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Are You Being Served?

454 pages
This publication presents tools and techniques for measuring service delivery in health and education and people's experiences from the field in deploying these methods. It begins by providing an introduction to the different methodological tools available for evaluating the performance of the health and education sectors. Country specific experiences are then explored to highlight lessons on the challenges, advantages and disadvantages of using different techniques to measure quality in a variety of different contexts and of using the resulting data to affect change. This book is a valuable resource for those who seek to enhance capacity for the effective measurement of service delivery in order to improve accountability and governance and enhance the quality of service delivery in developing countries.
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AreAreA e
New Tools
for Measuring
Edited by
Samia Amin
Jishnu Das
Markus GoldsteinAre You
Served?Are You
New Tools for
Measuring Service
Samia Amin
Jishnu Das
Markus Goldstein
Washington, DC© 2008 The International Bank for Reconstruction and Development / The World Bank
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Washington DC 20433
Telephone: 202-473-1000
Internet: www.worldbank.org
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All rights reserved
1 2 3 4 5 10 09 08 07
This volume is a product of the staff of the International Bank for Reconstruction and Development /
The World Bank. The findings, interpretations, and conclusions expressed in this volume do not
necessarily reflect the views of the Executive Directors of The World Bank or the governments they
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ISBN: 978-0-8213-7185-5
eISBN: 978-0-8213-7186-2
DOI: 10.1596/978-0-8213-7185-5
Cover design by: Serif Design Group, Inc.
Library of Congress Cataloging-in-Publication Data
Are you being served? : new tools for measuring service delivery / edited by Samia Amin, Jishnu Das,
Markus Goldstein.
p. ; cm.
Includes bibliographical references and index.
ISBN 978-0-8213-7185-5 — ISBN 978-0-8213-7186-2
1. Medical care—Developing countries—Quality control—Measurement. 2. Health
facilities—Developing countries—Quality control—Measurement. 3. School surveys—Developing
countries. 4. Quality assurance—Developing countries—Measurement. I. Amin, Samia, 1980-
II. Das, Jishnu. III. Goldstein, Markus P., 1970-
[DNLM: 1. Data Collection—methods. 2. Developing Countries. 3. Health Services Research—
methods. 4. Quality Assurance, Health Care—economics. 5. Quality
Assurance, Health Care—methods. WA 950 A678 2007]
