Social Provision in Low-Income Countries

New Patterns and Emerging Trends

During recent years, provision of key social services in low-income countries has been affected by adverse macroeconomic conditions and by radical changes in economic thinking. For example, the welfarist approach, which gives prominence to the state in delivering and financing social services, has been challenged by the neoliberal approach, which limits the role of the government to that of residual provider for the very poor. According to the neoliberal approach, the private sector could, by relying on price mechanisms, achieve more efficient provision. However, this approach relies on a rather narrow definition of efficiency which ignores social externalities in the delivery and use of services. "Social Provision in Low-Income Countries" analyses the merits and limitations of both welfarist and neoliberal approaches to the provision of key social services in terms of the outcomes and sustainability of the two approaches. The volume proposes an alternative model of social provision, characterized by multiplicity in service delivery and financing. The new model, in which households, civil society, and government play important roles, avoids the inefficiencies of state provision and the exclusion and fragmentation of market-based systems. The authors argue for an integrative approach which encourages the equity and efficiency gained from a synergistic relationship between various service providers. They further argue that the well-known market and government failures in social provision are due to undesirable extremes in policy design, rather than to inherent characteristics of market or government institutions. The strengths of this new approach are illustrated with case studies from Chile, China, Tanzania, and Zimbabwe. The volume also describes how social services in Finland were organized in the early stages, and draws policy lessons for present day developing countries.

Table of contents
  1. 1. Introduction: Context and Scope
    Germano Mwabu, Reino Hjerppe, Cecilia Ugaz, Gordon White
  2. Part I: Theoretical Background
    2. The Process of Economic Change
    Douglass C. North
    More Working Paper | The Process of Economic Change
  3. Part I: Theoretical Background
    3. Alternative Approaches to Welfare Policy Analysis: New Institutional Economics, Politics, and Political Economy
    Sarah Cook, Gordon White
  4. Part I: Theoretical Background
    4. Provision of Social Services: Civil Economy, Cultural Evolution, and Participatory Development
    Pier Luigi Sacco, Stefano Zamagni
  5. Part II: Patterns of Social Provision
    5. The Role of Civic Organizations in the Provision of Social Services: Towards Synergy
    Mark Robinson, Gordon White
    More Working Paper | The Role of Civic Organizations in the Provision of Social Services
  6. Part II: Patterns of Social Provision
    6. Strategies of Social Provision: Key Design Issues
    Sanjay Reddy
  7. Part II: Patterns of Social Provision
    7. Contexts of Caretaking: Privatism, Diversity, and Households in Social Provision
    Nanneke Redclift
  8. Part II: Patterns of Social Provision
    8. The Role of the State in the Provision of Social Services: Decentralization and Regulation
    Cecilia Ugaz
    More Working Paper | Decentralization and the Provision and Financing of Social Services
  9. Part III: Financial Issues
    9. User Fees, Expenditure Restructuring, and Voucher Systems in Education
    Simon Appleton
    More Working Paper | User Fees, Expenditure Restructuring and Voucher Systems in Education
  10. Part III: Financial Issues
    10. User Charges for Health Care: A Review of the Underlying Theory and Assumptions
    Germano Mwabu
    More Working Paper | User Charges for Health Care
  11. Part IV: Case Studies
    11. Provision of Social Services in Chile: A Search for a New Model
    Dagmar Raczynski
  12. Part IV: Case Studies
    12. Cost Recovery and Equity in the Health Sector: The Case of Zimbabwe
    Kevin Watkins
  13. Part IV: Case Studies
    13. Village-Based Provision of Key Social Services: The Case of Tanzania
    Marja-Liisa Swantz
    More Working Paper | Community and Village-Based Provision of Key Social Services
  14. Part IV: Case Studies
    14. Market-Based Reforms and Changes in China's Health Care System
    Dezhi Yu
  15. Part IV: Case Studies
    15. Social Provision in Finland: A Historical Perspective
    Sakari Härö, Esko Kalimo
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'... an extraordinarily rich and scholarly contribution with a strong policy flavour.' - Development and Change

'Often such collections suffer from weak and arbitrarily chosen analytical frameworks, unevenness in addressing key analytical and policy questions, and a general lack of coherence. This volume is a refreshing exception, and makes an important contribution to the development literature.' - Development and Change