Num comentario enviado na Semana 6, Belinda Calaguas da WaterAid examinou como prestadores de servicos de agua privados e publicos podem ser orientados a servir pessoas de baixa renda quando estes falham em faze-lo.
O primeiro passo e nao deixar nenhuma duvida de que as pessoas de baixa renda devem ser servidas, escreveu Belinda. Este requerimento deve ser incluido nos contratos entre prestadores privados e nos acordos de servico com fornecedores publicos ou nao-governamentais.
Entretanto, este e apenas o primeiro passo, porque ha outros obstaculos. Por exemplo:
'Em Dhaka, Bangladesh, o Departamento de Agua e Esgotos de Dhaka (Dhaka Water and Sewerage Authority - DWASA), que e um prestador publico, recusou-se a servir comunidades de baixa renda nas favelas da cidade, em parte devido a crenca de que os pobres nao pagam pelos servicos, em parte porque tal departamento baseou-se em normas urbanas e na legislacao de posse de terra urbana, as quais o prevenia de servir pessoas em loteamentos informais.

'Atraves do trabalho com ONGs locais que trabalharam com comunidades de baixa renda, o DWASA descobriu que os pobres nao apenas pagam pelos servicos, mas tambem que, de fato, eles sao melhores clientes se comparados a, por exemplo, os clientes domesticos, comerciais e governamentais que nao pagam suas contas regularmente, os quais contribuem consideravelmente com o indicador de agua nao-remunerada ou falha do DWASA.

'No entanto, mesmo onde o DWASA descobriu isso ate agora, e deseja prestar o servico para comunidades urbanas de baixa renda, tal departamento nao consegue assegurar os recursos para faze-lo (alem dos recursos de ONGs que continuam a trabalhar com o DWASA) entao seu programa de expansao para areas de comunidades urbanas pobres ou informais esta seriamente comprometido.'
O exemplo de Dhaka mostrou o que a campanha e defesa de direitos por parte de ONGs pode fazer, Belinda comentou, acrescentando que:
'Esta bem, voce nao pode ter uma ONG sempre disponivel para trabalhar junto a comunidades pobres para fazer suas vozes serem ouvidas, em todos os lugares em que isso e necessario. Por outro lado, especialmente em areas urbanas pobres, quase sempre ha grupos de bairro - associacoes de ajuda mutua, grupos de auto-ajuda ou organizacoes mais formais, associacoes de maes, etc. - que sao formados pelos membros da comunidade em virtude da sua necessidade.
'O que e preciso e uma unidade de servico dentro do prestador, cuja tarefa e aproximar-se destes grupos de bairro e de trabalhar com eles para examinar suas demandas relacionadas ao servico de agua. Se o prestador privado, como Manila Water, o concessionario oriental em Manila, pode criar uma unidade como esta (e, ainda por cima, uma unidade decentralizada e local), entao por que nao e possivel faze-lo dentro de um prestador publico?
'Estas unidades desempenhariam uma funcao similar a das ONGs no caso acima: fariam pressao para que os servicos fossem disponibilizados para pessoas de baixa renda e tambem vislumbrariam mecanismos que possibilitariam faze-lo. Prestadores publicos precisariam de recursos para criar estas unidades, que seriam contabilizados no preco do fornecimento de agua, especialmente nos subsidios cruzados.'

Belinda acrescentou ainda que os elaboradores de politica governamental, prestadores de servicos e representantes de pessoas de baixa renda precisam conversam mais entre si sobre como melhorar os servicos e, mencionou o exemplo bem-sucedido do papel desempenhado pela ONG Forum sobre Fornecimento de Agua em Kathmandu no Nepal.
Este 'tipo mais participativo e deliberativo de democracia' ja provou o seu valor e, com trabalho arduo, pesquisa independente e, acima de tudo, vontade politica, o sucesso de Kathmandu pode ser copiado em outros lugares.

Submitted by: Ana Beatriz Urbano Andari -- June 11,2003
Country of Residence: United Kingdom
Country of Origin/Citizenship: Brazil
Institutional Affiliation: Public World
Occupation: Mediadora (lingua portuguesa)
Language:

Decentralisation

The bias in favour of private provision against public is mirrored in the promotion of the local over the central. Empowering clients at the point of service delivery – a laudable objective - is assumed to require disempowering central government, which is depicted as predatory by its nature, and in hock to elite interests.

