Introduction

4

Improving Targeting Outcomes through Attention to Delivery Systems

Margaret Grosh, Phillippe Leite, Emil Tesliuc, Nina Rosas, and Priyanka Kanth

Introduction

Delivery systems are important for reducing errors of exclusion and inclusion, and for ensuring good implementation and dynamism. The importance of “implementation” in the context of targeting is suggested by Coady, Grosh, and Hoddinott (2004) and written about more explicitly by Devereaux et al. (2017) and Leite et al. (2017) and in a great deal of the program or country-specific case literature. Lindert et al. (2020) go far in codifying knowledge and improving a shared language around delivery systems. The volume also underscores the commonalities in delivery systems and their workings across many programs. Governments have made significant strides in this field in recent years, but a substantial need for improvement still exists, especially with respect to inclusion and dynamism.

This chapter focuses on delivery systems before discussing the choice of targeting methods, to emphasize the importance of implementation of different elements of the delivery chain for improving targeting performance, especially lowering errors of exclusion. No matter how aptly selected the targeting method is, it cannot deliver good outcomes without good implementation of each step of the delivery chain. Indeed, understanding how

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crucial delivery systems are comes in part from literature on age-based social pensions or child allowances, which, despite the simplicity of their eligibility criteria, struggle with some of the same practical issues as programs with more complex eligibility criteria to get to the desired level of inclusion.

In 2001, Bolivia’s universal social pension, for example, had an overall coverage rate of just 70 percent of the elderly and only 37 percent of the elderly in the poorest quintile, due to issues of lack of information, lack of identification (ID), and distance from pay points, which were more binding constraints for the poorer. The country made an effort to resolve these issues; as a result, only two years later, coverage was 79 percent overall and 58 percent among the poorest quintile. Overall coverage continued to improve to 90 percent and fully 90 percent of the poorest quintile, showing how sustained effort on delivery systems can improve outcomes (Muller 2016; Rofman and Oliveri 2012).

Nepal is also on a path to deliver its age-based programs, with more mature programs for social pensions for senior citizens and single women. Geographic coverage of the relatively newer child grant for children younger than five years, which was initiated in 2009, is being gradually expanded. A diagnostic report commissioned by the United Nations Children’s Fund to review registration in these programs (Thinkthrough Consulting 2021) reports higher coverage of programs for senior citizens and single women, at 85 percent of the eligible, compared with the child grant, at 50 percent, as of the 2019 Multiple Indicator Cluster Surveys. The report recommends actions along the delivery chain congruent with those explained in this chapter—strengthening outreach and awareness among the population, especially those with language and remoteness barriers; lowering transaction costs; improving grievance redress; and improving institutional capacities through better staffing, training, digitization, and internal monitoring procedures.

Although the details differ, most social protection programs follow a common delivery chain, and people can be incorrectly included or excluded at various steps (figure 4.1). The phases in the delivery chain that are common to most programs include outreach, intake and registration, assessment of needs and conditions, eligibility and enrollment, payments of benefits and provision of services, and beneficiary operations management, including beneficiary exits. People can be wrongfully left out or brought in due to implementation failures at any step, from the definition of the intended population to the caseload of enrolled claimants, generating targeting errors, which then filter through to subsequent stages. Thus, distributional outcomes depend on the entire delivery chain; all of these steps matter, not simply a single point at eligibility determination.

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Figure 4.1 Social Protection Delivery Chain

Outreach Intake and registration Assessment of needs and conditions Eligibility and enrollment decisions Determination of benefits and service package Notification and onboarding Provision of benefits and/or services

1 2 3 4 5 6

Intended population Registrants Registered population that is assessed for needs and conditions

Eligible population

Noneligible applicants (out)

Enrolled eligible applicants (in) Nonenrolled eligible applicants (wait list)

Enrolled beneficiaries 7

Source: Lindert et al. 2020.

People and institutions interact all along the delivery chain, and those interactions are facilitated by communications, information systems, and technology. Often the headline attention goes to information systems and technology. The information technology (IT) revolution can indeed be transformative for some aspects of delivery systems, but effective delivery systems also require sound rules (which the IT system may help to implement) and staffing to help make those rules and handle aspects of the job that need a human touch. The goal of social protection and its delivery systems is to make people’s lives better. Thus, it is important to understand how people journey through the delivery chain and address problems that make that journey difficult. Some of the solutions can be addressed by IT and others cannot.

Good delivery systems are important for compliance with several of the principles of the human right to social security. This chapter identifies many aspects of implementation that support accessibility, dignity and autonomy, nondiscrimination and equality, inclusion of vulnerable groups, gender sensitivity, and transparency and accountability as they are understood in

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the right to social security.1 For example, providing physical accessibility is specifically called for in Comment 19 on the right to social security of the Economic and Social Council, and clearly it is helpful in reducing transaction costs and errors of exclusion. Likewise, providing materials and staffing for various languages as needed is important for nondiscrimination and dignity and the inclusion of vulnerable groups such as indigenous groups, ethnic minorities, and immigrants. Providing clear information on processes can help people know whether and how to apply or appeal, which will lead to high inclusion and be in keeping with the transparency and accountability standards of human rights. Ensuring that all processes are effectively accessible to women is in keeping with gender sensitive social protection—which may imply working to remedy gender gaps in documents for identification, providing female interviewers or intake officers, and ensuring that grievance-redress mechanisms pay attention to gendered power differences, which may discourage women from voicing their concerns or lodging complaints. Indeed, a great deal of the bad reputation of targeting with respect to human rights is earned through insufficient delivery systems rather than inherent in the process of eligibility determination. Human rights perspectives can be quite useful in spurring or guiding improvements in delivery systems.

Minimizing process-related targeting errors, especially errors of exclusion, requires significant political will, management attention, and administrative budget, which are factors that all too often have been scarce. One of the concerns about choosing to differentiate eligibility by welfare is the administrative costs implied, which, as chapter 2 shows, are not prohibitive. However, concerns about transaction costs and stigma leading to errors of exclusion, reduced program impacts, and loss of political support can all be made worse by poor delivery systems. This chapter suggests many ways in which improved delivery systems can ameliorate some of these costs of targeting.

The importance of delivery systems is underscored every time there is a crisis or disaster. The tasks to be done—outreach, assessment, payment, and monitoring—still need to be done but with more urgency. Emergency responses can be hampered or facilitated by how well developed the basic building blocks of the delivery system are—coverage of unique IDs and bank accounts; coverage, recency, and pertinence of information in a social registry or integrated information system; capacity of staff; and so forth. This means that most improvements made in ongoing programs and during stable times are likely to pay off doubly, for their base use and for their ability to support emergency response. In addition, crisis adaptations can be facilitated with advance planning.

This chapter unpacks aspects of the delivery chain that are important for targeting performance without rehashing the available evidence on