When we looked into what happened, the striking fact was that recorded absence remained low even after the program fell apart. What went up sharply were “exempt days”—days when there was some reason, the nurses claimed, that excused them from coming in (training and meetings were the most common reasons cited). We tried to figure out why the exempt days suddenly exploded; we could find no record of meetings or training on the claimed dates. The only possible interpretation was that everyone in charge of supervising the nurses must have decided to look the other way when the nurses suddenly started reporting 30 percent more exempt days. Indeed, the nurses in the monitored centers ended up getting a bonus from the whole episode—they discovered just how little their bosses cared about whether they came to work and, based on that, figured that they had actually been coming in too often. At some point, attendance in the monitored centers actually fell below that in the unmonitored ones and remained lower until the end of the study. By the end, the nurses in monitored centers came to work only 25 percent of the time. No one complained. Villagers were so used to the centers not working that they had lost interest in the system altogether. In our visits to the village, we could hardly find anyone to acknowledge that the nurses were absent. Everyone had entirely given up on the system and did not find it worth their while to find out what the nurse was doing, let alone complain about it.
Neelima Khetan, the head of Seva Mandir, offered an interesting interpretation of what happened. Khetan is someone who leads by example. She sets a high standard of behavior in her own professional life and expects others to follow. The nurses troubled her because they seemed so unconcerned about their own dereliction. She had discovered, though, that what they were supposed to do was crazy: Come to work six days a week. Sign in, then take your medicine bag and head out to one of the hamlets to do the rounds. Walk anywhere up to 3 miles to reach the hamlet, even if it is 100°F in the shade. Go from house to house checking on the health status of women of childbearing age and their children. Try to convince a few uninterested women to be sterilized. After five or six hours of doing this, walk back to the center. Sign out. Take a bus to go home, two hours away.
It is clear that no one could do this day in, day out. What had happened was that everyone accepted that the nurses were not really expected to do the job as described. But given that, what should they actually do? The nurses got to set their own rules. In the course of our meeting with them, they very clearly told us that we could not possibly expect them to come to work before 10:00 AM. The center opening hour, clearly posted on the wall outside, was 8:00 AM.
The rules were (obviously) not designed with the objective of undermining the effectiveness of the entire health-care system in India. On the contrary, they were probably put on paper by a well-meaning bureaucrat, who had his own views of what the system should do and did not pay too much attention to what that demanded on the ground. This is what we call, for short, the “three Is” problem: ideology, ignorance, inertia. This problem plagues many efforts to supposedly help the poor.
The nurses’ workload was based on an ideology that wants to see nurses as dedicated social workers, designed in ignorance of the conditions on the ground, that lives on, mostly just on paper, because of inertia. Altering the rules to make the jobs doable might not be sufficient to get the nurses to come to work regularly, but it has to be a necessary first step.
The same three Is problem has similarly undermined India’s effort to make schools accountable to parents and students. The government of India’s last major education reform introduced the idea of parental participation in the oversight of primary schools. Under the Sarva Siksha Aviyan (SSA), a massive, federally funded effort to improve the quality of education, each village was supposed to form a “village education committee” (or VEC, the local equivalent to the American Parent-Teacher Association) to help run the school, find ways to improve the quality of teaching, and report on any problems. In particular, the VEC had the option to petition for funds for an extra teacher’s help for the school, and if it was granted the necessary funds, it had the authority to hire and, later, if need be, fire this extra teacher. This is a significant power, given that teachers are not cheap. But in a survey we conducted in the district of Jaunpur, in Uttar Pradesh (India’s most populous state), nearly five years after the program was launched, we found that 92 percent of parents had never heard of the VEC. Furthermore, when we interviewed the parents who were members of the VEC, one in four did not know that they were members; of those who knew they were members, roughly two-thirds were unaware of the Sarva Siksha Aviyan program and their right to hire teachers.
This program suffered from the classic three Is problem. Inspired by an ideology—people’s power is good—and designed in ignorance of what people want and how the village works, it was, by the time we were studying it, entirely sustained by inertia. No one had paid any attention to it for many years, except for some bureaucrat somewhere who was making sure that all the boxes had been checked.
Working with Pratham, the Indian education NGO responsible for the Annual State of Education Report (ASER) and the Read India program we discussed in Chapter 4 on education, we thought that making parents more aware of their rights could breathe new life into the VEC. Teams of Pratham field staff were sent to sixty-five randomly chosen villages to inform and mobilize parents around their rights under Sarva Siksha Aviyan.35 Because the Pratham team was somewhat doubtful that just telling people what they can do would have any effect without also telling them why they ought to do something, in another set of sixty-five villages a Pratham team taught interested villagers how to conduct the “dipstick” reading and math tests that are at the core of ASER and to prepare a report card for their village. The discussion of the report cards (which revealed that the number of children who could read and write was pathetically low in most villages) formed the starting point of the discussion on the potential role of parents and the VEC.
