2013年-世界发展银行全球_Education_and_Health_Services_in_Kenya___Data_for_Results_and_Accountability_16页_1mb

Summary of Education and Health Service Delivery Indicators in Kenya

Core Content

The Service Delivery Indicators (SDI) initiative is a collaborative effort by the World Bank, the African Economic Research Consortium, and the African Development Bank. It aims to measure and improve the quality of service delivery in education and health across Africa. The SDI for Kenya, launched in July 2013, is the first country to implement this standardized methodology, with data collected from 303 primary schools and 294 health facilities, involving 2,960 teachers and 1,856 health providers.

The initiative is funded by the William and Flora Hewlett Foundation, the World Bank, CIDA, and the USAID-funded Health Policy Project. The SDI provides objective, quantitative metrics to benchmark service delivery performance and increase accountability for improved service quality, especially in education and health.

Main Objectives

• To assess the quality of education and health services in Kenya and other African countries.
• To identify gaps in service delivery and track progress over time.
• To mobilize stakeholders (policymakers, service providers, citizens, donors) to improve service outcomes.
• To align institutional incentives with service delivery goals and improve human development outcomes.

Key Findings

What Providers Know

• Teacher knowledge is relatively low, with only 35% of public school teachers scoring at least 80% on curriculum-based tests.
• Pedagogical skills are even more concerning, with minimum knowledge scores at 35.1% for public teachers.
• Health providers also show gaps in knowledge, with 72.2% correctly diagnosing tracer conditions, and only 58% able to diagnose at least four out of five conditions.
• Adherence to clinical guidelines was low, with 44.6% of public providers following them for maternal and neonatal complications.

What Providers Do

• Absenteeism is a significant issue, particularly in public health facilities and public schools.
  • 29% of public health providers were absent, with 88% of absences being sanctioned.
  • 16% of public schools had an average absence rate, but 20-40% of schools had higher rates.
  • 42.2% of public school teachers were absent from the classroom, while only 55% were in class.
  • Private school teachers were less likely to be absent and spent more time teaching, resulting in 1 hour and 9 minutes more teaching time per day than public school teachers.
  • Public health providers were 66% more likely to be absent than private non-profit health providers.

What Providers Have to Work With

• School infrastructure and teaching resources are generally available and meet or exceed national standards.
  • 95% of schools have sufficient light for reading.
  • Teaching equipment is available in 95% of schools.
  • Student-teacher ratio is 33:1, which is better than the Kenyan norm of 40:1.
  • Students per textbook is 3.1, slightly better than the norm of 3.0.
• Health facility inputs are also largely available:
  • 76.4% of health facilities have access to basic medical equipment.
  • 72% of public health facilities meet basic equipment requirements.
  • Refrigeration is available in 98% of health centers and hospitals.
• Drug availability is a challenge, especially for maternal health:
  • 58% of public facilities had at least one tracer drug for mothers available.
  • 78% of public facilities had at least one tracer drug for children available.
  • Rural public facilities had 13% more tracer drugs for children than urban ones.

Public-Private Comparisons

• Private schools outperform public schools in terms of teacher effort and presence.
  • Private teachers were 33% less likely to be absent and spent 50% more time teaching.
  • Private school students received more teaching time per day.
• Private health facilities also performed better than public facilities in terms of absence rates and availability of essential inputs such as clean water and electricity.
  • Private facilities had 29% more access to clean water and 32% more access to electricity than public facilities.

Key Insights

• Provider knowledge and effort are more critical than input availability in achieving better service outcomes.
• Low provider effort in public schools and health facilities is a major concern, with absenteeism and lack of classroom presence affecting student learning and patient care.
• Management and oversight are key to improving service delivery, as provider behavior is influenced by institutional incentives and work environment.
• SDI data is designed to be objective and representative, offering actionable insights for policymakers and stakeholders to improve service quality and human development outcomes.

Conclusion

The SDI initiative provides a comprehensive and transparent framework for assessing the quality of education and health services in Kenya. It highlights the importance of provider knowledge and effort, while also identifying gaps in infrastructure and resource availability. The data underscores the need for targeted improvements in management and oversight to ensure that public resources are used effectively to improve service delivery and enhance human development outcomes.