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Supporting Reform in the Delivery of Social Services: Sector Strategy (1996)

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dc.contributor.author Inter-American Development Bank (IDB) en
dc.description.abstract The paper (GN-1932-1) explores the challenges encountered in the reform of delivery systems and reviews the Bank's mandate and recent experience in this area. It also discusses the context and elements of reform which need to be addressed in order for the Bank to act effectively in supporting social reform initiatives. The Bank's strategy for social service delivery systems is to support reforms which restructure the organization of the sector so that it generates incentives to further an efficient and effective allocation of resources consistent with stated social sectoral objectives. To carry out such an approach, realistic appraisal of the institutional context in which systems operate is needed, as is increased attention to implementation, given the added complexity of operations which support reform. en
dc.subject Health en
dc.subject Education en
dc.title Supporting Reform in the Delivery of Social Services: Sector Strategy (1996) en
dc.contributor.other LUCIANOO
dc.date.accessioned 2011-06-22T21:43:12Z
dc.date.accessioned 2014-07-29T12:26:04Z
dc.date.available 2011-06-22T21:43:12Z
dc.date.available 2014-07-29T12:26:04Z
dc.date.issued 1996-08
dc.identifier.uri http://www.iadb.org/en/publications/publication-detail,7101.html?id=17086
dc.identifier.uri http://hdl.handle.net/11319/1791
dc.format.extent 31
dc.format.medium ACROBAT
dc.language.iso en
dc.subject Social Development
dc.subject social reforms
dc.type Policies, Strategies & Guidelines
lacea.language.supported en
dc.date.modified 2013-11-15T08:50:04Z
dc.description.abstract2 This strategy (GN-1932-1) was formally considered by the Board of Executive Directors and the management of the IDB on July 17, 1996. Abstract Noting that the effectiveness of social service delivery systems in the region bears a surprisingly small relationship to the level of public expenditures, this paper concentrates on the delivery of social services. It explores the challenges encountered in the reform of delivery systems and reviews the Bank's mandate and recent experience in this area. It then discusses the context and elements of reform that need to be addressed in order for the Bank to act effectively in supporting social reform initiatives. The paper advocates restructuring the sector so that it generates incentives that further an efficient and effective allocation of resources. To carry out such an approach, a realistic appraisal of the institutional context in which systems operate is needed, as is increased attention to implementation. The report is available in PDF or RTF format and in printed form (sds/soc@iadb.org). The paper's Introduction and Summary is presented below. Introduction and Summary Over the last thirty years, Latin American and Caribbean countries have significantly improved the schooling and health of their populations. Despite these gains, however, average educational attainment and health conditions are inadequate when compared to other countries of the world with comparable levels of income. The effectiveness of social service delivery systems in the region bears a surprisingly small relationship to the level of public expenditures. In education, studies have shown that variations in spending are not the primary determinants of differences in educational performance. A recent study done by the Bank demonstrated that differences in the efficiency of the systems have a much more significant effect on educational outcomes than the level of spending. According to the World Bank's World Development Report 1993 health spending alone cannot explain all the variation in health status among countries. Nor can income, spending and education taken together. The focus on improving delivery of these social services is justified on several grounds. First and foremost, a healthier and better educated population is itself a widely accepted goal of our societies. Second, improved health and education will result in greater economic productivity, so that incomes and welfare can increase and services can be more readily financed. Third, the unequal distribution of educational attainment is a key exacerbating factor in the region's highly skewed distribution of income. Fourth, the skills and capacities of healthy and educated citizens can increase and improve their full and active participation in modern dynamic democracies. Finally, governments already route significant resources into social services, so that improving the effectiveness of these large expenditures should yield significant gains in both equity and growth. The limited size of IDB lending in the social area relative to total resources invested in the region underlines the need to push for reforms in order for lending to have a sustainable impact. If conditions are not propitious for immediate reform of delivery systems, alternatives for Bank action remain. Adherence to a vision of long-term desired results will lead the Bank to support demonstration projects and other activities which encourage movement towards reform. The IDB has much to offer countries seeking effective reform in the delivery of social services--potential contributions which must go beyond the financial resources provided by loans. The purpose of this paper is to identify the strategic elements for Bank lending and technical assistance operations which provide support to the reform of the delivery of social services. The paper proposes a Bank strategy for reform of delivery systems that will strengthen and solidify ongoing Bank efforts within the context of a coherent and realistic vision of the issues of social service delivery in the region. The paper explores the challenges encountered in the reform of delivery systems and reviews the Bank's mandate and recent experience in this area (Sections II & III); and discusses the context and elements of reform which need to be addressed in order for the Bank to act effectively in supporting social reform initiatives (Section IV). The Bank's strategy for social service delivery systems is to support reforms which restructure the organization of the sector so that it generates incentives to further an efficient and effective allocation of resources consistent with stated sectoral objectives. To carry out such an approach, realistic appraisal of the institutional context in which systems operate is needed, as is increased attention to implementation, given the added complexity of operations which support reform. The strategy and guidelines for implementation described in this paper are intended to orient the Bank's operating departments in the preparation of country and regional strategies, and in the design and supervision of specific operations. Issues raised will also provide an overarching framework for other departments within the Bank engaged in research, traning, or policy dialogue in the area of social reform.


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