crc, public affairs foundation, public health watch (phw) community monitoring workshop, march...
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CRC, Public Affairs Foundation, Public Health Watch (PHW) Community Monitoring Workshop, March 23-25, 2010
HOLDING A MIRROR TO THE HOLDING A MIRROR TO THE GOVERNMENT!GOVERNMENT!
EXPERIENCES WITH CITIZEN REPORT CARDS
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CRC, Public Affairs Foundation, Public Health Watch (PHW) Community Monitoring Workshop, March 23-25, 2010
OVERVIEW OF PRESENTATIONOVERVIEW OF PRESENTATION
The Context – Why Citizen Report Cards?
The Concept – What is a Citizen Report Card?
The Method – How Citizen Report Cards are designed?
The Impact – Major outcomes of Citizen Report Cards
The Learning – Critical lessons & experiences
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CRC, Public Affairs Foundation, Public Health Watch (PHW) Community Monitoring Workshop, March 23-25, 2010
WHY CITIZEN REPORT CARDS?WHY CITIZEN REPORT CARDS?
Budget Formulation – How public resources are allocated
Budget Review & Analysis – Diagnosing the implications of the budget when formed
Expenditure Tracking – Seeing where the money goes
Performance Monitoring – Even after the money is spent, see how the output/service is performing
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CRC, Public Affairs Foundation, Public Health Watch (PHW) Community Monitoring Workshop, March 23-25, 2010
A School Report CardA School Report Card
Name: Gopa; Class: IXSUBJ ECT MAX.
Marks HighestMarks
Actual marks
English 100 82 82
Math 100 85 53
Science 150 123 76
Social Studies 150 125 125
Total 500 415 336
Rank in class: 16/30
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CRC, Public Affairs Foundation, Public Health Watch (PHW) Community Monitoring Workshop, March 23-25, 2010
LEARNINGS FROM A SCHOOL LEARNINGS FROM A SCHOOL REPORT CARD…REPORT CARD…
Power of MEASUREMENTPower of COMPARISON
An Opportunity for REFLECTIONA trigger for CHANGE & IMPROVEMENTS
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CRC, Public Affairs Foundation, Public Health Watch (PHW) Community Monitoring Workshop, March 23-25, 2010
Citizen Report Cards: Defining Citizen Report Cards: Defining FeaturesFeatures
Pioneered by Public Affairs Centre as an independent assessment in 1993
Credible user feedback on public services
Uses the power of measurement & comparison
Communicates findings in a very easy and focused manner
Report always in PUBLIC DOMAINPUBLIC DOMAIN
Not a one-off effort – continued benchmarking
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CRC, Public Affairs Foundation, Public Health Watch (PHW) Community Monitoring Workshop, March 23-25, 2010
CONTENT OF CITIZEN REPORT CONTENT OF CITIZEN REPORT CARDSCARDS
FEEDBACK FROM ACTUAL USERS OF SERVICES REGARDING
AVAILABILITY, ACCESS & USAGE OF SERVICES QUALITY & RELIABILITY INCIDENCE OF PROBLEMS & RESPONSIVENESS OF
SERVICE PROVIDERS COSTS - CORRUPTION & FORCED INVESTMENTS SATISFACTION WITH SERVICE REASONS FOR DISSATISFACTION SUGGESTIONS FOR IMPROVEMENTS
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CRC, Public Affairs Foundation, Public Health Watch (PHW) Community Monitoring Workshop, March 23-25, 2010
STAGES IN CITIZEN REPORT STAGES IN CITIZEN REPORT CARDCARD
DEFINING SCOPE OF ACTION
PREPARATIONS AND COLLECTING CITIZEN FEEDBACK
RATING OF SERVICES
DIALOGUE AND RESPONSE OF AGENCIES
CITIZEN ENGAGEMENT IN REFORM
PERIODIC BENCHMARKING AND PUBLIC REVIEW
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CRC, Public Affairs Foundation, Public Health Watch (PHW) Community Monitoring Workshop, March 23-25, 2010
THE “3” BIG QUESTIONS…THE “3” BIG QUESTIONS…
WHAT DO WE WANT TO KNOW?WHAT DO WE WANT TO KNOW? ASSESSMENT OF SERVICES WHAT COMMUNITY HAS TO SAY SINGLE SERVICE OR COMPARISON OF SERVICES
HOW CAN WE OBTAIN THE REQUIRED INFORMATION?HOW CAN WE OBTAIN THE REQUIRED INFORMATION? WHICH POPULATION CAN GIVE REQUIRED INFO WHAT QUESTIONS WE NEED TO ASK WHAT WILL BE THE SAMPLING METHOD WHAT LEVEL OF SKILL SHOULD FIELDWORKERS HAVE
HOW WILL WE USE THE INFORMATION?HOW WILL WE USE THE INFORMATION? WHAT CONCLUSIONS WILL BE DRAWN WHO WILL SEE THE REPORT WHAT ACTIONS WILL FOLLOW
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CRC, Public Affairs Foundation, Public Health Watch (PHW) Community Monitoring Workshop, March 23-25, 2010
METHODOLOGY FOR CARRYING OUT METHODOLOGY FOR CARRYING OUT CITIZEN REPORT CARDSCITIZEN REPORT CARDS
IDENTIFYING ISSUES THROUGH FGDs IDENTIFYING ISSUES THROUGH FGDs (PROVIDERS & USERS)(PROVIDERS & USERS)
