Service Delivery

Faith-based organizations (FBOs) provide a substantial share of education, health and other social services in many developing countries, and it is often argued that the services provided by FBOs tend to be better targeted to the poor and possibly more cost effective than is the case for other private service providers and even for public providers. For instance, a 2006 WHO report suggests that many health services in Lesotho and Zambia are faith-based. These findings have implications for policy, because they affect how donors work with governments when assessing need, quality, and provision of services.

Unfortunately, good data necessary to document the role of FBOs in service delivery are often missing, especially in Africa. To improve data collection, DDVE is conducting a stock taking exercise of the information available in household surveys on the role of FBOs in service delivery. Preliminary results for Africa have been reflected in the 2008 issue of the Africa Development Indicators, the World Bank’s annual flagship publication on data in Africa. DDVE staff and other World Bank staff are also working on a range of case studies on the role of FBOs in service delivery:

• In Bangladesh, World Bank staffs have conducted research on the role of religious organizations in providing education. S ignificant steps to reform the Madrasa (Islamic) school system at the secondary level have included fiscal incentives to orthodox unregistered all-male Madrasas high-schools to register and include modern subjects such as physics and mathematics. Thanks in part to this support, most Madrasa secondary schools are now registered, follow a modern curriculum alongside traditional religious subjects, and they have become coed (50% of the enrollment in Madrasa high-schools are now females). Bank staffs have shown that the impact of financial incentives was significant in transforming Madrasas and promoting female education. Some of the results of World Bank staff work on Madrasas in Bangladesh are available as DDVE working paper 2008-9. Work is also underway to assess the quality of religious education, its effects on labor market participation. A DDVE Note is under preparation to provide a synthesis of this work. 
  
• In Africa, a number of case studies are also underway.  First, work is underway by the Africa Region on the analysis of the performance of various health service providers in Rwanda, with a focus on the impact of the type of provider (public or private, with most private service providers being faith-based) and the type of contractual arrangement on performance. Second, in Ghana, DDVE is conducting an assessment of the data available in the GLSS5 household survey on the nature and performance of various service providers and comparing those data with data from the Ghana District Health Information System, with a focus on analyzing the role of the CHAG (Christian Health Association of Ghana) in health service delivery.  Third, in Cape Verde, FBOs play an important role in delivering pre-school education, and DDVE is preparing a case study on this role for the Bank’s Cape Verde poverty assessment.  In addition, previous work on testing the altruistic behavior of faith-based health service providers in Uganda is available as DDVE Working Paper 2008-13.