But neither of these interventions made any difference in parental involvement in the VEC, VEC activism, or child learning (what we ultimately care about) after a year. It was not that the community was not ready to mobilize. The Pratham team had also asked the community to come up with some volunteers who would be trained in Pratham’s Read India techniques for teaching children how to read, and thereafter run after-school reading classes for the children. Volunteers did come forward, and they taught several classes each. As we saw in Chapter 4, children’s reading levels improved dramatically in these villages.
The difference was explained by the fact that the villagers had been given a clear, concrete task: Identify volunteers and send the children in need of help to the remedial classes. This was much better defined than the probably overambitious target to convince people to go lobby the administration for extra teachers, or to force teachers to come to school, as the SSA would have it. In Kenya, a study that gave parents’ school committees a narrow assignment was successful in getting them to act. The committees were given a sum of money and asked to hire extra teachers with it, and in some of the schools, they were given the additional responsibility of paying close attention to what this extra teacher was doing and making sure the school was not misusing the new teacher. The program was well implemented in all the schools, and its effects were even stronger in schools where the school committee was asked to pay close attention to how it worked.36 Thus, parent participation in school can work, but it requires some thinking about what parents are asked to do.
What these two examples (the nurses and the school committees) illustrate is that large-scale waste and policy failure often happen not because of any deep structural problem but because of lazy thinking at the stage of policy design. Good politics may or may not be necessary for good policies; it is certainly not sufficient.
So there is no reason to believe, as the political economy view would have it, that politics always trumps policies. We can now go one step further and invert the hierarchy between policies and politics. Can
good policies be a first step to good politics?
Voters adjust their views based on what they see happening on the ground, even when they are initially biased. The female policy makers in India are an example. Whereas the Delhi elite remained convinced that women could not be empowered by legal fiat, citizens on the ground were much more open to the opposite view. Before the policy of setting aside one-third of the seats of panchayat leaders to women, very few women were ever elected to a position of power. In West Bengal, in GPs that had never been reserved for women leaders, 10 percent of the pradhans in 2008 were women. Not surprisingly, the share jumped to 100 percent when the seats were reserved for women. But, once a seat that had been reserved went back to being open, women were more likely to be elected again: The share of women elected increased to 13 percent for currently unreserved seats that had been reserved once in the past and to 17 percent if they had been reserved twice. The same thing applied to city government representatives in Mumbai.37 One reason for this is that voters’ attitudes toward women changed. In West Bengal,38 to measure prejudices about competence, villagers were asked to listen to a recording of a leader’s speech. All villagers heard the same speech, but some heard it spoken in a male voice, and others in a female voice. After they heard the recording, they were asked to judge its quality. In villages that had never had reserved seats for women, and therefore had no experience of a woman leader, men who heard the “male” speech gave higher approval ratings than those who heard the “female” speech. On the other hand, in villages that had been reserved for women before, men tended to like the “female” speech better. Men did recognize that women were capable of implementing good policies and changed their opinion of women leaders. The temporary reservation of one-third of the seats for women could thus lead not only to some additional drinking water sources but also to a permanent transformation of the role of women in politics.
Good policies can also help break the vicious cycle of low expectations: If the government starts to deliver, people will start taking politics more seriously and put pressure on the government to deliver more, rather than opting out or voting unthinkingly for their coethnics or taking up arms against the government.
A study in Mexico39 compared the voting behavior at the 2000 presidential election in villages that had received the social welfare program PROGRESA—which gave poor households cash transfers as long as their children attended school and they visited health-care centers—for six months and in others that had received it for twenty-one months. Both the poll turnout and votes in favor of the PRI (the party that brought them PROGRESA) were higher in villages that had received the benefits for longer. It cannot be because the households were “bought” by the program, since by that time, all of them had received the benefits and knew the rules. But because the program was successful in improving health and education and the households that had received the program for longer had started to see some of these benefits in their lives, they responded by being more engaged (higher turnout) and rewarding the party that had initiated the program (higher vote for the PRI). In a context where all too many electoral promises are made and broken, tangible achievements provide useful information to voters about what the candidates may do in the future.
Lack of trust can explain why in the 2001 experiment in Benin, Wantchekon found that the clientelist message was more successful than an appeal to general interest. When politicians talked in broad terms about the “public interest,” no one took them seriously. At least, voters could more or less trust a clientelist message. If the “general interest” message had been clearer, more focused on some specific proposals, and had proposed an agenda that voters could hold the candidates accountable to if elected, they might have been more swayed.
