packages according to district workplan, targets local populations, monitors community needs, undertakes some outreach, particularly vaccinations.
Operation and Maintenance
q Drugs and supplies (ordering, payment, inventory)
q Vehicles and equipment
q Facilities and infrastructure / SSD: Medium to Limited
CSB: Medium to Limited / Primary responsibility for district operation and maintenance functions, funded through annual recurrent budget and drugs through PFU. Little discretion within public expenditure rules. / Primary responsibility for facility-level operation and maintenance functions. Oversees PhaGCom accounting and inventory, orders restocking as needed.
Information Management
q Health information systems (HIS) design
q Data collection, processing, and analysis
q Dissemination of information to various stakeholders / SSD: Limited
CSB: Minimal to None / No role in HIS design, collects health data and sends to DIRSAN and MINSAN, appears to play little role in data processing or analysis. Does some dissemination as part of service delivery. / Collects health and epidemiological data for transmission to higher levels, no role in analysis, some dissemination through community outreach and interaction with local officials.
Education Functions by Level
MINESEB / · Sets national policy and does country-wide planning for the sector.
· Prepares annual investment and operating budgets.
· Allocates resources to the provinces and school districts.
· Carries out financial and technical oversight, and quality control of public education institutions, and monitors private institutions.
· Manages personnel, including hiring, promotions, and firing.
· Manages the insurance fund for school-related accidents (PASCOMA, Protection Accidents Scolaire de Madagascar).
· Sets curriculum content and pedagogical standards.
· Assures teacher training and skills upgrading.
· Collects, analyzes, and reports on education data and statistics.
DIRESEB / · Conducts province-level planning, and preparation of the annual plan.
· Tracks and reports on provincial education indicators.
· Does financial and technical oversight of districts and their schools.
· Allocates staff within the province.
· Provides training and technical support for districts and schools.
· Serves as intermediary for CISCO reporting to MINESEB.
CISCO / · Supervises pedagogical activities, administration, and expenditures of the primary and secondary schools in the district (EPPs, CEGs, and Lycées).
· Maintains student records and manages the annual examination for promotions and award of diplomas.
· Allocates civil service staff within the district.
· Manages teachers hired on a contract basis by communes and FRAMs.
· Prepares an annual district workplan.
· Manages the non-salary portion of the recurrent expenditure budget.
· Manages the collection and accounting procedures for school fees, PASCOMA premiums, and other Caisse Ecole activities.
· Handles distribution of supplies and equipment to schools through FAFs.
· Compiles and reports on educational statistics for the district.
ZAP / · Serves as the administrative and technical interface for the CISCO with about 8-12 schools (some ZAPs have a secretary).
· Provides oversight and support to school directors.
· Facilitates information transmission to and from schools.
· Assures monitoring at the school level.
· Assists with the distribution of school supplies and equipment.
· Interacts with members of the FAF and FRAM.
EPP, CEG, Lycée / · Manages the instruction provided to students.
· Supervises teachers, both regular civil service employees and contract teachers (enseignants suppléants).
· Maintains school records.
· Transmits educational statistics for their schools to the CISCO via the ZAP.
· Oversees and accounts for supplies and equipment provided by the CISCO.
· Serves as a designated member of the FAF management committee.
· Interacts with the FRAM and individual parents.
Degree of Formal Decision-Making Discretion: CISCO and EPP
Planning
q Policy formulation
q Program/project design / CISCO: Limited
EPP: None / No role in national policy, sets educational targets in cooperation with DIRESEB and donor sectoral programs, prepares annual district workplan. / No role in national policy.
Finance
q Revenue collection
q Budgeting, resource allocation
q Expenditure management and accounting
q Financial audit / CISCO: Minimal to None
EPP: Minimal / Oversees FAF Caisse Ecole accounts through ZAPs, prepares annual district operating budget, executes budget according to official procedures, reports on spending, audits EPPs and FAFs. / Collects school and PASCOMA fees. Serves as secretary of FAF management team, reports on uses of funds.
Human Resources
q Staffing (planning, hiring, firing, evaluation)
q Salaries and benefits
q Training / CISCO: Medium
EPP: Minimal to None / Submits staffing needs to DIRESEB and MINESEB. Assigns teachers to posts. Provides input to personnel files. Distributes salaries; no role in setting pay rates or benefits. Hires/fires “hors solde” teachers. Provides some training to EPP and ZAP staff. / Submits staffing needs to CISCO through ZAP. Attends training sessions. School director supervises teaching staff.
Service Delivery
q Defining service packages
q Targeting service delivery
q Setting norms, standards, regulations
q Monitoring and oversight of service providers
q User participation
q Contracting / CISCO: Medium
EPP: Limited / Applies national education policy norms and regulations, targets service delivery through staff and resource allocation, monitors and supervises schools in district through ZAP. Meets with FAF and FRAM. Mediates disputes regarding contract teachers hired by communes and FRAM. / Implements MINESEB educational curriculum within national norms and regulations, manages civil service and contract teachers, oversees pedagogical process, responds to community needs, interacts with FAF and FRAM.
Operation and Maintenance
q Education and school supplies (ordering, payment, inventory)
q Vehicles and equipment
q Facilities and infrastructure / CISCO: Medium to Limited
EPP: Limited / Primary responsibility for district O&M functions, funded through annual recurrent budget. Little discretion within public expenditure rules. Decides which schools receive rehab & construction funds. / Responsible for school operation and maintenance functions. Oversees purchases of goods and services from Caisse Ecole in cooperation with FAF. Communicates needs to CISCO through ZAP.
Information Management
q Education information systems (EIS) design
q Data collection, processing, and analysis
q Dissemination of information to various stakeholders / CISCO: Limited
EPP: Minimal to None / No role in EIS design, collects/reports on educational statistics to DIRESEB & MINESEB, plays role in data analysis in monthly discussions at DIRESEB. Disseminates information as required. / Maintains student files, collects educational statistics for transmission to higher levels, no role in analysis. Disseminates some information to the community and local officials.