impact of social accountability mechanisms on service delivery and human development outcomes in...
TRANSCRIPT
Impact of Social Accountability Mechanisms on Service Delivery and
Human Development Outcomesin Satara District of Maharashtra
Presented By
Yashwantrao Chavan Academy of Development Administration
December 16, 2009, Jaipur
Section I
Context&
Accountability Interventions
Local Governance & Service Delivery Setup
• Panchayats are primarily accountable for delivery of crucial services under the flagships such as National Rural Health Mission, Integrated Child Development Scheme, Total Sanitation Campaign, etc.
• Three-tier Panchayati Raj and its health care delivery system in Maharashtra:
Zilla Parishad (District)
Panchayat Samiti (Block)
Gram Panchayat (Village) Village Health Committee
Primary Health Centre
Block Health Office
District Health Office
Health Sub-CentreCluster of Villages
• Poor targeting of beneficiaries and under-utilization of funds due to a lack of:
Demand for services by the communities
Dialogue between communities, service providers and government functionaries
Structured mechanisms for assessment of service quality and efficacy at various levels
• Result: Poor indicators of basic human development such as child and maternal mortality, nutrition, sanitation, school education, etc., in spite of relatively better economic status of Satara district
Problem
• Drawing from the rich experience of Village Microplanning in Maharashtra: Partnership of Unicef, YASHADA, NGOs and Youth Networks
• Integrating the tool of Community Score Card with Microplanning
• Strong support and ownership by Zilla Parishad
• Generous support of the World Bank
Genesis of Accountability Initiatives
Accountability Initiatives• Village Microplanning: Creating a strong demand for
services through participatory community mobilization• A five-day process consisting of PRA exercises• Participatory stock-taking, problem-analysis, solution-
seeking and intervention-planning• A village action plan owned by the community• SHGs, youth groups and village committees
• Community Score Cards: Creating a dialogue between communities, service providers and government functionaries for more accountable service delivery• Input tracking• Independent rounds of service assessment by
communities and service providers• Common discussion on scores in a gramsabha
Accountability Process
Sr. Sector Groups CBOs
1 Health All families, especially pregnant women, sick persons, BPL families
Village Health Committee
2 Nutrition 0-6 years children, pregnant & lactating mothers and adolescent girls
Village Health Committee
3 School Education
6-14 years children Village Education Committee
4 Water & sanitation
All families, especially the marginalized sections of the community
Village Water Supply and Sanitation Committee
Focus Sectors
Achievement of total sanitation in every village;
Improving nutritional levels in children, total eradication of acute
malnutrition;
Bringing every child in 6-14 age group to school;
Eradicating the water borne diseases by creating awareness about safe drinking water and the monitoring of water quality
Halving the Infant Mortality Rate in three years.;
Reducing maternal deaths;
Ensuring 95% institutional deliveries and 100% deliveries by
trained personnel.
Ensure that all marriages take place only after the legal age of
marriage.
Outcomes Envisaged
Village Microplanning
• Village level Micro Planning is a five day activity carried out by NGO facilitators from local area
• It includes a package of PRA activities, community games, IEC activities targeted towards creating awareness, analysing the situation on various HD parameters, identifying the resources of the village, enlisting the problems, prioritising and setting up an action plan for solving these problems.
Village MicroplanningMicro planning is a strategy for communication. Communication can be mass communication, group communication and one to one communication.
Micro planning is a package of PRA tools, IEC tools, surveys, community games.
Micro planning attempts at mobilizing the communities to take ownership of the community assets, programs, services, etc and become responsible for the protection and maintenance of the assets, delivery of the services and implementation of the programs.
Micro planning culminates in the final village plan with community priorities and an action plan to implement this plan.
Themes In Microplanning
Haemoglobin assessment especially of women Weighing of children in presence of mothers Creating awareness regarding sanitation, water quality, solid and liquid waste management, use of iodised salt,
nutrition, education, renewable energy sources, health issues, etc. Construction of soak pits, toilets, water conservation structures, vermiculture pits, etc. Group reflections of adolescent girls, self-help groups, women and other such groups Gender analysis to reveal gender bias Creating an action plan for achieving HD goals
Tools for Microplanning Transect walk to understand the situation in the village regarding water, sanitation, resources Social mapping to throw light on social distribution of resources, amenities and problems Time line to analyse the issues of population, availability
of water, development of social infrastructure Seasonality chart related to diseases, work, school
attendance, etc. Household survey to prepare a baseline on various HD parameters Venn Diagrams to understand the relative utility of
various service providers Marble game to understand accessibility to government schemes and discrimination . Human knot to discover the key to solutions of all
problems.
