Community Monitoring, International Aid and Sustainable Development: Reflections from India
Recently, a colleague of mine had a request from an international Non Government Organisation (NGO) for joining them on a community monitoring related project for which they were putting together an LOI (Letter of Intent). As the twin ideas of transparency and accountability gain credibility as important considerations of good governance for improving efficient utilisation of development funds, more and more large scale development projects require an accountability component. At least, this is what appears to be happening in India. World Bank, Department for International Development (DFID) and the Bill and Melinda Gates Foundation funded projects, to name just a few among the big players, have now started building community monitoring components into their health related grants/funds. In order to encourage transparency and accountability, most of these grants are also being awarded through tenders and bids. Many, if not all the larger development agencies today have resource mobilisation units, which have expertise in identifying appropriate opportunities and responding to them. Since many of these larger organisations have their primary expertise in service delivery, research or training (or some earlier development related competencies) they probably do not have adequate experience in community monitoring. They look for partnerships with indigenous and community rooted organisations to complement their skills, and probably this explained the phone call received by my colleague.
International aid agencies are right to be anxious about the effectiveness of their investments; and tenders and bids have been long been seen as valid methods to promote transparency in awarding contracts for bridges, roads and buildings (where the competencies are widely available). However, I have often wondered about the effectiveness and utility of using this method for identifying the appropriate development agencies (public service contractors) for implementing community monitoring projects.
Community monitoring at its core is an empowering and hence political process. It builds the confidence, capacities and skills of the most marginalised people to ask relevant questions from the public service providers, in our case health providers and managers. It seeks to empower the community with awareness about their entitlements and information about service quality parameters, and skills in documentation to make the process rigorous and evidence based. However, it is not a research process, but a change process. It is expected to induce a process of change, which challenges the existing power structure between the provider and the patient. The service seeker is no longer beholden for services sought, but an assertive citizen. This also challenges some of the collusion that may exist between service providers and the existing community leadership. Organisations which facilitate community monitoring and bottom-up accountability are usually aware of the inherent political tension of this work. Their work on participation and empowerment is usually based on an analysis of the power relations which correlates poverty and deprivation with exclusions and oppressions that are systemic and local at the same time. These groups also have long term relations with the marginalised communities, working with them as they slowly gain confidence and assertiveness.
Large scale time bound development projects are usually based on the assumption that short term interventions can strengthen the supply side or stimulate demand, and expect that this change will be sustained by the now strengthened public system (or public private partnerships) to provide the more lasting solutions. Community monitoring cannot be understood in this demand-supply mode (though some authorities do try) because it is essentially a negotiation between the community and the system. The data generation and collation process (valorised as „tool‟) is just an input into the more nuanced negotiation/ arbitration process which calls for changes - non-repetition, improvements and grievance redressals. These changes while appearing bland on paper are potentially political processes, which will call for either changes in relationships between client and provider – addressing impunity and corruption, clientelism, elite capture of resources and so on. If successful, these changes will redraw the balance of power at the local level, and thus will also be challenged by those who stand to lose their influence. People in positions of power and influence locally are usually linked upwards to the people in power and influence at higher levels and serve as local fiefs to political masters. Successful community monitoring thus has the potential to upset higher political masters as well. The local facilitating organisation, with a clear interest in the empowerment of the marginalised, may actually see this reorganisation of power lines as a measure of their success. The same may not be true of a large public service contractor organisation, which has taken up community monitoring as another development contract. International organisations engaged in this work may also be vulnerable because of their foreign origins. In India, the laws related to foreign aid for development organisations have also been changed to stop foreign funds being used for what could be perceived as activities of a „political nature‟. This may mean that some organisations would work with communities to apply the tools but not „push‟ the process of negotiation.
India has a long history of indigenous organisations working on development and rights. It has a long history of voluntary action for addressing social deprivation that has evolved over the years from charitable work to development action to work on inclusion and social justice. Social audit and right to information have emerged as powerful tools of accountability based on pioneering work done by Indian voluntary/civil society organisations. Now that these are part of the mainstream development aid and projects, the requirements and processes of tendering and bidding exclude many of the most capable organisations from meaningful participation. On the other hand, organisations with little rootedness, or ability or propensity to take „political risks‟, may just become the most appropriate choices for implementing community monitoring within large scale projects. I wonder about the future nature and scope of this methodology as it becomes mainstream.
Large scale time bound development projects are usually based on the assumption that short term interventions can strengthen the supply side or stimulate demand, and expect that this change will be sustained by the now strengthened public system (or public private partnerships) to provide the more lasting solutions. Community monitoring cannot be understood in this demand-supply mode (though some authorities do try) because it is essentially a negotiation between the community and the system.
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Abhijit Das is a Steering Committee member of COPASAH and also, Director of Centre for Health and Social Justice (CHSJ), a policy research and advocacy institution around health and human rights and men and gender equality in India. His areas of interest include maternal health rights, equity, human rights, accountability and governance in health programming, quality of care of health care service delivery and health and population policy. To know more about the work done by CHSJ, please CLICK HERE