What Happens when Public Expenditure is Scaled Up? An Enquiry into the Costs and Cost-effectiveness of Expenditure in Phases of Expansion

This paper asks whether the costs of providing public services in low-income developing countries tend to rise when expenditure on these services increases - as has been found to be the case in developed countries. It offers elements of an answer to this question by reference to evidence from country case studies relating to episodes of expenditure growth, mainly in the 1990s, in the fields of primary education, road maintenance and childhood immunisation.