metadata: authors: 0: author: Diagne,Mame Fatou Irene Aminata
1: author: Ringold,Dena
2: author: Zaidi,Salman
count: Europe,Central Asia
docna: 0: docna: Governance and public service delivery in
            Europe and Central Asia : unofficial payments, utilization
            and satisfaction
docty: Policy Research Working Paper
subtopic: Health Care Services Industry,Public Sector Administrative & Civil
            Service Reform,Public Health Promotion,Health Service Management and Delivery,Educational Sciences,Democratic Government,Economics and Finance of Public
            Institution Development,Public Sector Administrative and Civil
            Service Reform,De Facto Governments
teratopic: Public Sector Development,Governance,Health, Nutrition and Population,Communities and Human Settlements
abstracts: cdata!: Using data from the 2010 Life in
            Transition Survey, this paper examines the levels of
            citizens' satisfaction with public service delivery in
            Europe and Central Asia and identifies some factors that may
            help explain variation in utilization and levels of
            satisfaction with service delivery. It finds satisfaction
            with public service delivery in Europe and Central Asia to
            be relatively high, and, despite the adverse economic and
            social impact of the recent global economic crisis, to have
            risen since 2006 in most countries in the region. However,
            the level of satisfaction with public service delivery in
            Eastern European and Central Asian countries in 2010 remains
            lower than in Western European comparator countries.
            Although the Life in Transition Survey does not provide
            specific objective measures of service delivery quality and
            efficiency, the data provide three important clues that may
            help explain why satisfaction is lower in transition
            countries than in western comparators: (i) relatively higher
            utilization of public services in Eastern European and
            Central Asian countries, (ii) relatively higher reported
            prevalence of unofficial payments, and (iii) relatively
            underdeveloped mechanisms for grievance redress.
repnme: repnme: Governance and public service delivery in
            Europe and Central Asia : unofficial payments, utilization
            and satisfaction
display_title: Governance and public service
            delivery in Europe and Central Asia : unofficial payments,
            utilization and satisfaction
listing_relative_url: /research/2012/03/15924911/governance-public-service-delivery-europe-central-asia-unofficial-payments-utilization-satisfaction
topicv3: Public Service Delivery m1326771 728,Education m1327048 470,Health Services Delivery m1327294 1305,Public Health m1327519 635,Health m1504661 3480
publishtoextweb_dt: 2012-03-01T00:00:00Z
historic_topic: Public Sector Development,Governance,Health, Nutrition and Population,Communities and Human Settlements
no_of_pages: 24
author_keys: 0: author_key: 998520
1: author_key: 125394
2: author_key: 95623
model_extractions: WPS5994 Policy Research Working Paper 5994 Governance and Public Service Delivery in Europe and Central Asia Unofficial Payments, Utilization and Satisfaction _Mame Fatou Diagne Dena Ringold Salman Zaidi_ The World Bank Europe and Central Asia Region Poverty Reduction and Economic Management Unit March 2012
Policy Research Working Paper 5994

# **Abstract**

Using data from the 2010 Life in Transition Survey, this paper examines the levels of citizens’ satisfaction with public service delivery in Europe and Central Asia and identifies some factors that may help explain variation in utilization and levels of satisfaction with service delivery. It finds satisfaction with public service delivery in Europe and Central Asia to be relatively high, and, despite the adverse economic and social impact of the recent global economic crisis, to have risen since 2006 in most countries in the region. However, the level of satisfaction with public service delivery in Eastern European and Central Asian countries in 2010 remains lower than in Western European comparator countries. Although the Life in Transition Survey does not provide specific objective measures of service delivery quality and efficiency, the data provide three important clues that may help explain why satisfaction is lower in transition countries than in western comparators: (i) relatively higher utilization of public services in Eastern European and Central Asian countries, (ii) relatively higher reported prevalence of unofficial payments, and (iii) relatively underdeveloped mechanisms for grievance redress.

This paper is a product of the Poverty Reduction and Economic Management Unit, Europe and Central Asia Region. It is part of a larger effort by the World Bank to provide open access to its research and make a contribution to development policy discussions around the world. Policy Research Working Papers are also posted on the Web at http://econ.worldbank. org. The author may be contacted at szaidi5@worldbank.org.

_The Policy Research Working Paper Series disseminates the findings of work in progress to encourage the exchange of ideas about development issues. An objective of the series is to get the findings out quickly, even if the presentations are less than fully polished. The papers carry the names of the authors and should be cited accordingly. The findings, interpretations, and conclusions expressed in this paper are entirely those of the authors. They do not necessarily represent the views of the International Bank for Reconstruction and Development/World Bank and its affiliated organizations, or those of the Executive Directors of the World Bank or the governments they represent._ Produced by the Research Support Team
# **Governance and Public Service Delivery in Europe and Central Asia:**

## **Unofficial Payments, Utilization and Satisfaction**

**Mame Fatou Diagne, Dena Ringold, and Salman Zaidi**<sup>*****</sup>

**JEL Classification Codes** : H40, I00, K42, I18, I28

**Keywords** : Public service delivery, health, education, irregular payments

**World Bank Sector** : POV

> * World Bank, Washington DC. Correspondence: Salman Zaidi, World Bank, 1818 H Street NW, Washington DC 20433, USA. E. mail: szaidi5@worldbank.org. Phone: (202) 473 1976. Fax: (202) 522 2753. Martin Cumpa and Santhosh Srinivasan provided invaluable research assistance. The authors are grateful to Paolo Belli, Rekha Menon, Lars Sondergaard, and Owen Smith for their suggestions and comments on previous versions of the paper. This paper has also benefited from the comments of numerous colleagues at the World Bank. The opinions and views presented here are those of the authors and should not be attributed to the Executive Directors of The World Bank.

<mark>1</mark>
<!-- Start of picture text --> The state<br>Politicians Policymakers<br>oo ily<br>ff gute of aCcoyn,<br>Citizens/clients Short route Providers<br>Coalitions/inclusion Management<br>Nonpoor Poor Frontline Organizations<br>Services<br><!-- End of picture text -->
ways in which people interact with the state, as well as their perceptions and levels of trust. These are themes which LITS2 is uniquely positioned to address: the survey includes an expanded module on governance and service delivery which enables new analysis on the links between the ways in which people use, experience and interact with public services, their perceptions and trust in providers and institutions, and the quality of service delivery itself.

There are obviously a number of caveats in the interpretation of satisfaction data. The presence of externalities (e.g. additional social benefits of education, public health, etc.), may mean that users‘ satisfaction does not capture the full extent of desired social outcomes. Second, even if individuals and society share the same goal – such as more rapid student learning – some persons may have been conditioned to have low expectations, leading them to report high satisfaction despite poor service delivery outcomes. A third reason for caution is information asymmetries: this is particularly evident in health services, where providers have technical information and expertise that patients lack and cannot therefore evaluate properly (Fiszbein, Rogers and Ringold, 2011; Das and Hammer, 2007). Still, subjective data on peoples‘ experiences and perceptions of service delivery quality can help complement more objective measures of service delivery (e.g. from facilities surveys) to help policy makers and development practitioners track progress of country programs and strategies.

