PRIORITIZING OF SOCIAL NEEDS, DELIVERY OF SOCIAL SERVICES AND GENDER GAP, FINANCING SOCIAL EXPENDITURES AMONG ISSUES DISCUSSED BY EXPERTS

Press Release
SOC/4484

PRIORITIZING OF SOCIAL NEEDS, DELIVERY OF SOCIAL SERVICES AND GENDER GAP, FINANCING SOCIAL EXPENDITURES AMONG ISSUES DISCUSSED BY EXPERTS

The challenge of determining which social needs should receive attention and priority was among the issues addressed at the Commission for Social Development, during an expert panel discussion this afternoon on its priority theme of social services for all. Funmi Togonu-Bickersteth, Reader and Head of the Department of Psychology of the Obafemi Awolowo University, Nigeria, said that challenge was more daunting in the developing countries, where old needs had yet to be met and new needs were arising when there was a squeeze on available resources. Firstly, needs that had multiplying effects had to be addressed. Next, ways of bringing provisions to those in need had to be designed. While there were a number of administrative strategies that could be used to deliver provisions, whatever the strategy, it had to promote access to services and empower the beneficiaries. Nawal Ammar, member of the Criminal Justice faculty at Kent State University, Ohio, said delivery of social services within an increasing gender gap and increasing violence against women was another challenge. The twentieth century's reality was that females faced discrimination. There was also the challenge of delivery as part of an integrated process. Much delivery had been in the medical mode -- identifying a need and providing for that specific need. That, however, identified the problem in an isolated way and did not address the real problem. Siddiqur Rahman Osmani, Professor of Development Economics, University of Ulster, United Kingdom, said in most poor countries the lion's share of State subsidies in health and education went towards expensive activities such as curative practices and higher education, whose benefits accrued largely to the rich. Those inequities must be reversed and State expenditure reallocated, so that greater access could be ensured with the same level of resources. The rich must be made to pay for the expensive services. Sylvia Saborio, Consultant, said public resources would remain scarce and relative to needs. Several studies had agreed with financing basic social services by public account through general tax revenues. It was disturbing, however, to see the different tax revenue levels of various countries. It was not possible to finance high quality social services unless countries were prepared to shoulder a higher tax burden. The Commission will meet again at 10 a.m. tomorrow to continue its discussion of social services for all.

Commission Work Programme

The Commission for Social Development met this afternoon to hold an expert panel discussion on its priority theme of social services for all. The panellists were: Nawal Ammar, Criminal Justice faculty at Kent State University, Ohio; Siddiqur Rahman Osmani, Professor of Development Economics at the University of Ulster, United Kingdom; Sylvia Saborio, Consultant; and Funmi Togonu-Bickersteth, Reader and Head of the Department of Psychology of the Obafemi Awolowo University, Nigeria.

At its current session, the Commission is conducting a review of efforts to reach the goal of access by all to basic social services and a review of progress made in the implementation of the outcome of the 1995 World Summit for Social Development.

One of the 10 commitments adopted by the Social Summit was to work to make basic social services available to all. Reports before the Commission's session note progress in extending social services, particularly in terms of literacy and availability of basic education, but instances of setbacks or slow progress are also identified. Among other issues, the Commission is addressing the need to improve the quality of service, steps needed to ensure provider responsiveness to user needs, and measures to increase the efficiency and cost-effectiveness of services. (For background information on the session, see Press Release SOC/4482 of 8 February.)

Panel Discussion

FUNMI TOGONU-BICKERSTETH, Reader and Head of the Department of Psychology of the Obafemi Awolowo University, Nigeria, said that implementation of the Copenhagen commitments had raised a number of challenges. Nations had varied widely in the extent of progress made. While some had made remarkable leaps, others had made small steps. One of the challenges was determining what the term social services encompassed. A good definition was one that consisted of three groups of services: services meeting the essential needs of the entire population at all times, such as water and electricity; services appropriate to different stages of the life cycle, such as those for pregnant women and the aged; and services needed by population groups with specific needs, such as refugees. The goal of social services for all was to ensure a higher quality of life for all people, she continued. A higher quality of life meant that people would attain increased power over their own future. It also meant promoting a sense of belonging, and providing an enabling environment, which would allow people to fully participate in society. Mindful of the diversities among different countries, the Copenhagen Declaration had recommended that implementation of the Programme of Action be in consonance with the existential realities of each country and in conformity with all human rights and fundamental freedoms.

