Overwhelmingly it is women who access and use public services to meet household needs. New Public Management (NPM) emphasises empowering end-users as agents of accountability, and has influenced public service delivery reforms. This Institute of Development Studies (IDS) paper argues that the generic notion of end-users of public services found in NPM-inspired reforms is mistaken. It hides the constraints women face when accessing services, which can limit their efficacy as agents of accountability. Reformers need to consider gender power relations when designing service delivery reforms.
The design of public services is often based on the conception of the household as an undifferentiated (utility maximising) unit. This ignores gender and power imbalances and conflict within the household. Women have been invisible agents in recent service delivery reforms because policy-makers tend to see end-users as generic agents of accountability. They face constraints on their ability to voice household needs or exercise the best choices in the service marketplace.
Gender power relations influence the way decisions are formulated at household and community level:
- Women have greater responsibility in the household division of labour for education, health, clothing, and food. The gender of who obtains social benefits matters for the wellbeing of the household, particularly women and girls.
- Variables that can strengthen women’s voices at household level include: ability to earn an independent income; ownership rights; and education.
- Welfare programmes that explicitly incorporate operational rules to enhance the status of women can positively affect their bargaining power within the household.
- The introduction of user charges for public services is likely to have an adverse affect on girls and women. Demand for girls’ and women’s education and health is more price elastic than for that of men and boys.
- Public service cost-recovery mechanisms can work against the need to improve women’s health and education.
- Decentralisation increases political space for citizens to pursue their needs at local level. However, forces regarding women’s position within society are often stronger at community level, which can result in their needs not being met.
If women are to play a substantial role in holding public service providers accountable, service delivery reforms must counter power relations in the household and community that limit women’s agency:
- Collective action has played an important role in strengthening women’s voices at global, national and community levels.
- Women face gender-specific obstacles that constrain their ability to speak collectively. Their participation can be limited by: domestic and childcare responsibilities; gender social norms defining their role in the public sphere; and intra-household power dynamics.
- It cannot be assumed that women’s voices will emerge. Reforms that seek to enhance voice as an accountability mechanism need to consider obstacles to women’s collective action.
- The organisation of the state, public policy design, and the degree of political opportunity can inhibit or facilitate the expression of women’s collective voice.
- There is little research on the impact of recent reforms on women’s voice and choice. More specific and contextual research is required.