Using data from the 2010 Life in Transition Survey Round 2 (LITS2), this paper examines the levels of citizens‘ satisfaction with public service delivery in Europe and Central Asia and identifies some factors that may help explain how levels of satisfaction with service delivery vary across different population sub-groups and change over time. Section 2 describes the coverage of governance and service delivery in LITS2 and presents the key findings on the prevalence of unofficial payments, and utilization of and satisfaction with public services. Section 3 analyzes differences across individuals and across countries (over time) in utilization and satisfaction with public services. We conclude by discussing a few measures that governments can implement to further increase citizens‘ satisfaction with public service delivery.

# **2. UTILIZATION AND SATISFACTION WITH PUBLIC SERVICE DELIVERY**

# **2.1. The data:  Government performance and service delivery in the 2010 LITS**

The Life in Transition Survey was conducted jointly by the European Bank for Reconstruction and Development and the World Bank in 2006 and 2010. Between 1,000 and 1,500 households were interviewed in every country. In total, in 2010, almost 39,000 households were surveyed in 34 countries of Europe and Central Asia to assess public attitudes, well-being and the impacts of economic and political change.

The governance and service delivery module focuses on eight different public services or interactions: traffic police, official documents (such as passport or birth certificate), civil courts, primary or secondary education, vocational education, the public health system, unemployment benefits and other social security benefits. For each service, respondents were asked their 3
perceptions of the prevalence of unofficial payments<sup>3</sup> and then about their household‘s utilization, satisfaction and actual unofficial payments.

**Utilization:** Respondents were asked if any household member had interacted with, or used, each of the public services.

**Satisfaction with service delivery:** All respondents who indicated that a household member had used the service during the past 12 months were asked if they were satisfied with the quality and efficiency of the service interaction<sup>4</sup> . Satisfaction data can be a proxy for measuring actual quality of services, as well as an indicator of the extent to which services are responsive to the needs and preferences of clients. They can also help to assess the effects of service delivery reforms (see section 3.2).

**Unofficial payments:** Respondents were asked if they had to make unofficial payments and why – specifically whether the payment was requested, expected, offered or given as a gift – allowing for a more detailed analysis of the incidence and causes of informal payments than is usually possible from household surveys.

For education and public services, the 2010 LITS survey provides more in-depth information on perceptions of service quality and grievance redress mechanisms. Regarding education, the survey inquired about any lack of textbooks and supplies, poor teaching, teacher absenteeism, overcrowded classrooms and poor conditions of facilities. Similarly for health, it asked about doctor absenteeism, treatment by staff, availability of medicines, waiting times and cleanliness of facilities. The answers to these questions provide a snapshot of people‘s experiences with services and can act as another measure of service quality. Another new feature of the 2010 LITS is a set of questions related to grievance redress mechanisms in health and education. The survey asks whether people know where to file a complaint if they were unsatisfied with education and health services, whether they filed a complaint, received a response, or were satisfied with the response.

Finally, respondents were asked to rate the overall performance of their national, regional, and local governments using a five-point scale (ranging from 1: very bad to 5: very good), and whether they felt the overall performance of these three administrative tiers had worsened, stayed the same or improved in the previous three years.

# **2.2. Descriptive statistics**

**Utilization.** The proportion of respondents who interacted with service providers varied considerably according to the type of service (see figure 2). By far the most often accessed service was the public health system (70 percent in the previous 12 months). Utilization rates for other services were much lower. The next highest usage rates were for primary/secondary public education (23 percent), interaction with traffic police (20 percent) and requests for official documents (14 percent).

> 3 “In your opinion, how often is it necessary for people like you to have to make unofficial payments/gifts in these situations”, with responses recorded on a five-point scale: 1= never, 2=seldom, 3=sometimes, 4=usually and 5=always.

> 4 Respondents were asked: “How satisfied were you with the quality and the efficiency of the service/interaction?” and responses were recorded on a five-point scale: 1=very dissatisfied, 2=dissatisfied, 3=indifferent, 4=satisfied and 5=very satisfied.

4
<!-- Start of picture text --> Used public services in previous 12 months<br>Public health<br>Primary,<br>secondary<br>Traffic<br>police<br>Official<br>documents<br>Tertiary<br>Social<br>security<br>Unemployment"benefits<br>Courts<br>0 10 20 30 40 50 60 70<br>Affirmative responses (per cent)<br><!-- End of picture text --> <!-- Start of picture text --> Satisfaction rates by type of service<br>secondaryray a<br>rein ee<br>documents<br>om ee<br>Pc ea a<br>security<br>sunt a<br>Unem"Soraent a<br>cours LSS<br>police<br>oO 20 40 60 80<br>Per cent of respondents<br>= Strongly 4 Dissatisfied Neither [ll Satisfied [NN<br><!-- End of picture text -->
<!-- Start of picture text --> Official documents Primary/secondary<br>100<br>e e e<br>80} see°> Fo °<br>=e 6 “ee e e<br>8 fe 6 ® e @<br>S 40 . °<br>ra<br>9 Tertiary Public health<br>> 100<br>22 80 y o ° e .%e<br>” eo; a) 8 e e ry %<br>¢ ° 0°<br>3 é e e e<br>ee ee<br>40 e e<br>) 50 100 a0 50 as100<br>Respondents (per cent) that used service during past 12 months<br><!-- End of picture text -->
satisfaction with education in LiTS2, the 2009 PISA survey found that 83 percent of 15-year olds were functionally illiterate (they scored below PISA level 2).

# **Complaints and grievance redress**

About 67 percent of respondents who had used health services during the previous 12 months reported at least one problem with service delivery, and for education services the figure was 50 percent. The main problems reported for health were long waiting times, lack of drugs and payment for services that should be free (Figure 5); in the case of education, the main problems were lack of textbooks/supplies, payments for services that should be free, and poor conditions of facilities.

**Figure 5: Problems with public health and education provision in the previous 12 months reported by respondents**

<!-- Start of picture text --> Public health clinic/hospital Public education<br>Long waiting times No textbooks or other supplie s<br>Payments required for services that should<br>No drugs available be free<br>Payments required for services that shouldbe free Facilities in poor conditio n<br>Treated disrespectfully by staf f Poor teaching<br>Frequent / unjustified absence of doctor s Overcrowded classrooms<br>Facilities not clean Frequent / unjustified absence of teacher s<br>0 10 20 30 40 0 5 10 15 20 25<br>Per cent of respondents Per cent of respondents<br><!-- End of picture text --> Source: LiTS2 (2010).