DESIGNING THE SURVEY INSTRUMENTDESIGNING THE SURVEY INSTRUMENT FRAMING A SCIENTIFIC SAMPLEFRAMING A SCIENTIFIC SAMPLE CONDUCT OF SURVEYCONDUCT OF SURVEY CODING, ANALYSIS & INTREPRETATIONCODING, ANALYSIS & INTREPRETATION PRESENTATION OF FINDINGSPRESENTATION OF FINDINGS ADVOCACY & PARTNERSHIPS FOR SERVICE ADVOCACY & PARTNERSHIPS FOR SERVICE
IMPROVEMENTSIMPROVEMENTS
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CRC, Public Affairs Foundation, Public Health Watch (PHW) Community Monitoring Workshop, March 23-25, 2010
CITIZEN REPORT CARDS ARECITIZEN REPORT CARDS ARE……
BLENDING THE “SCIENCE” OF SURVEYS
WITH
THE “ART” OF ADVOCACY/REFORMS
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CRC, Public Affairs Foundation, Public Health Watch (PHW) Community Monitoring Workshop, March 23-25, 2010
CITIZEN REPORT CARDS IN BANGALORECITIZEN REPORT CARDS IN BANGALORE
THE POWER OF MEASUREMENT THE POWER OF MEASUREMENT
& COMPARISON & COMPARISON
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CRC, Public Affairs Foundation, Public Health Watch (PHW) Community Monitoring Workshop, March 23-25, 2010
First Report Card (1993): small experiment with focus on survey & minimal advocacy made quality of service a key governance issue
Second Report Card (1999): planned effort of PAC, survey followed by advocacy which enabledwide range of agency and govt. responsesgrowth in scope/scale of civil society action
Third Report Card (2003): PAC effortmajor improvement in service qualitymajor advocacy in progress
CITIZEN REPORT CARDS IN BANGALORECITIZEN REPORT CARDS IN BANGALORE
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CRC, Public Affairs Foundation, Public Health Watch (PHW) Community Monitoring Workshop, March 23-25, 2010
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34
49
0
20
40
60
1994 1999 2003
Year
OVERALL SATISFACTIONOVERALL SATISFACTIONAll round overall improvement
% S
ati
sfi
ed
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CRC, Public Affairs Foundation, Public Health Watch (PHW) Community Monitoring Workshop, March 23-25, 2010
34 36
49
62
0
20
40
60
80
1999 2003
General Households Slum
OVERALL SATISFACTION – Poor Vs RestOVERALL SATISFACTION – Poor Vs Rest%
Sati
sfi
ed
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CRC, Public Affairs Foundation, Public Health Watch (PHW) Community Monitoring Workshop, March 23-25, 2010
6
45
71
4
4654
9
30
73
25
43
37
1
16 15 1418
65
0
20
40
60
80
POWER WATER TELECOM Govt Hospital URBAN ATH TRANSPORT
1994 1999 2003
AGENCY WISE SATISFACTIONAGENCY WISE SATISFACTION %
Sati
sfi
ed
agency16
CRC, Public Affairs Foundation, Public Health Watch (PHW) Community Monitoring Workshop, March 23-25, 2010
31
65
33
57
41
55 52
74
29 29
0
20
40
60
80
POWER WATER Govt Hospital TRANSPORT MUNICIPAL
SERVICES
1999 2003
AGENCY WISE SATISFACTION - SLUMAGENCY WISE SATISFACTION - SLUM%
Sati
sfi
ed
agency
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CRC, Public Affairs Foundation, Public Health Watch (PHW) Community Monitoring Workshop, March 23-25, 2010
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24
1211
0
20
40
1999 2003
Slum General Households
PROBLEM INCIDENCEPROBLEM INCIDENCE%
Sati
sfi
ed
Significant reduction in problems while using services
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CRC, Public Affairs Foundation, Public Health Watch (PHW) Community Monitoring Workshop, March 23-25, 2010
STAFF BEHAVIOURSTAFF BEHAVIOUR
Major improvement in satisfaction with staff behaviour
Trends in Satisfaction with Behaviour of staff
40 4448 56
0204060
1999 2003
Year
Per
cen
tag
e o
f re
spo
den
ts
sati
sfie
d
General Household
Slum
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CRC, Public Affairs Foundation, Public Health Watch (PHW) Community Monitoring Workshop, March 23-25, 2010
CORRUPTIONCORRUPTION
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Коррупция по трем оценочным листам
19
9
2214
3225
0
10
20
30
40
1994 1999 2003
Год
% п
лат
ивш
их
Домохозяйства в целом Трущобы
CRC, Public Affairs Foundation, Public Health Watch (PHW) Community Monitoring Workshop, March 23-25, 2010
APPLICATIONS OF CRCsAPPLICATIONS OF CRCs
As a “Diagnostic Tool”
As an “Accountability Tool”
As a “Benchmarking Tool”
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CRC, Public Affairs Foundation, Public Health Watch (PHW) Community Monitoring Workshop, March 23-25, 2010
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BackgroundBackground
The pilot CRC project in Tajikistan was designed and implemented by United Nations Development Programme (UNDP) through a local partner –Zerkalo.
