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Addressing the unfinished quality agenda

Access to schools and clinics has increased in the majority of African countries, but many children who leave school are unable to read or do basic arithmetic, and the quality of care in clinics remains uneven. Increased spending and expansion in access to education and health services have not been matched with equivalent improvements in human development outcomes, suggesting an unfinished quality agenda.

Quality is critically dependent on what service providers know and what they do

Inspired by the World Bank’s 2004 World Development Report Making Services Work for Poor People, we know that the key characteristics of provider behavior are knowledge, skills and effort. While knowledge and skills are determined by levels of education and ability to perform in the classroom and health facility, effort is highly discretionary: determining how much time to spend with a patient or student is a judgment. This complicates relationships of accountability for education and health services.

Accountability for public resources

Developing country governments allocate roughly a third of their recurrent budgets to education and health. Demands for accountability and for the efficient use of public resources—from citizens and taxpayers in developed or developing countries alike—are gaining in prominence, partly because of the global economic situation.

You cannot hold service providers accountable for what is not measured

Without consistent and accurate information on the quality of services, it is difficult for citizens or politicians to assess how service providers are performing, to work towards corrective action, and ultimately to bring about improvements in service delivery.

The SDI surveys and data are different from other available studies in a few key ways:

  • The SDI surveys use robust and cutting edge data collection methods.
  • The survey instrument is nimble allowing for relatively rapid fieldwork and data analysis, making it more useful for decision-making and policy discussions.
  • It is focused on the links between expenditure and human development outcomes.
  • The indicators are standardized allowing comparison between nations and across subnational boundaries and over time.
  • The surveys are repeated every two years.