Local Government Accountability for Health Service Delivery in Nigeria

Posted: 29 Feb 2008

See all articles by Stuti Khemani

Stuti Khemani

World Bank; World Bank - Development Research Group (DECRG)

Date Written: June 2006

Abstract

Decentralisation to locally elected governments has recently become popular as a means to improve incentives of public providers for service delivery to poor people. Yet, empirical evidence on how decentralisation initiatives work in practice is lagging. This paper provides new survey evidence from the health sector in Nigeria, one of the few countries in the developing world to have significantly decentralised both fiscal resources and service delivery responsibilities, on how locally elected governments actually function in delivering basic health services to their citizens. We find evidence of limited accountability at local levels, specifically reflected in the non-payment of salaries of health workers, variation in which cannot be explained by appealing to lack of resources available to local governments. Faced with this evidence, we explore solutions in the context of on-going policy discussions on intergovernmental fiscal relations in Nigeria.

Suggested Citation

Khemani, Stuti, Local Government Accountability for Health Service Delivery in Nigeria (June 2006). Journal of African Economies, Vol. 15, No. 2, pp. 285-312, June 2006, Available at SSRN: https://ssrn.com/abstract=915482 or http://dx.doi.org/10.1093/jae/eji029

Stuti Khemani (Contact Author)

World Bank ( email )

1818 H Street, N.W.
Washington, DC 20433
United States

HOME PAGE: http://econ.worldbank.org/staff/skhemani

World Bank - Development Research Group (DECRG)

1818 H. Street, N.W.
MSN3-311
Washington, DC 20433
United States

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