Trust, Voice, and Incentives: Learning from Local Success Stories in Delivery in MENA

The Middle East and North Africa (MENA) is a rising middle-income region, and its citizens rightly expect quality public services. Yet too often they experience disappointment: students attending local schools are insufficiently prepared for the 21st century economy, and those needing health care too often find that public clinics have no doctors or medicines. Few in positions of authority are held accountable for such shortcomings. This situation both undermines the potential for improvement and heightens people’s unhappiness with the delivery system. Although dissatisfaction with education and health services is widespread in the MENA region, local successes do exist and offer inspiration. At the Kufor Quod Girls’ Secondary School in the rural West Bank, for example, Ms. Abla Habayeb, the school’s principal, provides her teachers with daily encouragement and support, and she involves community members, parents, and teachers in decisions about improving the school. Teachers, students, and the community then reciprocate that commitment. Thus, amid the surrounding poverty and instability, Kufor Quod girls excel in national tests. Similarly, in some poor villages in Jordan and Morocco, the leaders of schools and clinics are reaching out to the community, inspiring citizens’ trust and engagement through transparent and inclusive decision making and the delivery of excellent services. Learning from such local successes is vital because there are no blueprints for solving service quality problems. Countries around the world are striving to improve education and health care quality. But simply modernizing school and hospital facilities and training staff are no longer sufficient. Delivering quality services requires motivated staff. And staff motivation arises in turn from values and accountability, which are grounded in the wider political, administrative, and social rules, practices, and relationships. Providing high-quality services is hard; the World Bank itself has struggled to ensure that its projects enhance incentives in country systems to achieve better learning and health outcomes. We argue that because of the complex circumstances found in MENA countries, it is necessary to build on evidence of local successes and positive trends at the level of institutions, performance, and citizens’ trust and engagement. We hope that this report and its recommendations will help citizens, civil servants, policy makers, and donors alike jointly identify and build on the present foundation to improve the delivery of social services, shifting the cycle of performance into a virtuous gear. An improved cycle of performance is what those living in the MENA countries deserve and what would enable them to fulfill their hopes and dreams for the future.