Grievance redress or complaints mechanisms refer to the institutions and channels that people can use to express their preferences and hold providers to account<sup>5</sup> . There are a number of specific objectives associated with the use of complaints handling in the public sector: promoting accountability in the delivery of services; measuring the quality of service provision and the effectiveness of policy; and harnessing experience to improve service delivery (Lister et al., 2008).

Grievance redress mechanisms have long traditions in Western Europe, but they are relatively underdeveloped in transition countries<sup>6</sup> . While 16 percent and 11 percent of respondents, respectively, reported that they had filed complaints for education and health in the comparator countries, only 5 percent did so in transition countries for either service. Some countries in the region have begun introducing complaints-handling mechanisms to improve service delivery. For

> 5 Complaints handling systems take diverse forms, including customer complaints procedures; administrative appeals and tribunals systems; independent complaints handlers or ombudsmen; and judicial review (and other forms of legal action).

> 6 Sweden first installed an independent ombudsman function in the late 19th century. More recently, the adoption of complaints handling systems spread in the countries of the Organisation for Economic Co-operation and Development in the 1990s as governments looked increasingly to private sector practice to improve the standards of public service provision. Studies on the private sector highlighted that the presence of a complaints system in businesses was associated with better performance (Johnson and Mehra, 2002);

7
<!-- Start of picture text --> Unofficial payments needed when using services<br>Unemploymentbenefits I<br>securitySocial |<br>Courts i<br>documentsOfficial |<br>secondePrit fi |_|<br>Tertiary |<br>Trafficpolice ||<br>Public health ||<br>(e) 10 20 30 40 50 60 70 80 90 100<br>Per cent of respondents<br>OE Never Seldom Sometimes Usually [0 Always<br><!-- End of picture text -->

<!-- Start of picture text --> a<br>|<br>a<br>7<br><!-- End of picture text -->
# **3. SATISFACTION WITH SERVICE DELIVERY AND GOVERNMENT PERFORMANCE**

# **3.1. Utilization and satisfaction with public services**

We analyze satisfaction with public health and public primary/secondary education services (the two most accessed services), using probit regressions (where the dependent variable is binary, taking value 1 if the user is satisfied or very satisfied, and 0 otherwise) and ordered probit regressions (where the dependent variable is the satisfaction level, taking values 1 [very dissatisfied] to 5 [very satisfied]). Taking into account the fact that survey responses regarding satisfaction only apply to usage within the previous 12 months, we use a two-stage Heckman sample selection correction. The results are presented in Tables 5 and 6.

# **Public health**

Relatively wealthier households, those with more children and/or elderly people and those in urban areas are more likely to access public health services than poorer ones which have fewer children or elderly members, or are located in rural areas. Reported levels of satisfaction with public health service provision are positively associated with self-assessed good health, satisfaction with life and greater age (in so far as older respondents were more likely to approve the quality of services received). Richer and better-educated respondents were less likely to be satisfied with the quality and efficiency of treatment received. Personal experience of specific problems in local public health provision (as identified in Figure 5) also has a negative impact on satisfaction. The issue associated with the largest reduction in satisfaction levels is "payments required for services that should be free", followed by being "treated disrespectfully by staff", "long waiting times", "frequent and unjustified absence of doctors" and having "no drugs available" (see Table 5). The perception that unofficial payments are necessary for access is an important factor causing dissatisfaction. Users of the public health system who felt that unofficial payments are always needed are more than four times more likely to report being highly dissatisfied with services received than those who that felt that such payments are never needed.

# **Public education**

Differences in utilization rates across urban, rural and metropolitan regions are not statistically significant. The reported level of satisfaction with primary and secondary education is positively associated with satisfaction with life; however, other factors such as the socio-economic background of the household and education level of the respondent do not appear to have any discernible impact on satisfaction levels. Personal experience of specific problems in the education system has a negative impact on satisfaction. ―Poor teaching‖ is associated with the largest reduction in satisfaction levels, followed by being "frequent and unjustified absence of teachers‖, ―crowded classrooms‖ and ―payments required for services that should be provided free‖ (see Table 6). Reported satisfaction levels are significantly higher among those respondents who say unofficial payments are never needed. Primary and secondary school users who felt that unofficial payments are always needed were nearly six times more likely to report being highly dissatisfied with the service delivery than those who considered such payments unnecessary.

9
<!-- Start of picture text --> Turkey<br>Estonia<br>Georgia<br>Latvia<br>Croatia<br>Slovenia<br>Moldova<br>Czech Rep.<br>Lithuania<br>Slovak Rep.<br>Uzbekistan<br>Poland<br>Armenia<br>Bulgaria<br>Montenegro<br>Serbia<br>Hungary<br>Belarus<br>Russia<br>Tajikistan<br>Romania<br>Bosnia-Herzegovina<br>Kazakhstan<br>Kyrgyz Rep.<br>MacedoniaMon<br>Azerbaijan<br>Albania<br>Ukraine<br>0 20 40 60 80<br>Percentageof satisfied users,2010<br><!-- End of picture text --> <!-- Start of picture text --> Turkey ba<br>Moldova eee<br>Tajikistan eee!<br>Estonia —<br>Poland al<br>Russia el<br>Uzbekistan ee<br>Kazakhstan eee<br>Latvia nd<br>Serbia ee<br>Georgia nan<br>Romania el<br>Ukraine Es<br>Montenegro EE<br>Belarus _—_——l<br>Hungary ___]<br>Lithuania Es<br>Slovak Rep. es<br>Czech Rep. as<br>Croatia es<br>Bosnia-Herzegovina as<br>Slovenia —<br>Albania a<br>K Mongolia a<br>eigen. ==<br>Armenia =z<br>Macedonia a<br>Azerbaijan | “ee<br>-10 0 10 20 30<br>Change in percentageof satisfied users,2006-10<br><!-- End of picture text -->
- In _Tajikistan_ , the government‘s 2005 health financing strategy aimed to improve equity, efficiency and cost-effectiveness of the health system by increasing public funding (in particular to primary health care) and introducing a basic-benefits-package (BBP). The BBP provides free services for vulnerable population groups and provides a legal framework for developing the policy for co-payments by patients for selected health services in hospitals.

- Finally, in _Turkey_ , the Turkish government launched a major reform program in 2003 to make the health system more effective by improving governance, efficiency, user- and provider-satisfaction and long-term sustainability. The main elements of the program were to establish a single purchaser in the health system, make the public sector health services delivery network autonomous and strengthen human resources management and information systems. The program has had important effects on access to care, especially for the poor. In addition to improved health insurance coverage for the poor, productivity of health personnel and availability of services have increased. There has also been a rise in the immunization of under-five-year-old children, the use of ante-natal services by pregnant women and the overall utilization of health services (Chakrabourty, 2009).

