Civil servants’ perspectives on the role of citizens in public service delivery in Uganda

The state–citizen relationship in a Western context: a stakeholder approach to public service delivery

In most Western countries, a stakeholder approach is believed to be critical for public service delivery. The stakeholder concept refers to dealing with and actively involving individuals/groups that can affect or are affected by an organization (Freeman, 1984; Thompson, 1967). For (public) organizations, this implies taking into account service recipients in a systematic fashion. Public administration is not just about efficiency; it also involves ideas of democratic participation, accountability, and empowerment. The stakeholder concept for public service delivery implies not only public organizations taking citizens into account, but also citizens themselves playing an active role. Denhardt and Denhardt (2007), for example, contend that democratic citizenship implies a duty on the part of the citizen to contribute to the betterment of the community.

According to Hoogwout (2005), the role of a citizen as an individual in relation to a government body is fundamentally different from the role of a customer in relation to a private service provider. As Hoogwout (2005) explains, in the latter relationship, a customer decides what they want to buy and the supplier they want it delivered from. The exchange of money makes the service provider dependent on the customer for financial survival, and induces an incentive for the provider to treat the customer in a satisfying way. A ‘customer’ of the government does not combine these roles, as the government determines the content specifics of the services it provides, and the existence of the services does not depend on individual citizens (Hoogwout, 2005). Although this provides a rather theoretical (and perhaps overly simplistic) picture of the market versus the government model, it nevertheless clarifies some of the major differences between a private service customer and a public service recipient.

In a Western context, citizens expect government services to be as good as, if not better than, what they can get from the private sector (Institute of Public Administration of Canada, 2000). They also expect to have the opportunity to influence the type of services they receive, as well as the quality of the services, through access, choice, information, redress, and representation (Denhardt and Denhardt, 2007). To gain legitimacy, governments are expected to have a dialog with service recipients and other stakeholders. Similar ideas have been voiced in recent public management literature. Moore (2013), for instance, encourages public managers to appreciate that ‘service recipients and obligates’ are the ones who should assess the extent to which public value is attained, because only they can ultimately determine the quality of good service delivery. Literature on public values (cf. Bozeman, 2007) also indicates that a distinction should be made between citizens as a collective who determine (for instance, via the elective process) what public services should be provided by the government or other actors, and individual citizens who are themselves service recipients.

Citizen empowerment has progressed in consonance with developments in public service governance principles and structures. In the discourses of New Public Management (NPM) and Re-inventing Government of the 1980s and 1990s, ideas about organizing government in a business-like manner resulted in the infusion of competition in public service delivery and the provision of citizens with more consumer choices and powers. Public organizations began to listen carefully to their customers using a wide variety of methods, including customer surveys and focus groups. Nevertheless, the citizen’s role in actual service delivery was still seen as being based on the separate interests of producers and consumers, rather than on the value of collaboration (Alford, 1998).

At the end of the 1990s and into the 2000s, the citizen’s role as a mere ‘customer’ of the services delivered was called into question, and co-production as a theme arose under the New Public Governance (NPG) paradigm. NPG assumes that for the delivery of public services, the government needs to collaborate with other (public, private, and nonprofit) actors (e.g., Osborne, 2010). Citizen empowerment is seen as essential to enhance the quality of services, increase the credibility of the decisions made, and raise the legitimacy of the government (OECD, 2001). Rather than being well informed customers with a ‘voice’, as advocated in the NPM paradigm, NPG approaches citizens as well informed partners (Moynihan and Thomas, 2013). This concerns both the citizens as a collective and as direct recipients/users. To achieve sustainable quality, it is crucial to organize the public sector in such a way that it allows citizens to participate in the whole policy cycle (Benington, 2009). In short, public services are no longer seen as for the public but by the public, and citizens are expected to contribute to their delivery (Bovaird and Löffler, 2012).

