GOVERNANCE EQU I TA BLE GROW T H, FI N A NCE & I NST I T U T IONS NOT ES GovTech Case Studies: Solutions that Work Tunisia: Problem-Driven and Adaptive Approach for Citizen-Centric Service Delivery Citizen-centric public services that are universally accessible Supported by the GovTech Global Partnership: www.worldbank.org/govtech © 2024 International Bank for Reconstruction and Development / The World Bank 1818 H Street NW Washington DC 20433 Telephone: 202-473-1000 Internet: www.worldbank.org This work is a product of the staff of The World Bank with external contributions. The findings, interpretations, and conclusions expressed in this work do not necessarily reflect the views of The World Bank, its Board of Executive Directors, or the governments they represent. 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Because The World Bank encourages dissemination of its knowledge, this work may be reproduced, in whole or in part, for noncommercial purposes as long as full attribution to this work is given. Any queries on rights and licenses, including subsidiary rights, should be addressed to World Bank Publications, The World Bank Group, 1818 H Street NW, Washington, DC 20433, USA; fax: 202- 522-2625; e-mail: pubrights@worldbank.org. Introduction The Tunisia Digital Transformation for User-Centric Public Service Project (Tunisia GovTech project, P168425), which approved by the Board in June 2019 and became effective in June 2020, supports the Government of Tunisia (GoT) to provide equitable access to quality social protection and education services through a GovTech approach. Aiming to make an important contribution to improving human capital outcomes in Tunisia, the project targets the government’s stated priority sectors that are widely used by citizens. As the first operation of its kind in the Middle East and North Africa (MENA) region, the project was distinct in its approach to place the citizen at the center of the reform process by design and combine public sector innovations, change management, and digital technologies in the reform. When the project started in June 2020, Tunisia’s poorest households and the country’s education systems had been hard hit by measures to curb the spread of COVID-19, with 2.15 million children affected by school closures. To accelerate the government’s immediate response and to mitigate the social and economic impacts of the crisis, the project was quickly restructured in that month and then again in March 2021. The first restructuring accelerated the digitalization of social service provision by interjecting liquidity and expanding the application of existing foundational systems, such as social security system database and digital learning management system. The second restructuring expanded into the health sector to support the COVID-19 vaccine beneficiary information system (eVAX). This note captures the experience and lessons learned in Tunisia on its GovTech approach to: (1) pursue a problem-driven project design by placing citizens at the center; and (2) be iterative to rapidly respond to the immediate needs of the government, and to accelerate the cross-sectoral response to the COVID-19 pandemic while bringing innovative digital technologies to social sector reforms. TUNISIA: PROBLEM-DRIVEN AND ADAPTIVE APPROACH FOR CITIZEN-CENTRIC SERVICE DELIVERY <<< 3 Country and Operational Context Tunisia is facing simultaneous political, constitutional, and economic crises. The country entered a critical political juncture in July 2021, when President Saied introduced measures such as the partial suspension of the 2014 Constitution and the dissolution of the parliament. A new Constitution, which established a presidential system of government, was adopted by referendum in July 2022, and parliamentary elections took place between December 2022 and January 2023. Post-revolution policies prioritized social peace by increasing public expenditure, particularly through public employment and cash transfers, without adopting measures to support the expansion of the market economy, resulting in a macro-fiscal crisis and structural vulnerabilities. Furthermore, the government’s capacity to implement public policies and reforms has been eroded, and parts of the population are still largely excluded, especially women and young people who are more vulnerable and disproportionally disadvantaged in the labor market. In terms of human capital, a child born in Tunisia today will be 52 percent as productive when she grows up as she could have been if she enjoyed complete education and full health, according to the World Bank’s Tunisia Human Capital Index 2020. Tunisia’s Human Capital Index of 0.52 is lower than the MENA region average (0.57), but higher than the average for lower-middle income countries (0.48). In Tunisia, a child who starts school at age 4 can expect