New Data: Information Access in Health and Education Service Delivery in Macedonia

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Global Integrity is pleased to announce the release of our first Local Integrity Initiative pilot project in the health and education sectors, an exercise we collaborated on last year with the World Bank’s Human Development anchor and the Center for Research and Policymaking (CRPM) in Macedonia. Our fieldwork attempted to answer a relatively simple but powerful question: does increased access to key information impact health or education service delivery at the facility level? To answer that, we developed and fielded Integrity Indicators aimed at unpacking the role that information access plays in improving (or not) education and healthcare service delivery in Skopje, Macedonia.

Why the focus on information access in key human development sectors? For the past several years, information transparency has been theorized to be one of the key pillars of good governance in health and education service delivery, especially with respect to its potential to empower citizens to demand better service delivery and hold providers accountable. To unpack this claim, Global Integrity and CRPM attempted to assess four key dimensions of information access in the health and education sectors that have been hypothesized to have a significant impact on citizen empowerment and participation. These four dimensions, or “buckets,” included: 1) Basic Issues around the Existence and Usability of Information in Healthcare and Education; 2) Redress Mechanisms that Enforce Accountability in the Health and Education contexts; 3) Availability of Fiscal/Budget Information with which to Conduct Citizen Audits of Local Schools and Clinics; and 4) Citizen Participation in Local Decision-Making as Influenced by Availability of information.

The results of this pilot study did not address why certain information transparency and accountability mechanisms may or may not empower beneficiaries, but they proved a useful tool in mapping and identifying what information-related rights, institutions, and mechanisms exist and how effective they are (or are not) at providing health- and education-related information to service beneficiaries.

While some of the results were predictable, others surprised us. To wit:

The absence of home-grown, citizen audit and community monitoring groups in both sectors, which stands in contrast to the relative robustness of official government audits and monitoring in these sectors;

Significant implementation gaps between information access laws (as they relate to education and healthcare service delivery) and their implementation and enforcement;

The importance of informal mechanisms and processes in information sharing and dissemination;

How information is transmitted significantly determines whether citizens can access information that is publicly released.

The full report has all of the details describing the methodology as well as detailed results (and spreadsheets of data!).

Based on the initial success of the Macedonia assessment, we are expanding similar work to Kenya and Ukraine and will begin fielding data soon in both countries, likely in two localities in each target country. Stay tuned.

— Global Integrity

— Image: Yana Buhrer Tavanier (CC by/nd)

Global Integrity
Global Integrity

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