June 24, 2016 Master’s Thesis Name: Sudip Bhandari Supervisor/ First Reader: Dr. David Laws Student ID: 11124016 Second reader: Dr. David Connolly Course: MSc in Conflict Resolution and Governance
Table of Contents
1. Introduction 3 1.1. Research questions and aims 1.3. Research relevance and significance 2. Theoretical framework and concepts 6 2.1. Public service delivery 2.2. State legitimacy 2.3. Relationship between public service delivery and state legitimacy 2.4. Understanding state legitimacy in postconflict societies 3. Research Design and Methodology 17 3.1. Methods and philosophical underpinnings of choices 3.1.1. Literature review of background documents 3.1.2. Semistructured interviews 3.1.3. Focus group 3.2. Data Analysis 3.3. Reflections on fieldwork 3.3.1. Access to the field 3.3.2. Challenges 3.4. Ethical considerations during fieldwork 4. Conflict in perspective 27 4.1 Political history of Nepal 4.2 Who are Madhesis? 4.3 Systemic exclusion 4.4 The rise of Madhesi ethnonationalism 5. Background of health provision in Nepal 32 5.1. Historical development of health policies in Nepal 5.2. Organizational framework of health system 5.3. Political underpinnings of “free healthcare for all” policies 5.4. Reflections6. Findings 37 6.1. Expectations before fieldwork 6.2. Results from my research 6.3. Madhesi’s perception 6.3.1. Madhesis’ perception of the overall health delivery mechanism 6.3.2. Madhesis’ relationship with the health service providers 6.3.3. Madhesis’ perception of the state 6.4. Healthcare providers’ perception 6.4.1. Relationship of the health service providers with Madhesis 6.4.2. Health care workers’ constrains and limitations 6.4.3. Rooms for improvement 7. Discussion of findings 49 7.1. Madhesis’ perception 7.1.1. Madhesis’ perception about health care workers 7.1.2 Madhesis’ perception about the state 7.2. Health care worker’s perception towards Madhesis 7.3. Limitations of the research 7.4. Lessons drawn from the field 8. Conclusion 57 8.1. Theoretical and practical contributions 8.2. Questions and opportunities for future research 9. Bibliography 59 10. Appendix 63 10.1. List of semistructured interview questions 10.1.1. Interview questions for the Madhesi clients 10.1.2. Interview questions for the streetlevel bureaucrats 10.2. Questions for focus group discussion
Chapter 1: Introduction
The wisdom accrued over the last decade about the relationship between service delivery and state legitimacy suggests that improving the delivery of state services—from supplying clean water to quality education and even proper garbage collection—is fundamental to achieving state legitimacy in fragile or postconflict states. Some scholars take this a step further and argue that legitimacy must be earned through the quality performance of these services (Zoellick, 2008: p.73). While providing essential services, especially in postconflict and fragile states might be a starting point to improve state’s legitimacy, many studies suggest that the relationship is far more causal. Shifting factors like “expectations of what a state should provide, subjective assessment of impartiality and distributive justice, the relational aspects of [service] provision, how easy it is to attribute (credit or blame) performance to the state, and the characteristics of the service” may also play integral roles in citizens’ perception of the legitimacy of the state (Mcloughlin, 2015: p. 347). This qualitative research sets out to explore the relationship between service delivery and state legitimacy in the eyes of Madhesis, an ethnic minority in the southern plains of Nepal. It investigates the perceptions of Madhesis who live in the district of Parsa about the health services they receive. The study analyzes the nuances of the relationship between the recipients’ perceptions about these services, and their views on the state’s legitimacy within the health service domain. Multiple methods were employed for such investigation: a literature review, a focus group, and semistructured interviews with Madhesis and frontline healthcare practitioners in the Narayani subzonal hospital, a staterun health facility. While the focus of the research was on Madhesis’ perceptions, I also interviewed streetlevel bureaucrats, the frontline professionals delivering health care, who helped me gain a holistic picture of the relationship. These interviews provided an opportunity to examine discrepancies in Madhesi service recipients’ narratives about how Madhesis and streetlevel bureaucrats view their relationship, the conflicts that arise due to these discrepancies, and possible implications. This study lays a path for more extensive research that could help form effective health policies that meet the needs of Madhesis and rebuild trust with the Nepalese government . Such research could also provide a voice to the service recipients who are often left out of the health care policy debate, and to the service deliverers as they explore possibilities for improving their services.1.1. Research questions and aims