RA399.D44A74 2007
Foreword xi
Acknowledgments xiii
About the Editors and Authors xv
Abbreviations xxv
Part One
Overview 1
1 Introduction: Why Measure Service Delivery? 1
Markus Goldstein
2 Assessment of Health Facility Performance: 19
An Introduction to Data and Measurement Issues
Magnus Lindelow and Adam Wagstaff
3 An Introduction to Methodologies for Measuring 67
Service Delivery in Education
Samia Amin and Nazmul Chaudhury
Part Two
Use of Administrative Data 111
4 Administrative Data in a Study of Local Inequality and
Project Choice: Issues of Interpretation and Relevance 111
Peter Lanjouw and Berk Özler
5 What May Be Learned from Project Monitoring Data?
Lessons from a Nutrition Program in Madagascar 131
Emanuela Galasso
6 Program Impact and Variation in the Duration of Exposure 147
Jere Behrman and Elizabeth King
Part Three
Public Expenditure Tracking Surveys 173
7 Tracking Public Money in the Health Sector in
Mozambique: Conceptual and Practical Challenges 173
Magnus Lindelow
8 Public Expenditure Tracking Survey in a Difficult
Environment: The Case of Chad 191
Waly Wane
9 Lessons from School Surveys in Indonesia and
Papua New Guinea 221
Deon Filmer
Part Four
Facility Surveys 233
10 Assessment of Health and Education Services in the
Aftermath of a Disaster 233
Elizabeth Frankenberg, Jed Friedman, Fadia Saadah,
Bondan Sikoki, Wayan Suriastini, Cecep Sumantri,
and Duncan ThomasCONTENTS vii
11 Ukraine School Survey: Design Challenges,
Poverty Links, and Evaluation Opportunities 251
Olena Bekh, Edmundo Murrugarra, Volodymir Paniotto,
Tatyana Petrenko, and Volodymir Sarioglo
12 Qualitative Research to Prepare Quantitative Analysis:
Absenteeism among Health Workers in Two
African Countries 271
Pieter Serneels, Magnus Lindelow, and Tomas Lievens
13 Use of Vignettes to Measure the Quality of Health Care 299
Jishnu Das and Kenneth Leonard
Part Five
Combined Household and Facility Surveys 313
14 Client Satisfaction and the Perceived Quality of
Primary Health Care in Uganda 313
Mattias Lundberg
15 Health Facility and School Surveys in the Indonesia
Family Life Survey 343
Kathleen Beegle
16 Collection of Data from Service Providers within the
Living Standards Measurement Study 365
Kinnon Scott
Part Six
Conclusion 389
17 Sharing the Gain: Some Common Lessons on
Measuring Service Delivery 389
Markus Goldstein
Index 401viii CONTENTS
12.1 Incidence and Nature of Health Worker Absenteeism 277
12.2 Health Worker Employment Conditions 279
12.3 Limitations and Risks in Employment 282
12.4 Challenges to Measuring Absenteeism Quantitatively 287
1.1 Association between Outcomes and Public Spending 3
1.2 Key Relationships of Power 6
2.1 Provider-Household Links 21
2.2 Provider Performance 22
3.1 Scope of the Instrument 69
3.2 Framework of Accountability Relationships 97
5.1 Proportion of Sites That Joined the Seecaline Program
over Time, 1999–2003 134
5.2 Differential Treatment Effects 143
6.1 Learning Patterns 152
6.2 Distribution of the Length of Program Exposure 164
7.1 Financial and Resource Flows to Primary Facilities 180
8.1 Budgeted Versus Effective Regional Public Spending
and Production in Health 203
8.2 Structure of Patient Costs in Primary Health Centers, 2003 205
9.1 Student Enrollment in Primary and Lower-Secondary
Schools, 1995/96–1999/2000 225
9.2 School Funding by Grant Receipts and Public or Private
Status, 2000 226
9.3 Delays in Subsidy Receipt, 2001 228
9.4 Depletion in the Effective Supply of Teachers, 2002 229
10.1 Northern End of Sumatra 237
11A.1 Formation of the Territorial Sample for the
Household Living Conditions Survey, 2004–08 262
13.1 Information by Vignette and Country 308
14.1 Mean Time Spent Traveling, Waiting, and
in Consultation, 2004 322
14.2 What Did the Health Care Worker Do during the
Consultation Today? 324CONTENTS ix
3.1 Public Expenditure on Education in Bolivia by Household
Income Quintile, 2002 75
3.2 Evaluating Data Needs 105
4.1 Distribution of FISE Projects by Type, 1993–96 114
4.2 Access to Toilets and Latrines by Quintile of Per Capita
Household Consumption 115
4.3 Standard Errors Based on 100 Simulated Samples of the
Palanpur 1983–84 Population 118
5.1 Differential Program Treatment Effects, by Age Group 142
6.1 Municipalities with ECD-Related Programs, by Region
and Survey Round 161
6.2 Service Providers Who Have Received Program Training,
by Type of Training 162
6.3 Distribution of Children across Program Exposure
Categories, by Age 164
6.4 Distribution of Significant Positive Effects, by Age
and Months of Exposure 167
7.1 Examples of Allocation Rules 177
7.2 Summary of the Findings of the Mozambique
Tracking Survey 182
7.3 Key Survey Findings beyond Leakage 185
8.1 Ministry of Health Budget, 2003 194
8.2 Receipt of Resources at Regions and Health Facilities,
2003 202
10.1 Disruptions in Service Provision in the Aftermath of
the Tsunami, December 26, 2004 241
10.2 Communities Experiencing Changes in the Availability
of Elementary Schools and Public Health Centers 243
10.3 Facilities Reporting Worse Conditions after the Tsunami,
by Service Area 245
10.4 Enrollments and Staffing before the Tsunami and at the
Time of the Survey 246
10.5 Condition of Electricity and Water Connections in
Community Health Posts 247
11A.1 Distribution of Sampled Institutions, by Oblast and
Type of Settlement 265
11A.2 Composition of the Economic Regions 268

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