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PROFILE

M. YOUSUF SHAIKH

COLUMN FOR THE RECORD
SOCIETY 1- HIGHER EDUCATION
2- FAST FOOD IS IT SAFE FOOD?
POLITICS & POLICY POOR DELIVERY OF SOCIAL SERVICES
SPECIAL REPORT DOMESTIC REGULATION AND DIPLOMACY IN TELECOMMUNICATIONS
 
POOR DELIVERY OF SOCIAL SERVICES
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Adding to poverty in Pakistan


By AKRAM KHATOON
Mar 15 - 21, 2003
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Quite a number of developing countries specially in South East Asia, including Pakistan have made a headway in achieving macro economic stability, lowering inflation and fiscal deficit and removing stagnancy from economic growth rate. Yet almost all the reports released by United Nations Development Program (UNDP) regarding status of human development and poverty in 174 countries, based on each country's literacy rate, longevity, gender sensitivity and status regarding environmental protection have awarded low ranking to majority of Asian & African countries. The report depicts that countries striving for higher economic growth rate and macro-economic stability have not been able to get out of clutches of poverty. It is just because of the fact that social sector was not accorded due attention despite enhanced budgetary allocations and liberal funding received from foreign agencies to achieve UN Millenium development goal of halving the poverty by the year 2015.

In Pakistan, despite enhanced funds allocation for education, no significant improvement is visible in enrolment at primary level in schools nor reduction in drop out rate. 'Education for all' program has not gained momentum. Thus achievement of 80% enrolment target by 2005 remains a distant dream. The standard of education in state-owned schools continue to deteriorate.

On the health front, although mortality rate has considerably reduced, but female mortality at reproductive age and neonatal deaths remain highest among developing countries.

Gender inequality is being felt with greater intensity in almost all aspects of life, despite country being signatory to 'Convention on Elimination of all Discrimination Against Women' (CEDAW).

Environmental degradation is going on unchecked, especially in industrial cities despite sizable funds allocation for environmental protection. Resultantly poverty situation is getting worse with each passing day in the face of improved economic growth indicators.

Sizable allocation of Rs.160 billion in developmental budget and its promised future enhancement @0.2% of GDP, if properly managed and monitored at all levels of delivery of these social services can make a difference. Actually it is establishments failure to properly monitor use of funds and infrastructure both for providing safety nets and direct service to the poor like health care, education, clean drinking water, sanitation and transport facility etc. Allocation of funds, on the average, amounting to 2.7% of GDP annually during the current decade is far below the minimum of 4% prescribed by UNESCO. On top of that, either it is misutilisation of funds or negative attitudes of provider of these services at lower levels, which has brought stagnancy in rate of growth of literacy, thus set target of providing education to all by 2015 seems difficult to achieve.

Despite introduction of local government system, monitoring of delivery of social services to masses has not improved. It is due to so called clash of interest between provincial and local governments. Federal government being policy maker for education and health sector in consultation with provincial and local governments and other relevant stake holders, who are in direct contact with public/communities, need to delegate implementation task to local governments with allocation of budgeted funds. In this regard it is essential that local governments are fully authorized to reallocate the funds according to changing needs of each sector. Local governments in turn must ensure that service is delivered to the targeted population (poor), for which they need to do vigorous monitoring and unhindered release of funds at all levels and at each stage of the project undertaken. The front office or front personnel (In health sector hospitals, doctors and field staff and in case of education, universities, Directorate of education in each district, Principals of colleges and schools etc), who are directly in touch with targeted users, for delivery of services, should have regular supply of funds and resources to offer services on continuous basis.

Newly introduced local governments, being a tier of establishment have direct link with user of services. Hence there is need of proper coordination and cooperation among local and provincial government for proper and timely utilization of budgeted funds to achieve set targets of delivery of services relating to each component of social sector. It is due to lack of coordination that an initiative from the side of Federal government to allocate a budget of Rs.160 billion for public sector developmental expenditure could not meet periodical target. As per news item of February 19, 2004 appearing in leading Dailies, during half year between July and December of 2003, only 30% of the PSDP allocations were utilized. For social sector only 28% of annual budget amount was released for the first half of current fiscal year and even out of that only 23% could be utilized. This leaves a wide gap between developmental work to be done during first half of the year and what was actually done for the social sector. Things cannot be left as they are. Despite political rivalries and administrative clogs, social services need to be delivered to the poor segment of population in order to ensure success of poverty reduction program.

Regarding education sector priority should be to improve enrolment rate and arrest drop out rate in primary and secondary state owned schools. No doubt current fiscal budget contains sizable allocations, but it needs strict monitoring and also collaboration with Non governmental agencies (NGOs) and Community based organizations (CBOs) who due to their presence in rural and far-flung areas can influence parents to send their children to schools. Some of the NGOs headed by notable singers have ventured into eliminating child labor and providing cash incentives to financially disadvantaged parents to send their children to schools.

