Service delivery on the cheap? Community-based workers in development interventions

Abstract

Within current neo-liberal approaches to development, models of community-driven development assume that community-based workers (CBWs) are key actors in improved and accessible service delivery. We argue that use of CBWs is under-theorised and seems to be based largely on untested assumptions about community participation and responsibility. Drawing on case studies on potable-water management and home-based care for HIV/AIDS patients in Tanzania and South Africa, the article explores issues of accountability, professionalism, and personal motivations in systems involving CBWs. It argues that many assumptions in relation to the effectiveness of CBW programmes require re-visiting.

Prestation de services à bon marché ? Les travailleurs communautaires dans les interventions de développement

Dans le cadre des approches néolibérales actuelles du développement, les modèles de développement impulsé par la communauté supposent que les travailleurs communautaires (TC) sont des acteurs clés dans la prestation améliorée et accessible de services. Nous soutenons que l'utilisation de TC est sous-théorisée et semble se baser largement sur des suppositions qui n'ont pas été mises à l'épreuve concernant la participation et la responsabilité de la communauté. Sur la base d'études de cas de la gestion de l'eau potable et des soins à domicile pour des patients atteints du VIH/du sida en Tanzanie et en Afrique du Sud, cet article examine les questions de redevabilité, de professionnalisme et de motivations personnelles dans les systèmes faisant intervenir des TC.Il soutient que de nombreuses suppositions concernant l'efficacité des programmes de TC doivent faire l'objet d'une nouvelle réflexion.

Distribuição barata de serviços? Trabalhadores comunitários em ações de desenvolvimento

Nas abordagens neoliberais atuais relativas ao desenvolvimento, os modelos de desenvolvimento orientados pela comunidade pressupõem que trabalhadores baseados na comunidade (CBWs) são agentes-chave na implementação de serviços melhores e acessíveis. Argumentamos que o uso de CBWs está sub-teorizado e parece estar baseado em grande parte em pressupostos não testados sobre a participação e responsabilidade da comunidade. Baseando-se em estudos de caso sobre gestão de água potável e cuidados em domicílio para pacientes portadores de HIV/AIDS na Tanzânia e África do Sul, o artigo explora questões sobre accountability, profissionalismo e motivações pessoais em sistemas envolvendo CBWs. O artigo argumenta que muitos pressupostos em relação à efetividade de programas de CBW precisam ser repensados.

¿Entrega de servicios con el menor gasto? Trabajadores comunitarios en acciones de desarrollo

En el marco actual de enfoques neoliberales en el desarrollo se da por supuesto que los trabajadores comunitarios (TC) son actores clave en los modelos de desarrollo comunitario para asegurar una mejor y más accesible entrega de servicios. Los autores de este ensayo argumentan que el empleo de TC tiene poco sustento teórico y parece fundamentarse en gran parte en supuestos de participación y responsabilidad comunitarias que no se han comprobado. Basándose en estudios de caso sobre la administración de agua potable y el cuidado de pacientes con VIH/SIDA en Tanzania y Sudáfrica, el ensayo analiza temas como la rendición de cuentas, el profesionalismo y la motivación del personal en proyectos que emplean a TC. Sostiene además que deben reconsiderarse muchas suposiciones sobre la eficacia de los programas que emplean a TC.

Keywords:

• Aid
• Social sector
• Sub-Saharan Africa

Acknowledgements

This research, funded by the UK Department of International Development (DFID) under the title: ‘Understanding the Inter-linkages in Community-Driven Development’, was headed by Frances Cleaver and hosted by the Bradford Centre for International Development at the University of Bradford. The views and opinions expressed are not necessarily those of DFID. We thank an anonymous reviewer for helpful suggestions.

Notes

http://www.bradford.ac.uk/acad/bcid/research/poverty/projects/interlink/papers/index.php

The African Institute for Community-Driven Development, Khanya, has done and is still doing extensive research into the functioning of CBWs at local levels in Southern Africa. Their work is accessible at www.Khanya-mrc.co.za

Additional information

Notes on contributors

Jelke Boesten

Jelke Boesten is Senior Lecturer in Social Development and Human Security at the University of Leeds. She has published extensively on gender, social policy, and violence in Peru, including a monograph Intersecting Inequalities (Penn State University Press, 2010). With Nana Poku she edited Gender and AIDS (Ashgate 2009) and is interested in AIDS, aid, and poverty in Tanzania.

Anna Mdee

Anna Mdee is a Senior Lecturer in Development Studies and a Director of the John and Elnora Ferguson Centre for African Studies in the School of Social and International Studies at the University of Bradford. Her research focuses on aid effectiveness, community-based development, civil society, and sustainable livelihoods in sub-Saharan Africa (particularly Tanzania). <[email protected]>

Frances Cleaver

Frances Cleaver is Reader in the Department of Development and Economic Studies at the University of Bradford. She is interested in water resources and sanitation, community development and participation, gender, and basic infrastructure and health care delivery in sub-Saharan Africa and beyond. <[email protected]>