Are people satisfied with public service delivery in Africa?

Public services in Africa are perceived to be scarce and of a poor standard. However, there has been little analysis of the strengths and weaknesses of the public delivery systems for education and health services, as viewed by the people who use them. How do Africans feel about these services and what determines their levels of satisfaction?

There is already an extensive record of poor people’s demands for socioeconomic development, such as health and education. There is also evidence from India that service delivery by governments is improved by the free flow of information during competitive democratic elections. Research has shown, however, that democratic elections and public spending by governments are not enough to deliver high quality social services or fair service delivery.

A study by Afrobarometer, an independent research project, explores which factors influence people’s levels of satisfaction with basic health and education services in 18 countries in Africa. It analyses the issues from the perspective of the people who use the services. This is based on the results of national surveys from March 2005 to February 2006 on people’s attitudes towards democracy and various aspects of development. It also considers possible explanations, including poverty status, perceptions of service accessibility and people’s personal experiences with service providers.

The report shows:

• People value health care services over education. Yet in general, health care services are in shorter supply than education.
• Roughly two thirds of people were satisfied with basic health and education service delivery, which shows a recent increase in levels of satisfaction. Governments stand to gain from even small improvements in the quality of basic services, especially in rural areas.
• More people prefer high quality education to free education, despite many countries introducing free primary education. However, this majority appears to be declining over time.
• The location of schools and health care clinics in relation to people’s homes has little effect on general satisfaction with basic services. Except for rural clinics, expanding service infrastructure is unlikely to have a significant impact.
• Corruption has mixed effects – perceptions that officials are corrupt decrease people’s satisfaction, but paying a bribe to ensure a service increases satisfaction.

People measure the quality of basic social services according to how user-friendly the service agencies are. Governments can gain by ensuring that services respond to people’s needs and by making delivery open and accessible. The research makes several recommendations.

• When allocating budgets and social welfare resources, African governments seeking re-election would do better if they prioritised health care services over education.
• Gains can also be made by improving the quality of schooling rather than quantity.
• Education ministries should prioritise improving the quality of teachers and teaching instruction. Governments should work hard to reduce the cost of primary services, especially for the poorest users.
• Poor people need affordable social services and certain targeted programmes, for instance targeting poor women’s health care needs.
• People’s perceptions of corruption have more effect on their service satisfaction than first-hand experiences. Governments need to clarify and publicise widely the rules and procedures for equitable service delivery.
• Penalties for corruption must be enforced at the point of service delivery.

Source(s):
‘Are You Being Served? Popular Satisfaction with Health and Education Services in Africa’, Afrobarometer working paper 65, Michael Bratton, 2007 (PDF) Full document.

Funded by: The World Bank

id21 Research Highlight: 09 March 2008

Further Information:
Michael Bratton
Afrobarometer
Michigan State University
Department of Political Science
East Lannsing
Michigan 48824
USA

Tel: +1 517 3533377
Fax: +1 517 4321091
Contact the contributor: mbratton@msu.edu

Afrobarometer

IDASA Pos
6 Spin Street
Church Square
Cape Town 8001
South Africa

Tel: +27 21 4615229
Fax: +27 21 4612589
Contact the contributor: annie@idasact.org.za

Institute for Democracy in South Africa, Public Opinion Service (IDASA POS)

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