With respect to perceptions of the need for unofficial payments when interacting with public officials, the LiTS2 data give a mixed picture on their evolution (see Table 4). In Albania, Bulgaria, Macedonia and Russia, fewer respondents in 2010 felt that unofficial payments are usually, or always, needed compared to 2006, while the opposite was true in Azerbaijan, the Kyrgyz Republic, Moldova and Turkey.

# **3.3. Perceptions of overall government performance**

Average perceptions of improvements or worsening in overall government performance appear to have been strongly colored by the severity of impact of the recent global economic crisis (Figure 9). When asked to assess the overall performance of the government, respondents in Tajikistan, Georgia, and Azerbaijan rated the performance of their respective national governments much more highly than did respondents in Romania, Croatia, and Lithuania. At the individual level, we estimate a probit regression where the dependent variable is the rating of government performance (a binary variable equal to 1 if respondent thinks government performance is worse than three years ago) and the main explanatory variable is the respondent‘s subjective assessments of the extent to which he or she was affected by the crisis. Using country fixed-effects and controlling for income and other demographic factors, those reporting being affected ―a great deal‖ by the crisis were on average 14 percent more likely to respond that the performance of the national government worsened in the past 3 years compared to those who were not affected by the crisis. This coefficient is significant at the 5 percent level and this impact of the crisis on government ratings is also found (albeit to a lesser extent) for ratings of local and regional performance.

11
**Figure 9: Performance Ratings of National Government and Changes over Time**

<!-- Start of picture text --> Overall Ratings of the Performance of National Government<br>Uzbekistan<br>Tajikistan<br>Sweden<br>Azerbaijan<br>Georgia<br>Turkey<br>Belarus<br>Montenegro<br>Kazakhstan<br>Hungary<br>Albania<br>Estonia<br>Mongolia<br>Bulgaria<br>Moldova<br>Great Britain<br>France<br>Macedonia<br>Slovenia<br>Kyrgyzstan<br>Russia<br>Armenia<br>Germany<br>Ukraine<br>Czech Republic<br>Poland<br>Bosnia-Herzegovina<br>Serbia<br>Italy<br>Latvia<br>Slovakia<br>Lithuania<br>Croatia<br>Romania<br>0 20 40 60 80 100<br>Percent of respondents<br>Very Good Good Neither Bad Very Bad<br><!-- End of picture text --> <!-- Start of picture text --> Perceptions of change in performance of national government<br>Georgia<br>Uzbekistan<br>Azerbaijan<br>Tajikistan<br>Turkey<br>Bulgaria<br>Armenia MontenegroHungary Sweden MacedoniaKazakhstanMongolia Belarus<br>Albania<br>Estonia Moldova Poland Kosovo<br>Slovenia<br>Great Britain<br>Ukraine Czech RepublicSlovakiaSerbiaKyrgyzstan<br>Russia<br>Latvia Bosnia-Herzegovina<br>Lithuania CroatiaItaly GermanyFrance<br>Romania<br>-10 -5 0 5 10<br>GDP growth 2009-2010<br>Source: LITS 2006 and 2010, IMF. 2010 growth numbers are estimates (IMF WEO October 2010 Update).<br>40<br>30<br>20<br>10<br>0<br><!-- End of picture text --> Source: LiTS2 (2010).

12
# **4. CONCLUSION**

Despite the impact of the crisis, LiTS2 data indicate that satisfaction with public service delivery has risen over time in most countries in the region. Prevalence of unofficial payments is quite low: when respondents were asked how often it is necessary for people to make unofficial payments/gifts when using public services, a large majority reported that such payments are never needed. Nevertheless, the data show that the level of satisfaction with public service delivery in most transition countries tends to be lower than prevailing levels in western European comparator countries. Conversely, the perceived frequency of unofficial payments is higher than in comparator countries.

We find that satisfaction data on peoples‘ experiences and perceptions of service delivery quality can usefully complement more objective measures of service delivery (e.g. from facilities surveys) to help policy makers and development practitioners track progress of country programs and strategies. The data provide insights on the linkages between utilization, satisfaction and the prevalence of unofficial services, as well as the availability of grievance redress mechanisms. An important limitation is, however, that comparisons across countries or individuals must be interpreted with caution, as people may not share the same basis for comparison or have information about the level of quality and service they should be expecting. Still, perceptions data can serve as a ―call to action‖ for governments if the data reveal outcomes that fall short of expectations (or conversely indicate low expectations). It can also serve a diagnostic function: while there is increased recognition that the quality of governance and service delivery affects service delivery outcomes, the empirical evidence on those links remains limited.

How can governments in transition countries further increase citizens‘ satisfaction with service delivery? The insights gained from the LiTS2 provide clues as to how this might be achieved. First, LiTS2 data show utilization of public facilities in transition countries to be generally higher than in the western comparators; this suggests that further analysis may shed more light on the potential for efficiency and quality improvements, and the extent to which better demand management practices could free up public resources to improve quality of services. Second, the prevalence of unofficial payments in transition countries is higher than in western Europe, and is an important factor in explaining dissatisfaction with public service delivery.<sup>8</sup> Lastly, the data show that mechanisms for grievance redress in the transition regions are still relatively underdeveloped in comparison to those in the comparator countries, and should be strengthened to help provide citizen feedback to policymakers on the main problems faced when interacting with public service providers.

> 8 The inverse correlation between satisfaction on the one hand and usage rates and perceived prevalence of unofficial payments is confirmed by an Ordinary Least Squares ( _OLS)_ regression of country-level average satisfaction rates for each of the eight public services covered in the LiTS2 questionnaire. This uses as explanatory variables (i) average usage rates (that is, the percentage of respondents in the country that use that particular public service) and (ii) unofficial payments prevalence rates (the percentage who say that unofficial payments are usually or always needed for that particular service). The derived coefficients for the two explanatory variables in the regression are statistically significant at the 1 percent level.

