Local government accountability for health service delivery in Nigeria
Local government accountability for health service delivery in Nigeria
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DOI：
10.1093/jae/eji029
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发表时间：
2006-06-01
影响因子：
1.6
通讯作者：
Khemani, Stuti
中科院分区：
文献类型：
--
作者：
Khemani, Stuti
将权力下放给地方选举产生的政府最近变得流行起来，这是一种改善公共服务提供者向穷人提供服务的激励措施的手段。然而，有关去中心化举措在实践中如何发挥作用的经验证据却滞后。这篇论文提供了来自尼日利亚卫生部门的新的调查证据，尼日利亚是发展中国家中少数几个显著下放财政资源和服务提供责任的国家之一，关于地方选举产生的政府在向公民提供基本卫生服务方面实际上是如何发挥作用的。我们发现地方一级问责制有限的证据，具体反映在不支付卫生工作者的工资上，这种差异不能用呼吁缺乏地方政府可用的资源来解释。面对这一证据，我们在尼日利亚正在进行的关于政府间财政关系的政策讨论的背景下探索解决办法。
Decentralisation to locally elected governments has recently become popular as a means to improve incentives of public providers for service delivery to poor people. Yet, empirical evidence on how decentralisation initiatives work in practice is lagging. This paper provides new survey evidence from the health sector in Nigeria, one of the few countries in the developing world to have significantly decentralised both fiscal resources and service delivery responsibilities, on how locally elected governments actually function in delivering basic health services to their citizens. We find evidence of limited accountability at local levels, specifically reflected in the non-payment of salaries of health workers, variation in which cannot be explained by appealing to lack of resources available to local governments. Faced with this evidence, we explore solutions in the context of on-going policy discussions on intergovernmental fiscal relations in Nigeria.