The links between State Action, Citizen Action and Information WORK - - PowerPoint PPT Presentation

Social Development Department The World Bank

Unpacking ‘Context Matters’ The links between State Action, Citizen Action and Information

WORK IN PROGRESS

March 2014, Jakarta, TA Learn Conference Helene Grandvoinnet, SDV Anuradha Joshi, IDS Social Accountability Cluster - SDV

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I. What are the knowledge gaps

• II. Our approach
• III. Unpacking the Black Box
• IV. What practical use is this approach?

(an example from Sierra Leone)

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Outline

Starting Point: Knowledge gaps

• Lack of clarity around the notion of SA
• Evidence is incomplete or mixed—

incomparable interventions, varied contexts, contradictory outcomes

• Need understanding on how and under what

circumstances various processes that are part

• f SA might lead to various outcomes.
• Need for unearthing underlying assumptions
• f SA interventions

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Different Approaches

Two slightly different complementary approaches:

• Build the Evidence Base: Multi-method, robust,

long term, comparative research on the impacts of SA in different contexts (e.g. the T4D project)

• Reorganize the existing evidence: Aggregate the

existing evidence base in a new way—unpacking assumptions and developing causal chains (World Bank Flagship)

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Our Approach

• SA as part of a long term ongoing political

engagement by social actors with the state

• SA can have a range of outcomes of interest
• Causal chains can help highlight the different

potential pathways towards reaching impacts

• A means of organizing evidence, a framework

for understanding critical aspects of context, helping develop a theory of change and enabling revisions as work evolves

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• Look at different entry points

Better assessing the level of ambition

• n “What can be changed by SA

interventions in a local context” Developing a more relevant “Theory of Change” and pointers for a M&E framework

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The Aim

Unpacking the Black Box

• Unpack SA into its constitutive elements
• Unpack drivers for each SA element
• Provide guiding questions for practitioners

to assess drivers for a specific issue/problem

• Summarize evidence on

enabling/constraining factors

• Highlight inconsistencies from evidence
• Suggest mitigating actions

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SA components and their relations

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INFORMATION

CITIZEN-STATE ENGAGEMENT INTERFACE STATE ACTION CITIZEN ACTION

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INFORMATION

Accessibility to citizens Salience (to drive citizen action, to drive state action) Trustworthiness (for citizens , for state officials) Consistency/Novelty Information on existence & accessibility of the interface Information strengthening credibility of interface

CITIZEN ACTION

Awareness of the Problem Salience of the Problem Efficacy (Perception of citizen agency to bring change) Capacity for collective action (as individuals, as groups or organizations) Intrinsic motivation Incentives/costs linked to (in)action

CITIZEN-STATE ENGAGEMENT INTERFACE

Path Dependency of existing structures & state- society relations Existence of interface platform(s) Awareness of interface platform(s) Credibility and Accessibility of interface platform(s)

STATE ACTION

Awareness on the Problem Ability to resolve the Problem Organizational capacity (within state or third-party) to enforce state accountability Intrinsic motivation driving state action Incentives/costs linked to (in)action Official attitudes towards engaging with civil society demands or voice Level of complexity of state action

Ex post assessment

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INFORMATION

Accessibility to citizens Salience (to drive citizen action, to drive state action) Trustworthiness (for citizens , for state officials) Consistency/Novelty Information on existence & accessibility of the interface Information strengthening credibility of interface

CITIZEN ACTION CITIZEN-STATE ENGAGEMENT INTERFACE STATE ACTION

Unpacking contextual drivers of SA elements

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INFORMATION

Accessibility to citizens Salience (to drive citizen action, to drive state action) Trustworthiness (for citizens , for state officials) Consistency/Novelty Information on existence & accessibility of the interface Information strengthening credibility of interface

CITIZEN ACTION

Awareness of the Problem Salience of the Problem Efficacy (Perception of citizen agency to bring change) Capacity for collective action (as individuals, as groups or organizations) Intrinsic motivation Incentives/costs linked to (in)action

CITIZEN-STATE ENGAGEMENT INTERFACE STATE ACTION

Unpacking contextual drivers of SA elements

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INFORMATION

Accessibility to citizens Salience (to drive citizen action, to drive state action) Trustworthiness (for citizens , for state officials) Consistency/Novelty Information on existence & accessibility of the interface Information strengthening credibility of interface

CITIZEN ACTION

Awareness of the Problem Salience of the Problem Efficacy (Perception of citizen agency to bring change) Capacity for collective action (as individuals, as groups or organizations) Intrinsic motivation Incentives/costs linked to (in)action

CITIZEN-STATE ENGAGEMENT INTERFACE

Path Dependency of existing structures & state- society relations Existence of interface platform(s) Awareness of interface platform(s) Credibility and Accessibility of interface platform(s)

