The contributors of the thirteen articles, contained in this book explore the pro¬blems associated with reaching the benefits of develop¬mental programmes to the poorer sections of societies in Asia, Latin America and Africa. The changes necessary in structure and process of, government are identified, and the implications of such changes in the concepts and practices of planning are analysed. The corresponding need for reorienting research and training at the manage¬ment institutions operating in these regions is indicated.
The articles highlight several factors that contribute to the problem of effectiveness. To itemize the major difficulties: (1) development planning is done centrally by technicians who, according to some contributors, are removed from the people and their needs; (2) it is implemented through structures designed to follow central direction rather than be responsive to local reality; (3) the programming often lacks the involvement and participation of the people for whom it is meant;
(4) implementation frequently involves multiple agencies and departments among whom there is little coordination; (5) district level functionaries are given inflexible budgets and no discretion to make significant alterations; (6) dis¬trict level functionaries, parti¬cularly in poorer regions, do not stay in their posts long enough; (7) the poorer sections have no organization to re¬present their interests and influence planning and imple¬mentation; (8), the conditions of service in such areas make it difficult for government personnel to contribute their best, even in the rare event that a person is committed to the task; (9) the national poli¬tical leadership does not have the necessary commitment or has only a limited one, pro¬nouncements notwithstanding; (10) the theoretical perspective on which planning is done is narrow, piecemeal and not ‘holistic’ as it needs to be.
Typically, more than one of these factors were indicated by contributors based on their experience. The order in which these are mentioned is not meant to indicate their relative importance. One does not dispute the validity of many of these observations. What is more important in such works is the suggested alternatives.
At the outset, I would like to make a general observation. The countries from which cases are drawn do share many common features, including of course the widespread poverty that is scarcely diminishing. In addition, many of these governments have increasingly come to resemble each other in their publicized commitment to the poor. Yet there are wide differences in their politi¬cal set up and the character of national leaders, which one cannot ignore. For instance, one cannot put at par the regimes of Nyerere of Tanza¬nia and Marcos of the Philip¬pines. The former has an abiding commitment to an egalitarian society. The latter is more likely to be working basically to safeguard his own position. Therefore, when arti¬cles based on work in both these countries are presented in one place, the impression is likely to gain ground that the character of a regime and leadership play a minor role; the ‘processes’ play a greater role. Nonetheless, the point made in the book—that, since the bureaucracy is a widely present entity, one must think of ways to improve its effec¬tiveness—is well taken.
Maru examines the evaluation of the rural health system in India, and ascribes earlier failures to there being several field operatives attending a community, each in a specific sphere—such as malaria, vac¬cination, sanitation, family planning, etc. In addition, the size of the community these workers had to service was too large, making it phy¬sically impossible to attend to all. Subsequently changes were made, integrating the functions and assigning these to one functionary. Also, the population to be covered by each was reduced. Maru finds, however, that this did not lead to any significant change in the health status of the community, or significantly greater coverage. More drastic changes, therefore, were made in 1977, when the idea of Community Health Worker (CHW) was intro¬duced. A CHW belonging to the village was trained for a short period in basic health and returned to the village, and thereafter paid a regular small stipend for his service to the village. This did extend the coverage.
But it was again only insofar as curative medicine was con¬cerned. It did not lead to education in wider health problems as hoped for, nor did it trigger any changes in the health system. Maru feels that there is again a need for change. According to him, since routine functions (cur¬ative) tend to get more empha¬sis than the non-routine (health education, etc.), he re¬commends that these be separated and assigned to separate individuals, and this be followed by suitable evalu¬ation procedures so as to reward non-routine functions. One wonders if it is really a ‘new alternative’. To this re¬viewer it seems more like getting back to square one.
One also fails to see the point of four ‘models’ suggested by Maru at the end, wherein the CHW is to be placed under a Block Development Officer (BDO) in one case, the Panchayat in another, and so on. If Maru’s analysis of the prob¬lems of the health system is correct, then the solution does not lie in finding a new supervi¬sor for the CHW, but rather in changing the manner in which he looks at health problems and health-related functions. Maru is, perhaps, closer to the mark in saying that there is a need to introduce changes in medical education itself, giving it a different orientation and culture. But he does not arti¬culate how.
Satia, who also analyses the health system, advocates the need to give more flexibility to district level functionaries, and in turn the need for them to take greater initiative in for¬mulating plans for locally specific conditions. This is no doubt a very valid point, particularly so in relation to health programmes. It is tempting, however, to look at the remark of a district health officer quoted by Satia:
Infant mortality is a com¬plex phenomenon influenc¬ed by a variety of socio-economic factors that are not our concern.