Building on the background information above, this study aims to answer the following question: How do Madhesi recipients of health care in the Narayani sub–zonal hospital in Parsa district of Nepal judge the delivery of services they received in the last one year? Further, the study aims to address the question: How do the recipients of these services relate the experience with health care services to the legitimacy of state institutions in Nepal?By attempting to answer to these questions, I hope to gain an understanding of a two topics. First, I have tried to reveal how citizens from the primary ethnic minority in the Madhesh region of Nepal perceive the performance, characteristics, and arrangement of a primary function of the state—the delivery of health services. Health holds a prominent position in the Nepalese constitution, which grants all citizens the right to basic health care free of cost from the state (Nepalese Constitution, 2015: art. 35, sec. 1). The constitution also guarantees equitable access to all citizens, regardless of their ethnic background. My inquiry revolves around expectations of performance, impartiality, and other features of the services. Through fieldwork I have tried to gain an understanding of Madhesis’ judgments of government’s effectiveness in meeting their expectations around these indicators. Second, I have tried to make sense of how state legitimacy is shaped—in the eyes of Madhesis—in the day to day interactions they have with frontline health deliverers. The majority of Madhesis’ interactions with the state and its policies does not take place in the parliament halls of Nepal, but in the waiting rooms of district hospitals in their home towns. The interface between these citizens and the state are the doctors and nurses they visit for their diagnosis of their illness, and with community health workers who come to their homes to teach them about preventing Malaria. This research is organized to address these questions and includes the perspectives of the streetlevel bureaucrats who delivered statesponsored health services in the Madhesh region. The majority of the research is focused, however, on the experience and perceptions of the citizens who were the beneficiaries of these services. Thus the research focuses on the key relationship that Michael Lipsky framed in his book “Street Level Bureaucracy.” His focus was on the frontline practitioners, the discretion they enjoy, the constraints they face, and how they manage the relationship with their clients. My focus is complementary; it centers on the citizenclients who are in the picture in Lipsky’s analysis in a dependent and largely silent role. Through this research, I aim to turn the table and give a voice to citizens’ perspectives and narratives and their central role in these dramas of streetlevel practice. Madhesis’ stories provide the core of the research that I tell about service delivery and state legitimacy in Nepal.
1.2. Research relevance and significance
Choosing this focus raises other questions about the context of the study. In particular, why explore the perspectives of the Madhesis, rather than another minority group? Or, what makes studying Madhesis versus any other ethnic group more relevant in the contemporary Nepal? To answer these questions, one must understand the ongoing interethnic conflict and distrust between the Madhesis and the Pahadilead central government over political rights and representation. This distrust was explicitly expressed in the massive Madhesiled protests in Nepal from September 2015 to February 2016. The immediate cause for these demonstrations was the promulgation of a new constitution of Nepal on September 20, 2015, which, according to Madhesis, “eroded their political representation, compromised the architecture of inclusion, divided up their territory and carved out federal units which would deprive them of selfrule, and institutionalized discriminatory citizenship provisions” (Jha, 2016: web).This conflict is also linked to questions of identity. In Nepalese economic and political institutions power is vested in the Pahadis, the ethnic Hill tribes who predominantly live in the mountainous and hilly regions. The majority of Madhesis reside in the southern Terai region. Traditionally, the Madhesis are subjugated to Pahadis' power and expressed their frustrations through protests and parliamentary blockades. The demonstrations they organized in 2015 and early 2016 crippled the Nepalese economy and created a humanitarian crisis as the protests evolved into an economic blockade of major border entry points with India, Nepal’s main trading partner. The blockade lasted for over four months and choked the importation of essential goods like petroleum, medicine, and earthquake relief materials (Jha: 2016, web). While this political conflict has subsided and the blockade has been lifted, the Madhesis’ grievances persist. Thus the Madhesis are a kind of litmus test for the effect of service delivery on state legitimacy. Moreover, studying the perspectives of Madhesis provides a chance to understand their grievances, and to get an idea of what it would mean to respond appropriately. It might, in this way, contribute a pathway towards conflict resolution and impact on how governance and state legitimacy are shaped in contemporary Nepalese politics. Figure 1: Map of Nepal shows Madhesh region (also popularly known as Terai) in green, Pahad (the Hill region) in red, and Himal (the mountain region) in white. Birgunj, the site of this study, and Kathmandu, the capital of Nepal are highlighted using yellow ovals.
