A case study from Reducing Poverty, Sustaining Growth--What Works, What Doesn't, and Why A Global Exchange for Scaling Up Success Scaling Up Poverty Reduction: A Global Learning Process and Conference Shanghai, May 25­27, 2004 Holding the State to Account through Citizen Report Cards in India Dr. Samuel Paul Chairman, Public Affairs Centre No. 422, 80 Feet Road 6th Block, Koramangla Bangalore 560095 (Karnataka, India) Tel: +91-80-25537260/25525452/53 The findings, interpretations, and conclusions expressed here are those of the author(s) and do not necessarily reflect the views of the Board of Executive Directors of the World Bank or the governments they represent. The World Bank cannot guarantee the accuracy of the data included in this work. Copyright © 2004. The International Bank for Reconstruction and Development / THE WORLD BANK All rights reserved. The material in this work is copyrighted. No part of this work may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or inclusion in any information storage and retrieval system, without the prior written permission of the World Bank. The World Bank encourages dissemination of its work and will normally grant permission promptly. CASE STUDIES IN SCALING UP POVERTY REDUCTION Executive Summary When a government is indifferent, the initiative for change must come from civil society. Citizens who elect and pay for governments cannot and should not remain quiet when essential services are in disarray and public accountability is lacking. It was against this background that a small of citizens launched a "citizen report card" (CRC) on public services in Bangalore, a large city in Southern India in 1994. A CRC represents an assessment of public services of the city from the perspective of its citizens. The latter are the users of these services and can provide useful feedback on the quality, efficiency, and adequacy of the services and the problems they face in their interactions with service providers. When there are different service providers, it is possible to compare their ratings across services. The resultant pattern of ratings (based on public satisfaction) is then converted into a "report card" on the city's services. A citizen report card on public services is not just one more opinion poll. Report cards reflect the actual experience of people with a wide range of public services. The survey on which a report card is based covers only those who have had experiences in the use of specific services and interactions with the relevant public agencies, or other aspects of public services. Users possess fairly accurate information, for example, on whether a public agency actually solved their problems or whether they had to pay bribes to officials. Of course, errors of recall cannot be ruled out. But the large numbers of responses that sample surveys generate lend credibility to the findings. Stratified random sample surveys using well-structured questionnaires are the basis on which report cards are prepared. It is generally assumed that people from similar backgrounds in terms of education, culture, etc., are likely to use comparable standards in their assessments. But these standards may be higher for higher income groups than for the poor whose expectations about public services tend to be much lower. Dividing households into relatively homogenous categories is one way to minimize the biases that differing standards can cause. The first report card on Bangalore's public agencies in 1994 covered municipal services, water supply, electricity, telecom and transport. Since then, Public Affairs Centre (PAC) which was set up in Bangalore by the small group of citizens referred to above has brought out report cards on several other cities, rural services and also on specific sectoral services such as health care. But since it has tracked services for a longer period in Bangalore, a case study of this experiment is described below. The findings of the first CRC on Bangalore were most striking. Almost all the public service providers received low ratings from the people. Agencies were rated and compared in terms of public satisfaction, corruption and responsiveness. The media publicity that the findings received and the public discussions that followed brought the issue of public services out in the open. Civil society groups began to organize themselves to voice their demands for better performance. Some of the public agencies responded to these demands and took steps to improve their services. The inter-agency comparisons and the associated public glare seem to have 2 CITIZEN REPORT CARDS contributed to this outcome. When the second report card on Bangalore came out in 1999, these improvements were reflected in the somewhat better ratings that the agencies received. Still several agencies remained indifferent and corruption levels continued to be high. The third CRC on Bangalore in 2003 has shown a surprising turnaround in the city's services. It noted a remarkable rise in the citizen ratings of almost all the agencies. Not only did public satisfaction improve across the board, but problem incidence and corruption seem to have declined perceptibly in the routine transactions between the public and the agencies. It is clear that more decisive steps have been taken by the agencies to improve services between 1999 and 2003. What lessons can we learn from this experiment? A whole complex of factors seem to have influenced the outcomes described above. Some, like the report card and the advocacy by civil society groups seem to have worked on the demand side of services. Other factors influenced the outcome from the supply side. A major initiative came from the new Chief Minister who was very much concerned about the public dissatisfaction with the city's services. He set in motion new mechanisms such as the "Bangalore Agenda Task Force", a forum for public-private partnership that helped energize the agencies and assist in upgrading services. The civil society groups and the media supported and monitored these efforts. What is significant is that the initial trigger for these actions came largely from the civil society initiative that we call "citizen report cards". It is obvious that these initiatives are more likely to succeed in a democratic and open society. Without adequate space for participation, CRCs are unlikely to make an impact. A tradition of activism within the civil society also can help. People should be willing to organize themselves to engage in advocacy and seek reforms supported by credible information. Political and bureaucratic leaders must have the will and resources to respond to such information and the call for improved governance by the people. Last, but not the least, the credibility of those who craft CRCs is equally important. The initiators of the exercise should be seen as non-partisan and independent. They need to maintain high professional standards. The conduct of the survey and the interpretation of the findings should be done with utmost professional integrity. A report card does not end with the survey and its publication. Much of the advocacy work that follows will draw upon the report card findings. The CRC thus is a starting point, to be followed by further action through organized advocacy efforts, including civic engagements and dialogues with the relevant public agencies. When a government on its own improves its services and accountability, initiatives such as CRCs may not be necessary. Even under these conditions, a report card can be an effective way for civil society groups to monitor the performance of government and its service providers. Public agencies can on their own initiate report cards on their performance as indeed some in Bangalore have done. But when a government is indifferent to these concerns, the report card approach can be an aid to civil society groups that wish to goad the government to perform better. 