13
**Table 1: Satisfaction with Public Service Delivery by Country**

||**Percent o**|**f responden**<br>**Education**|**ts satisfie**|**d withqualit**|**y and efficie**<br>**Education**|**ncy ofpub**<br>**Social**|**lic service d**|**elivery**|
|---|---|---|---|---|---|---|---|---|
|**Country**<br>**Pub**<br>|**lic health**<br>**system**|**(prim.**<br>**/sec.)**|**Traffic**<br>**police**|**Official**<br>**documents**|**(vocational**<br>**)**|**security**<br>**benefits**|**Unemp.**<br>**benefits**|**Civil courts**|
|Estonia|78|83|61|90|84|73|70|76|
|Georgia|75|82|75|92|83|28|-|36|
|<br>Turkey|79|72|39|75|72|38|55|49|
|Latvia|70|83|53|80|79|74|74|35|
|Moldova|67|80|39|82|79|59|39|65|
|Slovenia|70|71|50|75|70|70|67|65|
|Croatia|70|76|64|72|65|69|54|35|
|Lithuania|64|69|56|72|79|67|78|44|
|Poland|62|85|52|81|83|49|39|57|
|Belarus|59|74|50|73|79|60|66|54|
|Hungary|59|74|64|73|70|60|61|38|
|<br>Montenegro|60|73|51|71|72|53|28|42|
|<br>Slovak Rep.|64|78|49|70|76|42|37|45|
|Uzbekistan|64|74|43|54|65|48|14|29|
|Russia|58|75|41|68|79|74|59|51|
|Czech Rep.|66|73|45|70|68|43|47|44|
|Bosnia-|||||||||
|Herz.|55|70|56|75|63|31|15|69|
|Armenia|61|72|44|70|70|43|39|30|
|Bulgaria|61|75|26|52|84|59|48|17|
|Serbia|60|68|43|61|66|50|47|26|
|Romania|57|76|49|63|67|49|53|33|
|Tajikistan|57|62|36|62|51|42|38|29|
|Kazakhstan|54|69|40|50|62|50|43|27|
|Mongolia|53|67|14|48|66|34|36|17|
|<br>Ukraine|45|72|22|57|73|57|41|34|
|Macedonia|45|66|41|44|53|30|33|42|
|Kyrgyz Rep.|53|58|21|36|56|46|44|5|
|Albania|45|67|29|51|49|31|29|47|
|Western|||||||||
|Europe|80|76|55|80|78|67|52|40|

Note **:** Countries ranked in order of average satisfaction rates across all eight public services.

14
**Table 2: Reported Prevalence of Unofficial Payments by Country**

||**Perce**<br>**Public**|**nt of respond**|**ents that**|**report unoff**|**icialpayments**|**are usually **<br>**Social**|**or always need**|**ed**|
|---|---|---|---|---|---|---|---|---|
|**Country**|**health**<br>**system**|**Education**<br>**(prim/sec)**|**Traffic**<br>**police**|**Official**<br>**docs.**|**Vocational**<br>**Education**|**security**<br>**benefits**|**Unemp.**<br>**benefits**|**Civil**<br>**courts**|
|Estonia|4|1|1|0|1|1|0|1|
|Poland|8|1|4|1|2|1|1|2|
|Latvia|12|1|5|2|1|1|1|3|
|Georgia|7|5|1|1|5|2|4|3|
|Slovenia|8|3|3|3|3|3|3|5|
|Czech Rep.|11|5|5|3|7|3|3|3|
|<br>Montenegro|13|6|7|4|6|4|4|3|
|<br>Lithuania|22|1|6|2|3|7|4|2|
|Croatia|17|4|8|2|8|3|3|6|
|Macedonia|13|3|5|5|8|8|7|7|
|Bulgaria|17|3|13|3|7|3|3|8|
|<br>Belarus|21|6|14|3|9|2|3|4|
|Serbia|23|3|11|6|7|5|4|6|
|Russia|19|10|13|3|12|2|3|6|
|Bosnia-|||||||||
|Herz.|22|9|11|6|11|6|6|8|
|Hungary|42|3|11|6|6|3|4|7|
|Romania|44|7|12|5|9|4|4|10|
|Slovak Rep.|22|11|12|5|19|6|8|12|
|<br>Mongolia|19|9|12|11|16|8|9|15|
|Kazakhstan|18|9|21|12|16|8|7|13|
|Turkey|17|21|16|15|14|11|11|11|
|<br>Uzbekistan|20|20|18|12|25|11|9|8|
|Armenia|28|15|22|19|18|13|13|12|
|Ukraine|43|17|28|14|26|7|8|17|
|Tajikistan|39|18|29|16|32|10|10|13|
|<br>Albania|39|24|19|22|23|15|14|14|
|Moldova|45|18|32|23|24|11|9|19|
|Kyrgyz Rep.|49|38|43|37|51|29|32|33|
|<br>Azerbaijan|72|65|66|60|65|63|65|61|
|Western|||||||||
|Europe|3|1|1|1|1|1|1|1|

Note: Countries ranked in reverse order of average prevalence rates across all eight public services.

15
# **Table 3: Changes in satisfaction with service delivery in transition countries, 2006-10**

||||**Percen**|**t of R**|**espond**|**ents S**|**atisfie**|**d With**|**Qual**|**ity and**|**Effic**|**iency**|**of Pub**|**lic Serv**|**ice D**|**eliver**|**y**||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
||**Pub**<br>|**lic He**<br>**System**|**alth**<br>||**Road**<br>**Police**|<br>|<br>**Do**|**Officia**<br>**cume**|**l**<br>**nts**|**Une**<br>**B**|**mploy**<br>**enefit**|**ment**<br>**s**|**Ot**<br> <br>|**her Soc**<br>**Security**<br>**Benefit**|**ial**<br> <br>**s**||**Civil**<br>**Courts**|<br>|
||**2006**|**2010**|**Ch.**|**2006**|**2010**|**Ch.**|**2006**|**2010**|**Ch.**|**2006**|**2010**|**Ch.**|**2006**|<br>**2010**|**Ch.**|**2006**|<br>**2010**|**Ch.**|
|Moldova|43|67|25|27|39|13|49|82|33|13|39|26|4|59|55|43|65|22|
|Russia|42|58|16|21|41|21|33|68|35|28|59|31|25|74|49|18|51|33|
|Turkey|51|79|28|41|39|-2|60|75|15|21|55|34|42|38|-5|35|49|13|
|<br>Tajikistan|37|57|20|21|36|15|34|62|28|11|38|27|26|42|15|38|29|-9|
|<br>Estonia|60|78|18|64|61|-4|73|90|17|49|70|21|63|73|10|48|76|28|
|Montenegro|49|60|11|28|51|23|54|71|17|20|28|8|22|53|31|22|42|20|
|<br>Romania|46|57|11|44|49|5|36|63|26|24|53|29|16|49|33|27|33|6|
|Belarus|49|59|9|43|50|7|42|73|30|17|66|50|29|60|31|49|54|5|
|Kazakhstan|39|54|15|24|40|16|36|50|14|42|43|1|38|50|13|35|27|-8|
|Bosnia-|50|55|5|30|56|25|54|75|22|33|15|-18|9|31|22|32|69|37|
|Herz|||||||||||||||||||
|Serbia|46|60|14|33|43|10|51|61|9|32|47|15|6|50|44|17|26|9|
|Ukraine|34|45|11|25|22|-3|42|57|15|11|41|30|20|57|37|28|34|5|
|Georgia|63|75|12|71|75|4|59|92|33|27|0|-27|21|28|7|43|36|-7|
|<br>Poland|46|62|16|50|52|2|67|81|14|32|39|8|41|49|8|51|57|6|
|Hungary|50|59|9|47|64|17|62|73|12|27|61|34|51|60|8|46|38|-9|
|<br>Slovenia|65|70|5|36|50|14|62|75|13|50|67|17|36|70|34|46|65|19|
|Czech Rep|60|66|6|27|45|17|51|70|18|35|47|11|42|43|1|28|44|16|
|<br>Croatia|65|70|6|55|64|9|54|72|17|29|54|25|30|69|39|41|35|-6|
|Latvia|56|70|14|50|53|3|65|80|14|76|74|-3|66|74|7|59|35|-24|
|Uzbekistan|48|64|16|41|43|2|48|54|6|14|14|-1|53|48|-5|25|29|4|
|Lithuania|56|64|8|49|56|7|56|72|16|53|78|25|60|67|7|53|44|-9|
|Albania|40|45|5|19|29|10|38|51|13|14|29|15|37|31|-6|29|47|18|
|Slovakia|58|64|7|43|49|6|56|70|15|12|37|24|37|42|5|39|45|6|
|Mongolia|48|53|4|19|14|-5|35|48|13|13|36|23|54|34|-20|18|17|-1|
|<br>Armenia|64|61|-2|32|44|13|62|70|8|27|39|12|50|43|-6|11|30|19|
|Kyrgyzstan|50|53|3|17|21|4|35|36|1|19|44|25|43|46|3|23|5|-18|
|<br>Bulgaria|60|61|1|23|26|2|72|52|-20|41|48|7|29|59|29|31|17|-15|
|<br>Macedonia|50|45|-5|38|41|3|53|44|-8|16|33|17|18|30|12|24|42|17|
|Azerbaijan|56|45|-10|24|16|-8|51|61|10|15|5|-10|21|12|-9|47|26|-21|