Chapter 2: Theoretical framework and concepts
This is a thesis about streetlevel bureaucracy. Public service agencies like police stations, courts, and welfare organizations which “employ a significant number of streetlevel bureaucrats in proportion to their workforce are called streetlevel bureaucracies” (Lipsky, 1980: p.3). The streetlevel bureaucrats are public service workers who interact with the citizens on a day to day basis: they are the health care workers, teachers, police officers, social assistance officers and other public employees who are at the frontline of service delivery (Lispky, 1980: p. 3) and implementers of public policies and government programs. Because they are at the forefront of execution of policies, they define and redefine the boundaries of the organizations they work for. One of the ways they make policy is by enjoying discretion and thus determining the nature, quality and quantity of benefits as well as penalties bestowed to the citizens. “Policemen decide who to arrest and whose behavior to overlook. Judges decide who shall receive a suspended sentence and who shall receive maximum punishment. Teachers decide who will be suspended and who will remain in school, and they make subtle determinations of who is teachable” (Lipsky, 1980: p. 13). There are definitely rules and regulations that bound the practice of street level bureaucrats. However, some of those rules are so contradictory, voluminous, and constantly shifting that they can only be referred to selectively. “In most public welfare departments, regulations are encyclopedic, yet at the same time, they are constantly being changed. With such rules, adherence to anything but the most basic and fundamental precepts of eligibility cannot be expected” (Lipsky, 1980: p. 14). While protocols and guidelines usually provide general direction to how the workers should conduct their tasks, their nature of the work itself prevents mechanistic rituals. There are moments when these workers have to make quick decisions – like a policeman in a potentially hostile situation – or provide an individualized care – like a teacher responding to particular needs of her students – which would require actions that go beyond instructions in a booklet. These decisions that workers make on a day to day basis sum up to reflect the behavior as well as policies of the agencies they belong to. Another aspect through which the streetlevel bureaucrats become policy makers is through a certain degree of autonomy they enjoy from organizational authority. “Lower level participants in organizations often do not share the perspectives and preferences of their superiors and hence in some respects cannot be thought to be working toward stated agency goals. At least this is the case when workers are not recruited with an affinity for the organization’s goals; workers do not consider the order from ‘above’ legitimate; or the incentives available to supervisors are matched by countermeasures available to lowerlevel participants”(Lipsky, 1980: p. 16). This conflictual relationship can strain the results of performance of the agency, and could consequently “expose [managers] to critical scrutiny” (Lipsky, 1980: p. 19). The streetlevel bureaucrats create conditions and sometimes resist the organizational authority to hold on to their discretionary roles, and maximize autonomy. Their opposition to organizational pressures partly characterize their roles and again, ends up shaping the agency’s performance, behavior, and also policies. These policies are what the clients experience on a daily basis, and execution of these policies condition their judgments about the agency, and sometimes about the state too.This notion that streetlevel bureaucrats are policymakers is important to understand because it directly relates to my thesis. The health care workers who provide services to the clients in Narayani subzonal hospital are invariably molding the behavior of hospital. They play the central role in the statesociety relations. They are in many ways similar to streetlevel bureaucrats that Lipsky explores in his book: they are at the forefront of service delivery, they enjoy discretion and relative autonomy from organizational authority, and they are bound by the resource constraints that delineate their roles and functioning. Like the streetlevel bureaucrats in Lipsky’s account, these health workers navigate the inexhaustible demand for services by the populace. Lipsky argues, “In the area of health, as in virtually every other area in which streetlevel bureaucrats operate, there is no imaginable limit to the amount of health care the population would seek and absorb if it were truly a ‘free good’ available without significant explicit or implicit costs” (Lipsky, 1980: p. 33). The diagram below illustrates the dominant position the frontline healthcare workers play in navigating the often abstract nature of national policy making arena with the day to day tangible needs of the clients in the health service delivery arena. Figure 2: Shows the intermediary roles of the health service providers. The arrow heading down from the top level box towards the health care workers denote the flow of directives, rules, and regulations that roughly bind the health workers’ work behaviors. The twoway arrows between the box representing the health workers and the clients demonstrate the transactional relationship between these parties. The clients have resources with which to affect the relationship, even though the relationship is not a balanced one. “The relationship is primarily determined by the priorities and preferences of streetlevel bureaucrats, but the character and terms of the relationship are substantially affected by the limits of the job” (Lipsky, 1980: p. 59).