3 CASE STUDIES IN SCALING UP POVERTY REDUCTION DURING 1993-94, a small group of citizens in Bangalore, a city in Southern India prepared a "Report Card" on the public services in their city, based on the feedback from the users of these services. The reason for this unusual initiative was the dismal state of essential services in the city and the public perception that the government was on the whole indifferent to this problem. The report card entrepreneurs hoped that their initiative might stimulate citizens to demand greater public accountability from the service providers, or at a minimum, give wider publicity to this problem. Bangalore was a city with a population of over four million in 1993. It was a growing industrial city and was turning into India's hub of information technology in the early nineties. A quarter of its population was poor, most of them living in slums spread throughout the city. As in other Indian cities, Bangalore's residents too depended on several public agencies established by the provincial (state) government for their essential services. Thus the city's municipal corporation provided services such as roads, street lights and garbage removal, while electricity was supplied by another large agency. Similarly, water, transport, telecom, health care, and urban land and housing were the responsibility of other large public service providers. A common feature of all these services was that they were monopolistic or dominant supply sources. People had little choice in terms of alternative suppliers. This mattered even more to the poor as they could not afford some of the high cost options that richer people could tap in the event that public service providers failed. Thus when electricity failed, the rich could turn on their generators. They might use private vehicles when public transport failed. Such options were seldom feasible for the poor. The poor suffered from yet another handicap, namely, their lack of influence and voice to get their problems solved at the agency level. Collective action by citizens to address these problems was also difficult to organize and costly in terms of time and resources. Planning and Implementing Report Cards It was against this background that the small citizens' group in Bangalore launched a survey of citizens to gather feedback on the public services in the city. The actual survey work was carried out by a market research firm, Marketing and Business Associates, that supported this initiative. The survey costs were met through local donations. The survey was launched after the group assessed the service related problems being faced by the people through focus group discussions. Structured questionnaires were designed in light of this knowledge and pre tested to ensure their relevance and suitability for field level interviews. The survey covered nearly 1200 households selected from among the middle class and low income households. Separate questionnaires were used for interviewing these two segments. But the objectives of the survey in both cases were to find out (1) how satisfactory the public services from the user's perspective; (2) what aspects of the services were satisfactory and what were not, and (3) what were the direct and indirect costs incurred by the users for these services. Satisfaction was measured on a rating scale (1 to 7) and aggregated to yield averages for its different dimensions. Trained investigators conducted the field interviews. The results obtained from an analysis of the data were used to rate the different 4 CITIZEN REPORT CARDS service providers in terms of the quality of the service, corruption and overall user satisfaction. A structured summary of these ratings across the agencies involved was called the "citizen report card on public services". A report card is not just another opinion poll. It is designed to reflect the actual experience of people with the specific services they use. Users possess fairly authentic information on whether they actually receive the services, whether their transactions with the agencies produce positive outcomes, and whether they have to pay bribes in the process. They know how long it takes to solve their problems and how well they are treated by the agency staff. The survey covered only those households that had direct experience with the services and had interactions with the agencies so that they could provide answers to questions on these subjects. The representative nature of the sample, the professionalism and neutrality in the conduct of the survey, and the large number of respondents ensured the credibility of the findings. Governments and service providers do have a wealth of data on the services they provide. But the kinds of information that a report card provides are rarely gathered by public agencies. As result, the user perspective and insights into the problems that ordinary people face in the course of service delivery are not always known to them. If services are to be effective and efficient, answers to such problems need to be found. It is this gap that a report card can attempt to fill. Needless to add, a report card can only be a diagnostic tool. It does not provide the answers. But it may well stimulate the search for answers or at a minimum, a further probe into the problems being highlighted. There are three different roles that report cards can play in the context of improving public services. First of all, when government's own monitoring is weak or incomplete, it can compensate for this gap by tracking service delivery from a user perspective. When a report card is repeated after a year or two, both the government and citizens can see whether things are improving or not. This is the benchmarking role of report cards. Both governments and citizens may take action depending on the results of the benchmarking exercise. The second role it can perform is to create a "glare effect". By publicizing the results of a report card, service providers can be put under a "public scanner" that makes their performance widely known to one and all. It can bring shame to the agency if its ratings are bad. It can also motivate service providers to perform better because of the sting of adverse publicity through inter-agency comparison of ratings. Needless to say, this will work only in settings where there is freedom of the press and a relatively open society. Third, report cards can motivate organized civic groups and institutions to be proactive in demanding greater accountability from the service providers. They may, for example, engage in dialogues with the agencies on ways to improve services. They may propose reform options and seek to create greater public awareness about the needed remedies. In varying degrees, these three roles have been played out by the Bangalore report cards. The first report card on Bangalore (1994) revealed several interesting patterns about the city's public services. It showed that the satisfaction levels of the middle income respondents did not exceed 25 per cent for any of the seven service providers covered by the survey. Dissatisfaction levels, on the other hand, were much higher, and in the case of the Development Authority was as high as 65 per cent. Public satisfaction with staff behaviour in these agencies 5 CASE STUDIES IN SCALING UP POVERTY REDUCTION was a mere 25 per cent and over a quarter of the people had to make three visits or more to the agencies to solve their problems. The problem resolution was 57 per cent when all agencies were taken together. On an average 14 per cent of the respondents had paid bribes to the agency staff and 50 per cent of them claimed that bribes were demanded by the staff. Many households incurred additional costs because of the investments they had to make to compensate for the unreliability of the services (eg., generators to cope with power outages). The feedback from the sample of low income households was also similar. Over 70 per cent of them had to make three or more visits to the agencies to solve their problems. Nearly a third of them had to pay bribes. Their problem resolution rate was much lower than that of the middle class households. Yet, their satisfaction with the service providers was not as low as in the middle income sample, perhaps because of their low expectations from services. The report card from both the middle income and low income households presented a picture of highly unsatisfactory and non-responsive service providers in the city. The report card findings were widely publicized through the press in Bangalore. The government and the service providers were also kept informed of the full report card. Citizen groups were invited to debate the findings and propose ways and means to deal with the problems being highlighted by the report card. Newspapers played a major role in creating public awareness about the findings of the report card. A leading paper, the Times of India, published the findings about each of the agencies every week, a feature that continued for a few months. Beyond the publication of the report card, the citizen group that started the initiative did not take any other follow up action. But enquiries began to reach the leader of the group on how this work along with advocacy for reform could be scaled up. The growing public interest in this endeavour persuaded the leader of the group to establish