The limited capacity of service recipients as a challenge for public service delivery in sub-Saharan Africa

How are these Western developments, as outlined above, relevant to sub-Saharan Africa? Museveni (1997) describes the majority of the population of Uganda – and Africa as a whole – in a very generalizing (and simplifying) fashion, as ‘peasants’:

… peasants are, very largely, illiterate people who depend on subsistence farming as opposed to specialization and exchange, the crucial factors which bring about modernization, efficiency and the flow of business. But if people are frozen in their subsistence activities, effectively trying to be jacks of all trades and masters of none, the economy cannot grow and society cannot develop. At present, our people grow their own food; they are their own carpenters, their own masons and even their own doctors. (Museveni, 1997: 188)

In the above assessment, improving governance within public services refers both to government’s capacity to provide high quality service delivery, and to citizens’ capacity to make demands for such services. According to Booth (2012), on the one hand, improvements in the management of services may be expected as political systems become less patrimonial and comply more closely with modern administrative practices. On the other hand, politicians and provider professionals will be influenced by bottom-up pressures for better performance as governance becomes more democratic, and both voters and service users gain more voice and become empowered. In low income sub-Saharan Africa, however, voter and user pressure are weak; factors for improving performance must therefore also derive from a shift in incentives from the top down.

Efforts have been made to strengthen the supply and demand side of accountability. For example, the African Public Service Charter, adopted in 2001, highlights the need to adapt public services to new requirements, and defines a framework to guide public services in taking legislative, regulatory, technical, and practical measures (Economic Commission for Africa, 2003). This provides a ray of hope in sub-Saharan Africa for co-production and the creation of public value. A potential tension for governments, however, lies in the possibility that more active participation by individual citizens, neighborhood groups, and voluntary associations will result in more vocal challenges to government policies and programs (Benington, 2009). Consultation fatigue may also occur, whereby participants feel that they are being asked for their opinions, but see too few changes as a result, and thus lose faith in the process (Coats and Passmore, 2008).

A number of issues are debated in the context of citizen empowerment in sub-Saharan Africa. First, citizens are seen as being able to acquire more leverage over bureaucracy if they can organize themselves into non-governmental organizations (NGOs) (Rose-Ackerman, 2004). The capacity to organize gives citizens a ‘voice’ (the ability to monitor the performance of bureaucracy, generate valuable information, and pressure politicians for action) and ‘client power’ (the ability to engage directly with service providers). In practice, however, citizens generally find it difficult to organize themselves, and public managers rarely try to actively create a constituency for their agency. Donor funded NGO activism, focused on stimulating citizen demand for better services, is seen as a comparatively minor ‘nuisance’ for most governments, and certainly not a prime demand for public managers, as Moore (2013) would have it (cf. Booth, 2012).

The lagging behind of citizen involvement is closely linked to deficiencies in terms of transparent approaches to addressing challenges in service delivery, which partly hinges on information, education, and communication. Information is of primary importance in enhancing citizens’ empowerment and promoting participation in public service delivery. Indigenous channels of communication can serve as powerful instruments of change. Some obstacles to development in Africa are, however, traceable to a lack of appropriate communication strategies that allow the full and active participation of service beneficiaries (Dia, 1996), as well as of citizens in general.

Finally, in sub-Saharan Africa, decentralization of public service delivery has been pursued as a key reform objective intended to bring services nearer to the people (Ayee, 2005). In different countries in the region, for people living in previously neglected rural areas, decentralization has led to incremental increases in access to central government resources and institutions (e.g., the construction and maintenance of roads, school classroom blocks, clinics, places of convenience, as well as the provision of water and electricity). It has also enabled local people to show interest in their own affairs and participate, even if only minimally, in the policies and programs of their areas.

This theoretical discussion has identified both trends as well as a number of challenges relating to the involvement of service recipients in public service delivery in sub-Saharan Africa. These issues guide our empirical research. Before outlining our findings, however, the research design is described.

