Saturday, July 6, 2013

Social marketing campaigns in the Cote d'Ivoire

Baobab has a good post on corruption in the Cote d'Ivoire, which is poor even by sub-Saharan African standards, but which seems to be improving under President Ouattara: 
One of the indicators in the ruling justly category is control of corruption, an area in which Côte d’Ivoire fares particularly poorly. The World Bank’s most recent corruption rankings, from 2011, put it 38th out of 49 African countries. Transparency International ranked it 130th out of 176 countries last year in its Corruption Perceptions Index, ahead of Nigeria and Guinea but well behind neighbouring Liberia, Burkina Faso and Ghana. 
Progress has been made under President Alassane Ouattara, who came to power in May 2011. The Transparency International ranking is a big improvement over past years when Côte d’Ivoire hovered around 150th. Mr Ouattara is credited with curbing the corruption that prevailed under his predecessor, though many Ivorians insist shady dealings remain as prevalent as ever, if slightly better concealed.
But the government recently began a publicity campaign against corruption: 
The ostensible idea of the publicity campaign is to create a popular groundswell against corruption to compel elected officials to clean up their acts. Yet the adverts seem to have been met mostly with indifference. Baobab’s unscientific polling over the past few days suggests many Abidjaners think the billboards are adverts for Orange, a mobile service provider.  
A tough new anti-corruption law might be more helpful. But the one being drafted, which would establish an authority to investigate allegations of impropriety, is riddled with loopholes. Many of the original draft’s provisions have been heavily watered down, according to a source close to the process. The latest version reduces the statute of limitations on corruption-related offenses from ten years to three, making it extremely difficult to prosecute cases in time.
It's not a particularly well executed campaign thus far, but I tend to think that such campaigns have the capacity to do more good than new laws.  Even if the government were to pass a model law -- which seems unlikely -- the greater problem lies with enforcement.  In countries such as Rwanda, campaigns aimed at changing norms have met with impressive success, and such campaigns have much to recommend them.  Ultimately, however, the success of either approach will depend on leadership and how well the government's leaders are willing to prioritize the issue.

Thursday, July 4, 2013

How to provide health services at low cost in poor countries

A 2010 McKinsey study proposes "three innovative delivery models to improve low cost primary care" in Tanzania's health care system: 
  1. Community health workers have only limited training but undertake health promotion activities and serve as liaisons to more highly trained colleagues. Because almost every village can have its own community health worker, the basics of health care delivery are available to all. 
  2. Mobile health care is a way to extend the reach of dispensaries and health centers. Health workers regularly travel to surrounding unserved villages (one day a week, for example), bringing basic medical supplies and communication tools. 
  3. Call centers staffed by nurses (with oversight from doctors) can support both community and mobile health workers, who use mobile phones or other communication technologies to consult with call center staff.
Another suggestion (that Dan will enjoy) is to encourage more private ownership of health facilities: 
Many countries encourage ownership of some forms of care delivery...  One innovation that has been used successfully elsewhere is to encourage nonprofit and private organizations to provide more primary care. In some developing countries, dispensaries and health centers that are owner-operated or managed through a social-franchising model complement public-sector facilities. In Kenya, for example, more than 65 franchised dispensaries provide health care to more than 350,000 patients annually. The cost of these facilities is covered not only by government spending and donor contributions but also by payments from patients—which gives staff an incentive to improve care delivery. 

Tuesday, July 2, 2013

Let urbanisation flourish?

Such evidence has one critical implication. There's need to re-consider the role of public investment in urban areas for poverty reduction. In fact it is a popular tenet that investments in Zambia need to be concentrated in rural areas in order to reduce poverty, as our poorest people are mainly concentrated there. However, investments in rural areas are often very onerous as substantial resources are needed to reach a population which is scattered around vast territories. To the extent that urbanisation may have substantial poverty reducing effects on rural areas, urban investments may become an important complement to rural ones in poverty reduction strategies.
More from Zambian Economist here.

Sunday, June 30, 2013

Does economic development inevitably lead to democracy?

Dan and I discussed this awhile back in regard to China (certainly the most important case study).  In light of the recent protests in several emerging countries, the Economist chimed in with some thoughts:
CHAMPIONS of modernisation theory—the idea that prosperity begets democracy—are upbeat. Street protests in Brazil, India and Turkey have rallied mostly middle-class crowds demanding better public services and an end to corruption. Proof, surely, of the American sociologist Barrington Moore’s dictum: “No bourgeoisie, no democracy”...
Yet exceptions abound. Mostly middling earners in Chile supported Augusto Pinochet’s coup in 1973. Few among China’s 800m-strong middle class have demanded democracy. Nor is protest a middle-class monopoly. “Miners and diggers stood up for democracy” in 19th-century Australia, says Daron Acemoglu, an economist at MIT. Their struggle brought secret balloting. In South Korea prosperity and democracy arrived together—but unions and students, not the well-off, called for liberal government. India’s democratic constitution long predated its middle class; and Botswana’s fair institutions took root when it had only a few graduates. 
I agree that the protests from the past few months are a strong point in favor of the idea that development begets democracy, but the issue is far from settled.  The arguments about India and Botswana are neither here nor there.  The question is not whether democracy can exist in the absence of development, but whether authoritarianism can be maintained in a developed economy.