a new non-profit body called "Public Affairs Centre" (PAC) in Bangalore in 1994 to expand and strengthen this work in the country. One of its early activities was to respond to the requests for advice from three of the city's service providers covered by the report card. One of them was the worst rated agency which sought PAC's help in further probing into its problems and finding remedies. Though the report card did not provoke all the service providers to take immediate steps to improve their services, it is creditable that three out of eight agencies initiated action and sought help from PAC on their own. Another interesting initiative that followed was the creation of a joint service provider- civil society forum with the support of the municipal commissioner. It acted as a forum not only for dialogue on the city's services, but also as an instrument to generate new reform ideas and experiments. PAC prepared a second report card on Bangalore's public services in 1999. It provided new evidence on the state of public services in the city after a lapse of five years. The survey methodology used was essentially the same as in 1993, but the sample size was increased to 2000 households. The results showed a partial improvement in public satisfaction with most of the agencies, but the satisfaction level was still only below 50 per cent even for the better performers. A disturbing finding was that corruption levels in several agencies had increased. The low income people continued to visit agencies more often than their middle income 6 CITIZEN REPORT CARDS counterparts to solve their problems. The report cards indicated a clear link between petty corruption and inefficient service provision. The finding on corruption showed how difficult it is to root out the non-transparent and arbitrary procedures and mind sets of many agencies. But the two report cards demonstrated how such phenomena could be tracked and highlighted through credible methods and used to bring the agencies under a "public scanner". The follow up actions in 1999 differed significantly from those in 1994. Well before the public dissemination of results, PAC presented mini report cards to the major service providers in the city on a one on one basis. This was followed by a seminar for the management teams from selected agencies to exchange their experiences with reforms since the first report card. The objective of this exercise was to learn from each other. The deliberations showed that agencies other than those who sought its help were also engaged in improving their services in different ways. The final event was a public meeting where the report card findings were presented to both leaders and staff of all the service providers with citizen groups and media also present. Leaders of the agencies addressed the gathering and explained to the public their plans to deal with the problems highlighted in the report card. This event and the report card findings were widely covered in the news media. Though the report card of 1999 showed only partial improvements in the city's services, it was clear that several of the service providers had initiated action to improve service quality and respond to the specific issues raised in the first report card. One example is the improvements in billing procedures in some of the agencies. Another is the increasing use of joint forums with users to improve the responsiveness of staff. But within a few months of the second report card, the new Chief Minister of the state of which Bangalore is the capital announced the creation of a Bangalore Agenda Task Force (BATF) to improve the services and infrastructure of the city with greater public participation. He set up BATF as a public-private partnership with several non-official and eminent citizens as members along with the heads of all service providers. In contrast to the more limited agency responses, this move by the Chief Minister raised the level to systemic responses across agencies. It created a forum where all the stakeholders could be brought together both to solve the city's problems and to tap ideas and funds from the private sector. It was the first time that a Chief Minister had launched an initiative to improve services in response to citizen feedback. BATF began its work in earnest in 2000 and catalysed a number of reforms in a number of agencies. An important reform was the reform of the property tax that resulted in increased revenues and reduced hassles for the citizen. Solid waste management, sanitation and roads were other areas of visible improvement. BATF also prepared a simpler version of the report card to monitor the progress of the different city agencies. Over a three year period, its report cards (based on public feedback through interviews) showed a positive response from the people to the reforms and some improvement in the working of most of the city's public agencies and their services. 7 CASE STUDIES IN SCALING UP POVERTY REDUCTION Outcomes and Impact In respect of public services, impact can be gauged only though the improvements in services, measured in terms of their quality, adequacy and other features. This can be a stupendous and costly task, given the multiplicity of services and the complexity and size of the agencies involved. An alternative is to approximate such measures through an indirect approach that draws on an assessment of services by a sample of users as explained in an earlier section. We summarise below the evidence on impact that has thus been gathered through user feedback on the services at different points in time. We begin with the findings of the third report card on Bangalore (2003). A comparison of these findings with the earlier report cards will show whether there has been any improvements in the city's public services. A person's satisfaction with an agency's services reflects his/her overall assessment of that agency. Full satisfaction with an agency implies a higher rating of its services than partial satisfaction. Satisfaction can be measured for different dimensions of the quality of a service or agency. We present below four measures of agency responsiveness, namely, problem incidence, staff behaviour, time taken to attend to problems and bribes paid or demanded. These measures reflect different aspects of quality as experienced by the users of services. An increase in the proportion of users who are satisfied with a service/agency is an indirect indicator of an improvement of that service/agency. The findings presented below are divided into two parts: the first pertains to general households (mainly middle income), and the second to low income or slum households. The names of the nine agencies covered by the report cards are listed in the box below. BMP : Bangalore Municipal Corporation BDA : Bangalore Development Authority BESCOM: Bangalore Electricity Company BWSSB : Bangalore Water Supply and Sewerage Board BMTC : Bangalore Metropolitan Transport Corporation BSNL : Bharat Sanchar Nigam Limited POLICE : Bangalore Police RTO : Road Transport Authority Feedback from General Households Overall satisfaction:The satisfaction of the middle income citizens of Bangalore with the different services ranged from 70 to 96 per cent in 2003. Chart 1 shows the user satisfaction levels (measured by the proportions of users who are fully or partially satisfied) for the nine agencies. User satisfaction among general households ranged between 96 percent for BMTC and 73 percent for BWSSB, BMP and Government Hospitals. Agencies did vary, however, in respect of the proportions of people who have given a rating of "completely satisfied". While BMTC had the largest proportion of satisfied users, it is BESCOM which had the largest segment of users expressing "full satisfaction". The fact that a number of agencies have significant segments 8 CITIZEN REPORT CARDS of users who are partially satisfied suggests that much could be done to improve upon what has been achieved till now. It also signals that improvements in services are being experienced by larger proportions of people (greater spread) even though the quality standards achieved by agencies may not be anything close to perfection. Chart 1 Overall Satisfaction 2003 General Households 94 96 92 100 85** 73 73 73 78 77 deisfi 80 20 29 22 60 23 28 31 70 44 36 sat 40 74 67 70 % 20 50 50 46 15 29 37 0 OM BDA BMP C L B LS SS LICE RTO BESC BMT BSN BW V. HOSPITA PO GO agency Completely satisfied Partly satisfied A comparison of the performance of these agencies over the last ten years (in Chart 2) revealed a significant improvement in the satisfaction of users of services. Of the nine agencies