Notes: Ch. denotes change in satisfaction between 2006 and 2010. Countries sorted in order of average increase across all seven services. Data on satisfaction are not fully comparable between the 2006 and 2010 LiTS surveys. The 2006 survey asked respondents if ―you personally‖ used a service (and, conditional on use, whether you were satisfied); while the 2010 survey asked if ―you or anyone in your household‖ used the service.

16
**Table 4: Changes in reported prevalence of unofficial payments in transition countries, 2006-10**

||||||Pe|r cent|of resp|onden|ts that|report|unoffici|al pay|ments|are usu|ally/a|lways n|eeded|||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
||Pub<br>s|lic heal<br>ystem|th|T<br>|raffic<br>police||O<br>doc|fficial<br>ument|s|Ed<br>(T|ucation<br>ertiary)||Unem<br>be|ploym<br>nefits|ent|Oth<br>secur|er soci<br>ity bene|al<br>fits|Ci<br>co|vil<br>urts||
||2006|2010|Ch.|2006|2010|Ch.|2006|2010|Ch.|2006|2010|Ch.|2006<br>|2010|Ch.|2006|2010|Ch.|2006<br>|2010|Ch.|
|Macedonia|23|13|-10|10|5|-5|11|5|-6|17|8|-9|11|8|-4|11|7|-4|13|7|-7|
|Bulgaria|24|17|-7|21|13|-8|9|3|-6|11|7|-4|6|3|-3|6|3|-3|16|8|-8|
|Uzbekistan|33|20|-13|22|18|-3|15|12|-2|30|25|-5|12|9|-2|14|11|-3|12|8|-3|
|Russia|24|19|-5|19|13|-6|9|3|-5|20|12|-8|4|2|-2|6|3|-3|7|6|0|
|Ukraine|40|43|3|28|28|-1|20|14|-6|33|26|-8|11|7|-4|13|8|-5|18|17|-1|
|Albania|48|39|-8|23|19|-4|28|22|-5|17|23|6|15|15|1|15|14|-1|21|14|-7|
|Poland|15|8|-7|4|4|-1|1|1|0|4|2|-3|1|1|0|1|1|0|1|2|1|
|Latvia|13|12|-1|6|5|-2|3|2|-1|3|1|-1|1|1|0|1|1|0|2|3|1|
|Mongolia|17|19|3|18|12|-5|16|11|-5|15|16|1|6|8|2|7|9|1|15|15|0|
|Montenegro|18|13|-5|4|7|3|3|4|1|8|6|-2|3|4|0|4|4|0|4|3|0|
|Estonia|3|4|0|0|1|1|1|0|0|1|1|0|0|1|0|1|0|0|1|1|0|
|Georgia|8|7|0|1|1|1|2|1|-1|4|5|1|4|2|-2|4|4|0|2|3|1|
|Lithuania|23|22|-1|6|6|-1|4|2|-2|4|3|-1|0|7|7|2|4|2|5|2|-3|
|Croatia|14|17|3|6|8|2|3|2|-1|5|8|3|4|3|-1|6|3|-4|5|6|1|
|Bosnia-Herz.|19|22|3|16|11|-5|7|6|0|8|11|2|4|6|2|5|6|1|7|8|1|
|Czech Rep.|10|11|1|6|5|-1|2|3|1|7|7|-1|1|3|2|1|3|2|3|3|0|
|Slovenia|7|8|1|2|3|1|1|3|2|5|3|-2|2|3|1|1|3|2|2|5|3|
|Romania|31|44|13|10|12|2|8|5|-2|9|9|0|6|4|-2|7|4|-2|7|10|2|
|Serbia|17|23|6|7|11|4|4|6|2|5|7|2|3|5|2|3|4|1|6|6|1|
|Slovak Rep.|21|22|1|12|12|-1|3|5|2|13|19|6|2|6|4|2|8|5|12|12|1|
|Kazakhstan|11|18|7|16|21|5|10|12|1|16|16|0|4|8|4|6|7|1|9|13|4|
|Belarus|12|21|9|9|14|5|4|3|-1|5|9|4|1|2|1|2|3|1|1|4|3|
|Hungary|33|42|10|6|11|5|5|6|1|5|6|1|0|3|3|1|4|3|5|7|2|
|Armenia|19|28|9|18|22|4|11|19|8|16|18|2|8|13|5|10|13|3|7|12|5|
|Tajikistan|33|39|6|14|29|15|15|16|0|23|32|9|8|10|2|8|10|2|8|13|5|
|Turkey|11|17|6|8|16|7|6|15|9|6|14|8|4|11|7|5|11|7|4|11|7|
|Moldova|32|45|14|18|32|14|12|23|11|17|24|7|8|11|3|9|9|0|12|19|7|
|Kyrgyz Rep.|28|49|21|24|43|18|22|37|15|29|51|22|12|29|17|14|32|18|14|33|20|
|Azerbaijan|30|72|42|11|66|56|15|60|45|16|65|49|7|63|55|7|65|57|8|61|53|

Note: Ch. denotes change in prevalence of unofficial payments between 2006 and 2010. Countries sorted in reverse order of average prevalence rates across all seven services.

