Open Governance for Better Health Outcomes

Open, transparent and accountable governance

• Improving public services

• Increasing public integrity

• More effectively managing public resources

• Creating safer communities

• Increasing corporate accountability  

Principles:

• Transparency

• Citizen participation

• Accountability

• Technology & innovation

Policy makers

RELATIONSHIPS OF ACCOUNTABILITY

Politicians

The State

PoorNon poor

Citizens

Organiza-tions

Frontline

ProvidersCoalitions/Inclusions Management

CompactVoice

Citizen Power

Services

Short Route

Increasing Public Integrity, Improving Service

Delivery

- Capabilities – collaborative governance, technical and ethical competence

- Accountability – transparency, public engagement

- Responsiveness – understanding community needs, joint problem solving

- Evidence- strong data collection, management and sharing to inform policy and practice

Community-driven Accountability

Dem Rep of Congo

FOCHI

- Health- Roads- Land

- Electricity -Watsan

Afghanistan

Integrity Watch

Afghanistan- Health centers

- Schools- Roads

- Electricity- Police station

Kenya

CRSP

- Education-Energy- Watsan

Kyrgyzstan

MSDSP

- Health- Social

Protection-Watsan

Liberia

Poverty Reduction Strategy Tracking Network

Infrastructure and basic

services of the PRS

Nepal

CAHURAST

- Education services- Health

- Irrigation- Roads

Sierra Leone

NMJD & IMT

- Health- Education- Contractors

Sudan

Collaborative for Peace

-Natural Resources

- Health

Palestine

Teacher Creativity

Centre

- Roads- Schools- Watsan- Library- Parks

-Food security

Uganda

Uganda Debt Network

- Education

Timor Leste

Luta Hamutuk

- Roads- Electricity- Veteran housing- Health centers

- Schools

Local monitoring dynamics and initiatives

MOBILIZATION LMG TRAINING ASSISTANCE TO ACCESS INFO INFO SHARING/CHANNELING ADVOCACY POLICY IWA FACILITATION ROLE

PEOPLE CHOOSE

LOCAL MONITORING GROUP (LMG)

PROJECT TO BE MONITORED (CORRESPONDING TO THE COMMUNITIES’ PRIORITIES)

SURVEY BENEFICIARIES'

VIEWS

OBTAIN PROJECT

DOCUMENTSFIELD VISITS

INTEGRITY MONITORING BY THE LOCAL MONITORING GROUP (LMG)

MONITORING REPORT

LMG SHARE MONITORING

RESULTS WITH

RESULTS

SOLUTIONS

BEST PRACTICES

ARE SHARED

SOLUTIONS ARE FOUND TO CORRECT

PROJECT

IMPACT

1.HOLD IMPLEMENTERS ACCOUNTABLE

2.EMPOWER COMMUNITIES

3.FIGHT CORRUPTION

4.INFORM THE DONORS ON THE IMPACT OF THEIR WORK

5.IMPROVE EFFICIENCY OF FUNDING AT THE LOCAL LEVEL

6.BUILD CREDIBILITY OF CITIZENS’ ACTION

7.OFFERS AN ALTERNATIVE TO SPOILERS AT THE LOCAL LEVEL

REPORTING

SELECTION PROCESS

Pressure

LMG’S MONITORING RESULTS RECEIVE COMMUNITY’S APPROVAL

2

34

5

1

DONORS

STATE

PROJECT IMPLEMENTERS

COMMUNITY

LOCAL MONITORING GROUPS (LMG)

COMMUNITY BASED MONITORING PROCESS

AS IMPLEMENTED BY IWA IN JABULSARAJ SINCE 2007

Liberia PRSTN - RBA

GoalProvide basic health

services to all citizens

How many people are actually receiving quality

water services?

How many find the water services acceptable to

use?

How many are able to access the available

water services?

What is the availability of required resources for providing basic water

services to all citizens?