on which citizens of Bangalore provided feedback, all received satisfaction ratings above 70 percent this time in contrast to less than 40 percent in 1999 and much lower ratings in 1994. Chart 2 Overall Satisfaction across Three Report Cards General Households 94 100 92 96 73 78 85 77 80 73 73 dei 67 sfit 60 41 47 42 34 32 32 sa 40 2534 16 % 14 20 5 6 4 9 n/a0 1 n/a0 0 P BM OM B SS BSNL S ITAL LICE BDA TC BM RTO BESC BW HOSP PO GOV agencies 1994 1999 2003 9 CASE STUDIES IN SCALING UP POVERTY REDUCTION The improvement was the greatest in the case of BDA where citizen satisfaction moved up from 16 percent to 85 percent. In the cases of BWSSB and BMP, the improvement in citizen satisfaction has been less impressive. Maintaining the high levels of satisfaction that has been achieved by agencies such as BMTC and BESCOM are a challenge. An important next step for them is to increase the proportion of users who are completely satisfied. An across the board improvement in the satisfaction with all the agencies raises a number of questions. Does the improvement in satisfaction reflect real changes that might have occurred in the quality of services, responsiveness of the service providers, and efficiency of service delivery? Is the users' need for interaction with the agencies much less now than before? What actions might have been taken by the government and its service providers to achieve such positive outcomes? The comparative charts given below provide some answers to these questions. Problems in dealing with public agencies: People are likely to be more satisfied when they have fewer problems in getting a service or interacting with an agency. "Problem incidence" of this type can be measured by comparing the proportions of users who face problems with the agencies. Service related problems can be of two types. Some problems are of a routine nature, like billing errors. Other problems could be more complex and occur in the context special services like getting a building sanction or a water supply connection. The extent to which users of services experience problems of both types has come down in 2003 except in the case of BMP (see chart 3). Fewer problems mean fewer interactions with the agencies. This can happen only when more people experience more reliable or hassle free services. Chart 3 Problem Incidence across Report Cards General Households 100 e 80 66 60 dencicni 39 40 29 31 27 31 % 16 16 19 20 20 20 15 5 8 7 13 12 3 0 P A BM BESCOM SB LS BWS POLICE C BMT SPITA RTO BSNL BD HO V. GO 1999 2003 The reduction of problems is an important reason for the improvement in levels of satisfaction. This reduction in problems is in line with investments to augment capacity, introduction of IT enabled services and other initiatives to improve efficiency of service delivery by the agencies that have taken place since 1999. Users of Bangalore Police's services (20 10 CITIZEN REPORT CARDS percent) reported the highest incidence of problems in the 2003 survey. Nevertheless, it is much below the 1999 level. The rate of decline has been sharpest in the case of BESCOM, where only 5 percent reported encountering problems as compared to 29 percent in 1999. Problems cannot be completely avoided and agencies devise ways to deal with problems. The findings serve to indicate how reduction in the intensity of routine problems translates into fewer interactions with citizens, thereby reducing the scope for delay, harassment or corruption. Satisfaction with the quality of service: The regularity and reliability of services have improved significantly during the period, according to users. Satisfaction with regularity of garbage clearance by BMP has gone up from 16 percent in 1999 to 75 percent in 2003, accuracy of billing in BWSSB from 32 percent to 90 percent, to give two examples. The reduction in problems described above has been matched by significant improvement in satisfaction with behaviour of staff (see chart 4). Chart 4 S a tisfa ction w ith S ta ff Be h a viour G e ne ra l Hou se hold s 100 92 97 88 89 81 84 89 80 80 80 deifsitas 61 54 60 51 33 40 26 3126 2428 3431 27 % 18 20 n/a n/a 1115 0 0 0 0 SSB COM TC P BM BM LICE L O A RT BD BW BES PO BSN .HOSPITALS GOV agency 1994 1999 2003 Satisfaction with the behaviour of staff was 97 the highest in the case of BSNL (97 percent). The largest improvement in this rating took place in BDA (80 percent). Here again, agencies did vary in the extent of improvement, but the fact is that there was a positive and substantial change in behaviour. It is difficult to imagine that people who gave low ratings in the past to the same staff would applaud them now without valid reasons. While improved procedures have reduced the possibility of abuse of discretion, most agencies have invested heavily in training their staff. These efforts may have positively influenced the attitude and mindset of staff since 1999. An important aspect of quality is the responsiveness of staff to customers. The time taken to attend to a user's problem is an index of responsiveness and good behaviour. Chart 5 below shows that compared to 1999, this indicator has improved significantly in 2003. The satisfaction levels of users who have visited agencies for routine problems and those who have 11 CASE STUDIES IN SCALING UP POVERTY REDUCTION gone to them for more serious problems are separately shown in this chart. All agencies have been taken together for computing this measure of efficiency. Chart 5 Time Taken to Attend (All Agencies) 100 92 81 80 edifsi 60 sat 40 30 % 20 10 0 1999 2003 Routine Problem Complex Problem Encounters with corruption: An important question is whether service improvement has been accompanied by a reduction in corruption. Evidence on this is given in the chart below. Earlier report cards did not show any improvement on the corruption front. In fact, it had worsened, according to the report card of 1999. But the latest report card shows that corruption prevalent in the routine transactions with agencies has come down in 2003 (chart 6). Some examples of how this might have happened are given below. This does not imply that all pockets of corruption have been eliminated. In specialized areas such as building permits and approvals of various kinds, corruption may still be substantial, but this survey was not designed to unearth them. Chart 6 Corruption incidence across Report Cards d 25 pai 22 ohw 20 15 egatnecr 14 10 9 5 pe 0 1994 1999 2003 year 12 CITIZEN REPORT CARDS Among the much-reduced number of citizens who encountered problems, 9 percent had to deal with corruption as against 22 percent in 1999. All the agencies have been taken together for this computation. This is a major achievement in itself. But caution must be exercised in taking this as an all-encompassing indication that corruption has almost been eliminated. But the findings definitely support the premise that simpler procedures and improved efficiency in routine operations such as self assessment of property tax by BMP, one time Sale Deed by BDA and the like, have served to reduce harassment and extortion that citizens faced in the late nineties. Feedback from Slum Households Slum dwellers' satisfaction with services: While the poor (slum dwellers) also indicated substantial improvement in satisfaction with services, their ratings are significantly lower, with four of the six agencies receiving satisfaction ratings above 70 percent. The poor do not use the entire range of services shown against the general households (middle income). Chart 7 O v e ra ll S a tisfa c tio n 2 0 0 3 S lu m H o u s e h o ld s 1 0 0 9 3 8 8 8 3 8 0 1 9 7 5 diesfit 2 3 6 5 3 3 6 4 6 0 2 0 2 9 3 7 sa 4 0 7 4 % 6 0 5 5 5 5 2 0 3 6 2 7 0 COM BMP C ITALS CE BES BMT BWSSB POLI HOSP V. GO a g e n c y C o m p le te ly s a tis fie d P a rtly s a tis fie d The ratings given by slum dwellers ranged between 93 percent for BMTC and 64 percent for Bangalore Police. As in 1999, a larger proportion of slum dwellers were satisfied with most services in comparison with general households. Problem Incidence in services: This is not to suggest that quality of services in the slums has not improved much. Feedback from slum dwellers indicated that service quality in terms of availability of water in public toilets and regularity of garbage clearance had improved substantially. Problem incidence has also declined and compared well with that reported by general households (see chart 8). Slum dwellers encountered problems in the course of their interactions with agencies most often while dealing with the Bangalore Police. This was the case in 1999 also. The most significant decline in problems