17
**Table 5: Utilization and satisfaction: public health system**

||(1)|(2)|(3)|(4)|(5)|
|---|---|---|---|---|---|
||Utilization|Satisfied<br>(0-1)|Satisfied<br>(0-1)|Satisfacti<br>on level<br>(1-5)|Satisfacti<br>on level<br>(1-5)|
|||||Ordered|Ordered|
||Probit|Probit|Probit|probit|probit|
|**Household-level variables**||||||
|_Consumption group_||||||
|Lower|-0.456***|0.146***|0.0908*|0.0947**|0.0413|
||(0.0384)|(0.0565)|(0.0545)|(0.0452)|(0.0452)|
|Middle|-0.137***|0.164***|0.112**|0.163***|0.111***|
||(0.0380)|(0.0420)|(0.0435)|(0.0357)|(0.0358)|
|Upper||Refe|rence catego|ry||
|_Locality_||||||
|Rural|-0.0628*|0.0650|0.0585|0.0163|0.00467|
||(0.0351)|(0.0409)|(0.0415)|(0.0348)|(0.0343)|
|Metropolitan|-0.146***|-0.0422|-0.000152|-0.105**|-0.0591|
||(0.0559)|(0.0622)|(0.0631)|(0.0529)|(0.0527)|
|Urban||Refe|rence catego|ry||
|Number of children (0-14)|0.181***|||||
||(0.0230)|||||
|Number of women aged 15-44|0.0769***|||||
||(0.0235)|||||
|Number of men aged 15-44|0.137***|||||
||(0.0246)|||||
|Number of women aged 45-64|0.0102|||||
||(0.0367)|||||
|Number of men aged 45-64|0.212***|||||
||(0.0380)|||||
|Number of women aged 65+|0.130**|||||
||(0.0506)|||||
|Number of men aged 65+|0.272***|||||
||(0.0483)|||||
|**Individual-level variables**||||||
|_Health status of respondent_||||||
|Very good|-0.232***|0.423***|0.363***|0.360***|0.284***|
||(0.0535)|(0.0681)|(0.0721)|(0.0602)|(0.0616)|
|Good|-0.224***|0.216***|0.142***|0.181***|0.111***|
||(0.0373)|(0.0472)|(0.0482)|(0.0398)|(0.0400)|
|Medium||Refe|rence catego|ry||
|Bad|0.195***|-0.180***|-0.141**|-0.180***|-0.143***|
||(0.0545)|(0.0593)|(0.0612)|(0.0508)|(0.0506)|
|Very bad|0.258**|-0.235**|-0.141|-0.200**|-0.115|
||(0.106)|(0.0978)|(0.0951)|(0.0910)|(0.0917)|
|_Education of respondent_||||||
|<br>Lower secondary or below||Refe|rence catego|ry||
|<br>Upper secondary|-0.0502|-0.0725<br>|-0.0649<br>|-0.101**<br>|-0.0906**|
||(0.0413)|(0.0502)|(0.0512)|(0.0422)|(0.0418)|
|Post secondary or higher|-0.0551|-0.0906*|-0.0406|-0.109**|-0.0659|
||(0.0431)|(0.0513)|(0.0532)|(0.0425)|(0.0425)|

18
**Table 5 (continued)**

||(1)|(2)|(3)|(4)<br>Satisfacti|(5)<br>Satisfacti|
|---|---|---|---|---|---|
|||Satisfied|Satisfied|on level|<br><br>on level|
||Utilization|(0-1)|(0-1)|(1-5)<br>|(1-5)<br>|
||Probit|Probit|Probit|Ordered<br>probit|Ordered<br>probit|
|_How often are unofficial payments needed_||||||
|Never||0.254***<br>||0.215***<br>||
|Seldom||(0.0504)<br>0.0444<br>||(0.0410)<br>0.0502<br>||
|||(0.0583)||(0.0451)||
|Sometimes<br>Ull||0215***<br>Refe|rence categ|0202***<br>ory||
|suay||-.||-.||
|||(0.0539)||(0.0440)||
|Alwas||-0342***||-0423***||
|y||.<br>(0.0629)||.<br>(0.0587)||
|Female||0.0624*|0.0731**|0.0176|0.0237|
|||(0.0367)|(0.0372)|(0.0305)|(0.0303)|
|18-34||-0.108**<br>(0.0522)|-0.0720<br>(0.0545)|-0.105**<br>(0.0434)|-0.0657<br>(0.0441)|
|35-44||Refe|rence categ|ory||
|45-54||0.137**<br>|0.0936<br>|0.129***<br>|0.0902*|
|||(0.0599)|(0.0624)|(0.0484)|(0.0487)|
|55-64||0.121**|0.0492|0.133***|0.0723|
|||(0.0605)|(0.0622)|(0.0506)|(0.0506)|
|65+||0.323***<br>|0.240***<br>|0.295***<br>|0.219***<br>|
|_Satisfied with life_||(0.0680)|(0.0705)|(0.0586)|(0.0579)|
|Strongly disagree||-0.292***|-0.239***|-0.300***|-0.258***|
|||(0.0567)<br>***|(0.0591)<br>**|(0.0493)<br>***|(0.0501)<br>***|
|Disagree||-0.142|-0.108|-0.147|-0.111|
|Neither disagree nor agree||(0.0480)<br>Refe|(0.0488)<br>rence categ|(0.0400)<br>ory|(0.0394)|
|Agree||0.0952|0.113*|0.110**|0.129***|
|||(0.0586)|(0.0609)|(0.0473)|(0.0474)|
|Strongly agree||0.278**<br>(0114)|0.260**<br>(0115)|0.192**<br>(00970)|0.163*<br>(00941)|
|_Problems encountered in local public health clinic or h_|_ospital in past 1_|.<br>_2 months_|.|.|.|
|<br>Frequent and unjustified absence of doctors|||-0.321***<br>||-0.246***<br>|
||||(0.0630)||(0.0531)|
|Treated disrespectfully by staff|||-0.482***<br>||-0.455***<br>|
||||(0.0532)||(0.0430)|
|No drugs available|||-0.255***<br>||-0.234***<br>|
|Long waiting times|||(0.0489)<br>-0.353***<br>||(0.0400)<br>-0.355***<br>|
||||(0.0404)||(0.0324)|
|Facilities not clean|||-0.115||-0.0809|
||||(0.0728)||(0.0569)|
|Payments required for services that should be free|||-0.513***||-0.477***|
||||(00500)||(00414)|
|Inverse Mills Ratio (from selection equation)|||.|-0.0719|.<br>-0.0761|
|||||(0162)|(0158)|
|Constant|0.320***|-0.204|0.192|.|.|
|Cut 1|(0.0771)|(0.147)|(0.125)|-1.402***|-1.895***|
|||||(0.114)|(0.114)|
|Cut 2||||-0.331***|-0.725***|
|Cut 3||||(0.113)<br>0.0914|(0.111)<br>-0.261**|
|Cut 4||||(0.113)<br>2057***|(0.111)<br>1821***|
|||||.<br>(0.116)|.<br>(0.113)|
|Observations<br>|28,920<br>|28,248|28,248|19,510<br>|19,510<br>|
|Pseudo R-squared<br>Robust standard errors in parentheses|0.0720|||0.0567|0.105|
|<br>*** p<0.01, ** p<0.05, * p<0.1<br>Country-level dummies not shown||||||
|<br>Columns (2)-(5): with Heckman sample selection corre|ction|||||