2.1. Public service delivery
Public services are deliverables that a state provides. It can include statesponsored functions like arranging transportation to its citizens, providing electricity and running water, facilitating education and healthcare, and even collecting garbage from the streets. Public service could also entail statebacked social insurance and welfare programs for elderly citizens, disabled, people under poverty, etc. Historically, the expansion of the role of the state in terms of providing public services like these has been associated with the process of democratization of the state and economic growth (Jones, 2012: p. 240). Such trend is demonstrated in the amount of public expenditure and Gross Domestic Product (GDP) allocated to social security expenses on programs like child welfare and unemployment. OECD countries, for example, pledge at an average of 13 percent of their GDP to social security programs, whereas lowincome countries spend an average of less than two percent (Townsend, 2009). While greater emphasis is being placed on building comprehensive social security systems that provide citizens with basic public services in all countries, including the poor ones, the advent of technological and information revolution through television, the internet, phone, and fax have improved citizens’ capacity to hold the state accountable for the effectiveness of public services it already delivers (Shah, 2005: p. xxiii). Greater attention to how public services are developed, implemented, and revised have also put forth the question of measurement of performance of those services. There are many benefits to measuring the outcomes of service delivery. It can help “identify problem areas, identify the extent to which service quality has changed after improvement actions have been taken, improve budgeting so that resources are allocated to produce the maximum benefit to citizens, make public agencies more accountable to the public, and increase the public’s trust in their government” (Shah, 2005: p. xxx). Scholars have attempted to evaluate, and also provided suggestions for evaluation of the performance of essential public services like health and infrastructure as a way to allow policy planners in designing appropriate strategies for addressing inefficiency and inequity in those services. For example, Soucat and colleagues delineated three related questions that they claim provide an avenue to evaluate the performance of the health system delivery, especially to the poor populations in lowincome countries: “1. Do health systems choose to do the “right” things, providing the services of greatest potential benefit to the poor and promoting policies that encourage use by the poor? (Government policies and actions) 2. How well do those health systems provide the “right” things, with their limited resources? (Health systems and related sectors) 3. Do the poor actually use health services,and does that use improve health outcomes? (Households and communities)” (Socut et al., 2005: p. 155) These questions provide the conceptual framework against which they have developed indicators like technical efficiency, per capita public expenditure, and physical accessibility to measure outcomes of health service delivery. These indicators are further broken down to subindices. For example, one indicator, “Relevance and Utilization” is evaluated by subindex of the “proportion ofchildren 1223 months having received at least one shot of vaccine” (Socut et al., 2005: p. 165). Indicator for “Physical Proximity” is be measured by the supply of services in relation to the population being served, or by the proportion of facilities or service delivery points. Scholar Hadi Salehi Esfahani has attempted to develop a similar framework for evaluating the performance of the government in service delivery of infrastructures like the water system, telecommunications, and transportation. Let’s consider power infrastructure as a case in point. Esfahani suggests categorizing the performance measure for this infrastructure into three aspects: “Outputs/processes”, “Productivity/efficiency” and “Assets”. Each of these aspects contains subindices. Outputs/processes include indices like Kilowatt generated, Kilowatt delivered, Days without power for various types of customers, consumer satisfaction rating (survey), etc. Productivity/efficiency includes indicators like the cost for a kilowatt of energy, capacity utilization rate, etc. And Assets include generation capacity, the number of employees, etc. Esfahani acknowledges that given the multiplicity of indicators, governing agencies would need to select a limited number of indicators that they deem crucial. Such a process, however, should not come at the expense of other indicators. He mentions, “Significant attention may be paid to a few key indicators, but minimum standards for a variety of other measures must also be met” (Esfahani, 2005: p. 203). While the attempts by scholars like Esfahani and Socut et al. are worthy of attention, there are considerable obstacles to putting them into practice, especially in lowincome countries. Harry Hatry outlines problems like the limited funds available in these lowincome countries to implement outcome measurement. He also points to other reasons – lack of formal training of the staff members to conduct quantitative measurements, unavailability of data processing technology, shortage of political will and previous experience in obtaining input from citizens, and varied interests in part of the donors who may provide different level of support for outcome measurement (Hatry, 2005: p. 86). Other scholars like Bouckaert and Walle have outright rejected the attempts for measurements by calling these endeavors “misleading”. They argue that measurements which try to capture public sector performance or governance are either too specific and fail to capture the overall picture of how state functions are viewed through public eyes, or they are too broad to say something meaningful about the issue (Bouckaert and Walle, 2003: p. 330). Their argument is based on the premise that some of the indicators used in performancebased measurement tools try to draw causal connections between for example quality of a certain service delivery and user satisfaction. This they believe is a faulty assumption. They argue that there are “differences in producer and consumer views on quality, changes not only in quality and perceptions of it but also in expectations and different service characteristics” that an index of some performance measures fails to take into account (Bouckaert and Walle, 2003: p. 332). The academic debates about performance measurement continue, and they have come to converge towards a direction where scholars realize the importance of measuring public service delivery but have disagreements in determining what should constitute as indices for these measurements, and how to interpret the results.