with service has been in relation to BMTC. It is in relation to 13 CASE STUDIES IN SCALING UP POVERTY REDUCTION BWSSB that the decline has been of a small order, since there were a number of institutional issues that affected its service provision in the slums. Chart 8 Problem Incidence across Report Cards Slum Households 100 e 75 80 dencicni 60 34 38 40 27 28 13 18 26 17 8 % 20 3 6 0 BMP BESCOM BWSSB POLICE BMTC GOV. HOSPITALS agency 1999 2003 Satisfaction with staff behaviour: In most agencies, satisfaction with staff behaviour was higher among slum households than among general households (see Chart 9 below). Chart 9 Satisfaction with Behaviour of Staff Slum Households 100 100 84 91 93 deisfit 80 64 64 72 60 54 45 43 33 sa 40 17 % 20 0 BWSSB BESCOM BMTC BMP POLICE . HOSPITALS GOV 1999 2003 In spite of the relatively higher frequency of incidence of problems, users who interacted with BWSSB gave it's staff the highest ratings. Although Bangalore Police received the lowest ratings, significant improvement over 1999 was reported even in this case. But in the case of BMP, where overall satisfaction was comparatively lower, satisfaction of slum households with staff behaviour has turned out to be surprisingly high. 14 CITIZEN REPORT CARDS The Corruption score: The slum households survey also shows a decline in the proportion of people that have paid bribes. The proportions have declined from 25 percent in 1999 to 19 percent in 2003. In this regard, the experience of the poor is similar to that of the middle class. But the proportions are higher for the poor than for the middle class households. The corruption incidence thus continues to be higher on the poor than on the rest of the population. In summary, the report card findings discussed above show that a significant turnaround has taken place in Bangalore's public services over a ten year period. The improvement in public satisfaction levels reported above has cut across all the major service providers. This improvement is reflected in the feedback provided by both middle and low income households. The positive changes reported in the quality dimensions of the services are consistent with the higher overall satisfaction ratings of the different agencies. There is a surprising degree of internal consistency among the foregoing findings. If through various reforms, streamlining, etc., most agencies have managed to reduce the problems or hassles that people encounter during the interactions with agency staff, the scope for petty corruption would tend to decline. This is an unusual finding and has major implications for corruption control strategies. Similarly, when the problem incidence declines, the overload on agency staff tends to go down and this in turn may enable them to serve the remaining customers better. This perhaps explains why users have given much higher ratings for staff behaviour in 2003 for most agencies. Drivers of Change Many observers believe that the improvement in services reported above did not happen overnight. Starting with the first Report Card in 1994, the spotlight on public services had set in motion a series of actions by different stakeholders, which converged and cumulated to produce these results. Some agencies had taken remedial steps to improve their services as is evident from the report card of 1999. How these and other factors interacted and cumulated to achieve this turnaround in Bangalore is not easy to measure and explain. Nor is it possible to attribute the precise contribution of each of these factors to the turnaround. Needless to add, the same constellation and sequence of factors may not be required in other settings. It may not perhaps be easy to replicate the drivers of change that worked in one context in another. Nevertheless, the contributions made by the different interventions in Bangalore may have some lessons to offer reformers in other settings. The drivers of change in Bangalore can be divided into two categories: One set of factors operated from the demand side, and the other from the supply side. Demand for better services tends to operate from outside the government system. Citizen demands and media pressure are some examples. In a real sense, all demand side factors act as external catalysts. They have no direct role in the design or delivery of services. These external pressures can be sustained, however, only in open, democratic societies that tolerate dissent and debate. 15 CASE STUDIES IN SCALING UP POVERTY REDUCTION The supply of services, on the other hand, is the business of government itself. The factors that cause supply responses to happen therefore tend to be linked to government and are largely within its control. They could take action on their own, or they may act in response to demand side drivers of change. The interaction between the demand side and supply side factors that caused positive service outcomes has been a special feature of the past decade in Bangalore. In terms of sequence, demand side forces were the first to appear on the city scene. The supply responses came later. Demand Side Interventions The glare effect of citizen report cards The Bangalore report cards exerted pressure on the city's service providers in three ways. First, The focused information on their performance from the citizens' perspective put them under the "public scanner". Since such information was new to them, and much of it was negative, it had the effect of "shaming" the poor performers. Evidence from the corporate world shows that measuring and quantifying work and outputs tend to make organizations pay more attention to what is being measured. Something similar seems to have happened in the Bangalore agencies too. The chairman of the Bangalore Development Authority (BDA) recalled his reaction after the first report card that gave his agency a low rating: "For the first time, there was a feedback from the public on the performance of agencies. My curiosity was triggered by the fact that in the rankings the report card assigned to the various agencies, I found the BDA had got the first rank from the bottom. I thought I should do something about this"1. A similar motivation is evident in the initiative some agencies took after the first report card to contact PAC for its advice and assistance to improve services. Public agencies tend to be sensitive to adverse publicity, especially in a democracy. Second, inter-agency comparisons seem to have worked as a surrogate for competition2. Though each service provider is a monopoly and its area of activity is distinctive, the report card challenges this power by permitting an inter-agency comparison of certain common attributes. Users, media and civil society groups see delays, bribery and non-responsiveness as negative features in any service provider. The fact that the chairmen of some of the agencies called PAC to find out where they stood in the second report card before its findings were released also shows that organizations do pay attention to how the public views them. They wanted to know not only whether their ratings have improved, but also whether they are ranked higher or lower than others. This, despite their objection to inter-agency comparisons in public! Third, it appears that at least the chairmen of some of the agencies saw the report card as an aid in their efforts to reform their agencies. Though the feedback on their agencies was negative to begin with, these leaders took a positive view of the exercise. They used the findings to goad their colleagues to take action to improve the services. It shows that a report card, when 1Quoted from an interview in "State f India's Public Services: Benchmarks for the Millennium", Video Documentary, Public Affairs Centre, Bangalore, 2003. 2Market competition has so far affected only one service provider, namely, Bangalore Telecom (BSNL). Cell phones had begun to make inroads by the late Nineties. 