to complete 10.6 years of school by her 18th birthday. However, when what children actually learn is factored in, the expected years of schooling goes down to only 6.5 years. The country’s structural fiscal challenges have been aggravated by the impacts of the COVID-19 pandemic and Russia’s invasion of Ukraine. At the onset of the COVID-19 pandemic, the Government of Tunisia (GoT) introduced strict confinement measures and other restrictions to help contain the spread of the virus. These negatively impacted the economy and the livelihood of the poor and vulnerable population. The initial impact assessment at the onset of the pandemic estimated that the Tunisian economy could potentially contract by 4 percent, and 25 to 30 percent of formal and informal jobs could be lost in the most affected sectors, including tourism. Tunisia’s gross domestic product in 2020 contracted by 9.2 percent. The economic rebound in Tunisia remained moderate in 2021 at 2.8 percent, well below the expected rebound rate of 5.8 percent. The socio-economic impact of COVID-19 continues to affect the vulnerable population: the poverty rate that increased at the onset of the pandemic is expected to remain high in 2022 at almost 18.7 percent. The GoT urgently needed to respond to a double challenge of the pandemic—the congestion of health systems due to the rise in COVID-19 cases and an economy plagued by the restrictions imposed to curve the spread of the COVID-19. Moreover, the COVID-19 shutdowns and slowdowns escalated social tensions. The government’s economic response consists of a National Plan of Reform, which includes both a program for swift economic and financial stabilization and a Development Plan for 2023-25. In this context, improvements in governance and public service performance are central to the country’s continued economic, political, and institutional transition and for renewing the social contract between the state and its people. Rapid improvements in the way government responded to citizens required a transformative approach using a combination of the latest digital technologies with public sector reform innovations that placed citizens at its core. TUNISIA: PROBLEM-DRIVEN AND ADAPTIVE APPROACH FOR CITIZEN-CENTRIC SERVICE DELIVERY <<< 4 Solutions and Approaches The project is truly citizen-centric and problem-driven by design. A citizen journey map was used during the project design phase to identify service delivery bottlenecks from the user perspective; pinpoint priority service areas; and define the project components and activities that correspond with the service delivery challenges. Service users identified four broad challenge categories: unequal access, poor quality, weak accountability, and poor user-orientation. These service delivery problems are rooted in four interrelated causes: (1) complex service delivery procedures; (2) lack of appropriate service delivery mechanisms; (3) public and private sector and civil society difficulties in identifying service users due to the absence of good quality data lists; and (4) challenges in providing higher-quality services due to broadband connectivity difficulties. This problem identification exercise helped the project to identify four flagship areas to prioritize in the education and social protection sectors: (1) cash and benefit transfers (social assistance); (2) pensions and health insurance (social security); (3) dropouts and enrollment (education management); and (4) learning outcomes (the learning management system). Approaches and Analytical Tools for citizen centric GovTech operations • A life-events approach places the user at the center of the public administration reform process. The project focused on three key delivery events in social protection and education: “I need a social assistance benefit;” “I need social security benefit;” and “I need to enroll my child in primary or secondary school, to follow his/her schooling, and improve his/her learning.” These life events mapped the user journey to access a given service and focused on the different points at which the user interacts with the service providers. This approach identified the needs and problems in the public service delivery chain from the user perspective, and then sought to find solutions to the identified bottlenecks. Service users have been consulted periodically during implementation to ensure that their feedback is taken on board and adjustments are made accordingly. • Diagnostics on digital divide were undertaken during the preparation with special attention to gender, house- holds in rural areas, and age. The study found that the digital gap between rural and non-rural households was significant; broadband internet coverage was 7 percent among rural households in 2015, compared with 38 percent among urban households. Women are at a significant disadvantage compared with men regarding these factors: around 50 percent of young women in rural Tunisia are not in education, employment, or training; female illiteracy in rural areas can reach 40 percent, with men at 23 percent; and the gender gap in mobile internet use in Tunisia is considerably wider than the mobile ownership gap in other low- and middle-income countries. The diagnostics contributed to generating specific digital divide mitigation measures to enable the GovTech project to provide more equitable access to envisioned GovTech solutions. • “As-is-to-Be” review of administrative processes related to the four flagship areas is planned to be conducted during project implementation. The review will include creating an action plan aiming to simplify, automate, and optimize relevant processes using human centric design and journey mapping approach to ensure the GovTech solutions will be more efficient and user-friendly. Implementation of “As-is-to-Be” review in four flagship areas is one of the Disbursement Linked Results (DLRs).1 1. When applicable, multiple DLRs form a Disbursement Linked Indicator (DLI) to enable a phased approach. This DLR on “As-is-to-Be” review is, for example, linked to the DLI, “Adopting Key GovTech and Digital Economy Regulatory Reforms,” together with four other DLRs. TUNISIA: PROBLEM-DRIVEN AND ADAPTIVE APPROACH FOR CITIZEN-CENTRIC SERVICE DELIVERY <<< 5 >>> Figure 1. Problem Driven Approach at the Entry Point Problems & Unequal Poor Weak Poor user- Challenges access quality accountabilty orientation Citizen Centric • Citizen journey 9 Complex service delivery procedures map 9 Lack of appropriate service delivery mechanisms Interrelated 9 Dificulties in identifying users due to absence of good • Life event Causes data approach 9 Challenges in providing higher-quality services due to broadband connectivity difficulties • Diagnostics on digital divide Cash and benefit transfer Pensions and health insurance • As-is-to-Be Flagship areas (Social assistance) (Social security) review to prioritize Drop-outs and enrollment Learning outcomes (Education management) (Learning management) Source: Authors Therefore, the project aimed to improve equitable access to and the quality and accountability of selected social protection and education services under three components that mirrored the causes of service delivery bottlenecks: (1) simplifying, digitizing and optimizing key administrative processes, and introducing user-friendly digital and institutional solutions (Component 1, US$17.6 million); (2) building the public and private sector capabilities for speedier and more responsive service delivery (Component 2, US$46.4 million); and (3) boosting the indoor and outdoor connectivity needs in service provider facilities, and addressing the digital divide on the supply side (Component 3, US$36 million). The GovTech project introduced multiple Disbursement Linked Indicators (DLIs) to achieve the project development objective and respond effectively to the identified development challenges. Thirty percent (US$30 million) of the Investment Project Financing was allocated to DLIs under Component 2 to incentivize GovTech-related reform adoption and implementation.2 The GovTech solutions’ development and strengthening activities included the establishment and strengthening of the digital cash transfer payment system, digital ID system, simplified case management system of beneficiaries, a strengthened grievance redress mechanism, and a digital education management platform. These GovTech solutions serve as foundational, back-end systems to enable service delivery. Simultaneously, this component supports the digitalization of existing and new deployment of 69 digitized stationary and mobile access points with human assistance in 19 districts where physical and digital access to key administrative services remain very low—less than 25 percent on average. These access points provide human-assisted access to social assistance applications, social security enrollment and updates, enrollment for health insurance and school, and education management platform services and assistance. Thirteen stationary access points will be established in the most lagging governorates to bring the services and service interface nearer to 300,000 citizens. This will improve access for all citizens, but it is especially necessary for reaching the target vulnerable groups – low-income groups, women in rural areas, illiterate, and people with disabilities. Additionally, the most lagging districts in terms of performance on education and schooling indicators will have nine stationary access points. Fourteen mobile access points are planned to be deployed in rural and remote areas. 2. The project amount per component and the disbursement amount allocated to DLIs reflect the two restructurings the project underwent in June 2020 and March 2021. The original project amounts per component and the associated DLI amounts were $16.3 million for Component 1; $41.4 million, with $20 million DLI for Component 2; and $42.3 million for Component 3. TUNISIA: PROBLEM-DRIVEN AND ADAPTIVE APPROACH FOR CITIZEN-CENTRIC SERVICE DELIVERY <<< 6 The project remains problem-driven and proved to be adaptive in nature to respond to the emerging priorities of the GoT amid the COVID-19 pandemic. When COVID-19 hit in early 2020, the GovTech project was yet to be ratified by the Tunisian parliament. The GoT continued to work on loan implementation readiness supported by the World Bank via its complementary GovTech Technical Assistance (TA) Program. The TA placed a strong emphasis on reforms and capacity development, which later served as critical enablers for intragovernmental coordination in response to COVID-19. After the project became effective in June 2020, the GoT requested restructuring in the same month to accelerate the government’s COVID-19 response. On the one hand, the restructuring went smoothly as the project was already cross-sectoral with a focus on supporting the social protection and education systems and targeting the most vulnerable households in the country. On the other hand, the restructuring meant that the sequencing, scope, and types of GovTech solutions developed and deployed needed to be modified as the immediate priority was to focus on the rapid rollout of the COVID-19 related mitigation measures. Results The first restructuring of the project allowed interjection of liquidity and expansion of the existing service delivery systems in the social protection and education sectors. It focused on the following: • Expand social security system to provide temporary COVID-19 social assistance: The GovTech project supported the expansion of the digital social security database to include 700,000 households. A new simplified registration process was introduced to optimize the existing database. This simplification and expansion of the database enabled the GoT to accelerate the collection of additional data while improving on the validation and quality of the database, and facilitated emergency cash transfer to 370,000 of the poorest and the most vulnerable households. The simplified registration process allows the GoT to cross-check the registered household with other databases of the Ministry of Social Affairs (MSA), the National Pension Fund (Caisse Nationale de Retraite et de Prévoyance Sociale, CNRPS), the National Social Security Fund (Caisse Nationale de Sécurité Sociale, CNSS), and the National Agency for Employment and Self-Employment (ANETI) using the individual’s national identity card and birth date. The expansion of the social security system was supported by a new DLR of US$2 million, and another new DLR of US$18 million covered the delivery of the emergency cash transfer. • Enhance the digital education management platform: Upgrading of the digital education management platform for enrollment, student/school monitoring, and drop-out detection based on the “As-is-to-Be” review was planned under the original Tunisia GovTech project with an allocated budget of US$3.1 million. Given the urgency of situation during the COVID-19 lockdown, where schools moved to distance learning, the restructuring enabled the project to focus on the automation of student registration and monitoring of student attendance with the student identifier and sign-on system. While the scope of the upgrading is limited, this rapid enhancement facilitated nationwide digital enrollment and monitoring. • Improve the digital learning management system: The original project allocated US$1.5 million to improve student, teacher, and inspector access to and usage of high-quality learning materials and services through the design and implementation of a Digital Learning Management System. The restructuring prioritized addressing the immediate needs of providing distance learning. It launched education programs delivered via television and rolled out the digital learning platforms, where new digital learning contents were made available, teachers were able to receive trainings to conduct virtual teaching, and enabled virtual communication between school administrators, teachers, students, and parents. TUNISIA: PROBLEM-DRIVEN AND ADAPTIVE APPROACH FOR CITIZEN-CENTRIC SERVICE DELIVERY <<< 7 The first restructuring in June 2020 was speedily completed and facilitated rapid disbursement of US$20 million supported by the newly introduced DLRs and laid the foundations for the speedy preparation of a new US$300 million World Bank emergency operation, the Tunisia COVID-19 Social Protection Emergency Response Support Project (P176352). During the closure of schools that began on March 11, 2020, affecting an estimated 2.15 million children, the GovTech