- WHO. 2001. "The Multi-Country Evaluation of IMCI Effectiveness, Cost and Impact (MCE): Progress Report May 2000-April 2001." Geneva.

_JPub5lic Expenditre 2"rackiirg Smrveys_ In recent years, the public expenditure tracking surveys (PETS) have been implemented in a range of countries in response to perceived public expenditure management and service delivery problems. These surveys have varied considerably both in terms of scope and focus, to the extent that the use of a single term in reference to the variegated survey activities may be misleading. In general, it is possible to distinguish two types of surveys under the umbrella of public expenditure tracking: tracing studies and quantitative service delivery surveys (QSDSs). Tracing studies have been used to identify the location and extent of impediments in financial flows to sub-national levels of administration or service delivery units. Government resources, which are typically earmarked for particular uses in the budget (votes, line items), flow, upon release, within a pre-defined legal, regulatory, and institutional framework, passing through the layers of the government and via banking system down to districts or facilities. Tracing studies track the flow of resources through these institutional strata in order to determine how much of the original resource reaches each new level, and how long the resource takes to get there. In contrast, QSDSs are more akin to facility surveys, although they have often tried to capture different aspects of the relationship between service delivery units and the administrative and logistical system "upstream". The focus on efficiency and quality in service delivery is in recognition of the fact that even if budget outturns reflect allocations, ultimate impact in terms of development objectives also requires that financial resources are efficiently transformed into appropriate public services.

As noted, PETS can in part be seen as a response to the lack of information about the systems through which budget resources are transformed into services. Indeed, the first PETS, implemented in Uganda in 1996, asked why it was that service delivery outputs in the health and education sectors had failed to respond to considerable increases in public spending. The survey was carried out in 19 of Uganda's 39 districts. It focused on a sample of 250 government schools and 100 public health clinics, and spending data for the period 1991-95 were collected (Ablo and Reinikka 1998; Reinikka 1999). For the education sector, the survey compared central government outlays for non-wage spending with the corresponding school income. Specifically, it focused on the capitation grant that is paid out per student enrolled as a matching government contribution against the mandated tuition fees paid by parents. The results demonstrate how weak governance and lack of accountability can hamper the process of budget implementation, and that _defacto_ public spending may be determined by the bargaining power of individual facilities (Reinikka and Svensson 2001). The survey also demonstrated the inaccuracy of administrative data on school outputs. 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 expropriated by staff.

A follow up study was carried out in Uganda in 1999 (Ministry of Education and Sports (Republic of Uganda) 2000). This was a tracing study in the education sector, where, for a sample of 427 schools and 11 District Headquarters, four monthly releases in 1998 and 1999 were traced through the payment system. The objective of the survey was to track flow 38