Centre for Health and Social Justice

Context

Over the last seven years, social accountability and community monitoring (CM) have gained importance and  acknowledgement within the overall national policy context in India. CHSJ was set up ten years ago to work at the national level in India, in order to take the opportunity to systematically do some activities (including community monitoring) that were previously done at a state level. The experience of the key personnel who set up CHSJ had included designing and implementing different CM mechanisms and CHSJ continues to work with these.

Website
www.chsj.org
Area of Work
India
Contact Person
Abhijit Das

Approaches to implementing Community monitoring/ accountability

  • CHSJ implements different tools such as: Social Audit, Public hearing/Public Tribunal/Public Dialogue, use of citizen report and community score cards.
  • In the implementation of all the above, CHSJ emphasise the processes rather than the tools. Thus the common elements in CHSJ approach  are – community or CBO ownership of the idea of collective enquiry – NGO facilitated but CBO/community participation based enquiry process – a collective platform for sharing where policy makers/program managers are invited.
  • One of the important facilitating factors for CM in our practice has been to identify state led standards of service delivery.
In the current scenario, the overall policy climate seems beneficial but in practice many states and district authorities do not believe in community monitoring. The program managers have negative attitudes towards monitoring as well.
While government funds are theoretically available, they are not accessible. There are two kinds of civil society dilemmas – on the one hand groups who have been closer to the needs and realities of the marginalized continue do not trust the government and on the other hand, once community monitoring was seen as an NGO intervention,  many more joined in this kind of work.

Community Based Monitoring in India

A short video clip on community based monitoring of health services under National Rural Health Mission in India. This film was produced by CHSJ.

Results

  • Public announcement of policy change.
  • Improved service delivery – range and quality, reduction in costs especially bribes/informal payments.
  • Increased trust between service providers and community.
  • Participation of partners and CHSJ team in programme review and planning forums.
  • Also some negative consequences such as the backlash on the marginalized community by state authorities – at the individual or community level or the facilitating NGO and also by removing the endorsement to the process.

Lessons

  • Community monitoring strengthens community faith/participation in governance, improves service delivery, and gives credibility to the community and facilitators.
  • To be effective, community monitoring requires that a number of conditions be in place: strong community interest; Government endorsement; availability of standards of practice which derive from/ or can be related to human rights standards; possibility of change (without a possibility of change the community can become fatigued); nuanced relationship with front line service providers to be critical as well as maintain the possibility of improved relationships and improvement in services.