http://www.adb.org/sites/default/files/pub/2013/empowerment-public-service-delivery-asia.pdf
Foreword
I feel very privileged to be associated with this report, which will be presented at the Annual Meeting of the Board of Governors of the Asian Development Bank in New Delhi in May 2013. The general theme of this meeting is “Development through Empowerment,” and the report makes a fine contribution toward an understanding of that path to development. The particular subject matter of this study, ably led by Shikha Jha and Anil Deolalikar, is the critical importance of essential services in helping the expansion of human well-being and the reduction of poverty and deprivation, and the part that empowerment of the people can play in facilitating this process. It also discusses the distinct ways in which empowerment of people can be advanced and the kind of results we should expect to see as a result of these constructive changes.
The report is self-contained, with a good statement of the questions asked and the conclusions reached, and it is not necessary for me to re-state here what the authors have discussed very well in the body of the text. However, there is a case for placing the report in a wider perspective. In understanding the background to this enquiry, it is important to appreciate (i) the nature and richness of the idea of empowerment, (ii) the direct and indirect roles of essential services in promoting human empowerment, and (iii) the respective roles of the state and the market in development through empowerment.
Empowerment is integrally related to the expansion of human freedom—the freedom of people, often very disadvantaged people, to be able to do and achieve what they want (and have reason to want). Empowerment can, thus, be seen as enhancement of human capability. But it concerns particularly those capabilities that give a person an ability to catch up with others, and in particular, not be dominated by people in more privileged positions, because of wealth, social standing, or political entitlement.
Consider Aneurin Bevan’s famous comment, “The purpose of getting power is to be able to give it away,” which Michael Foot separated out for special attention in his biography of Bevan. The remark may initially appear to be mysterious, but it is an eloquent articulation of the fact that the underdogs of society may seek power not so much to use it over others, but to make sure that others do not have power over them. To have power without using it is quite different from not having that power at all. This idea fits generally with the capability perspective, which points to the importance of having the freedom to do something one has reason to value (whether or not one actually chooses to do it). And yet the idea of empowerment goes beyond that. The language of power can be very effective in drawing attention to the conflicting aspects of interdependences involved in social, economic, and political relations. For example, having the power to make public authorities, or private businesses, pay attention to the concerns of the underdogs of society is a quintessential example of significant empowerment. And on this subject (among others), the report has much insight to offer.
Empowerment has importance of its own in advancing human freedom and well-being, but it also helps in the consolidation, advancement, and improvement of essential services, which in turn expand human wellbeing and freedom. This report is much concerned with these linkages. The contribution of empowerment to the successes of development works indirectly as well as directly. An extensive expansion of the capabilities and freedoms of people (especially less privileged people), and the corresponding enhancement of their powers, are part and parcel of the development process, and there is no need to look for indirect connections in acknowledging the importance of this basic recognition. The ability of people to lead a long and fulfilling life, to be educated and numerate, to avoid suffering from disease and from uncared old age, and other such fundamentally important freedoms must, with good reason, be seen to be constitutive parts of human development.
While those direct connections are easy to appreciate, there are also more complicated relations in understanding the different ways in which human empowerment can also contribute to expanding the delivery and use of essential services, like schooling, medical care, social amenities (such as sanitation, water supply, and, of course, environmental preservation). There is a two-way relationship here. To illustrate, just as schooling and medical care contribute to empowering people, people with clearer understanding and articulate voices, and strengthened by good social organization can demand with energy and force more—and better—public services. There can be many indirect connections in enhancing people’s power to make strong demand for more facilities, and to insist on good quality of the services offered. And empowerment may reflect itself also in arrangements for monitoring what is offered to the people.
These diverse—but interrelated—connections are particularly worth investigating, both because of their importance and because of their complexity. This report has a great deal to say on these connections: how they work, and what can be done to enhance their vigor and reach.
The third issue concerns the role of the market in providing many of these services, when they can be incorporated within a profit-seeking framework. However, sometimes this becomes difficult to do, because of barriers to successful marketization, which economists have studied for a long time, involving absence of competition, presence of “externalities,” the importance of indivisible “public goods,” and asymmetric information affecting the relations between buyers and sellers. The motivations of private firms, seeking profits in an aggressive way (e.g., the steps taken by health insurance companies to exclude patients with previous records of serious illnesses or proneness to particular ailments) can also clash fairly comprehensively with fair and just provision of services (in this case of medical services).
There are further issues of instrumental use of markets, even when the planning and support for the services come from the state. The state can deliver some services directly, and often has reason to do so, but in other cases the process of state support for these services (e.g., for schooling or medical care) can make use, to varying extents, of the market mechanism. For example, in providing nutritional support, the state can either provide food to people in kind, or provide income support to the poorer people, leaving them to buy food from the market, with the help of their enhanced cash position. Similarly, alternatives to state-run schools include selfreliant private schools, or private schools that are made to accommodate a certain proportion of non-fee-paying pupils, or a proportion of pupils who have publicly-given vouchers that they can use to go to one private school or another.
There is, thus, a large cluster of difficult choices that have to be faced and addressed in deciding on the right public–private mixture in the provision of essential services, including important issues of efficiency and equity. The report has probingly investigated many of these decisional problems. The choices link very extensively with the role of empowerment of people in making these services available and effectively usable. The terrain of development strategy studied in this report is quite central to the approach of development through empowerment. We have excellent reason to be grateful to the authors of this far-reaching and enlightening report.
Thomas W. Lamont University Professor
and Professor of Economics and Philosophy
Harvard University
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