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One of the immediate challenges was determining which social needs should receive attention and priority, she said. That challenge was more daunting in the developing countries, where old needs had yet to be adequately met and new needs were arising at a period when there was a squeeze on available resources. Firstly, needs that had multiplying effects had to be addressed. It was more economical to focus on prevention strategies. Next, ways of bringing provisions to those who needed them had to be designed. There were a number of administrative strategies countries could use to deliver provisions. Whatever strategy was used, it had to promote access to services, and empower the beneficiaries.

She said a number of factors had to be taken into account in the context of delivery, which should be structured to reach the targeted groups, reduce costs to the recipient, and have a built-in information system. In addition, delivery should be procedurally fair and transparent, culturally acceptable, and empower the clients. While countries were encouraged to draw from the experiences of others, the ultimate delivery strategy should be designed according to the needs of individual countries. The challenges were many, but definitely surmountable given the political will.

NAWAL AMMAR, member of the Criminal Justice faculty at Kent State University, said that the simple question she wanted to raise was what some of the new challenges facing the delivery of social services at the dawn of the new millennium were. There were five issues which framed that perspective. First, the distinction between basic needs and social services targets. Secondly, the difference between delivery and financing of social services, and access to under-served populations. The third issue related to three Summit goals, namely, the need to maintain and progressively raise the quality of services; the need to ensure that service providers were sensitive to the needs of users; and the need to secure efficiency and cost-effectiveness in the delivery of services.

She said that there were seven challenges faced by nations regarding the delivery of social services for all. One very important challenge was the delivery of services within the opposing ethos of universalism and cultural particularism. The holding of those two values together posed new challenges regarding democracy, order and efficiency, human rights, technical expertise, and the delivery of services. The second challenge dealt with delivery within the new operating mode of non-profit/non-governmental organizations. When some services get picked up by private organizations or businesses, needs such as quality control measures and monitoring schemes had to be addressed. The third challenge involved the new class of billionaires and their social responsibilities towards supporting, financing and educating towards better delivery of social services for all. In light of government divestment, there was a need to rethink the delivery of social services and the consequences of such concentrations of power.

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Delivery of social services within an increasing gender gap and increasing violence against women was another challenge, she said. The reality of the twentieth century was that women and girl children were being discriminated against. Next was the challenge of delivery within new technologies that required training and skills. Modern technology presented a dual challenge. On the one hand, it provided increased coverage and reach of services, such as the use of distance learning programmes for women who could not leave their homes. On the other hand, it left an impression that people who did not have access to such technology would be left behind.

Yet, another challenge was the delivery of services within a crisis or war situation, she continued. In 1996, there had been 40 armed conflicts in 34 States, almost all of which had been internal wars. That, in turn, had created a refugee problem. Almost half of refugee women were internally displaced persons and thus could not be assisted by international aid. Social services delivered in that context required a system that was dynamic and that maintained a certain level of standards. Lastly, there was the challenge of delivery as part of an integrated process and within a holistic perspective. Much of delivery had been in the medical mode, that was to identify a need and provide for that specific need. For example, providing an aspirin for a headache without addressing the causes of the headache. That identified the problem in an isolated way and did not address the real problem.

SIDDIQUR RAHMAN OSMANI, Professor of Development Economics, University of Ulster, United Kingdom, said it might be necessary to target public provision towards specific groups to ensure universal access for all. If the State tried to provide free food or free health services in a resource-poor economy, it would invariably fail to cover the entire population. In that situation, it was likely that the rich and powerful would corner all the benefits. Since the rich would have enjoyed the services without State provision, universal access could be ensured in that situation only by targeting the subsidy to the poor.