For my research study, trying to quantify the performance of health service delivery would be relevant but there exists no standard measure that would help me compare and contrast my results. It would be futile to statistically compute a performance measure and have no standard against which to equate the results. Developing a unique measure which includes indices of my own would have been possible, it would be beyond the scope and nature of my study.
2.2. State legitimacy
While there are uncertainties about the exact ways of measuring the effectiveness of public service delivery, many state and nonstate actors that are focused on development and peace, especially in postconflict and fragile states, have emphasized improved effectiveness of these services as a way to enhance state legitimacy. But what is state legitimacy? According to scholar Bruce Gilley, state legitimacy means that people accept the state’s fundamental right to rule over them (Gilley; 2009). In other words, legitimacy “involves capacity of a political system to engender and maintain the belief that existing political institutions are the most appropriate and proper ones for society (Lipset, 1960: p. 64). He argues that the question of the political legitimacy of a state is one of the central questions in the study of politics (Gilley, 2006: p. 499). State legitimacy, however, has multiple elements. For example, one way to define state legitimacy is by understanding citizens’ belief about whether or not the state has the right to rule them. In other words, citizens’ perception of the state is central to legitimacy thinking. This perception of legitimacy, what Levi et. al. (2009: p. 356) term valuebased legitimacy develops in citizens ‘a sense of obligation or willingness to obey authorities’. There is also the behavioral dimension to legitimacy, whereby the citizens’ sense of obligation transforms to ‘actual compliance with governmental regulations and laws’ (Levi et al. 2009). In this case, legitimacy becomes “observable and, in principle, measurable” (Brinkerhoff et. al, 2012: p. 275). Another way to understand legitimacy is its direct relationship with effectiveness, which is a policy concern. Mcloughlin mentions, “All states a need a degree of legitimacy to govern effectively. The only alternative to legitimacy is to rule through the threat (or exercise) punishment or reward” (Mcloughlin, 2014: p. 1). Levi, Sacks, and Tyler concur. They mention that compared to ineffective or poorly performing governments, those governments that provide services and avenues to improve the overall welfare of the citizens are more legitimate in the eyes of the people. “To the extent citizens perceive government agencies as producing the goods and services expected of government, the likelihood of obeying rules should increase” (Levi, Sacks, and Tyler, 2009; p. 354). Lipset argues that effectiveness and legitimacy are interconnected in a continual balancing act and that a severe breakdown in effectiveness would jeopardize the stability of otherwise highly legitimate state (Lipet, 1984, p. 91). For him, legitimacy comes from a combination of effectiveness, the organization of political power, and how societies have in the past settled out divisive issues. In his view, effectiveness and legitimacy are engaged in a continual balancing act. There are powerful groups like the military and businesses that may reject the legitimacy of even a highly effective state if its basic values do not fit with their own. This essentially qualifies the relationship between service delivery and legitimacy by indicating that the effects of service delivery may depend onwhose opinions count. Scholars Francois and Sud have taken a step further on this topic and have suggested that “performance legitimacy” as they name is, “derived from government performance and effectiveness in fulfilling core state functions”, and that “states which fulfill the two core functions of security/territorial integrity and improvements in living standards possess performance legitimacy in the eyes of their citizens” (Francois and Sudd, 2006: p. 147). They further express that “the major determinant of state failure is the inability (or unwillingness) of states to improve the standard of living of their citizens” (Francois and Sudd, 2006: p. 142). Improving the standard of living is inherently related to the effectiveness of the state in its ability to deliver services that consequently produces the desired results in higher quality of life and wellbeing. State legitimacy is conditioned by values and norms that exist in a society. For a state to be considered legitimate, it must appeal to the principles and ideals that inform how a society is structured. Habermas concurs. He argues that “the politically enacted law of a concrete legal community must, if it is to be legitimate, at least be compatible with moral tenets that claim universal validity going beyond the legal community” (Habermas, 1994: p. 25). What he is arguing for is