Today, in a context of very limited human and material resources, countries such as Mozambique, Uganda and Zambia are working with the World Bank to improve public service delivery.  While coverage and aggregate outputs for education and health services increased over the last years, in many cases quality has not kept pace.  The World Bank is concerned that citizens are not receiving the services intended for them and money is being wasted.


Service Delivery Surveys

Patricia faced a dilemma ten years ago, as a Public Sector Management Specialist at the World Bank.  She saw that anecdotal evidence indicated that drugs and text books were missing, health workers’ and teachers’ technical skills were weak, and “unofficial” payments were demanded.  However, there was no reliable way to prove the stories.

Patricia led the development of the first instruments used by the World Bank, Service Delivery Surveys, to gather the evidence from service users themselves and measure the coverage and quality of such public services.  Patricia managed pilots in Mali, Nicaragua, Uganda, Tanzania, and Jordan.

Experts were concerned about the approach because it was like “opening Pandora’s Box.”  However, survey responses confirmed anecdotal evidence and citizens provided practical ideas for improvement in health care, education, road maintenance, etc. 

Through her innovative collection of quantitative and qualitative evidence ~ the pilot Service Delivery Surveys ~ Patricia demonstrated this new approach for public sector reform in developing countries.

Patricia’s trendsetting pilots pointed the way for the further development of the Service Delivery Surveys which the Bank continues to use and has implemented in Lebanon, Bangladesh, India, Laos, Honduras, Mexico, and Georgia, among others. The Bank uses these surveys to assess efficiency, equity, and quality in the delivery of such services as primary health care and education and to design and measure progress of sector policy reforms.  (See Human Development and Public Services Research/Survey Tools.) 

By pioneering strategies to generate data to back up the stories people tell, Patricia has helped governments make better decisions on public sector spending.

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All photographs are the copyright of Patricia E. Langan



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Patricia E. Langan and Consulting for a Better World

Pathbreaking.  Empowering.  Connecting.