One wonders what good it will do to give more resources, vehi¬cles and discretion to health personnel unless the boundaries of their ‘concern’ are expand¬ed first. Physical resources are a serious limitation; the limi¬tation imposed by narrowness of concern can be equally real. Here again arises the question of education, which Satia, however, has not elaborated.
One must examine a little more closely the oft-repeated criticism that officials are prone to pursuing ‘targets’. Take the case of a marketing or production manager of a firm. First a corporate stra¬tegy is fixed. Afterwards it is translated into operational targets and details for each subsystem of the firm. The production manager or mar¬keting man is expected to work for the targets, and evaluated accordingly. I wonder if the marketing manager is told—’Your job is to see that the consumer gets the best utility from the product he buys or we sell’. The point is, it is neces¬sary to identify the lowest level in developmental admi¬nistration upto which an official can be expected to derive his work rules from the total developmental strategy or plan, and below which per sonnet must work with the operationalized plan, i.e., details and targets.
While discussing the Tanzanian situation, Maeda has made valuable observations regard¬ing the above aspect. He men¬tions that, while there is a great deal to gain from initia¬ting plans and projects at the local level with the direct in¬volvement of the people, it still remains necessary to give them an idea of total budge¬tary constraints, and also to supplement their technical skills. Thus, it is not enough merely to criticize the ‘target-bound’ approach; one must indicate feasible alternatives, so that project planning can be made as ‘local’ as possible without losing sight of general constraints, and leaving open the possibility of using techni¬cal skills from outside when necessary.
Ranjit Gupta has given a com¬prehensive analysis of the under-development of Dharampur Taluka and its people. His analysis is noteworthy for the fact that, while suggesting small reforms in administra¬tion, he has not lost sight of the need for more thorough structural changes such as implementation of the land ceiling laws. He points out that while land reform legis¬lation has been implemented to a fair degree, land ceiling laws have not, leaving a fetter on the development process. Gupta also points out that there is need for people of the region to organize and mobi¬lize for greater resources. He makes the important obser¬vation that resource allocation takes place on the basis of political strength and not merely on the strength of num¬bers. One wishes he had dealt in greater detail with the need to bring about a convergence between the planners and the implementers.
Alfonso has analysed the ex¬perience of initiating changes in the national irrigation administrative work in the Philippines. He emphasizes the pre-project community work, which is focused on involve¬ment and participation, edu¬cation and mobilization of the people for the project. The key element in this work has been the ‘community organi¬zer’ who begins work as soon as the decision about a project is taken. This person educates the people about the aims of the project, and learns of their concerns. All this goes into project design and imple¬mentation. This is extremely important. There is, however, a need to clarify how the conflict resolution takes place through the efforts of the ‘community organizer’. In situations where the com¬munity is homogeneous, social and economic conflicts are likely to be less severe, parti¬cularly when the mobilization takes place for such goals as water. Quite often, however, there are conflicting economic interests that are affected by the project one way or the other. I wonder what man¬date, capacity, skill, and back¬up support the community organizer has to settle the con¬flict in favour of the poor. Alfonso and Korten have pointed out several very real obstacles to participation which need to be overcome and which can enhance the value of the project. Korten does mention the conflict of interests as one of the obstacles to participation but has not elaborated on it sufficiently.
Maeda has made a valuable contribution by analysing Tan¬zania’s programme of social and economic reconstruction. Despite the fact that its situa¬tion Would differ from most other countries mentioned in the book, Tanzania offers many lessons applicable else¬where. One problem which this reviewer finds interesting problem of is the accounta¬bility of technical and adminis¬trative personnel to the com¬munity. He states that despite a clear mandate, the technical personnel manage to retain much power by virtue of their technical skills and control over information. This is a very real problem in India as well. The solution to my mind, however, does not lie in down¬grading the role of technical persons, but in developing balancing mechanisms. Spread¬ing information widely is one such possible instrument; a lot of information considered secret at the district level does not really need to be so. But technical skill has a distinct place in reconstruction and should be appreciated as such.
On the whole, the book is a useful one for the people in¬volved in development action, planning, development studies, and change-oriented training and research. Its usefulness would have been greatly enhanced if more effort had been devoted to drawing out rigorously the implications of various suggestions such as decentralization, participation, planning at local levels etc. The contributions are strong in identifying the causes of ineffectiveness. They are, however, rather weak in put¬ting together alternatives.
Girja Sharan is Professor, Indian Institute of Management, Ahmedabad.