the justifiability of institutions that are supposed to represent the people. On this note, Beetham adds that a “power relationship is not legitimate because people believe in its legitimacy, but because it can be justified in terms of their beliefs” (Beetham, 1991; p.11). Related to this concept is the importance of how the justificatory process unfolded historically. Habermas and Beetham criticize philosophers who tend to ignore the historical aspect of legitimacy by focusing only on the conditions necessary for the justification of political institutions. Habermas contends that in order to uphold legitimacy, institutions should allow people in participate in the justificatory process within a deliberative democracy. He then goes on to argue that state legitimacy partly depends on the quality of the end results of these deliberative decisionmaking procedures. He writes, “Deliberative politics acquires its legitimating force from the discursive structure of an opinion and willformation that can fulfill its socially integrative function only because citizens expect its results to have a reasonable quality” (Habermas, 1996: p. 304). These understandings conferred by Habermas is particularly relevant for my study given the identity politics/ethnic conflict that is central to the story of my thesis. Habermas provides a framework to consider whether or not legitimacy can be rooted in a historical account of the ethics of the Madhesi group and require accepting this group identity to participate politically. Discussion about state legitimacy begs another question – why is it important and worth investigating? State legitimacy is central to the political stability of states (Holsti, 1996). It “pertains to how power may be used in ways that citizens consciously accept”, and it is a “major determinant of both the structure and operation of states” (Gilley, 2006: p. 499). In fact, one can appreciate the importance of having state legitimacy in a situation where it does not exist. State legitimacy is alluded to more often when it is jeopardized or lacking than when it is thought to be protected and invulnerable (Baker 1990: p. 197). State that lacks legitimacy is more prone to overthrow or collapse because it may lack popular support from the people because it puts more resources in the maintaining its rule may be through force or through gerrymandering, and less in effective governance.
Despite the appreciation of the importance of state legitimacy, political scientists have rarely attempted to operationalize it, or quantify it in a way that would statistically measure legitimacy crossnationally. Sidanius et al. indicate that “while political theorists have been aware of the importance of legitimacy for the stability of social systems since at least the time of Thucydides and Plato”, state legitimacy “has only recently begun to be conceptualized in ways that make it accessible to the empirical methods of modern social science” (Sidanius et al., 2001: p. 330). The operationalization of state legitimacy to explore the concept is still rare (Sharma and Gupta, 2006: p. 8). Part of the reason why there are meager attempts to operationalize state legitimacy might have to do with, as some theorists have pointed out, to the complexity of the topic. King and colleagues argue that “[State legitimacy] is a large order, one that would require considerable ingenuity to execute adequately” (King et. al, 1994: p. 110). They even assert that scholars should not engage in “attempting to find empirical evidence of abstract, immeasurable, and unobservable concepts”. Along similar veins, Huntington argued that legitimacy is a “mushy concept that political analysts do well to avoid” (Huntingon, 1991: p.61). However, Gilley argues that there exists little “valid objection nor insuperable obstacle to [state legitimacy’s] measurement (Gilley, 2006, p: 500). Other complex topics like cultural diversity and crosstime democracy have been measured effectively as well, so why not attempt measuring legitimacy? He made a case for a crossnational measure of state legitimacy, which he operationalized by indicators like views of police, judges, and civil servants, political violence, election turnout and voter registration within a three subtypes of legitimacy – “Views of legality”, “Views of justification”, and “Acts of consent”. These indicators were then weighted and aggregated through a complex and elaborate model. The discussion of details of such model is beyond the scope of this thesis. He then ranked the 72 countries he was investigating by providing each with a legitimacy score. Denmark topped the list, and Russia was the lowest in the ranking. Gilley’s attempt was well received but he himself admitted that his endeavor was a “preliminary attempt” and that “many issues remain unresolved concerning the conceptualization and operationalization of the concept, as well as its enhancement through qualitative study” (Gilley, 2006: p. 521). Nevertheless, attempts like this one