User-Centered Approach to Service Quality and Outcome: Rationales, Accomplishments, and Limitations

Abstract

This paper addresses the rationales, accomplishments, and limitations of the “User-Centered Approach (UCA)” to service provision proposed and practiced as a solution to the problem of poor quality and insufficient outcome of services observed in impact evaluations (Global Monitoring Report 2011). After providing conceptual and analytical approaches to the question, conceptual articulation of the nature of services and classification of services based on degrees of discretion and transaction-intensity will be provided, followed by conjectures on two types of failures in service delivery. Next will be presented discussion on the effectiveness of the UCA models (co-production and self-management), the definition and articulation of two key concepts (agency and motivation), and typologies of user-provider relations and of user agency in service transaction and utilization. Some of the important proposals and experiences of UCA are summarized in the form of general propositions on co-production in public services, people-centered primary care, and chronic illness care, and in case studies of two salient programs in social work. As central argument of the paper, the activation and development of user agency for effective partnership in co-production and for self-management will be emphasized, making reference to a general conceptual examination of “empowerment” and to important cases of intervention for agency activation and development, with a view to drawing generalizable implications. Brief discussion on the rationales, accomplishments and limitations of UCA concludes the paper.