STATE ACTION

Unpacking contextual drivers of SA elements

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INFORMATION

Accessibility to citizens Salience (to drive citizen action, to drive state action) Trustworthiness (for citizens , for state officials) Consistency/Novelty Information on existence & accessibility of the interface Information strengthening credibility of interface

CITIZEN ACTION

Awareness of the Problem Salience of the Problem Efficacy (Perception of citizen agency to bring change) Capacity for collective action (as individuals, as groups or organizations) Intrinsic motivation Incentives/costs linked to (in)action

CITIZEN-STATE ENGAGEMENT INTERFACE

Path Dependency of existing structures & state- society relations Existence of interface platform(s) Awareness of interface platform(s) Credibility and Accessibility of interface platform(s)

STATE ACTION

Awareness on the Problem Ability to resolve the Problem Organizational capacity (within state or third-party) to enforce state accountability Intrinsic motivation driving state action Incentives/costs linked to (in)action Official attitudes towards engaging with civil society demands or voice Level of complexity of state action

Unpacking contextual drivers of SA elements

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Show table.

Caveats

• Very Much Work in Progress
• Need to incorporate heterogeneity of state

and citizens to show distributional issues and pro/anti accountability coalitions

• Need closer look at the role of intermediaries
• Need to include some weight/directionality to

drivers

• Need to depict the iterative nature of

accountability work

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Sierra Leone example

The problem:

• Ongoing work to improve human development –180/187 on 2013 Human

Development Index. Among highest maternal and under-five mortality rates in country

• Health services breakdown at level of primary care centers:
• Improper user fees
• Absent nurses/nurses with poor relations with community
• Up to 30% of drugs disappear

The intervention:

• Build off of successful Uganda CSC model; add in community-level

commitments to help improve health (rather than solely nurse commitments); build in increased attention to educating citizens and nurses on entitlements under Free Health Care initiative

• Allows for iterative approaches to solving local health problems and

course-correction mid-stream

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INFORMATION

Accessibility to citizens Salience (to drive citizen action, to drive state action) Trustworthiness (for citizens , for state officials) Consistency/Novelty Information on existence & accessibility of the interface Information strengthening credibility of interface

CITIZEN ACTION

Awareness of the Problem Salience of the Problem Efficacy (Perception of citizen agency to bring change) Capacity for collective action (as individuals, as groups or organizations) Intrinsic motivation Incentives/costs linked to (in)action

CITIZEN-STATE ENGAGEMENT INTERFACE

Path Dependency of existing structures & state- society relations Existence of interface platform(s) Awareness of interface platform(s) Credibility and Accessibility of interface platform(s)

STATE ACTION

Awareness on the Problem Ability to resolve the Problem Organizational capacity (within state or third-party) to enforce state accountability Intrinsic motivation driving state action Incentives/costs linked to (in)action Official attitudes towards engaging with civil society demands or voice Level of complexity of state action

Ex post assessment

Thanks and we look forward to your comments!

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CITIZEN ACTION

Awareness of the Problem Efficacy (Perception of citizen agency to bring change) Capacity for collective action (as individuals, as groups or organizations) Salience of the Problem Intrinsic motivation Incentives/costs linked to (in)action

Initial assessment citizen action

• Awareness of Problem – free health care

entitlements and mortality rates – supported by framing of information (aggregation, CSCs, health entitlements clarified)

• Low efficacy addressed through mutual

accountability approach, intermediation by external facilitation

• Salience of the problem assumed (health)
• Cost-benefit: material cost of attending day-long

meeting offset by transportation reimbursement; still opportunity cost of lost time for agricultural activities; intermediation and mobilization lowers fear of retribution or alienation of nurse

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CITIZEN ACTION

Awareness of the Problem Salience of the Problem Efficacy (Perception of citizen agency to bring change) Capacity for collective action (as individuals, as groups or organizations) Intrinsic motivation Incentives/costs linked to (in)action

Ex post assessment citizen action

• Salience perhaps overrated or overlooked: low sense of

control on health outcomes (fate), higher priorities (land), some level of choice (traditional healers), importance of free health care as compared to other targets – in practice, had to educate on salience and power of preventive health steps

• Low efficacy constraints stronger than anticipated (and

problem not only with “state” – chiefs)

• Collective action capacity constrained yet internalized by

population (“bylaws”, “inspectors”); compact meetings provide forum to overcome collective action problems

• Cost-benefit analysis biased by external, short term

intervention

• Corrective measure: Piloting of health management

committees and community paralegals (lay persons trained in law) as agents of complainants to compensate for low efficacy, and as mediators of community compacts – based on existing institutional infrastructure (40% of districts have paralegals)

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INFORMATION

Accessibility to citizens Salience (to drive citizen action, to drive state action) Trustworthiness (for citizens , for state officials) Consistency/Novelty Information on existence & accessibility of the interface Information strengthening credibility of interface

Initial assessment Information

• Individuals know that there is a problem but “individually” – power of

aggregation

• Individuals and nurses also know their own perspective on the

problem, but not the bigger picture – e.g. community level under-five deaths dramatically exceed clinic-level reported under-five deaths

