utilization rates and reduced mortality (Newman and others 2000). As a final example, a survey was carried out in Paraguay in 1998 with a view to identify and quantify the effect of transferring management control for basic health services provision from central to municipal government on costs, efficiency, basic health service quality, and patterns of health service use and equity. The study uses pre- and post-decentralization design, with a control group, and focused on family planning, maternal health, and infant and child health (Angeles and others 1999).49 Monitoring information can also serve to strengthen accountability in the delivery of services. This can include the use of survey methods both to shed light on the systems through which budget resources are transformed into services, as well as to give users an opportunity to express their views on public services. The World Bank's Public Expenditure Tracking Surveys (PETS) and Quantitative Service Delivery Surveys (QSDS) provide examples of the former type of surveys. The focus of these non-standardized surveys have varied. On the one hand, some surveys have been concerned with the actual flow of resources-in financial or real terms-from central level administration to the actual service delivery unit. Indeed, it was in response to these concerns that the first Public Expenditure Tracking Survey (PETS) was designed and implemented in Uganda in 1996 (see Ablo and Reinikka 1998; Reinikka 1999). This survey asked why it was that service delivery outputs in the health and education sectors had failed to respond to considerable increases in public spending. Data problems were severe, particularly in the health sector (a finding of some interest in its own right). Yet, the survey provided powerful evidence of how weak governance and lack of accountability can hamper the process of budget implementation. For example, on average only 13 percent of the total yearly capitation grant from the central government reached the school in 1991-95. Eighty-seven percent either disappeared or was used for purposes unrelated to education. Interestingly, the access to funds varied in systematic ways with school size, income, and the extent to which teachers were qualified.<sup>5 0</sup> Information asymmetry was seen to be the primary factor behind these findings. In response to the survey results, the government began publishing the monthly transfers to the districts in newspapers, broadcasting on radio, and requmrnf primary schools to post information on received funds in public places in the school. 5 A number of tracking surveys with at least partial focus on the health sector have been implemented in other countries.<sup>5 2</sup> From these experiences, it is clear that there is no standard approach to doing a PETS, largely because the administrative and logistical systems on which

> 49 A second round of data collection is planned, but has been delayed due to slower than expected implementation of decentralization.

> 50 In the health sector records were poor or non-existing, and little quantitative data were collected. On the basis of interviews, it was however estimated that on average, almost 70 percent of medical supplies and drugs were expropnated by staff. Similar findings are reported by McPake et al. (1999)

51 Follow-up surveys have documented a considerable increase in the proportion of funds received by schools. This can at least in part be attributed to improved access to information, although other factors are also likely to be important.

52 Surveys in Tanzania looked at the allocation of resources in priority sectors at different levels of administration, and at delays and leakages in the transfer of resources (Price Waterhouse Coopers 1999; Research on Poverty Alleviation (REPOA) and Economic and Social Research Foundation (ESRF) 2001). A survey in Ghana sought to measure actual expenditures (including in-kind transfers) on basic education and primary health care to estimate the leakage of public funds in the transfer process from central government via districts to facilities (Ye and Canagarajah 2001). A survey in Honduras looked at ghost workers, absenteeism and "job-migration" in both health and education sectors (World Bank 2001b).

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