The World Bank is urging governments and the private sector, especially in developing countries, to improve the delivery of basic services to the poor.
A World Bank report entitled, Making Services Work for Poor People, shows what many people, especially in the developing countries, experience on a daily basis: they are commonly and sometimes dramatically shortchanged when it comes to services.
The report finds that almost 70 percent of babies in sub-Saharan Africa's richest families are born in a health facility, while less than 20 percent of babies in Africa's families are born in hospitals.
It says nearly two of every 10 people in developing countries were without access to safe drinking water in 2000, five out of 10 lived without adequate sanitation and nine out of 10 lived without their wastewater treated in any way.
The report's author, economist Shanta Devarajan, says the poor should have a say in the making of policies and in overseeing the delivery of basic services.
He says services such as health, education, water, and sanitation seldom are provided in a competitive market.
"Rather, they are provided through what we call the indirect route of accountability, that is by poor people as citizens influencing policy makers, and those policy makers then influencing providers to provide the service," said Mr. Devarajan.
In this process, says Mr. Devarajan, politicians can manipulate the poor by, for example, using the delivery of public services to reward people who voted for them or punish those who did not support them. Service providers and politicians often manipulate one another.
The World Bank says the solution for improving service delivery to the poor, is to give them the chance to monitor and discipline service providers, to have a voice in policy making, and to encourage service providers to improve their service delivery to the poor.
The World Bank's prescription for improvements includes contracting services to commercial companies, spinning off some services to the private sector or letting local governments take control over the delivery of basic services.