Empowerment of service recipients to participate in the delivery of public services

Over the years, the government of Uganda has instigated a number of initiatives aimed at involving service recipients in the delivery of public services and strengthening the demand side of accountability. The interventions that have been implemented include: (1) national service delivery surveys, periodically undertaken with the objective of obtaining feedback from service recipients regarding the quality of public services provided; (2) household surveys undertaken every four years to collect data on the demographic, social, and economic characteristics of household populations to support evidence-based policy decisions; (3) client charters implemented by different government institutions, aimed at informing service recipients of the services available; (4) bottom-up participatory planning and budgeting through the decentralized local government system; (5) community meetings to discuss service delivery issues that cut across all public services provided by central and local government; and (6) the revitalization of facility management committees, including (among others) health facility management committees and school management committees. While serving as monitoring tools, these initiatives at the same time provide avenues for information, education, and communication with citizens.

In spite of these initiatives, findings from both secondary sources and study respondents indicate that the level of involvement of service recipients in the provision of public services in Uganda is still minimal. For example, although client charters have been introduced, the review report on the implementation of these charters (Ministry of Public Service, 2011) indicates that service recipients were not adequately involved in the development process of these charters and a feedback mechanism has not been institutionalized. In the National Service Delivery Survey 2008 (Ministry of Public Service and Uganda Bureau of Statistics, 2009), only 28% of respondents indicated that they had been involved in identifying government projects, while only 11% indicated being involved in monitoring and evaluating government projects. Our data presented in Table 1 support these insights. While 97% of the survey respondents recognized that client participation in public service delivery is important, only 39% believed that clients/citizens are actually empowered to do so.

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Table 1.

Civil servants’ perspectives on stakeholder participation and empowerment (Based on survey research in the Ugandan civil service.)

Client and stakeholder participation is an important aspect of performance and service delivery			Citizens are empowered and knowledgeable about their rights and obligations
	Frequency	Percentage		Frequency	Percentage
Strongly Agree	72	60.5	Strongly Agree	5	4.2
Agree	43	36.1	Agree	41	34.5
Neither Agree or Disagree	2	1.7	Neither Agree or Disagree	20	16.8
Disagree	0	0.0	Disagree	43	36.1
Strongly Disagree	2	1.7	Strongly Disagree	0	0.0
Total	119	100.0	Total	119	100.0

The Constitution of Uganda (Uganda, 1995) sets out the rights and obligations of citizens. Among the listed duties of a citizen are included: (1) being loyal and patriotic to Uganda and promoting her well-being; (2) engaging in gainful work for the good of the citizen, family, the common good, and national development; and (3) contributing to the well-being of the community in which the citizen lives. For these duties to be performed, every citizen and citizen contribution needs to be valued. Paradoxically, we found that in Uganda the role of citizens as voters negatively affects more direct involvement. Respondents were generally of the view that service recipients are: ‘highly valued as voters, and every effort is made not to upset their commitment to vote’ (focus group discussions, local governments). This has several consequences. First, service recipients are not adequately mobilized and sensitized to the specifics of certain policy initiatives, for example, ‘free’ education and health services does not mean that service recipients are exempted from making financial contributions, yet this message is not clearly communicated to them for fear of losing votes. Second, persistent clientelism hinders the potential to establish participation, as citizens seek public services not only from institutions but also from individual public servants and political leaders. Finally, because political leaders are perceived to lack the commitment to pay taxes themselves, their moral authority to demand that the public pays taxes, contributes user fees, or engages in community work is limited (Interviews and Focus Group Discussions, Kabarole and Tororo).

An important issue raised by respondents was the lack of empowerment of communities to contribute financially to public services. Respondents expressed the view that people believe the government has the capacity to provide all required public services, but chooses not to. According to public service providers, at the end of the day: ‘a service is not adequately provided or it is paid for in an informal and discriminatory fashion because standard user fees are not prescribed’ (Interview, Gulu). Providers say that they are not being put to task by service recipients because of the poor pay of public servants, the lack of adequate tools and structures to provide services, and citizens who expect services to be free of charge. As a result, citizens are seen as having no basis upon which to demand quality (Interview, Gulu). Furthermore, free services are perceived as breeding a lazy ‘I don’t care’ attitude among both providers and recipients. Health care payments, providers argue, could promote access to care (Interview, Tororo). Additionally, reference to the Universal Primary Education program as the ‘President’s program, and the pupils as the children of the President’ (Focus Group Discussions, Tororo and Luwero) is perceived as resulting in the lack of commitment by parents to provide food and scholastic materials to their children.

