Equitable access to essential public services is vital for human development, inclusive growth, and tackling persistent inequality. Underlying inequalities can be exacerbated or re-produced where access to public services is uneven, or marginalises certain groups on the basis of their identity or location.
Often the main barriers to inclusive service delivery are political and institutional. Common blockages include weak state capacity or commitment, elite capture, skewed incentives of front-line workers, policy incoherence, and an absence of accountability. Yet politics and institutions have also enabled progress in some cases. Recent experience suggests a stable political settlement, political entrepreneurship, and long-term policy continuity can underpin remarkable improvements in access and coverage.
Development partners seeking to support broad-based and inclusive public goods face significant challenges, especially in fragile states where the distribution of access can become deeply politicised, the state may have weak incentives to provide for the basic needs of its people, or where most services are delivered by non-state providers (NSPs). Failure to deliver public services is both a symptom and cause of fragility. Though it is often assumed that services can help to build the state’s legitimacy, in practice this is likely to depend on people’s locally-grown expectations of what should be provided, where, and by whom.
Providing users with information about their rights and entitlements, involving users in design and decision-making forums, strengthening accountability, bringing services closer to the people through decentralised governance, or distributing vouchers are some of the strategies used to improve services. Evidence is to date patchy and inconsistent on the effects of these interventions. Much research emphasises that there are both potentials as well as pitfalls in these approaches.
Whilst there are many challenges, there are also cases where aid has been effective at addressing weak front-line incentives, where services have been delivered in very difficult environments, or where access has been expanded equitably over time. These cases provide multiple lessons. Community engagement can help to address social norms around access. Understanding incentives is often key to improved performance. From an aid perspective, flexible aid, building trust between different actors, and adapting to changing realities are emerging lessons from recent experience.