Community of Practitioners on Accountability and Social Action in Health
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Foundation Open Society – Macedonia (FOSM)

Context

The Foundation Open Society – Macedonia (FOSM) was founded in 1992 as a foreign entity representative office, and in 1999 as a national legal entity – foundation, in accordance with the Law on Associations of Citizens and Foundations. FOSM is part of the Soros network in Central and Eastern Europe. 
Dedicated to the promotion of an open society, FOSM initiates supports and implements a wide spectrum of programs. The Foundation addresses its objectives by providing grants, awards, loans and other types of financial support on a one-time or continuing basis to individuals and legal entities that engage in activities consistent with the FOSM mission; implementing operational programs for the promotion of innovative ideas and for the development and growth of individuals and legal entities having activities relative to the FOSM mission.
Public Health Program promotes respect and protection of health rights of socially marginalized groups, by increasing individual and institutional capacities of civil society members for participation in the decision-making process on public health policy making. In addition, this program aims to increase accountability of governmental institutions and transparency in the health care sector, especially in regard to services provided for marginalized groups. FOSM’ PHP implements all program activities in close cooperation with the Public Health Program of the Open Society Foundation – New York. 
Website:
http://fosm.org.mk
Area of Work:
Macedonia, Europe
Website:
Suzana Velkovska

Approaches to implementing Community monitoring/accountability

Public Health Program aims to support civil organisations in their efforts to seek accountability from the institutions as regards the health sector results and delivery of health services. It includes community monitoring in the health sector, by means of systematic documentation of health services’ quality and availability. The critical element of the community monitoring process is the governmental accountability – to allocate and use the resources (human, financial and material) by giving priority to community needs, to develop policies that respect human rights and to implement programs in a way that results in available and quality services.
Also, Public Health Program aims to promote transparency of public funding, increase access to key health information, strengthen participation of marginalised populations in health policy debates, and increase the effectiveness, equity, and impact of health expenditures.
The monitoring is in the process of implementation by Roma civil organizations in five municipalities. Monitoring results related to the implementation of the planned budget will be the base for advocacy efforts targeting adequate budget allocations required for immunization of Roma children. Being actively involved in activities implemented under the Roma Decade from its onset, and on the basis of its track-record on good cooperation with the Ministry of Health, FOSM will continue to play an active role in convening, advocating, and pressuring the government to promote the project’s advocacy goals. Moreover, in order to provide sustainable technical assistance for budget monitoring and analyses, the project on capacity building for the Association for Emancipation, Solidarity and Equality of Women in Republic of Macedonia – ESE will guarantee in-country capacity on technical assistance provision to civil society organizations interested in using budget monitoring and analyses, whereby the situation regarding particular health issues can be changed based on the respective advocacy.

Results and lessons

  • Strengthened capacities of profiled NGOs to be vibrant and visible actors in advocacy process focused on health care and health rights of marginalized communities 
  • Legal empowered community to fight against discrimination, segregation and stereotypes 
  • Initiated patients’ rights cases litigation 
  • Introduced community monitoring and social audit methodologies and tools in advocacy work of NGOs 
  • Improved capacities of community based NGOs to ask for transparency and accountability of health institutions aim to improve delivery of public health services and implementation of governmental programs relevant for needs of the communities.