16 CITIZEN REPORT CARDS prepared impartially and professionally, can be used to encourage the more proactive among the public leaders to move ahead on the reform front. A recent assessment of the Bangalore report cards reports that several agencies characterised report cards as a "catalyst"3 One of the agency leaders stated that PAC's work on satisfaction levels and quality of services using feedback had a profound effect on him as a public manager4. Some agencies have adopted the practice of preparing their own report cards, affirming the value of user feedback as an internal management tool. The report card work did not end with the dissemination of its findings. The dissemination was followed up with advocacy for more responsive and efficient agencies. It was the repeated report cards (three in ten years) and the subsequent public advocacy work together that seem to have made a cumulative impact on the government and citizens of Bangalore. This work was done along with many other civic groups and NGOs in the city. Their education and networking abilities were part of the outcome of the advocacy work. After the public meeting held in Bangalore in connection with the second report card of 1999, a leading newspaper, the Times of India said in an editorial " ------ PAC, in creating this forum, has opened doors, even windows, for a healthy tete-a-tete with our service providers. The honesty on display was remarkable. ----- this is the spirit of democracy in action. Civil society working in tandem with government for the greater good of all."5 In the Bangalore context, the report cards and the associated advocacy thus acted as a stimulus to reform and responsiveness in the service providers. While its precise contribution to the turnaround in services is difficult to measure, it is reasonable to conclude that it activated the demand side and signalled the need for change to the service providers well before the positive findings of the report card of 2003. Demand pressure through civil society groups As noted above, PAC's advocacy work was carried out through a network of civil society groups in Bangalore. In fact, the number of such groups increased significantly since the time of the first report card. There were two types of organizations in the network. Neighbourhood groups called residents associations have a direct interest in all the service providers. Then there are NGOs that work citywide, but on specific civic or service related issues. There were only about 20 such active groups in 1994. By 2000, their number exceeded 200. Not all of them are dynamic groups, but many did participate in the campaigns and meetings organized by PAC. The demand pressure created by them can be divided into two types: First, their participation in public meetings and seminars where report cards or other civic issues were discussed became an effective means to voice people's concerns about the services and to demand improvement in agency performance. A case in point is the public meeting held soon after the second report card (referred to above). Their distinctive contribution was to engage the service providers in active public dialogues as opposed to the closed personal meetings with officials that were customary in all agencies. Some of the service providers began to take a cue from this and organized their 3A. Ravindra, An Assessment of Bangalore Citizen Report Cards on the Performance of Public Agencies, (mimeo), OED, The World Bank, Washington DC, 2004. 4Ibid, page 11. 5The Times of India, Bangalore, November 8, 1999. 17 CASE STUDIES IN SCALING UP POVERTY REDUCTION own forums where the civil society groups were invited to dialogue on the problems being faced by them. The electricity board, the Water and sanitation board and even the police have worked with such forums. The interactions between organized civic groups and the service providers have grown significantly in the past decade. Second, the citywide NGOs have made a different kind of contribution to these dialogues. Their focus on specific issues and their city wide campaigns have given greater visibility to the demand side pressure on the agencies. PAC has assisted and partnered them in most cases, thus strengthening the city's "social capital". One NGO undertook advocacy work linked to property tax reform. Another examined the municipal budget and engaged the city corporation in a debate on service efficiency and public expenditure. A third worked on the improvement of solid waste management and offered new ways to improve this service6. The common thread running through these diverse interventions was their signal to the service providers that their activities were being watched and assessed in a systematic fashion. In different ways, all these civil society groups were demanding better services and accountability from the government and its agencies. Reinforcement of pressure by the media The print media in Bangalore played an unusual role by adding their weight to the pressure for better services. In 1994, all that the newspapers had done was to publicise the negative findings of the report card or other similar critical assessments. Investigative reports on civic issues were few and far between. But the scene changed since then as some of the newspapers decided to devote more space to public service problems and related civic issues. Some of the newspapers sought PAC's advice and technical inputs for their new initiatives. One newspaper began a series of reports on the different wards of the city, highlighting their problems and focusing on their elected corporators. This was followed by another innovative campaign that newspapers seldom undertake. A leading newspaper organised interactive meetings in different parts of the city where citizens were invited to voice their specific area related problems in the presence of senior officials from a selected group of public agencies. A large number of public officials were thus exposed to the issues of the localities and stimulated to respond with answers. These meetings, of course, received much publicity in the newspaper. The remedial actions taken were also subsequently reported in the press. This public process clearly put increased pressure on the agencies to be more transparent and accountable and to deliver on their promises. The role of donor dialogues It is well known that international donors can work on both the demand and supply sides of the problem under discussion. Their work on the supply side such as approval of loans and grants, technical assistance, etc., are more visible and better known. But in Bangalore, there is some evidence that major donors have exerted pressure on the demand side too. Since much of this happened behind closed doors, it is difficult to offer documentary evidence in support of their contribution. But in personal communications, World Bank officials, for example, have 6 These and similar initiatives are discussed in Paul, S., Holding the State to Account: Citizen Monitoring in Action, Books for Change, Bangalore, 2002. 18 CITIZEN REPORT CARDS confirmed how in their dialogues with the government, they have lent support to the importance of user feedback and to the need to view civil society pressure as an aid to accountability. These signals may well have reinforced the demand pressure on the agencies from the different sources discussed above. As noted above, these four factors are demand side interventions and hence can be credited with adding to the external pressure on the service providers to deliver better services to the people. They have worked both in sequence and in an interactive mode. Thus the first report card stimulated media publicity as well as civil society activism. By the time of the second report card, civic groups and PAC were working together interactively. Supply Side Interventions The Bangalore Agenda Task Force: A State Initiative Until 1999, the modest improvements in services that occurred in Bangalore and reflected in the second report card were the result of the actions taken by the agency leaders on their own initiative. The constraints within which they operated would have limited the scope of the reforms they could attempt. The scene changed for the better in 2000 when the new Chief Minister (the elected head of the state government) created a new body called the "Bangalore Agenda Task Force" (BATF) to work with the major service providers in a partnership mode. This happened months after the release of the second report card and showed the government's determination to deal with the problems being experienced by the public. BATF consisted of several prominent persons from the private sector and the professional world along with the chairpersons of seven service provider agencies. This public-private partnership was authorized to mobilize funds and expertise to assist and stimulate change in the functioning of these agencies, and to involve the public in appropriate ways in the process. It provided a forum for the service providers to test and experiment with reform ideas, seek assistance and give an account of their plans and outcomes. This was indeed an institutional innovation that could potentially stimulate the service providers to adopt better practices and be more accountable. BATF launched a series of six monthly summits where citizens were also invited to listen to these plans