“community voices” annual score card on civil society monitoring of pro- poor policies &...
TRANSCRIPT
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“Community Voices”Annual Score Card on Civil Society Monitoring of Pro-
poor Policies & Programs under Ghana’s Poverty Reduction Strategy, 2004
Prepared by:Dr. Sulley Gariba
Jonathan LangdonIssifu Lampo
Institute for Policy Alternatives, Ghanawww.ipaghana.org
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Community voices is an attempt to:
Use a social accountability tool ommunity SCORE CARD -- to interrogate the implementation of pro-poor policyFrom the perspective of rural and impoverished communitiesFacilitated by organizations of civil societyWho have a potential to catalyze advocacy at Local Government level, with Parliament, at the level of central government
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Civil Society Monitoring of Poverty Reduction
Using Community Scorecard
What were the main issues?
What did we do?
&
What did we find?
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Context:
Policy environment which legitimizes participation in formulation, implementation and oversight of pro-poor policies
Legitimacy and rights of organizations of civil society to set-out unique and independent monitoring of poverty reduction policies
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Conceptual Framework
Monitoring for efficiency of public policies – were the targets of GPRS met? APRHow effective are the policies and programs – Impact Evaluations of GPRS (not yet initiated in Ghana)How accountable are these policies to the rights and responsibilities that citizens have vis-à-vis the state?
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Social Accountability defined as:
Process of balancing citizen leadership and capacity to demand their rights, while fulfilling their responsibilities; with the capacity and willingness of the state to facilitate the fulfillment of these rights and responding to citizen demand.
When applied to poverty reduction policies, social accountability has an added dimension of the fulfillment of the rights of the vulnerable and the marginalized society
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Therefore, we were challenged by GPRS to Assess:
Health Exemption Policies for the Poor
Education that is pro-poor
Resource Allocation as it applies to District Assemblies
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National Scope
Together, as a grouping of over ten civil society organizations we covered:
13 Districts in Ghana
8 Regions out of the 10 administrative regions
76 communities
Over 5,000 community leaders and members, local government officials, service providers and managers of health and education delivery
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National Coverage
Wa
Jirapa/Lambusie
Sekeyre East
Cape Coast
Bawku East
Builsa
West MamprusiZabzugu/Tatale
East Gonja
Kpandu
Dangme East
Savelugu/Nanton
Afram Plains
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What did we do?
The Three key themes of Health, Education and Resource Allocation were looked at, with a number of district covering each theme:
Health 4 Districts
Education 5 Districts
Resource Allocation 4 Districts
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Health for the Poor through Exemptions?
What did we Find?Communities, especially stakeholders of the poor and the vulnerable, want the right to quality and affordable health care, and a health service that respects them and their rights as “human beings”
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Indicators of Pro-poor Health
• 79 % of communities selected Staff Attitude and Quality Care as a major indicator assessing health services to the poor
• 75% selected Availability and Affordability of Drugs
75% 79%67% 58% 54%
0%
20%
40%
60%
80%
100%
Frequency of Indicator by % Selection
Frequency
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Health Grades, at a glance
51%
44%
47%
55%
41%
0% 20% 40% 60% 80% 100%
affordability of Drugs
Staff Attitude Access to Exemption (Pregnant
Women)Service delivery Time
Awareness
Health Exemption and Access Composite Community Scorecard Results
Grade
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Community Voices - HealthStaff Attitude and Quality of Care
They do not give the needed attention to patients – they sometimes completely refuse to attend to poor people who are sick people at times (particularly during the night and weekends), insult and shout at these patients. – Afram Plains District, Eastern Region
Drug Affordability and Availability
Bad; we buy the expensive drugs from the drug stores – Danku, Wa District, Upper West Region
Pregnant Women Many mothers prefer to deliver at home or with TBAs due to poor attitudes of nurses. This sometimes results in complications and death. The needed attention and care is also not given at clinics. . – Afram Plains District, Eastern Region
AwarenessI paid for my wife who went to deliver, only to hear from some one that I was not supposed to pay but I could not go back for my money. – Boli, Wa District, Upper West Region
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Some more Voices
Women in Bugiya, West Mamprusi, speak out about exemption policy & access to drugs
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Another Voice
A chief in West Mamprusi adds his voice to the discussion. He concludes that health service has led him to believe, “to die is honey and to live is salt.”
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In Education…
What did we find?: Communities are living up to their responsibilities as parents and as students, but GES and Government are not providing the support they need:
• There is a national crisis over the adequacy and quality of teaching in rural communities, considered to be the poorest
• The textbooks needed for rural students to have an opportunity to compete with their urban counter parts are not there
• The right to education for girls are denied
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What Indicators did communities use to assess Education?
• 100 % of communities selected Adequate, Qualified and Effective Teaching
• 96% selected Textbook access
100% 96%
54%46%
42%
0%10%20%30%40%50%60%70%80%90%
100%
Indicator by % Selection
% selected
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Education Grades, at a glance
48%
26%40%42%
35%
0% 20% 40% 60% 80% 100%
Textbooks
Adequate Teachers
School Building
Drinking water
Furniture
Quality Education Composite Community Scorecard Results
grade
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Community Voices - EducationAdequate, Qualified and Effective Teaching
You send your child to school because you want him to be somebody in future, now this is not possible because there are no teachers – woman, Suke
Textbook In the rainy season, a farmer without a hoe benefits nothing from the rains; so is a student without text book. – woman, Chetu
School Building
Building not protected so rainfall, sunshine and animals interfere and interrupt children’s attention during classes. Blackboards are pasted on walls instead and this creates inconvenience.