How many of the total population in need of health services we can provide for- in numbers and in %

How many, of the population for which the required resources are available, can access the service – in numbers and % of total

How many, of those who are able to access the services, are willing to make use of the services- in numbers and in % of total population

How many, of those who are willing to use the services, are having their health needs met- in numbers and in % of total population

AVAILABILITY

ACCEPTABILITY

ACCESSIBILITY

QUALITY OF CONTACT

A2I AND PARTICIPATION

GOL M&E Framework for PRS and CDA Implementation

CIVIL

SOCIETY

Ministry of Planning and Economic Affairs

Four Working Committees (WC):Security, Economic Revitalization, Governance & ROL, and

Infrastructure and Basic Services

County Development Steering Committee (CDSC)

Proposed County

Stats Office¹County Statistics Officer (LISGIS)Data Management ClerkMapper

LISGIS HQ

Line Ministry County Staff

DATA/STATITICS on PRS and other development framework indicators using census, survey and administrative records

Updates on PRS and CDA DELIVERABLES using the County Based Reporting Tool and maintain database of all development projects in the County

Cabinet, Public, Civil Society, etc (shared widely)

County Development Office/ CDSC Secretariat Assistant Superintendent for Development County Development Advisor (Proposed SES)Project Planner Field Monitors

National Line Ministries

8

LRDC Secretariat – (National Pillars - LRDC Steering Committee)

• In Kadugli, a man from the Koyat tribe came to Rasha from the Collaborative for Peace in Sudan (CfPS) to raise concern that his tribe had purchased 40 weapons. At the same time, a member of the Kolba tribe also approached Rasha warning that his men had been sent for military training in Kenya.

• The two tribes were in dispute over compensation from an oil company, with one tribe claiming the health clinic in the area was provided to the wrong tribe

• A meeting was arranged with the two communities, security representatives, native administration and the oil company in question.

• Rasha had previously consulted the deeds and, indeed, the oil company had got it wrong. After 3 days of negotiating, it was agreed the oil company would build a second health clinic in the community that had missed out. There are now open health services for all.

Sudan - Building integrity, health services for all

Students improving Ramallah Hospital

• In the West Bank, 34 grade nine female students identified 80 problems and chose to monitor pollution in Ramallah Hospital

• Complaints of insects, overcrowding, medical leftovers, very dirty WCs, hazardous waste, smoking in the units, unprotected babies

• Students studied relevant laws and policies

• Conducted interviews with staff, patients, govt, media

• Increase in annual deaths, but hospital refused A2I

• Having internal elections to choose suitable directors and management staff: the right person for the right position.

• Hospital cleaned up its administration and built a new wing, improving health outcomes for the population of Ramallah

Open Governance for Improved Service Delivery

• Sustainable forums for change – service providers, local leaders and community monitors review monitoring findings and develop practical solutions to challenges in service delivery

• Establishment of transparent procedures and criteria for procurement, recruitment and beneficiary lists – eg. Palestine

• Govt budget allocations to address identified gaps and needs – eg. Nepal, Timor Leste

• Strengthened local competences with identification and support of existing capacities and accountability mechanisms

• Improved service delivery by identifying and addressing community concerns and joint problem solving

Harnessing potential of Open Governance• Understand community needs and open governance across

decision making and service delivery– strengthen the social contract between the state and society

• Support multi-stakeholder partnerships and transparency initiatives that open resource flows and information (e.g. IATI, EITI, GIFT) and learning across these initiatives

• Support the Construction Sector Transparency Initiative for transparency and accountability in public infrastructure

• Build bottom-up open governance capabilities to enable communities to access and use data (eg. Transparency Portals)

• Ensure country systems and the use of ICT facilitate data collection, management and dissemination to communities (universities, stats offices)

Thank you!

Claire Schouten

Claire.schouten@tiri.org

www.tiri.org

www.facebook.com/NIRpage

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