A follow-up experiment that Wantchekon conducted before the 2006 election suggests that voters are indeed prepared to support those politicians who take seriously the job to design and explain social policies. 40 Wantchekon and other civil society leaders in Benin started by organizing a broad consultation: “Election 2006: What Policy Alternative?” There were four panels on education, public health, governance, and urban planning, and four experts (two from Benin and two from neighboring Niger and Nigeria) provided a white paper with policy recommendations. These were all broad proposals, without clientelist appeal. All the parties represented in the National Assembly, as well as representatives from various NGOs, attended the conference. After the conference, several parties volunteered to use the proposals made at the conference as electoral platforms on an experimental basis. They did this in randomly selected villages, in town meetings, where the proposals were presented in detail and participants had a chance to respond and react. In the comparison villages, the usual festive political meeting took place, with the usual mix of clientelist messages, and broad but vague policy proposals. This time, the results were reversed: Instead of showing support for the clientelist message, the turnout and support for the party running the campaign were higher in villages where the town meetings were held and specific policy proposals were discussed.
This result suggests that a credible message can convince the voters to vote in favor of general-interest policies. Once the trust is there, the individual politician’s incentives also change. He can start to feel that if he does something good he will be appreciated and reelected. Many people in positions of power have mixed motives—they want to be loved or do good, both because they care and because it secures their position, even when they are corrupt. These individuals will do things to promote change, as long as they are not entirely inconsistent with their economic objectives. Once the government proves that it is trying to deliver, and wins the people’s trust, a further possibility arises. The government can now afford to be less concerned with the short term, less keen to win the voters’ approval at all costs, less compelled to indulge in giveaways. This is its chance to design better and more farsighted policies. As we saw in Chapter 4, the demonstrated success of PROGRESA encouraged Vicente Fox, who took over as president after the PRI lost power in Mexico, to expand the program, instead of canceling it. What’s more, programs of this kind have expanded all over Latin America, and from there to the rest of the world. These programs may initially be less popular than simple giveaways, because to get the money, the family has to do something it may not otherwise want to do, but it is believed (although, as we saw, perhaps incorrectly) that the conditionality is an integral part of “breaking the cycle of poverty.” It is encouraging that parties, both on the left and on the right, now feel that they should run on platforms that put this long-term view at the center of the agenda.
Many Western scholars and policy makers are extremely pessimistic about political institutions in the developing world. Depending on their political leanings, they may blame old agrarian institutions, or the original sin from the West—colonization and its extractive political institutions—or just the unfortunate culture that countries are stuck with. Whatever the reason, this viewpoint holds that bad political institutions are in large part responsible for keeping poor countries poor, and getting out of that state is difficult. Some feel this is a reason to give up; others want to impose institutional change from outside.
Easterly and Sachs are both somewhat impatient with these arguments, for different reasons. Easterly sees no reason for “experts” from the West to judge whether a set of political institutions in another place is necessarily good or bad in that specific context. Sachs believes that poor institutions are a disease of poor countries: We can successfully address poverty, perhaps in a limited way, even in bad institutional environments, by focusing on concrete, measurable programs; and making people richer and more educated can start a virtuous circle where good institutions will emerge.
We agree with both of them: The focus on the broad INSTITUTIONS as a necessary and sufficient condition for anything good to happen is somewhat misplaced. The political constraints are real, and they make it difficult to find big solutions to big problems. Bu
t there is considerable slack to improve institutions and policy at the margin. Careful understanding of the motivations and the constraints of everyone (poor people, civil servants, taxpayers, elected politicians, and so on) can lead to policies and institutions that are better designed, and less likely to be perverted by corruption or dereliction of duty. These changes will be incremental, but they will sustain and build on themselves. They can be the start of a quiet revolution.
In Place of a Sweeping Conclusion
Economists (and other experts) seem to have very little useful to say about why some countries grow and others do not. Basket cases, such as Bangladesh or Cambodia, turn into small miracles. Poster children, such as Côte d’Ivoire, fall into the “bottom billion.” In retrospect, it is always possible to construct a rationale for what happened in each place. But the truth is, we are largely incapable of predicting where growth will happen, and we don’t understand very well why things suddenly fire up.
Given that economic growth requires manpower and brainpower, it seems plausible, however, that whenever that spark occurs, it is more likely to catch fire if women and men are properly educated, well fed, and healthy, and if citizens feel secure and confident enough to invest in their children, and to let them leave home to get the new jobs in the city.
It is also probably true that until that happens, something needs to be done to make that wait for the spark more bearable. If misery and frustration are allowed to have their way, and anger and violence take over, it is not clear that the spark will ever arrive. A social policy that works, that keeps people from striking out because they feel that they have nothing to lose, may be a crucial step toward preserving the country’s date with that elusive takeoff.
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