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Local Government Accountability for Health Service Delivery in Nigeria

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  • Stuti Khemani

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. Copyright 2006, Oxford University Press.

Suggested Citation

  • Stuti Khemani, 2006. "Local Government Accountability for Health Service Delivery in Nigeria," Journal of African Economies, Centre for the Study of African Economies, vol. 15(2), pages 285-312, June.
    • Handle: RePEc:oup:jafrec:v:15:y:2006:i:2:p:285-312
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    Cited by:

    1. Thiemo Fetzer & Stephan Kyburz, 2024. "Cohesive Institutions and Political Violence," The Review of Economics and Statistics, MIT Press, vol. 106(1), pages 133-150, January.
    2. Junaid Ahmad & Shantayanan Devarajan & Stuti Khemani & Shekhar Shah, 2006. "Decentralization and Service Delivery," Chapters, in: Ehtisham Ahmad & Giorgio Brosio (ed.), Handbook of Fiscal Federalism, chapter 10, Edward Elgar Publishing.
    3. World Bank, 2008. "Nigeria - Agriculture Public Expenditure Review," World Bank Publications - Reports 7923, The World Bank Group.
    4. Schaeffer, Michael & Yilmaz, Serdar, 2008. "Strengthening local government budgeting and accountability," Policy Research Working Paper Series 4767, The World Bank.
    5. Olofinbiyi, Tolulope & Mogues, Tewodaj, 2017. "Who Influences Government Spending in Agriculture? The Roles of Public Actors in Subnational Funding Allocation in Nigeria," Feed the Future Innovation Lab for Food Security Policy Research Papers 259572, Michigan State University, Department of Agricultural, Food, and Resource Economics, Feed the Future Innovation Lab for Food Security (FSP).
    6. Gauri, Varun & Jamison, Julian C. & Mazar, Nina & Ozier, Owen, 2021. "Motivating bureaucrats through social recognition: External validity—A tale of two states," Organizational Behavior and Human Decision Processes, Elsevier, vol. 163(C), pages 117-131.
    7. World Bank, 2007. "China : Public Services for Building the New Socialist Countryside," World Bank Publications - Reports 7665, The World Bank Group.
    8. Gauri, Varun & Jamison, Julian C. & Mazar, Nina & Ozier, Owen, 2019. "Motivating Bureaucrats through Social Recognition: External Validity — A Tale of Two States," IZA Discussion Papers 12251, Institute of Labor Economics (IZA).
    9. Stuti Khemani, 2010. "Decentralization by Politicians: Creation of Grants-financed Local Jurisdictions," Chapters, in: Núria Bosch & Marta Espasa & Albert Solé Ollé (ed.), The Political Economy of Inter-Regional Fiscal Flows, chapter 9, Edward Elgar Publishing.
    10. Mogues, Tewodaj & Olofinbiyi Tolulope, 2017. "Institutions And Public Agricultural Investments: A Qualitative Study Of State And Local Government Spending In Nigeria," Feed the Future Innovation Lab for Food Security Policy Research Papers 259576, Michigan State University, Department of Agricultural, Food, and Resource Economics, Feed the Future Innovation Lab for Food Security (FSP).

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