Managing Expectations, Leveraging Resources, Exploring New Delivery Mechanisms
The challenge for social policy is to navigate the ‘triple pressure’ that East Africa faces. The first comprises citizens’ growing expectations for more and better social services delivered by the public sector. The second source of pressure is a shrinking public purse due to declining aid flows coupled
with the difficulty of enhancing domestic resource generation. The final pressure comes from the changing roles of the private sector and civil society in the face of growing social stratification of service provision (as the rich seek private solutions leaving the poorest households to rely on ‘free’
but poor quality state services). In summary, the social policy challenge is one of responding to the growing mismatch between aspirations, resources and delivery mechanisms.
The first dimension of this equation requires the management of aspirations and greater honesty in establishing priorities and in the sequencing of interventions. Given limited resources, it may not, for example, be possible to simultaneously pursue increased completion rates for secondary
education and increased quality of learning. Unmanaged expectations drive governments to focus social spending on inputs (bricks and desks) rather than outcomes (useable knowledge and skills) using generic approaches that do not generate the quality necessary for people’s lives to change.
The tension between aspirations and resources is made more complex by the shrinking of development cooperation funds – a four per cent reduction in total overseas development assistance (ODA) in 2013 – and the limits being reached in domestic mobilization. Without changes in the structure of
the economy (higher wages, increased size of economic actors, greater value addition) that generate a broad expansion of income, it is almost impossible to increase tax collection without resorting to desperate but unproductive measures such as chasing after street vendors.
Additionally, limited discussions happen about the actual delivery mechanisms of social services. Little proof is needed to demonstrate that the provision of education, health and other social services is profitable. East Africa’s private sector is already engaged in these spaces, albeit focused on servicing the region’s high- and middle-income groups. Servicing the poorer end of the market are countless non-governmental and civil society organizations, supported by domestic and external donors. Improving the delivery of social services so as to enhance the quality of the outcomes requires a bold conversation centred on the allocation of scarce resources in the most efficient (least cost) and effective (high returns) ways. Should public resources be used to fund private schools and clinics in order to improve access to better learning and health care? Should there be upper limits to the fees that private schools and hospitals can charge? What kind of public, private, non-profit and community collaboration can both expand access to, and improve
the quality of social services?