19
**Table 6 :   Utilization and satisfaction: education**

||(1)<br>Utilization|(2)<br>Satisfied<br>(0-1)|(3)<br>Satisfied<br>(0-1)|(4)<br>Satisfacti<br>on level<br>(1-5)<br>|(5)<br>Satisfacti<br>on level<br>(1-5)<br>|
|---|---|---|---|---|---|
||Probit|Probit|Probit|Ordered<br>probit|Ordered<br>probit|
|**Household-level variables**<br>||||||
|_Consumption group_<br>Lower|-0.304***<br>(0.0468)|0.0477<br>(0.0830)|-0.0133<br>(0.0841)|-0.305***<br>(0.0474)|-0.0522<br>(0.0685)|
|Middle|-0.0973**<br>(0.0418)|0.158**<br>(0.0775)|0.125<br>(0.0792)|-0.101**<br>(0.0422)|0.0811<br>(0.0674)|
|Upper<br>_Locality_||Ref|erence catego|ry||
|Rural|0.0548|0.0688|0.0138|0.0493|0.0465|
||(00419)|(00728)|(00745)|(00423)|(00597)|
|Metropolitan<br>|.<br>-0.0472<br>(0.0632)|.<br>0.0817<br>(0.115)|.<br>0.0489<br>(0.120)|.<br>-0.0433<br>(0.0638)|.<br>0.0774<br>(0.103)|
|Urban<br>Number of children (0-18)|0.821***<br>|||0.819***<br>||
|**Individual-level variables (respondent)**|(0.0233)|||(0.0235)||
|_Education_<br>Lower secondary and below||Ref|erence catego|ry||
|Upper secondary|0.165***<br>(00503)|-0.0613<br>(00931)|-0.0113<br>(00949)|0.165***<br>(00509)|0.0385<br>(00772)|
|Post secondary or higher|.<br>0.132***|.<br>-0.103|.<br>-0.0378|.<br>0.133**|.<br>-0.0717|
|Fl|(0.0512)|(0.0997)<br>00970|(0.103)<br>0078|(0.0519)|(0.0804)<br>000776|
|emae<br>||.<br>(0.0677)|.5<br>(0.0690)||.<br>(0.0591)|
|_Age of respondent_<br>||||||
|18-34||-0.113<br>|-0.134*<br>||-0.111*<br>|
|35-44||(0.0755)<br>Ref|(0.0759)<br>erence catego|ry|(0.0621)|
|45-54||0.102<br>(0.0953)|0.0612<br>(0.0996)||0.0615<br>(0.0829)|
|55-64||0.104|0.0134||0.0140|
|65+||(0.139)<br>-0.258|(0.141)<br>-0.324||(0.101)<br>-0.314*|
|||(0.201)|(0.213)||(0.167)|
|_Satisfied with life_<br>Strongly disagree||-0.423***<br>|-0.417***<br>||-0.368***<br>|
|||(0.109)<br>|(0.111)<br>||(0.0950)<br>|
|Disagree||-0.185**<br>(0.0879)|-0.186**<br>(0.0890)||-0.180***<br>(0.0689)|
|Neither disagree nor agree||Ref|erence catego|ry||
|Agree||-0.0151<br>(0.100)|-0.0168<br>(0.102)||0.107<br>(0.0839)|
|Strongly agree||0.318*|0.270||0.206*|
|<br>_Problems experienced with local public schools in past 12_|_months_|(0.182)|(0.169)||(0.119)|
|<br>No textbooks or other supplies that should be provided f|<br>ree of charge||-0.0729<br>||-0.0876<br>|
|Poor teaching|||(0.0827)<br>-0.657***<br>||(0.0725)<br>-0.667***<br>|
||||(0.0889)<br>||(0.0762)<br>|
|Frequent and unjustified absence of teachers|||-0.389***<br>||-0.251**<br>|
|Overcrowded classrooms|||(0.133)<br>-0.381***||(0.128)<br>-0.290***|
|Facilities in poor condition|||(0.0984)<br>-0.0209||(0.0829)<br>-0.0640|
|Payments required for services that should be free|||(0.0890)<br>-0.271***<br>(0.0857)||(0.0697)<br>-0.306***<br>(0.0750)|
|_How often are unofficial payments needed_<br>||***||||
|Never||0.261<br>00930||||
|Seldom||(.)<br>-0.0946||||
|||(0.107)<br>||||
|Sometimes||Ref|erence catego|ry||
|Usually||-0.166||||
|Always||(0.102)<br>-0.103<br>(0114)||||
|Inverse mills ratio (from selection euation)||.||-00351|-00378|
|q||||.<br>(00582)|.<br>(00580)|
|Constant|-0.912***<br>|0.448**<br>|0.730***<br>|.<br>-0.959***<br>|.|
|Cut 1|(0.0702)|(0.181)|(0.178)|(0.0718)|-2.361***<br>|
|Cut 2|||||(0.162)<br>-1.446***<br>|
|Cut 3|||||(0.151)<br>-0.939***|
|Cut 4|||||(0.150)<br>1.313***<br>(0152)|
|Observations|28823|28495|28495|28495|.<br>6892|
|Pseudo R-squared|,<br>0.273|,|,|,|,<br>0.0728|
|<br>Robust standard errors in parentheses<br>*** ** *||||||
|p<0.01, p<0.05, p<0.1<br>Cll di h||||||
|ountry-eve ummes not sown<br>Columns (2)-(5): with Heckman sample selection correctio|n|||||

20
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<!-- Start of picture text --> Public health system<br>90<br>ee?<br>e<br>80 ° e<br>es °<br>s3 70 : e e .<br>8 e e . e .<br>B ° ee ° °<br>S e e e<br>& ° e e<br>50<br>e ee<br>40 e<br>0 10 20 30 40 50<br>Unofficial payments needed (per cent of usually/always)<br><!-- End of picture text --> <!-- Start of picture text --> 80 Other social security benefits<br>v<br>e<br>= °<br>oo8 60 °e e °<br>s28 e ee >% . .<br>3 e oe °<br>a e<br>co e 6% e<br>20<br>0 10 20 30<br>Unofficial payments needed (per cent of usually/always)<br><!-- End of picture text -->