Yet in many low-income countries, the absence of effective, predictable central government, rather than too much government is the problem. De facto decentralisation already exists across large parts of rural Africa, Asia and Latin America, where central government is physically and functionally distant. The result for poor people has been under-funded, unaccountable, unaffordable, inaccessible and inappropriate services, which reinforce the poverty cycle.

In these circumstances, the priority for the Bank, and for other institutions responsible for supporting international development efforts, should be the establishment of effective central government, not its circumvention. In short, empowering citizens will in many cases require empowering central government.

The choice of terminology in the draft WDR is telling – especially it’s description of the ‘long’ and ‘short’ routes to accountability. This language is prejudicial, and should be changed.

The ‘long route’ – accountability from government to the public, and from service provider to government – suggests a time-consuming, inefficient approach to accountability, which is prone to failure. Yet this is the main route of accountability in rich countries, and while imperfect it has been shown it can work.

The ‘short route’ is presented as a quick fix, but in practice it may not be so short. Information asymmetries between service provider and user, the opportunity costs of monitoring and regulation, and the presence of local monopolies mean that communities and individuals are often unable or unwilling to monitor or regulate basic services.

EDUCO in El Salvador, where communities are directly responsible for teacher hiring and firing, is cited as a prime example of the short route succeeding. Yet as evaluations of EDUCO show, the programme has struggled where there was no pre-existing community organisation around the school, poor rural communities resent being made to contribute in-kind to management costs which are met by the ministry in urban schools, and unit costs are no lower than for conventional ministry schools.

Meanwhile, staff turnover is much higher than in the mainstream system, as teachers try to obtain more secure postings in the ministry schools. The point is not that decentralisation of decision-making necessarily cannot work, but that it is difficult to generalise and scale up from specific experiences (EDUCO originated in the experience of community schools run in FMLN-controlled areas during the civil war, and is widely regarded in El Salvador as an attempt by government to co-opt institutions associated with the political opposition), and that there are serious equity risks where you decentralise too far, or too fast.

Ultimately, the WDR is presenting a false choice – you need both routes to accountability to be open, as they are in most OCED countries, where voter choice influences central government provision/regulation of basic services, alongside some form of community governance (for example, through PTAs and school boards).

Submitted by: Patrick Watt -- June 10,2003
Country of Residence: United Kingdom
Country of Origin/Citizenship: United Kingdom
Institutional Affiliation: ActionAid
Occupation: Policy adviser
Language:

Белинда Калагуас, работник сферы развития (организация УотерЭйд, Великобритания), предлагает несколько реформ, необходимых для того, чтобы бедные могли влиять на качество общественных услуг.
Прежде всего, провайдеры должны осознать, что бедных необходимо обслуживать. (Об этом должно быть недвусмысленно заявлено в контракте, если это частный сектор, или в соглашении о предоставлении услуг, если это общественная или неправительственная организация).
Существует множество барьеров тому, чтобы провайдер признавал бедных как клиентов. В секторе поставки воды, как государственные, так и частные поставщики считают, что бедные не могут или не хотят платить за воду. В действительности же бедные платят в несколько раз больше, чем государственный или частный заказчик (у которого, кстати, есть субсидии). Причина в том, что они получают воду от неофициальных провайдеров (продавцов воды) и наслаждаются благами неофициального рынка воды. (Этот рынок появился благодаря неспособности общественных услуг по обеспечению водой обслуживать бедных).

Submitted by: Oksana Buranbaeva -- June 09,2003
Country of Residence: United States
Country of Origin/Citizenship: Russia
Institutional Affiliation: Public World
Occupation: Moderator
Language:

This is a translation of comments, posted by Alexander Nika from Moldova. The original comment appears in Russian.

“In response to comments by Lena Safargaleeva from Russia, I would like to share my view of medical services in the post-soviet space.

In the healthcare sector, lack of funding and low salaries lead to bribery. In Moldova, where agriculture is the main sector of the economy, patients often pay for medical services with agricultural and farm products. Facing the choice between law and treatment, which, in fact, stand for death and life, health and sickness, people bribe doctors with food products. It is considered to be “normal” to thank an urban doctor who does not have his own garden or a farm.

