Trust, voice, and incentives : learning from local success stories in service delivery in the Middle East and North Africa

The Middle East and North Africa (MENA) is a rising middle-income region, and its citizens rightly expect quality public services. Yet too often they experience disappointment; students attending local schools are insufficiently prepared for the 21st century economy, and those needing health care too often find that public clinics have no doctors or medicines. Few in positions of authority are held accountable for such shortcomings. This situation both undermines the potential for improvement and heightens people’s unhappiness with the delivery system.