Samankwae
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How resources are allocated for Pro-poor development at District level
What did we Find?:Communities do not have the information about resources already committed to their development; feel their elected representatives are denied this information, and want the right to be involved in resource allocation decisions that affect their lives. They are tired of being under-valued and under-consulted when something is brought into their villages and towns.
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Community-driven indicators for assessing Resource Allocation
• 100 % of communities selected Consultation and involvement in Resource Planning
• 100% selected Information, including budgets, on resources allocated
100%100%89%89%
67%
0%10%20%30%40%50%60%70%80%90%
100%
Frequency of Indicator by % Selection
Frequency
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Resource Allocation Grades, at a glance
34%
72%
42%
26%
35%
0% 20% 40% 60% 80% 100%
Consultation/involvementInformation(including
Quality
Felt Need
Participation
Resource Allocation Composite Community Scorecard Results
Grade
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Community Voices – Resource Allocation
Consultation“We have no value, else they would have consulted us before sighting this culvert” – woman, Agbedrafor, Dangme East
Information (including budgets)
If They have nothing to hide, why we don’t know the costs of projects so as to appreciate how they value us.” – Elder, Nakomkope
QualityCan a Marginalized person of this community be given anything of value? – Elder Salom
Felt NeedWho knows what you may need, when planning is done in their big offices? – Youth, Toflokpo
ParticipationWhen they look mean on us, how can they allow us to participate? – Woman, Bonikope
TransparencyConstruction works on the road are done at night ïf you are not stealing, why do you not work during the day?
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Implications of these Findings for Pro-poor Policies and Programs:
Review of GPRS (currently on-going)
On-going implementation, monitoring and evaluation
Policy changes needed
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GPRS Review:
The initiatives in previous GPRS that were explicitly pro-poor must be retained and expanded
Ring-fencing of these specific pro-poor initiatives is needed in order that organizations of civil society representing the poor can focus on the accountability of these policies and programs to the poor
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Policy Change:
This assessment has revealed 4 main elements of rights of the poor that must be up-held:
The right to information about policy priorities and resources devoted to these on behalf of the poorThe right to participate in decision-makingThe right to be “valued” and,The right to question policies and programs (demand of accountability from officer bearers and service providers)
Any pro-poor policy and program initiative in GPRS must now include how these rights will be fulfilled by office bearers and service providers
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Continuing Community Voices:
This is the first, we are committed to doing this annually
Indicators that are determined by communities themselves need to inform the “objectively verifiable indicators” determined from the “top”
In time, we foresee a monitoring and evaluation regime that has two sides of the same coin – what the state has provided, and what communities have said about these
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Dissemination Strategies:
Dissemination within Districts
Dissemination at the national level
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District-level Dissemination:
Interface as the first stage in dissemination
Production of reports in popular version comprising:
One issue summaries with graphics
Illustrated local language versions
Radio talk shows on the issues
Media coverage of community meetings to discuss issues arising from the poverty monitoring
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National Level Dissemination
Validation and refinement of composite analyses and reportFinal Preparation of “Community FirstNational Launch of the Community First outlining the results and their implicationsAkontabuo -- Newsletter on Social AccountabilityVideo documentary on Poverty Monitoring and Social AccountabilityNational Talk-show on radio and television
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Policy Implications and dialogue:
Briefing sessions with key sector Ministries of Health, Education, Common Fund Administrator
Briefing sessions with the Multi-donor Budget Support Group
Engagement of Ministry of Finance and also NDPC to review the key findings vis-à-vis the Annual Progress Review (APR) of GPRS
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Advocacy with Parliament:
IPA is developing an agenda for advocacy with Parliament to be funded partly by the Parliamentary Center, Canada
Will be launched in April, to coincide with the next session of Parliament
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Who are we?Afram Plains Dev’t Organization (E.Region)Amasachina (Northern)Community Partnership for Health & Development (Northern)ISODEC (Ashanti)Radio Ada (Greater Accra)Civic Response (Central & Western)
Pronet-North (Upper West)SimliAid (Northern Region)Rural Media Network (Northern Ghana)Northern Ghana Network for Development (3 Northern Regions)Partnership for Sustainable Development (Bawku)Municipal Action Foundation (Volta Region)
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The 3 Cs:
Competence – in engaging citizens, in understanding the policies and programmes and in conducting the research
Credibility – seen as advocates of the poor, engaged in programmes ourselves, and also a close recognition of the officials and the communities as partners in the same process
Confidence – ability of the CSO to articulate the process and the findings of the monitoring process
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How Process is Governed:An 8-member Reference Group of Peers drawn from:
• Civil Society• Academic• Private Sector• Government• Legal profession
A volunteer group that reflects and advises; challenging ourselves to carve autonomous spaces where civil society can take initiatives and assume leadership
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Who is coordinating this?
Institute for Policy Alternatives (IPA) provided:Training services in social accountability
Supported the implementation of the social accountability initiatives – through monitoring and field support
Managed a social accountability fund provided by DfiD
Undertook community monitoring initiatives in 2 Districts, focusing on health exemption in one and mutual health insurance in another
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Appreciation:DfiD-Ghana provided funding to see these initiatives to fruitionCivic Engagement Group of the World Bank provided early methodological support and supported refinement of tools and training of trainersCommunities provided the energy and the resolveCSO partners undertook the journeyPublic officials grew in tolerance…and hopefully will grow in confidence to facilitate and hear the “Community Voices”
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An invitation to go North, to IPA:
Whether you a MP from Uganda or Tanzania
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An invitation to go North, to IPA:
Seeking engagement at the village
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An invitation to go North, to IPA:
Or simply to attend training training on monitoring, evaluation and policy analysis…at our training center in Tamale, Ghana