However, these conditions are changing. Moldova, in particular, has set a certain minimum of medical services that citizens receive for free. Medical consultations are included in this minimum, and another group of consultations can be received at a very low price. This innovation was caused by the necessity of financial self-sufficiency of medical organizations when the state budget is not able to provide funding for all social needs.

However, I assume paid medical services would bring about not only improvement of doctors’ attitude to their patients and introduction of quality services, but also elimination of bribery practices in healthcare. With low salaries in the healthcare sector, bribery appears a lot due to simple human desire to thank a doctor. Today, in Moldova one can do it openly through a cashier of a hospital.”

Submitted by: Oksana Buranbaeva -- June 07,2003
Country of Residence: United States
Country of Origin/Citizenship: Russia
Institutional Affiliation: Public World
Occupation: Moderator
Language:

Dans son commentaire (semaine 6), Belinda Calaguas de WaterAid explique comment les fournisseurs d'eau qu'ils soient privés ou publics peuvent être forcés à approvisionner la population pauvre.

Belinda écrit que tout d'abord il faut qu'il n'y ait aucun doute sur l'obligation de servir la population pauvre. L'obligation doit être inscrite dans les contrats des fournisseurs privés et dans les accords de service des autorités publiques ou non gouvernementales.

Cela n'est qu'un premier pas car il y a d'autres obstacles:

"A Dhaka, au Bangladesh, le service des eaux et des égouts de Dhaka (DWASA) qui est un fournisseur public refuse de servir les communautés pauvres dans les bidonvilles. Cela est du en partie à la crainte que les pauvres ne payeront pas et en partie à cause des régulations municipales et des lois foncières qui soit disant empêchent de servir la population urbaine pauvre vivant dans des habitations informelles.

Grâce au travail d'ONG locales qui ont travaillé avec les communautés urbaines pauvres, DWASA a découvert que non seulement les pauvres peuvent payer mais qu'en réalité ils sont de meilleurs clients comparés à ceux qui ne payent pas leurs factures d'eau régulièrement (gouvernement, entreprises et particuliers) et contribuent au manque de ressources de DWASA.

Cependant, alors même que DWASA veut désormais fournir plus de services à la population pauvre, le manque de ressources compromet sérieusement l'expansion des services dans les zones urbaines pauvres.

L'exemple de Dhaka montre ce que l'action des ONG locales peut réaliser commente Belinda qui ajoute:

"D'accord on ne peut pas avoir une ONG toujours disponible pour travailler avec les communautés pauvres et faire entendre leurs intérêts quand cela est nécessaire. D'un autre coté, dans les zones urbaines pauvres il y toujours des groupes communautaires – associations d'entraide, unions de mères de famille, organisations etc. – dont la création est liée aux besoins spécifiques de la communauté.

Il faut que les fournisseurs de services aient une unité dont le rôle est de faire le lien entre ces groupes et de travailler avec eux pour résoudre leurs besoins en eau. Si un opérateur prive comme Manilla Water, le concessionnaire d'eau de Manille, peut créer une telle unité qui en plus est décentralisée, pourquoi pas un opérateur du service public?

Ces unités auraient une fonction similaire à celle des ONG dans le cas cité plus haut: demander que les services soient fournis aux pauvres et établir les mécanismes nécessaires. Les fournisseurs publics auraient besoin de ressources pour créer ce type de département ce qui devrait être facturé dans le calcul du prix de l'eau".

Belinda ajoute que les décideurs gouvernementaux, les fournisseurs de services et les représentants de la population pauvre ont besoin de se concerter plus sur les moyens d'améliorer les services publics. Elle cite en exemple le rôle du Forum d'ONG sur l'approvisionnement d'eau à Katmandu, au Népal.

Cette "approche de démocratie plus participative" a montré ses bénéfices et avec un travail continu, des recherches indépendantes et surtout une volonté politique l'exemple de Katmandu pourrait être reproduit ailleurs".

Submitted by: Marie -- June 07,2003
Country of Residence: United Kingdom
Country of Origin/Citizenship: France
Institutional Affiliation: Public World
Occupation: Moderatrice
Language: