Community of Practitioners on Accountability and Social Action in Health
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Training and Research Support Centre- TARSC

Context

The organisation has been working for over 15 years primarily in Eastern and Southern Africa on various dimensions of research and training in human development, and with state and civil society. The conditions that demand various forms of community monitoring relate to the role of community knowledge and collective power in building public interest inputs to policy; particularly in contexts of economic and social disparities, exclusion, poor control over productive capacities and resources; disparities in power; limited public resources, liberalised and unaccountable private for profit sector activity and the need to build constructive interaction between civil society and state motivate and create pressures for this kind of work. Yet these are also challenging contexts and conditions!
The pivotal factors in whether these potentially disabling factors become facilitators depends on the communities and their civil society organisations: the leadership, democracy, capacity to support social dialogue and action, their consciousness and perspective and ability to forge trust based and constructive connections with like groups and communities. Linking internationally and regionally, though EQUINET (www.equinetafrica.org), on participatory action research and on community based and equity analysis has strengthened and created networks of solidarity for those involved.

Website
www.tarsc.org
Area of Work
Zimbabwe, East and Southern Africa
Contact Person
Rene Loewenson
Barbara Kaim

Approaches to implementing Community monitoring/accountability

TARSC carries-out its work through 3 different approaches that are interlinked:
  • Community monitoring approach: Based within member civil society organisations , through community monitors in sentinel sites in districts of Zimbabwe with approximately three sites in each district. It triangulates evidence from monitors in each district to report on indicators of socio-economic progress that have been identified within civil society forums and by community monitors and through feedback from national and technical institutions.  The system is subjected to scientific and peer review and reported nationally. It has features of other participatory approaches in synthesizing, organising and presenting the evidence of ordinary people.
  • The community based research approach: Draws the agenda and deeper questions through dialogue with civil society members. We build research capacities in membership based CSOs through training in designing, implementing and reporting on research and support for engaging stakeholders for action or policy changes based on the CSOs priority areas. CSO members are capacitated through training in research questions and data collection, data presentation and reporting, and mentored in doing the work. The programme facilitates dialogue on the research findings and on possible interventions.
  • The participatory action research: Implemented through a learning network through building skills and resources for participatory inquiry, building common protocols across communities to allow for exchange on the knowledge generated and the actions taken across sites, including on the role of participatory inquiry in building power and action within communities through the learning network, to better apply and sustain the methods and develop further the work around the evidence.

Results and Lessons

  • Raising the profile or prioritization of issues in national policy documents, e.g. primary health care in the National Health Strategy
  • Raising information to clarify options for action: e.g. responsibilities for tackling solid waste in local areas.
  • Raising perspective on issues; e.g. universal social security as an issue across the life course issue for unions to take a broader public lens in negotiations.
  • Raising direct action; such as on how  communities and health workers plan for work in the catchment areas of heath centres.
  • Raising input to policy debates, such as on community views on issues under debate in the public health law reform.
  • Raising specific problems and issues- e.g. rising costs of key items for health; availability of essential foods. Lessons:
  • Strengths of community monitoring: fosters collective inquiry; shifts control over evidence to community level; encourages use of community experience; profiles evidence from communities at higher levels; strengthens voice; rapid turnover of results; a tool for civil society that is seen to be based on evidence rather than politics; brings community rather than CSO organizational issues into negotiations; can make stronger links between CSOs and their members; can bridge local issues into national policy dialogue; can produce change
  • Weaknesses of community monitoring: May not always produce the positive effects above- depending on the context, capacities, leadership, links with engagement by CSOs, perceived quality of the evidence. With control of many areas of delivery at national level in a centralized health system, depends on engagement actions of the CSOs and coalitions at national level, ‘displacing communities; local level engagement and actions may not address structural  determinants so may build power around less fundamental determinants that are more accessible to local action, leaving key areas of state and private sector performance unchanged.