All States, rich or poor, should, however, aim to provide free or heavily subsidized universal services of certain basic kinds such as prime health care and primary education, he said. Free universal provision of those services should not be beyond the financial capacity of even the poorest countries. The reason was that those services tended to be labour-intensive, and labour was cheap in those countries. The poorer the State, the cheaper its labour, and the cheaper it was to provide those services. Also, the greater provision of social services should be an essential part of economic reform. First, those services should provide a safety-net cushion against short-term dislocations caused by reforms. Secondly, those services would help strengthen the stock of human capital that would form the basis of sustained long-term growth.

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Beyond the basic level, however, subsidies would have to be targeted towards the poor, he said. In most poor countries, the lion's share of State subsidies in health and education went towards expensive activities such as curative practices and higher education, whose benefits accrued largely to the rich. Those inequities must be reversed and State expenditure reallocated, so that greater access could be ensured with the same level of resources. The rich must be made to pay for the expensive services. Many attempts to target subsidies to the poor had ended up in diverting benefits to the wrong people. The solution was to devise self-selection mechanisms where the target population would select themselves to claim the benefit, while the rich excluded themselves in their own interest.

He said that when resource constraints were really binding, it might be necessary to charge some fee even to the poor. If it became possible to ensure universal access to services by charging a small fee to the poor, that was much better than not providing any services at all due to lack of resources. What was needed though was to devise appropriate institutional mechanisms that would enable the poor to pay with the minimum of pain. Provision of services by the State did not itself ensure effective utilization of services. One solution lay in the active involvement by the local population in ensuring that the services meant for them were actually provided to them.

SYLVIA SABORIO, Consultant, said the goals of the Copenhagen Declaration to provide high quality social services for all were a very expensive proposition that would tax many countries' capacities and require enormous political commitment to achieve. There was tremendous diversity in the apparent return to social expenditure, both within and between countries, as reflected in various types of social indicators. That suggested that there were important factors related to the organization of social service delivery that needed to be considered. In general, in Latin America, it was found that integrated public health systems produced better outcomes than those that were either fragmented or depended on a great deal of outsourcing.

She said that the existing inefficiencies in the provision of social services provided a silver lining; the amount of additional resources needed to improve the quality, quantity and coverage of services was less, to the extent that some of the improvements might be financed by using existing resources more effectively. That was an area where a great deal of experiments were being carried out at both national and international levels. "We can profit from the outcome of such experiments", she noted. It would be easier to mobilize resources for social services if they were perceived to be effective.

Another silver lining, especially for the least developed countries, was provided by the rapid pace of innovation in communication, transportation and information technologies. Through communication technology, classrooms could be improved without first having to improve the quality of teachers which could take at least one generation. If it ever was, development today was clearly not a

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linear process and the possibility of "leap-frogging" in such areas as social service delivery must be seen as a very promising avenue for amassing vast amounts of human capital in a relatively short time.

Public resources would remain scarce and relative to needs, she continued. There was a need to do some expenditure switching. It would also be necessary to reallocate resources within the social sectors themselves and align them with priorities. For instance, too much expenditure went to tertiary rather that primary education. Likewise, there could be a social benefit by transferring expenditure on costly medical practices to more basic and necessary medical needs. In financing financial services, several studies agreed with the idea of financing basic social services on public account through general tax revenues. It was disturbing, however, to look at the structure of public revenues in developed and developing countries. There was a vast difference between the tax efforts and revenues of various countries. It was not possible to finance high quality social services unless countries were prepared to shoulder a higher tax burden.

Responding to the questions concerning the use of social indicators, Ms. TOGONU-BICKERSTETH said that it was true that most of the data collected in developing countries was not very reliable. That was due in part to the belief that data collection and information gathering was a luxury they could ill afford. There was a need for a database which identified the needs to be met. Countries had to improve data collection at the primary level. Because the world was a global village, someone in Nigeria could see what good health service in the United States looked like through television. Then that person would wonder why it was not available in that country. With regard to how far to go in providing services, the question that needed to be asked was what would happen if certain services were not provided, and what would be the consequences of not providing certain services.