have helped flesh out the meaning of state legitimacy and have posed theoretical challenges that have furthered the understanding of the topic. The question of state legitimacy is particularly important in Nepal because the country has faced, and continues to face numerous moments of legitimacy crises in the last three decades. In 1990, the thirty years of monarchy’s direct rule was challenged by the people, led by a political party, which ultimately instituted democracy. In 1996, the Maoist rebels challenged the nascent democratic political system – which they claimed was oppressive against the minorities – by waging a civil war, which ended in 2006 and consequently overthrew the monarchy. In 2007 and in 2015, Madhesis revolted against the state in demand for more rights and political representation. While these moments of crises have inevitably led to more democratic and representative society, they have also have disrupted the social fabric, economic structures, and political systems. The civil war in Nepal resulted in over 15,000 deaths and contributed to instability and strain in statesociety relations. In the current postconflict state that Nepal finds itself in, a weak or absent state legitimacy could lead to potential relapse to violence and towards state failure. Brinkerhoff and colleagues argue that “in postconflict statebuilding legitimacy can facilitate negotiation of a
political settlement to reestablish the State as the highest authority. In the subsequent stages of statebuilding, legitimacy enables constructive bargaining between state and society to manage conflict, assure equitable access to resources and produce public goods and services” (Brinkerhoff et. al, 2012: p 275). Research also shows that the sustainability of peace process is highly dependent on the legitimacy of the state order in the postwar period (Krampe, 2016: p. 55).
2.3. The relationship between service delivery and state legitimacy
Over the past decade, many state and nonstate actors have commented on the importance of providing vital public services like education, health, and sanitation as one of the modus operandi for improving state legitimacy (Zoellick, 2009). This understanding of the importance of maintaining state legitimacy comes with a crucial question: how can actors improve state legitimacy? Brinkerhoff argues that fulfilling core state functions including effective provision of public services that is provided in a way that is satisfactory to most citizens would be a good starting point for legitimization. He discusses other sources of legitimacy like the “management of political participation and accountability, which (under democratic governance) results in responsive and accountable government, representation and inclusiveness; and security, where state authority and power assure its monopoly on the use of force to maintain border integrity, preserve law and order and protect people and property” (Brinkerhoff et al, 2012; p. 276). Scholars have quite explicitly mentioned that the relationship between service provision and state legitimacy are not causal and there are multiple other variables including citizens’ concept of distributive justice, state’s sensibility to society’s norms and principles, and opportunities available for citizens to voice their grievances as contributing factors to the interpretation of state’s legitimacy. Claire Mcloughlin, explains the difference in the approach of sense making of the sources of state legitimacy quite clearly: “In the statebuilding literature, a distinction is sometimes made between legitimacy that derives from what the state does, versus what it is, or its deeper meaning to people. Institutionalist scholars argue legitimacy flows automatically from functioning institutions (democracy, security apparatus, legalrational bureaucracy), while sociologists view legitimacy as much more entwined with the deeper meaning of the state, including the kinds of ideas and values it represents” (Mcloughlin, 2014: p. 2). Another part of this puzzle is the question about where citizens actually experience state legitimacy. Through his study about India, Stuart Corbridge argues that local service delivery mechanisms provide an opportunity for citizens to view and understand the state’s functioning, thereby allowing them to form expectations and interpretations about state’s legitimacy (Corbridge, 2005). Other scholars concur and maintain that through engagements with the frontline practitioners in the localized services of the state, citizens might view state’s legitimacy positively or develop mistrust (Brinkerhoff, Wetterberg, and Dunn 2012, 279). Lipsky mentions that most citizens encounter the government through street level bureaucrats, the frontline practitioners who interact directly with the citizens and deliver services to the clients, the citizens. The process of legitimization, in manyrespect takes place through these streetlevel bureaucrats, who in many citizens’ eyes are the manifestation of the state.
