Some of the most repeated advice to donors supporting service delivery in fragile states is to coordinate their interventions, take a long-term approach, build local capacity, foster local involvement and target marginalised groups.
OECD DAC. (2008). Service Delivery in Fragile Situations: Key Concepts, Findings and Lessons (OECD/DAC discussion paper). Paris: OECD.
How can service delivery be strengthened in the context of a fragile state? This report reviews evidence on the impact of state fragility on service delivery. Donors should tailor interventions to context, maintain a long-term focus on governance and state-building and manage transition and hand-back sensitively. Efforts at national government level need to be balanced with programmes linked to local authorities and communities.
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Commins, S. et al. (2013). Pooled Funding to Support Service Delivery Lessons of Experience from Fragile and Conflict-Affected States. London: DFID.
The literature on pooled funds highlights their potential advantages, but it also notes that their performance frequently falls short of expectations. Potential advantages include coordination and harmonisation among donors, enabling operation on a larger scale and with lower transaction costs, and allowing participating donors to pool the risks of operating in fragile contexts. At the same time there are many examples of pooled funds that have fallen short of expectations, with slow disbursement; dissatisfaction with results often leads donors to pursue alternative or parallel channels of funding. This paper distils factors associated with success and failure.
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See also: individual analyses from pooled funds in Liberia, South Sudan and Yemen.
Krasner, S., & Risse, T. (2014). External Actors, State-Building, and Service Provision in Areas of Limited Statehood: Introduction. Governance: An International Journal of Policy, Administration, and Institutions, 27(4), 545–567.
It makes little sense to orient external efforts at capacity-building and service provision toward an ideal of consolidated statehood that only exists in some parts of the world. The effectiveness of external support to services depends on three things. First, legitimacy: politically relevant audiences in the target state must accept the legitimacy of efforts by external organizations. Second, task properties: the simpler the task, the more likely it is to be provided. Third, institutional design: appropriate resourcing and higher legalization increase the prospects for effective state-building and service provision.
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Oswald, S., & Clewett, J. (2007). Delivering health services in fragile states and difficult environments: 13 key principles. London: Health Unlimited.
What is needed to extend appropriate, effective healthcare to the under-served in fragile states and difficult environments? This paper draws on case studies from Burma/Myanmar, Cambodia, Ethiopia, Guatemala, Peru and Somaliland. Flexibility, understanding of a given context, the establishment of trust and long-term commitment are key to improving health outcomes. Targeting support to marginalised communities fosters a trickle-up effect, also providing improved service delivery to others along the ‘marginalisation’ continuum.
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Berry, C. (2009). A framework for assessing the effectiveness of the delivery of education aid in fragile states. Journal of Education for International Development, 4(1). How can the effectiveness of education aid in fragile states be assessed and improved? This paper presents an assessment framework based on OECD principles of coordination, state building and ‘do no harm’. The framework is applied to four approaches to education aid (sector-wide approaches, trust funds, social funds, and UN-led approaches). No single approach will provide all the answers. Planning structures that include a wide range of stakeholders are particularly important in fragile state contexts.
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Case examples
Al-Iryani, L., De Janvry, A., & Sadoulet, E. (2013). Delivering good aid in hard places: The Yemen Social Fund for Development approach (WIDER Working Paper, No. 2013/080). Helsinki: UNU-WIDER.
Since its inception, the Yemen SFD has been widely viewed as successful in implementing programmes to deliver services in rural and urban communities throughout the country. It has steadily expanded and scaled-up its activities, despite Yemen’s weak state and political unrest. Its success is attributed to: (1) stakeholder ownership over projects due to its close work relationship with local communities following a demand-driven approach; (2) trust based on its political neutrality in allocating resources; (3) flexibility due to its mode of project funding and operations; and (4) relevance of SFD interventions for beneficiaries who in reciprocity provide strong support to its programmes.
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Newbrander, W. et al. (2014). Afghanistan’s Basic Package of Health Services: Its development and effects on rebuilding the health system. Global Public Health: An International Journal for Research, Policy and Practice, 9(Supplement 1), S6-S28.
The Afghan health system was rebuilt based on the Basic Package of Health Services (BPHS). BPHS helped translate policy and strategy into practical interventions, focus health services on priority health problems, and helped the Ministry to exert its stewardship role. As a result, access to and utilisation of primary health care services in rural areas increased dramatically; access for women to basic health care improved; more deliveries were attended by skilled personnel; supply of essential medicines increased; and the health information system became more functional.
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Johnson, R., Ockelford, J. & Power, T. (2013). Learning from BSF: Lessons from the Basic Services Fund, South Sudan, 2006 to 2012. London: Department for International Development.
This review seeks to provide lessons to DFID and other stakeholders in the design of future pooled funds and coordinated delivery mechanisms. What began as a short-term bridging fund to deliver basic services in health, education and WASH over 20 months has been renewed with a succession of short- term extensions, to the end of 2012. Over this period, in a context where other programmes have been seen to struggle, BSF has developed a reputation for delivering outputs on the ground.
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Zivetz, L. (2006). Health Service Delivery in Early Recovery Fragile States: Lessons from Afghanistan, Cambodia, Mozambique, and Timor Leste. Washington, D.C.: United States Agency for International Development (USAID) and BASICS.
What are the impacts of foreign assistance on state stewardship of the health sector in early recovery fragile states? How can foreign aid encourage better state performance? This case study finds that donors have undermined state capacity to regulate service delivery by creating a two-track system. Promising approaches to support state stewardship include: contracting with NGOs; equity funds; civil service performance-based reform; sectoral plans; and budget support. Increased donor harmonisation is also important.
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For further resources, see section on service delivery in fragile and conflict affected contexts in the GSDRC’s fragile states’ guide.