Ms. SABORIO said, concerning the allocation of public resources, that they needed to be redirected since the social return of basic education tended to be very high relative to the returns of tertiary education. The issue was who ended up financing such programmes.

On the issue of social indicators, Ms. AMMAR said that in countries where they were available, some of the questions were who created them and for whose benefit. The social creation of data was important both for those who had information and those who did not.

With regard to user charges, Mr. OSMANI said that they were necessary when their imposition led to the provision of a wider range of services than would otherwise be possible. The kind of charges, whose imposition actually excluded the poor and needy was not what he suggested. He believed in the idea of catching up and that developing countries ought to have the higher degree of tertiary education needed for that process. The question was

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whether the government should subsidize tertiary education, and he believed that it should not. However, there should be targeted subsidies for poor students at the tertiary level.

Mr. Osmani, responding to the question of defining basic social services, said it was an issue on which 100 per cent convergence was unlikely. The word "basic" was relative, since what was basic in Europe might not be basic in Africa. While keeping those correlatives in mind, there was a need to think of the distinction between basic and non-basic services for a number of reasons. For instance, should governments have the responsibility of providing universal services? If they were to, then they should identify priorities since they could not provide all the services on their own. In most scenarios, however, primary education and health care were basic services that needed to be provided by governments.

Responding to a question on financing of social services while disregarding growth, he said there was a growing consensus that growth was essential to provide the resources to provide social services. The importance of growth could not be minimized. There was, however, a complacency in some quarters because it was felt that once growth was ensured,everything else would take care of itself. Growth was good depending on what happened to the fruits of growth. In the Republic of Korea, on the one hand, those fruits were used to provide a number of social services. Other countries,on the other hand, had exhibited growth, but the fruits had not been utilized for the benefit of the poor.

Ms. SABORIO, responding to questions on borrowing in order to finance investment in social sectors, said it was inevitable that the sources for financing social services would have to come from abroad in those countries which were unable to find the necessary resources. She believed that such an approach was perfectly appropriate. Unless countries were being given free resources,then it was necessary to borrow. The Inter-American Development Bank was very active in financing social services in some countries. In terms of the overall concept of investment in social services, the Bank's last mandate required it to lend 50 per cent of its resources to social sectors.

Mr. OSMANI, replying to a question raised on the integration of social and economic issues, cited the problems of AIDS and smoking-related illnesses in developing countries. He said that once the diseases broke out,it became so much more expensive to deal with them. The cost of education campaigns was much less than dealing with the consequences of the outbreak of diseases. Thailand and Uganda had launched good campaigns for AIDS. The costs of the campaigns, while extensive, were considerably less than dealing with an outbreak of the disease.

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Closing Comments

Ms. TOGONU-BICKERSTETH said that the definition of social services varied from country to country depending on the level of development and cultural factors. The question was what the consequences of not providing basic services would be. In the long run, it would be more beneficial to provide the services rather than addressing the consequences of not having provided them. She reiterated the need to include the participation of beneficiaries in the process of identifying what was needed, since it was an important aspect of any effort to deliver services. The needs of people changed and, hence, their input was needed to reflect those changes in the delivery of services.

Ms. AMMAR said that perhaps social and economic goals were often pitted against each other due to the political atmosphere within countries. The question that arose was not just that of social services for all, but also of which services would be kept. Collaboration was required not only in terms of needs, but also with regard to the gathering of information and research. Clients, deliverers and evaluators should be heard from in that process.

Mr. OSMANI said that the problem of poverty as a whole, especially the provision of social services for all, was being addressed because there were too many people who were too poor to afford those services. The whole issue of poverty eradication was fundamental to the question of providing social services to all. Despite efforts, poverty would remain in developing countries for some time. As long as it continued to exist, governments had certain responsibilities. Apart from the policy spectrum of eliminating poverty, the government also needed to look into ways of providing social services while poverty existed.

Ms. SABORIO said that the provision of social services would not happen unless the country recognized its responsibility. If that recognition was there, then the rest was mechanics and would follow. The real hurdle was for people to believe that society as a whole would be better off with the provision of social services to all.

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