Let's open debate on financing social services

| Thursday August 2, 2007 00:00

People bring up a cocktail of arguments for and against fees, centering on Human Rights and on Universal Access. However, all these are not straightforward issues; it does not always follow that charging a fee is an infringement of Human Rights, or that it impedes universal access. In the case of education, children as rights holders do not have to only expect these rights from the State, but should also expect them from the parents.

It is the responsibility of every parent to ensure that his/her child gets education. Designing a system for financing health care, or financing education, needs to take into account various factors that include affordability, physical access, the right to access and many others. That is why although many Governments around the world do charge fees for various social services; they usually put in place mechanisms of exemption, so that those unable to pay are not denied access.

In recent years, universal access to 'essential health care' and to Primary Education have been accepted by most countries, including Botswana, under the auspices of the UN and its Agencies such as WHO, UNICEF, UNESCO and so on, and the easiest way of ensuring this access is to make essential health care and primary education free at the point of service for everybody. However, when it comes to secondary care and secondary education, there are divergent views.

My experience when working in various countries is that those for and against fees usually argue from the point of view of two broad areas, viz., cost recovery and community ownership or participation in services provision. People in some of these countries have often expressed dismay when I told them that in Botswana the Government initiates and builds Primary Schools, health facilities, boreholes and so on, and then runs and maintains them without any financial or in kind contribution from the beneficiary communities.

The more common view I encounter in these debates is that if a Government does these things without financial or in-kind participation by the community, the community feels no sense of ownership for the facility and therefore does not try in any way to protect it. Thinking of it in retrospect, I wonder if this issue has ever been really examined or interrogated in Botswana, especially in view of recent reports (which in fact reflect long-standing problems) of vandalism in schools and at standpipes in villages and in poorer parts of urban areas.

The argument for cost recovery tends to be weak. The concern for sustainability is a universal one, for example over the last few years many European countries had to relook at their welfare systems because of the 'welfare spiral'. With the Ministry of Education in Botswana accounting for 30 percent of Government budget, it is no wonder that Government and many people are worried about sustainability.

Even more worrying is the apparent disinclination to make the investment by many parents who have reasonable disposable income and could afford to invest in their children's education. One cannot help but contrast the situation with those parents who pay for their children, even when they are struggling, because they believe it is worthwhile investment.

Such parents instill a positive feeling for the value of education in their children, and it is not common to see such children engaging in wholesale vandalism that is so common in public schools. It is not a secret that many parents who did not pay school fees until Government took the drastic action of returning students home were quite capable of paying. But then in the last three decades, Batswana seem not to want to pay for any service, even if they can afford it.
 

In developing countries like Botswana, experience has shown that for fees to make any meaningful contribution to the budget, they have to be set quite high. Otherwise the cost of collecting and administering the fee system may end up being higher than what the exchequer gets from it.

The more persuasive argument for fees or contributions is the one of fostering a sense of ownership and participation in the beneficiary community. In order to encourage this, different mechanisms have been tried; for example, instead of the collected fees going to the central treasury, they are utilised by the collecting facility to improve its service, supervised by a board of elected community members or some similar mechanism. While I cannot apply this to the education sector, I have seen reasonable success in the health field in employing this approach. 

In discussing user fees in Botswana, we should not behave like we are inventing the wheel. It is a long debated subject around the world and in Africa. In the immediate post-independence era, most African Governments, especially in Anglophone Africa embraced the concepts of 'Free Education' and 'Free Health Care'.

By the 1980s, economic realities forced many of them to relook at these policies, and many instituted fees or cost-recovery policies. Most of their economies were in a state of free fall, and they just had no money to provide 'free' social services. They had to embrace the Structural Adjustment Programmes of the Bretton Woods Institutions or face economic collapse. Botswana's economy on the other hand was undergoing sustained growth, and the country could afford to introduce free social services.

The pendulum has since swung back to free social services, following a change of heart from the Finance Institutions and Donors. What is generally agreed now is that Primary. The issue of financing of social services should be debated not only in relation to secondary education, but also to the rest of education and to health care and other services. It should also be related to the strengthening of the social safety net in general.
   
Dr Edward T Maganu
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