project helped to mitigate the immediate impacts by improving school connectivity and back-office data sharing infrastructure and providing the necessary tools for distance learning. Close collaboration with the Strengthening Foundations for Learning Project and its restructuring ensured complementarity of the World Bank’s support for COVID-19 response in the education sector. The second restructuring in March 2021 focused on supporting the GoT to rapidly rollout eVAX (www.evax.tn), the COVID-19 vaccine information system, with estimated costs of $1.8 million. In January 2021, the GoT outlined a plan to vaccinate 50 percent of the population by the end of that year. This ambitious goal needed to be met to decrease the risk of serious illness and death, maintain the capacity of health system, and reduce the social and economic impact of the pandemic. The development of eVAX was led by the Ministry of Information and Technology and Communication (MTC), the lead implementing agency of the GovTech project, in close collaboration with the Ministry of Health (MoH) and its Directorate of Basic Health Care. Tunisia’s eVAX platform is a blockchain-based vaccination delivery and management platform. The development was started in November 2020 by bringing together MTC, MoH, and private sector firms and individuals. The team took an all-hands-on-deck approach given the urgency and the magnitude of the COVID-19 crisis. MoH led the process through its IT center while the MTC deployed a technology development team and a call center. ProsperUs, a Tunisian company that specializes in blockchain in the financial sector, volunteered to develop the vaccination certificate module with a QR code, and local telecom companies donated SIM cards at the vaccination centers. The 4G or 3G connectivity at health and vaccination centers was financed by the GovTech project. The sense of urgency drove the team to be agile, to think big yet starting small and adapting fast. The initial user registration module was developed within two – early January 2021 – and additional modules were added as the deployment at health care centers quickly expanded to include 94 vaccination centers, 600 healthcare centers, and 800 alternative providers, such as pharmacies, dentists, and mobile providers. TUNISIA: PROBLEM-DRIVEN AND ADAPTIVE APPROACH FOR CITIZEN-CENTRIC SERVICE DELIVERY <<< 8 The GovTech approach of citizen-centricity, interoperability across government entities, and simplified process is embedded in the eVAX design, functions, and operations. For example, citizens and residents can register for vaccination through four channels – online, SMS, Unstructured Supplementary Service Data (USSD), and toll-free call center – to address the known digital divide. Registration is directly linked to the national ID card (CIN) database, managed by the Ministry of Interior, for cross-referencing and checking of vaccine eligibility. Once eligible, users receive a SMS notification for a vaccine appointment based on their locality’s vaccination availability, and another SMS is automatically sent to remind a registered user of future vaccine appointment(s). A certificate with QR code that is compliant with the European Union standards is issued when fully vaccinated. The vaccination pass obtained via a mobile device is managed by a two-factor authentication process to add a layer of data and privacy protection. Walk- in vaccination is now registered and managed on eVAX. Though the system initially encountered several technological hiccups, corrective actions were quickly taken to provide citizens a one-stop shop for COVID-19 vaccination management. >>> Figure 2. eVAX Webpage Source: Screenshot of the eVAX webpage As the immediate COVID-19 related deliverables have been met, the Tunisia GovTech project is now leveraging its early-stage experience and lessons learned from the COVID-19 response measures. The project will continue to support the GoT to improve and expand the scope of the eVAX platform. The platform showcased the possibility and value of an integrated digital infrastructure that pre-pandemic vaccine management system did not have. The healthcare centers and other health service points are now connected to the internet, and the MoH plans to update and expand eVAX to cover all routine vaccinations to allow citizens to make appointments, track immunizations, and share vaccination records with relevant officials throughout life. TUNISIA: PROBLEM-DRIVEN AND ADAPTIVE APPROACH FOR CITIZEN-CENTRIC SERVICE DELIVERY <<< 9 Lessons Learned Rapid rollout of GovTech solutions through two sequential restructurings of the Tunisia GovTech project allowed the GoT to respond to the citizens’ immediate needs and mitigate economic and social impact of the COVID-19 crisis. The project continues to evolve as it prepares for the deployment of GovTech