Consider the following initiatives in service delivery and what they have in common. The Punjab government is handing over the management of 5,000 under-performing government primary schools to NGOs under a public-private arrangement.
In the Lodhran district, the Tareen Education Foundation of political leader Jahangir Tareen has taken over 85 government schools, aiming to improve them in partnership with the Bookgroup, an NGO headed by Karachi educationist Sami Mustafa, which has already established its credentials for making a difference in Sindh.
CARE Foundation, established by Seema Aziz, the owner of the Bareezé chain, has been adopting non-functional government schools in Lahore and other parts of the country, and turning them around.
The Sindh government sponsored the People’s Primary Healthcare Initiative (PPHI), now an autonomous company limited by guarantee under the Companies Ordinance. The PPHI is managing 1,140 government health facilities that were handed over to it, and providing services at a level that has never been seen before in the province.
The PPHI owes its origins and approach to Jahangir Tareen, who enabled the transformation of basic health units in Lodhran, starting in 1999, then in Rahimyar Khan, and eventually in 11 other districts of Punjab.
In Karachi, the Sindh government handed over two schools to the Zindagi Trust, established by pop star Shehzad Roy, who partnered with the Bookgroup to turn them into high-quality institutions. The government then handed over three schools in Khairpur to the Bookgroup under the Sindh Education Reforms Initiative.
These are all provincial government initiatives, supported by the chief ministers, to improve service delivery by taking it outside provincial government departments. All of them have improved, or have the potential to improve, the management of human and financial resources and physical facilities, leading to better results for citizens. All of them have innovative features that can be replicated in other locations, sometimes after adapting them to local conditions.
The websites of these initiatives, validated by the views of independent specialists, highlight the kind of changes that were introduced once the facilities were taken outside the line departments. Any objective observer would agree that these are signposts to the future for improving health and education outcomes.
At the same time, these are all ad-hoc measures, with neither plans nor means for scaling up through the state structure. They affect a fraction of the country’s health and education facilities and a fraction of the population that depends on the state for these services. They remain provincial initiatives, accountable to provincial authorities, lacking transparency and accountability to service users and other local stakeholders. They depend on the limited resources of the provincial governments and the largesse of a few philanthropists. They do not tap into local goodwill and ingenuity and the capacity to contribute among well-to-do local residents. Commendable as they are, these initiatives are not substitutes for institutional reform.
The need for reform should be clear by now. The ratio of taxes to national income in Pakistan is 10 percent, with no sign of increasing and multiple demands that will not allow the state to serve most of its citizens in any sector. Taxpayers and service users are unwilling to pay more to centralised provincial bureaucracies that do not deliver as expected.
Except in a few privileged communities, provincial governments do not have the resources to provide adequate basic services to the growing population. Whether by diligent analysis or physical observation, it is impossible to escape the conclusion that the state in Pakistan does not have the means to provide basic services to the large majority of its citizens, and that this will not change if present trends and systems continue.
The directions for reform should also be clear, now that local government is a provincial subject as a consequence of the 18th Amendment to the constitution, and neither generals nor ministers in Islamabad can be held responsible for its structure and performance.
In mature democracies, local governments provide basic services with their own resources and substantial financial support from senior governments, for whom the removal of regional imbalances is a prime concern as part of the overall approach to fiscal federalism.
In Pakistan, provincial authorities oppose effective local government. Indeed, even initiatives such as those mentioned above are opposed by provincial ministers and civil servants. The state structure is not only ineffective but also incomplete, lacking the vital lowest tier that is closest to the people and most appropriate for many services.
The provinces have done well to engage the best in the country to demonstrate innovative approaches. They now need to engage citizens through special-purpose local governments that focus on health, education, waste management, security and other services for which service users and others have the capacity to pay. There is no other option in sight.
The writer is an economist and international development consultant.
Email: thusain@edcpk.com
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