and achievements. The main contributions of BATF can be summarized as follows: · The private donations mobilized by BATF enabled the service providers to experiment with new systems, practices and infrastructural options. Government funds would not have given them the degree of flexibility that private funds did. The speedy introduction of the fund based accounting system in BMP would not have occurred without the money provided through the BATF. · BATF's practice of getting the service providers to make public statements on their plans and outcomes acted as a force for increased public accountability. The summits where these public commitments were announced were attended by citizens as well as the Chief Minister who also questioned the heads of agencies on their plans and achievements. BATF thus played the role of a public monitoring forum, creating greater openness and a sense of public participation. BATF also brought out report cards on the progress of its own work. 19 CASE STUDIES IN SCALING UP POVERTY REDUCTION · The professional expertise that BATF brought in the course of its work enabled the service providers to work on new options they might not have considered. The private funds raised by BATF were used in part to finance such selective technical assistance. Some projects such as road building did not need BATF's technical support. The property tax reform, on the other hand, required the finetuning of criteria, preparation of a manual, workshops for citizen orientation, etc., that needed careful planning and attention to detail. These tasks benefited much from BATF's inputs. Teaming up with BATF experts speeded up the process and goaded BMP staff to move forward faster. · All these contributions were made possible by the support and commitment provided by the new Chief Minister to BATF. His participation in the summits and willingness to solve tricky problems of coordination between some of the service providers in the course of these meetings were a testimony to his commitment. BATF had no legal or administrative authority over the public agencies with which it worked. It did not approve their budgets or oversee their programmes or projects. Its influence stemmed solely from its partnership and catalytic mode of operation, reinforced by the political support behind it. It provided strategic inputs and assistance to the agencies that found them valuable and timely. Resource mobilisation by the agencies A parallel development since the BATF was set up was a visible improvement in the resources available to the seven service provider agencies. New projects and expansion of infrastructure did call for more resources. There is clear evidence that the leaders of the different agencies mobilized additional resources through a variety of sources. In the case of BMP, its roads and related infrastructure programme was financed by a loan from the Housing and Urban Development Corporation. Similar loans were accessed by BMTC, BWSSB and BESCOM from other sources. BDA was a unique case where most of the funds required for new infrastructure projects was raised from its own internal surpluses. The budgets of these agencies had increased by 50-100 per cent over a three year period from 2000. Upgrading of services and infrastructure though increased borrowing could have been attempted in the preceding years too. But it took the proactive support of the state government and the catalytic role of the BATF to make this happen in a short period of time. Role of the Lok Ayukta (ombudsman) The ombudsman ("Lok Ayukta") in Karnataka State (of which Bangalore is the capital) played an indirect role in enhancing accountability in the agencies. He has powers not only to investigate grievances from the people about public agencies, but also to initiate investigations into the operations of the agencies on his own. In Bangalore, the ombudsman has been active on both fronts, even since his appointment in 2000. His raids on offices and the subsequent actions taken to penalize public officials who indulged in corruption have given much adverse publicity to many agencies and departments of the state government. His integrity and courage have been lauded by civil society, the media and political leaders. Although it is difficult to prove this, many observers believe that the ombudsman's actions have had a "deterrent effect" even on 20 CITIZEN REPORT CARDS agencies that have not been investigated by him. Strong support from the Chief Minister was a major factor that made it possible for the ombudsman to function fearlessly. Through the BATF, the Chief Minister nudged and stimulated the public agencies to perform better. Through the ombudsman, he created a sense of fear among the agencies that corruption and sloth will not be tolerated. These two approaches were mutually reinforcing. Political commitment and support The common thread that runs through the different supply side interventions discussed above is the political commitment and support of the Chief Minister of the state. This was a weak factor during the period 1994-1999. The change in the chief ministership in 1999 made a decisive difference. The new chief minister was a leader committed to improving public services and infrastructure. He was determined to find answers to the citizen dissatisfaction with essential services and industry's dissatisfaction with infrastructure. It is why he took the initiative to set up an innovative partnership called BATF. He then signaled the public agencies to mobilize more resources and facilitated their efforts. He appointed a new ombudsman known for his integrity and willingness to deal with corruption and other abuses of power in the government. These were wide ranging actions that could not have been achieved without political commitment at the highest level. The boldness of the chief minister was in no small measure due to the strong majority he had in the legislature. Political commitment is a product of the leader's vision and the stability of his government. Both these factors were much weaker in the 1994-99 period. That political commitment can vary with changes in leaders and governments does raise questions about the sustainability of reforms. It underscores the critical role of civil society institutions as monitors of governance and catalysts for reform. Civil society initiatives and demand for accountability are essential for coping with the vagaries of political commitment. The foregoing discussion highlights the contributions made by a variety of interventions that reinforced one another in the Bangalore context. It is their joint influence that is reflected in the report card of 2003 (See the charts above). As noted above, the precise influence of each of the factors is difficult to quantify. An agency head, for example, could take credit for the turnaround in his/her services. But the fact remains that without the support or pressure from the other factors mentioned above, the agency head may not have taken the necessary actions. Some drivers of change like the political commitment of the Chief Minister would have worked as an enabling condition. The assistance provided by BATF may have brought better ideas and more citizen friendly practices to the agency (eg., improved solid waste management, simpler tax system, improved billing procedure, etc.). Report cards and media publicity would have acted as external catalysts and speeded up the change. The service improvement for which the agency takes credit may not have happened in the absence of the joint influence of all these drivers of change. Other Applications The Bangalore report cards were the first to be initiated by PAC. But there have been many other applications of this tool in Bangalore as well as in other parts of India and in other countries. One case of special relevance to the poor was PAC's report card on the maternity hospitals for 21 CASE STUDIES IN SCALING UP POVERTY REDUCTION poor women in Bangalore. Its findings were followed by systematic advocacy work by several NGOs and led to the adoption of important reforms in the management of these hospitals that have benefited low income mothers and children. bPAC's report card on the investment climate in Karnataka State also made a similar impact. Its findings showed that despite the great publicity given by the state government to the rising investments in Karnataka, prospective investors were facing major hurdles with respect to their projects. There was clear evidence that the volume of actual investment in the state was way below the quantum of approved project investments. A sample survey of investors had shown that