solutions beyond COVID-19 crisis response. This section summarizes the early-stage lessons learned for World Bank task teams and other governments from the experience around citizen-centric design and implementation and the iterative nature of the operation. • The life-events approach with a journey map embedded into the design of GovTech operation was key to support the project’s strong commitment for citizen-centric service delivery to address concrete delivery bottlenecks. The GovTech approach is transformational as it harnesses the power of digital connectivity to lay foundations for a new digital economy with citizens at the center. It combines the latest digital technologies with the public sector reform innovations, including the change management approach, to address complex service delivery bottlenecks in a citizen-centric manner. This citizen-centricity harnessed by the life-events approach, citizen journey maps, and other tools continued to inform the two sequential restructurings in COVID-19 pandemic and rapidly rollout priority redressal mechanisms. • The World Bank’s cross-Global Practice (GP) collaboration inspired the intra- and inter- ministerial coordination and collaboration. The inherent nature of the Tunisia GovTech project that encompasses multiple sectors required the Whole-of-World Bank approach to support the GoT. Five GPs – Governance, Digital Development, Social Protection and Jobs, Education, and later Health – worked seamlessly on this project, and continue to do so. This cross-GP collaboration, together with a series of strategic communications as well as change management and collaborative leadership activities, planted a seed for the GoT’s Whole-of-Government approach during the design, restructuring, and rapid implementation of the COVID-19 response through the project. The shift in mindset for intra- and inter-ministerial coordination was a prerequisite for the rapid restructuring and implementation of COVID-19 related measures. • The World Bank team’s agility motivated and catalyzed the GoT counterparts’ agility to swiftly respond to the crisis. The immense needs for scaled-up social assistance for Tunisia’s poorest and vulnerable households pushed the cross-GP GovTech project team to adopt an agile approach. During June 2020 restructuring, a new DLR was introduced, which was subsequently achieved in that year. This DLR tracked achievement regarding release of a one-time payment to 370,000 eligible households. Furthermore, the restructuring introduced an additional mechanism for a DLI verification protocol aimed at ensuring the integrity of the social assistance program. The project pioneered the use of the General Auditor of Public Services (GAPS), a government institution, as the Independent Verification Agent (IVA) for more sustainable independent verification of DLIs. The beneficiary data for the one-time payment came from the MSA’s information management system, and the GAPS validated the payment report and data as the IVA after the cash payment and conducted field visits as needed to ensure the integrity of cash transfer program. TUNISIA: PROBLEM-DRIVEN AND ADAPTIVE APPROACH FOR CITIZEN-CENTRIC SERVICE DELIVERY <<< 10 • The rapid restructuring was facilitated by the strong foundations nurtured during the design and implementation of the Tunisia GovTech project, where the complementary TA Program and Advisory Services and Analytics (ASA) played critical roles as building blocks towards the lending operation. During the design of the Tunisia GovTech project, the World Bank team employed agile political economy and change management tools. This allowed the project built a reform coalition within government across key ministries and be based on more feasible design. At the onset of the project, it experienced delays largely due to late ratification by the Parliament, which went through elections in October 2019, and experienced further delays with the onset of the COVID-19 crisis. During this time, the TA program financed by the Moussanada multi-donor trust fund enabled the quick launch of the GovTech operation once it was ratified. The TA, for example, supported key reforms, facilitated operation implementation, and provided hands-on capacity building and training on change management, which contributed to influencing the thinking and modus operandi in the Tunisian public service. The Tunisia GovTech project has demonstrated that TAs and ASAs can facilitate rapid project preparation and implementation and deepen engagement with the client. Contact Information Geoff Handley, Senior Public Sector Management Specialist, ghandley@worldbank.org. Saki Kumagai, Governance Specialist, skumagai@worldbank.org. TUNISIA: PROBLEM-DRIVEN AND ADAPTIVE APPROACH FOR CITIZEN-CENTRIC SERVICE DELIVERY <<< 11 Supported by the GovTech Global Partnership: www.worldbank.org/govtech