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Usefulness of Microplanning
• Rights based self-help approach of microplanning leads to community empowerment and self reliance
• Strengthen Panchayati Raj System and active participation of women in decision making
• Active collaboration between communities and government agencies
• Social inclusion of underprivileged and youth • Unique, flexible and highly effective IEC device with wider
replicability• Social Audit of service delivery system• Strengthening administrative functioning through Block
Response Plan and District Plan • Create conducive environment for decentralized
community managed programming - NRHM, Jalswarajya, NREGS, SSA and ICDS
Community Score Card
Four-Step Process
Input Tracking
Performance Assessment
Self-Evaluation
Community Scorecard Process
Interface Meeting
Partnerships and Alliances
YASHADA&
UNICEF
ZillaParishadSatara
NGOs
VillageCommunities
TheWorldBank
Tie-Ups
World Bank - YASHADA
YASHADA - ZP Satara
ZP Satara - NGOS
NGOs - Youth Facilitators
•The CSC process finally culminates in an action plan prepared by the community and the facility staff to correct the gaps in the delivery system.
•The actions may be required to be taken by the community or by the local authorities, or by the district administration or by the government. Whichever the agency for carrying out the requisite action the community has to set up a team to follow up the progress of the action.
•Repeat the process of CSC periodically to monitor the progress in the delivery systems.
The Follow Up
Section II
Impacts
Changed Outlook through MP and CSC
• The role of each individual vis a vis government is clearly understood. The message of Microplanning:
" the outside agencies cannot solve our problems which we have ourselves created, they can be solved together by the individuals and the community. Government is the facilitator not the solution provider“.
• The message of the CSC is Government is a service provider and accountable
for what it provides. The community has a right to demand and assess what it is entitled to get. Mutual interaction improves service delivery.
Impact Cycle
Impact Milestones
Information Seeking
Accountability Seeking
Development Seeking
Institutional Change
Process Change
Policy Change
Accountable Governance & Development
Behavior Change System Change
Mother & Child Health• Proactive seeking of ANC• Regular intake of iron tablets• Strong preference to
institutional delivery• Enhanced breast feeding• Monitoring of immunization• Better Anganwadi enrollment• Monitoring of child weighing• Better child feeding practices
Sanitation• Regular cleaning of
water sources• Regular use of chlorine• Regular upkeep of
drainage• Ban on open defecation• Regular use of toilets• Use of soap for hand-
wash• Village cleanliness
drives
Sense of Empowerment• Continuous community dialogue and action• Ability to mould community practices• Information & accountability seeking• Community contribution to programme funds
Behavior Change
Service Strengthening• Swift action on staff shortages• Stocktaking of medicines,
vaccines, nutrition supplements• Regular health checkups, home
visits, immunization rounds• Door-to-door search for needy• Toilet construction drive• Special counseling centres• Capacity building of service
providers
Accountability• Dialogue of service
seekers & providers• NGOs/ volunteers as
neutral monitors• Formal recognition to
community data• Regular review of
corrective actions• Tracking of outcomes
rather than inputs
More Responsive System• District & block taskforces for monitoring• Block response plans based on felt needs• Service strengthening using CSC feedback• Ownership of accountability through
investing ZP’s own funds in interventions
System Change
Human Development Outcomes
• Per village cost of accountability interventions: Approximately Rs. 7000
• Cost of accountability interventions for district: Rs. 7000 x roughly 1000 villages = Rs. 7 million
• Average district development budget: Well over Rs. 700 million
• Cost of accountability interventions: Barely 1% of the development budget
Costs and Benefit
Costs and Benefit…
Average AnnualDistrict Budget
Cost ofAccountability
Processes
Saving of financial, social
and human costs caused by a lack
ofaccountability
• Creative mobilization of funds for accountability interventions: Sources are not fixed
• Continuous follow up: Maintaining the tempo
• Sustainability: Community initiatives, NGO partnerships, ownership by administration
Challenges
• Village microplans are now a mandatory requirement for district planning as per Planning Commission’s Manual for Integrated District Planning (January 2009)
• Block and district budgets are to be actually based on community demands
• Annual bottom-up planning: An avenue for institutionalization of MP and CSC
Solution: Institutionalization
Thank You!