corruption, infrastructure, taxation and interface with government were serious barriers (in descending order) to their progress. The regulatory agencies with which investors had to deal were also rated by them in terms of the relevant attributes (eg., time taken for processing, number of visits made, complexity of procedures and bribes demanded). These findings were published in the press after the release of the report card. PAC's Chairperson received a call from the Industry Minister the very next day. He sought an urgent meeting with the PAC team to learn more about the report card. In a lengthy meeting with the PAC team, the Minister narrated the progressive policies and actions his ministry had taken to improve the investment climate. He impressed on the team the damage that could be done to the state through the adverse publicity generated by the study findings, especially in the context of a global investment meet being planned. The PAC response was that the report card merely reflected the experience feed back by the investors in the state, and hence had to be taken seriously. Policies could have flaws, and policies need not always be implemented as designed. Monitoring of what happens on the ground was perhaps being done incompletely. There was no consensus on what to do about the findings and the PAC team with the distinct impression that the Minister was unhappy with the outcome of the meeting. Six months later, PAC's Chairperson received another call from the Minister's office. The Minister was planning to call a meeting to discuss the problems of investors and the reforms necessary to address them. At this meeting, the Minister wanted the PAC Chairperson to present the report card findings and highlight the steps necessary to remedy the problems of investors. The PAC Chairperson spoke at the meeting that was held a few weeks later. Apart from the Minister and his senior officials, the meeting was attended by representatives of industry associations and other organized groups. At the close of the deliberations, the Minister spoke about the motivational role played by PAC's report card and announced that a reform package was being worked on in his department to respond to the problems of investors. He also invited the Chairperson to comment on the reforms under consideration. It was not an outcome that PAC would have predicted after the team's first meeting with the Minister. Once the reform package was prepared, senior officials of the department got in touch with PAC with a request that a new report card be prepared as part of a benchmarking exercise to assess progress changes in the investment climate after the reforms are implemented. PAC has since completed this exercise and given the findings to the Minister. Meanwhile, the reform package has been passed by the legislature and has received the assent of the President of India (a legal requirement). The reforms are presently under implementation. 22 CITIZEN REPORT CARDS This case is yet another example to show how user feedback, when properly assembled and interpreted, can act as a trigger for public action. In the present case, it was a political leader who was challenged, and who eventually responded positively. He recognised that negative feedback and its "glare effect" would hamper his mission. Perhaps similar messages may have reached him from other sources too. There is no guarantee that such a positive impact would be achieved in all contexts. But in a democratic setting, where leaders are sensitive to the signals from user feedback, there is a good chance that report cards that focus on systemic issues will receive serious attention. Lessons Learned Governments are responsible for the provision of essential public services in most developing countries. There is much, however, that service providers and their supervising authorities can learn about the quality and adequacy of their services by listening to citizen feedback. Citizen report cards offer a valuable tool to gather such feedback from the users of services. It is the diagnostic information provided by report cards that separates this tool from the protests and complaints by the people against public agencies. When government's own monitoring is incomplete or weak, report cards tend to fill this gap and act as a useful aid to policy makers and managers. The relevance of this tool for the poor cannot be overemphasized. It is difficult and costly for poor people to make their voice heard in powerful and large public agencies. Often their voice may not be correctly represented by their leaders or even mediating organizations. The survey methods used by report cards permit the poor to make their voice heard directly and with minimal bias. Report card findings can empower the poor by giving them information that they can use in their interactions with service providers. When a government and its service providers are non-responsive or perform poorly, the only option left is for civil society to demand greater accountability. Report cards in conjunction with advocacy can then become a tool for civil society to stimulate government and its service providers to respond to the systemic problems being experienced by the people. The Bangalore report cards and other examples given in this case study show how this has been accomplished. Report cards work only from the demand side and hence there is no guarantee that such positive impacts will occur in every case. The diagnostic value of this tool to agency leaders and the glare effect it can cause may persuade them to become more responsive to the people. Though a report card on public services can be conducted as a technical exercise, the dissemination and advocacy work to follow will benefit a great deal if concerned civil society institutions are involved in the process from the start. Citizen groups and other civic associations, NGOs and the media can play a useful role both in supporting the initiative and taking it forward through advocacy and dialogue. In Bangalore, consultations with NGOs working with the poor helped sharpen the survey's focus on their problems. Public-private partnerships can be an effective vehicle for catalyzing reform and improving services, once the government takes a positive stance in favour of change. 23 CASE STUDIES IN SCALING UP POVERTY REDUCTION Some pre-conditions need to be in place to ensure the acceptability of report cards. The credibility of those who use the tool and engage in advocacy is extremely important. The exercise should be seen as impartial and independent. The conduct of the survey and the interpretation of its findings should be done with utmost integrity. In general, competent and professionally managed organizations need to act as intermediaries for this to happen. These conditions apply irrespective of whether the initiative comes from civil society or the government. Report cards are likely to be used by civil society groups in relatively open and democratic societies that respect dissent. This is not to say that non-democratic settings cannot benefit from this tool. But its proper use is unlikely to happen unless there is strong interest on the part of the political leadership to listen to public feedback and use the findings to improve public services or other aspects of governance. 24 CITIZEN REPORT CARDS Bibliography Ravindra, A., An Assessment of the Impact of the Bangalore Citizen Report cards on the Performance of Public Agencies, OED Working Paper, World bank, Washington DC, 2004. Paul, Samuel, Holding the State to Account: Citizen Monitoring in Action, Books for Change, Bangalore, 2002. Goetz, A.M., and Gaventa, J., Bringing Citizen Voice and Client Focus into Service delivery, IDS, Sussex, U.K., 2001. Paul, S. and Shekhar, S., Benchmarking Urban Services: The Second Report Card on Bangalore, Public Affairs Centre, Bangalore, 2000. Balakrishnan, S. and Iyer, A., Bangalore Hospitals and the Urban Poor: A Report Card, Public Affairs Centre, Bangalore, 1998. Paul, S., et al, " The State of India's Public Services: Benchmarks for the States", Economic and Political Weekly, February 28, 2004, pages 920-933. Paul, S., Wanted: An Enabling Industrial Environment in Karnataka, Public Affairs Centre, Bangalore, 2000. Deichmann, U., and Lal, V.L., Are You Satisfied? Citizen Feedback and Delivery of Urban Services (mimeo), Development Research Group, World Bank, Washington DC, 2003. Nilakeni, N., Bangalore Agenda Task Force: Partnership With Promise?, Public Affairs Centre, Bangalore, 2003. Paul, S., A Report Card on Public Services in Indian Cities: A View from below, Public Affairs Centre, Bangalore, 1995. 25