Public Accountability and Service Delivery in Enugu State Civil Service : Interrogating Major Challenges

This article examines the crisis of the career civil service systems in Sub-Saharan African (SSA) countries in the 1990s against the background of the progressive abandonment of the key features of the Weberian bureaucratic models inherited by the countries at independence in the 1960s. After analysing the major explanatory factors for the crisis (adoption of one-party systems, advent of military governments and the triumph of patronage over the merit system) and the consequent decay of the institutions in many countries, the efforts made to rehabilitate the institutions in the 1990s are assessed. The assessment pays particular attention to the two strong developmental trends of the decade: simultaneous establishment of functioning market-friendly economies and functioning democratic governments. The article concludes by proposing the redesign of Africa’s career civil service systems with a view to addressing three key challenges that are critical to achieving and sustaining functioning market economies and functioning democracies: state continuity, efficient service delivery and accountability of the governors to the governed. Specific changes to the career civil service systems that are proposed include, among others, clear separation of political from career appointments; the introduction or increased use of contract appointments at managerial and technical professional levels (as a transitional arrangement); and de-linking local governments and parastatals from the civil service. The critical importance of an enabling sociopolitical and economic environment for a civil service capable of tackling the three challenges is also emphasized.

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Adapting Public Sector Services to Local Delivery

THE LAHORE JOURNAL OF ECONOMICS ◽

10.35536/lje.2012.v17.isp.a15 ◽

2012 ◽

Vol 17 (Special Edition) ◽

pp. 359-385 ◽

Cited By ~ 1

Author(s):

Ishrat Husain

Keyword(s):

Local Government ◽

Service Delivery ◽

Public Service ◽

Local Governments ◽

Business Processes ◽

Civil Service ◽

Fiscal Decentralization ◽

Education And Health ◽

Number Of Factors ◽

Management Policies

This article describes the local government system established in the 2001 Devolution Plan and its evolution over the period 2002-07, with a focus on two essential public services, education and health. We believe that the devolution of service delivery functions, delegation of financial powers, decentralization of authority, and deconcentration of executive powers, can, together, lead to better accountability of results and, hence, to improved public service delivery to the poor and marginalized. The Devolution Plan made inroads toward these goals, particularly in education, but their achievement was incomplete due to a number of factors, among those incomplete fiscal decentralization, limited targeting of backward areas, and centralizing tendencies of the provincial departments and civil service. Recommendations are offered on how to further develop the local government system more generally, with an eye towards increasing accountability and improving coordination both across local governments and between tiers. For this, complementary reforms to simplify business processes and revamp human resource management policies are needed; introducing a district level civil service is among the suggested changes. The article concludes with detailed recommendations on improving the decentralized delivery of education and health services.

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How ready is the system to deliver primary healthcare? Results of a primary health facility assessment in Enugu State, Nigeria

Health Policy and Planning ◽

10.1093/heapol/czaa108 ◽

2020 ◽

Vol 35 (Supplement_1) ◽

pp. i97-i106

Author(s):

Adanma Ekenna ◽

Ijeoma Uchenna Itanyi ◽

Ugochukwu Nwokoro ◽

Lisa R Hirschhorn ◽

Benjamin Uzochukwu

Keyword(s):

Service Delivery ◽

Urban Health ◽

Primary Healthcare ◽

Communicable Disease ◽

Service Availability ◽

Facility Assessment ◽

Primary Health ◽

Health Centres ◽

Service Readiness ◽

Enugu State

Abstract Primary health centres are an effective means of achieving access to primary healthcare (PHC) in low- and middle-income countries. We assessed service availability, service readiness and factors influencing service delivery at public PHC centres in Enugu State, Nigeria. We conducted a cross-sectional study of 60 randomly selected public health centres in Enugu using the World Health Organization’s Service Availability and Readiness Assessment (SARA) survey. The most senior health worker available was interviewed using the SARA questionnaire, and an observational checklist was used for the facility assessment. None of the PHC centres surveyed had all the recommended service domains, but 52 (87%) offered at least half of the recommended service domains. Newborn care and immunization (98.3%) were the most available services across facilities, while mental health was the least available service (36.7%). None of the surveyed facilities had a functional ambulance or access to a computer on the day of the assessment. The specific-service readiness score was lowest in the non-communicable disease (NCD) area (33% in the rural health centres and 29% in the urban health centres) and NCD medicines and supplies. Availability of medicine and supplies was also low in rural PHC centres for the communicable disease area (36%) and maternal health services (38%). Basic equipment was significantly more available in urban health centres (P = 0.02). Urban location of facilities and the presence of a medical officer were found to be associated with having at least 50% of the recommended infrastructure / basic amenities and equipment. Continuing medical education, funding and security were identified by the health workers as key enablers of service delivery. In conclusion, despite a focus on expanding primary care in Enugu State, significant gaps exist that need to be closed for PHC to make significant contributions towards achieving universal healthcare, core to achieving the health-related Sustainable Development Goal agenda.

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