Public servants think that creating a direct link between fees or taxes and services is critical for promoting ownership and empowering citizens to demand quality services. Equity between those who can and those who cannot afford services, however, is a major challenge. The Household Survey 2009/10 (Uganda Bureau of Statistics, 2010), for instance, indicates that in this period, 24.5% of Ugandans were poor, the majority of whom lived in rural areas. The issue of financial contribution adds to a discrepancy between government and private services where service recipients have the capacity and are willing to contribute. It would also create discrepancy in the provided public services and variance in terms of the quality between central and local governments, among local governments, and within a local government. The establishment of user fees could improve citizen participation, as many respondents argued, since it would create a sense of ownership and increase the demand for quality services. It might, however, further turn away poor people who cannot afford to pay and who struggle with the ‘free’ services as they currently exist, since: ‘even in the presence of universal (‘free’) primary education, poor families will not take children to school. When they do, the children drop out!’ (Interview, Tororo). Moreover, according to Waiswa (2012), research in low- and middle-income countries suggests that introducing user fees for health services has little public health benefit in terms of either access to services or health care outcomes. Rather, the use of preventive and curative health care services is likely to decrease.

According to the National Service Delivery Survey 2008 (Ministry of Public Service and Uganda Bureau of Statistics, 2009), 20% of the Ugandan population has no formal education, while 30% of pupils who enroll in school do not complete primary education. This information is comparable to that of the Household Survey 2009/10, which indicated that the literacy rate among persons aged ten years and older was only 73%. The Household Survey also showed that based on literacy rates, women are less empowered to participate in the delivery of public services, especially in rural areas. The male literacy rate is overall 79%, while for females it is 66%, and for men and women combined, urban literacy is 88%, compared to 69% in rural areas. Literacy is important for the empowerment of service recipients. Rose-Ackermann (2004, based on Reinikka and Svensson 2004) discusses how the severe leakage of central government funds for local primary schools in Uganda was countered by a simple, information-based reform, whereby increased official monitoring was combined with the publication of funding levels by a newspaper, so that parents can know what funds their children’s schools are due to obtain. A key feature of this success, however, was the existence of parent–teacher groups at the village level to perform the monitoring, and the existence of a certain degree of literacy among parents and community members. By contrast, a study on the tracking of expenditure and the utilization of primary education funds in Northern Uganda (Transparency International Uganda, 2011) was less positive, as it showed that the level of competence and activism among the citizenry (parents and communities) was very low, which resulted in a weak demand side in education service delivery. Parents were seen as apathetic, both about monitoring education service delivery, as well as their children’s attendance and performance. Furthermore, school management committees in most of the schools surveyed, due to parents’ low education levels, did not have the capacity to supervise head teachers.

Responsiveness of provided public services

Responsiveness includes elements of accessibility and timeliness. The National Service Delivery Survey 2008 (Ministry of Public Service and Uganda Bureau of Statistics, 2009) established that the average distance that people in Uganda must travel to reach a government health facility is six kilometers. The survey also established that at the national average, about 79% of pupils travel a distance of about three kilometers to reach school, while 1% travel ten kilometers or more. This implies that about 20% of pupils must travel a distance of between three and ten kilometers to reach school. The Household Survey 2009/10 established that 76% of all primary schools nationally were managed by the government. For primary schools in rural areas, 80% were managed by the government. In urban areas, 51% were managed by private entities. Concerning health care, the survey found that 51% of the urban population and 41% of the rural population sought treatment from a private clinic as the first point of contact. These findings indicate that both government and private providers play a significant role in the delivery of education and health services, and that there are issues of responsiveness and quality that need to be addressed.