 

 

Next needed initiative is to improve standard of education in public sector schools. This would be possible only by deploying qualified teachers, selected strictly on merit. The curriculum needs revision keeping in view advancement in science and technology. In this area also public and private sector partnership is needed. Recent move to offer public sector schools for adoption by private sector organizations and individuals has been found quite successful in improving quality of education in government schools. The adoption does not pass on the ownership to adopter. The teachers remain on pay roll of government. However the adopting agency or individual can induct additional teachers and monitor the performance of existing teachers by applying carrot and stick approach. This can be done by providing incentives in the form of cash awards for good performance and menace of frequency of absenteeism among teachers, which is a common complaint against them can be checked by moving education department to take disciplinary action against defaulting teachers.

The writer having association with an NGO who have adopted four government schools of katchi abadis in Karachi see a significant improvement in teachers' behavior, discipline amongst students and above all standard of education of those schools.

The NAZIMs in each district/town must form teams of retired educationists for monitoring performance of public sector schools in particular through frequent scheduled as well as surprise visits.

In order to achieve UN Millenium goal for eliminating gender disparity from education sector, which is more acute in rural areas, it should be ensured that girl schools are available in sufficient number in each district. In order to ensure that quality education is imparted in these schools, induction of teachers should be strictly on merit. The teachers residing in cities if posted in far-flung and less developed areas must be given special incentives and facilities.

A very recent initiative of Punjab government to provide scholarship of Rs.200/- per month to girl students of state-owned schools, and similar moves in other provinces for providing free lunch, text books and uniforms to girls from financially disadvantaged families, would definitely enhance female enrolment in schools. Of late UNESCO has come forward in big way to assist Government of Pakistan to implement all projects to improve literacy rate among women.

In health sector, for making services accessible to people at grass root level, budgetary allocations need to be enhanced. Spending 0.7% of GDP on health and even that not always directed to the needs of poor population. In the scenario where political patronage is the assumed norm of life, little can be expected for betterment of common man.

The appointment of lady health visitors to serve female population in rural areas and katchi abadis in urban parts has helped provision of basic health facilities and guidance to women and children. However there is need to strictly monitor and supervise the performance of field medical staff, which can be done in collaboration with CBOs and area councilors.

In order to make all immunization and vaccination programs really work effectively, these services should be contracted out to private or non-profit sector.

Further, it is the fact that despite government's total focus on eradicating poverty from masses, things have not improved at all in rural areas. It is mainly due to the fact that parliamentarians in general and those from rural areas in particular are not pro-poor, as such never bother to ensure provision of all medical care to disadvantaged families of their constituencies. In such circumstances it would be advisable to contract out delivery of basic health services to NGOs doing community development work in rural and less developed parts of the country.

Lack of information about medical facilities available is yet another factor responsible for inaccessibility of services to masses. Dissemination of information through NGOs, field health workers, electronic media, press and leaflets in vernacular languages can make the poor use various health services available at local medical centers and hospitals.

In recent years private sector has also come forward in a big way to share the responsibility of providing free health care or low cost medical facilities for poor. Quite a number of NGOs are providing free medical check ups, medicines and meeting all type of surgery needs cost free by occasionally arranging medical camps and also through their members owned hospitals etc. Some of the NGOs having Trust funds and sizable assets of their own and also philanthropists have set up hospitals in less developed areas of the country. However there is need of replication of such moves all over the country.

In order to monitor and supervise the delivery of medical services to masses, it is advisable that "Community health councils" are formed in all towns, mohalla and villages on the pattern of UK and other European countries, which come under the category of voluntary services. The doctors, teachers and members of the community work as watch-dogs to find out the quality of service offered in hospitals through direct contact with patients.

Apart from providing medical facilities NGOs have been found motivating inmates of villages to make available for them clean drinking water through tube wells etc on self help basis. NGOs initiate such programs by putting in little seed money, thus motivating inmates of communities to make their contribution for boring the tube well.

 

 

Some notable NGOs, through their endeavors, have considerably improved the sanitation conditions in villages and katchi abadis by motivating people to put in place a proper drainage system on self help basis. Orangi Pilot project is the living example of such initiatives from the side of a non-governmental organization.

Lastly for making all policies gender sensitized, women parliamentarians, senators and councilors having sizable representation in Assemblies and Local government can play an important role. They instead of furthering their individual political agenda must collectively fight for eliminating all discrimination against women and thus empowering them economically and socially to ensure their participation in all walks of life on equal footings.