• Comparisons with district-wide performance will strengthen salience
• Information through external support but in local language
• Information to State focused on front-line providers

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INFORMATION

Accessibility to citizens Salience (to drive citizen action, to drive state action) Trustworthiness (for citizens , for state officials) Consistency/Novelty Information on existence & accessibility of the interface Information strengthening credibility of interface

Ex post assessment Information

• Collectively ratified information (on health entitlements and sources of

illness/death) more credible and durable

• Information by ‘third-party’ neutral facilitator was welcomed as non-

biased and trustworthy; appears to have strengthened credibility of interface meetings

• Information to meso-level of government mostly missing
• Corrective measure: Support to Government to clarify policies,

entitlements, and grievance channels – actionable information. Consider more neutral local agents who can facilitate credible information-sharing

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CITIZEN-STATE ENGAGEMENT INTERFACE

Path Dependency of existing structures & state-society relations Existence of interface platform(s) Awareness of interface platform(s) Credibility of interface platform(s) Accessibility of interface platform(s)

Initial assessment citizen-state engagement interface

• Learn from past failures: rigorous “monitoring” has sometimes led to adversarial

relations with nurses; follows “Community Compact” type intervention to build mutual accountability, with citizens and nurses making commitments to one another

• Existing Health committees do not have capacity to facilitate community

compact meetings – need for external support:

• CSO visits villages to inform about Community compact meetings; five

representatives constituting a cross-section of community are invited to meeting

• Accessibility of interface increased by reimbursement of transportation fees/

lunch for representatives

• CSO-trained facilitators guide the meeting, using CSCs on clinic and

community-reported maternal and under-five mortality to direct the discussion

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CITIZEN-STATE ENGAGEMENT INTERFACE

Path Dependency of existing structures & state-society relations Existence of interface platform(s) Awareness of interface platform(s) Credibility of interface platform(s) Accessibility of interface platform(s)

Ex post assessment citizen-state engagement interface

• Accessibility of interface facilitated by reimbursement of transportation

fees – has posed a challenge for sustainability although some villages continue to meet in absence of transportation fees

• Path dependence and credibility of interface – varied composition of local

representatives based on local power dynamics (chief’s relatives attended in some instances vs. strong health champions); likely impacted effectiveness at local level

• No existing interface for engagement meant project had to use ‘fly-in’ CSOs

– problem of sustainability

• Corrective measure: Piloting support to new government-formed health

management committees and existing community paralegal organizations to identify and strengthen local structure to continue engagement

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STATE ACTION

Awareness on the Problem Ability to resolve the Problem Organizational capacity (within state or third-party) to enforce state accountability Intrinsic motivation driving state action Incentives/costs linked to (in)action Official attitudes towards engaging with civil society demands or voice Level of complexity of state action

Initial assessment state action

• High level awareness of the problems – Free Health Care

initiative and high mortality rates – although content of entitlements remained unclear (e.g. fuel for ambulances, registration cards) and scope of mortality problem and ways to remedy also unclear

• Local level community compact rightly focuses on changes

possible at the community level (behavior, mutual support), as well as encouraging public-level commitments through compact to ‘bind’ state actors

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STATE ACTION

Awareness on the Problem Ability to resolve the Problem Organizational capacity (within state or third-party) to enforce state accountability Intrinsic motivation driving state action Incentives/costs linked to (in)action Official attitudes towards engaging with civil society demands or voice Level of complexity of state action

Ex post assessment state action

• Certain state agents faced limits in resolving

problems (poor attendance at clinic; low level of preventive health measures in community) – needed to partner with community to act together

• Ceiling of local level demand-side improvements

(how to address nurse not on payroll or policy confusions?)

• Strategy to go beyond local level to address

supply-side gaps or confronting more powerful elite actors missing – weakness of administrative accountability recognized as major impediment.

• Corrective measure: Encourage local state actors

to resolve problems collectively with community; engage agents like paralegals to target improvements beyond the ceiling

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Institutional Instrumental States State-society relationships Social actors Responsive public

• fficials

Reduced corruption Institutional channels for interaction Improved provision

• f public goods

Better policy design Good governance State-building Democratic Deepening Legitimacy Trust Empowered citizens Inclusive Social Norms

Outcome Expectations of Social Accountability

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Civil Society

• Capacity and commitment of

citizens/ CSOs to demand accountability

• Authority, credibility, legitimacy
• f CSOs
• Capacity to network within and

across state –society

State-Society relations

• Social contract
• Path Dependency of existing structures &

state-society relations

• Character of formal/informal state-society

accountability and bridging mechanisms

Political society

• Commitment and capacity of

bureaucrats, elected officials and political parties to promote and respond to SA

• Nature of rule of law

Main “macro” contextual factors

Social Norms Global Factors Political Settlements