In our empirical study respondents indicated that the structures for service delivery are in place, at the level of central government, local governments, and service delivery points, but are not fully functional. A general issue raised at the central government level was that recent public sector reforms have been concerned more with efficiency gains than with service delivery requirements. At the local government level, while it was acknowledged that decentralization should have a meaningful impact in terms of having the government felt by the people, influencing the way in which services are provided to suit unique requirements, and creating a system that promotes participation and ownership of programs, raised concerns that this has not always been the case. Management committees are recognized as being part of the structures for service delivery, yet they may not be fully functional or do not always have the capacity to undertake their role. Management committees are perceived as being functional mainly in urban areas, where service recipients are more involved (Focus Group Discussion, Ministry of Public Service).

In our questionnaire, respondents indicated the extent to which they felt that clients and stakeholders were satisfied with the different aspects of the public services delivered. The responses are shown in Table 2. Interestingly, a reasonable number of the responding public servants remained neutral on most of the issues, with the exception of the aspect of public servants being helpful and services being accessible.

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Table 2.

Perceptions of respondents regarding responsiveness of public services: To what extent do you feel clients and stakeholders are satisfied with the different aspects of public services delivered by your school or health center? (Based on survey research in the Ugandan civil service.)

	Frequency	Percentage		Frequency	Percentage
Accessibility of Services			Timeliness/ Responsiveness of Services
Strongly Agree	18	15.1	Strongly Agree	12	10.1
Agree	68	57.1	Agree	46	38.7
Neither Agree or Disagree	16	13.4	Neither Agree or Disagree	32	26.9
Disagree	15	12.6	Disagree	25	21.0
Strongly Disagree	2	1.7	Strongly Disagree	4	3.3
Total	119	100.0	Total	119	100.0
Quality of Services			Cost of Services
Strongly Agree	9	7.6	Strongly Agree	13	10.9
Agree	55	46.2	Agree	42	35.3
Neither Agree or Disagree	31	26.1	Neither Agree or Disagree	28	23.5
Disagree	20	16.8	Disagree	30	25.2
Strongly Disagree	4	3.4	Strongly Disagree	6	5.0
Total	119	100.0	Total	119	100.0
Public servants are helpful and courteous to clients
Strongly Agree	19	16.0
Agree	70	58.8
Neither Agree or Disagree	18	15.1
Disagree	10	8.4
Strongly Disagree	2	1.7
Total	119	100.0

At the level of schools and health units, respondents identified some achievements, which included the fact that decentralization of the service delivery system has brought services nearer to the people. This was, however, not the situation in all local governments. There are still areas where service recipients have to walk long distances to reach a service facility, mainly because of lack of uniformity in the approach to policy implementation and the dysfunctionality of the facilities that are within reach. The empirical findings also indicate a gap between citizens’ expectations and reality, which is significant in some cases, though absent in others. The difference was mainly attributed to service recipients who are unaware of their rights and of service delivery standards, and those who have been disappointed by past experiences and have thus either resigned themselves to what is available or have given up trying to obtain a service.

Priority areas for consideration when designing stakeholder participation

Public servants were requested to indicate their views on client/stakeholder participation for the services that they provide. In Figure 1 the results are ranked according to different aspects, on a scale of one to five, where one is least preferred and five is most preferred. The aspects were: (1) well-defined roles and responsibilities of service providers and recipients; (2) well-defined processes and service standards that service recipients should expect; (3) appropriate user fees that are published, known, and commensurate with the service; (4) a mechanism for clients to provide feedback; and (5) consultation of clients when policies and programs are being designed. OPEN IN VIEWER

The respondents identified it as a priority to have well-defined roles and responsibilities, followed by well-defined processes and service standards. Respondents in focus group discussions indicated that efforts should be made to encourage citizens to contribute to public services within their means. Examples given included the importance of parents ensuring that their children attend school, providing meals and scholastic materials to pupils, and discussing the performance of pupils. Respondents thought that parents should be conscientious about attending meetings convened by schools and should participate in programs and projects. Regarding health services, respondents felt that patients need to seek timely treatment and adhere to the advice provided by medical personnel. They indicated that minimal user fees should be prescribed and service recipients encouraged to pay, in order to improve the quality of service delivery.