Public Affairs Foundation (PAF), Bangalore, provided technical assistance for the pilot project, which was funded by the UNDP.
Following a workshop with participation of UNDP Democratic Governance Programme, government agencies, and selected research company (El-Pikir Center for Public Opinion Study), a task force was set up to carry out the study in Kyrgyzstan.
Tajikistan- Opinions of Health Tajikistan- Opinions of Health Services by AspectServices by Aspect
CRC, Public Affairs Foundation, Public Health Watch (PHW) Community Monitoring Workshop, March 23-25, 2010
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0.0
10.0
20.0
30.0
40.0
50.0
60.0
70.0
Очень хорошо
Скорее хорошо
Скорее плохо
Очень плохо
Tajikistan- Overall Opinions on Tajikistan- Overall Opinions on Health ServicesHealth Services
CRC, Public Affairs Foundation, Public Health Watch (PHW) Community Monitoring Workshop, March 23-25, 2010
Percent
Very good48.8
Somewhat good28.8
Somewhat poor2.0
Very poor20.5
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Kyrgyzstan- The Overall Scorecard Kyrgyzstan- The Overall Scorecard on the Services of on the Services of
the Oblast Hospitalsthe Oblast Hospitals
CRC, Public Affairs Foundation, Public Health Watch (PHW) Community Monitoring Workshop, March 23-25, 2010
4.1 4.193.98 4.13 3.98
4.16 4.2
3.593.78
4.1 4.03
0
1
2
3
4
5
Staff
Attitu
de
Cleanlin
ess of
war
d
Cleanlin
ess of
conv
enien
ces
Availa
bility o
f equipm
ents
Availa
bility o
f Med
icines
Care f
or pat
ients
Skill of
per
sonn
el
Distan
ce to
facil
ityCos
ts
Effecti
vess
of T
raet
ment
Overa
ll sco
re
Score out of 5
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Bangalore- Public Hospitals Bangalore- Public Hospitals 1999 (general households)1999 (general households)
CRC, Public Affairs Foundation, Public Health Watch (PHW) Community Monitoring Workshop, March 23-25, 2010
Client satisfaction with agency interactions
Percent satisfied (1994) 25Percent satisfied (1999) 43
Percent dissatisfied (1994) 19Percent dissatisfied (1999) 6
The bribery matrixProportion in sample claiming to have paid a bribe (%)
(1994)17
Proportion in sample claiming to have paid a bribe (%) (1999)
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Average payment per transaction in Rupees (1994) 396
Average payment per transaction in Rupees (1999) 289
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CRC, Public Affairs Foundation, Public Health Watch (PHW) Community Monitoring Workshop, March 23-25, 2010
Bangalore- Public Hospitals Bangalore- Public Hospitals 19991999 (general households) (general households)
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Улучшение услуг за последние три года
61
62
64
59
60
61
62
63
64
65
Аспект услуг
% о
твет
ивш
их,
что
ест
ь ул
учш
ени
е
Общее качество услуг Поведение персонала
Легкость взаимодействия
Bangalore- Public Hospitals Bangalore- Public Hospitals 2003 (general households)2003 (general households)
CRC, Public Affairs Foundation, Public Health Watch (PHW) Community Monitoring Workshop, March 23-25, 2010
Indicator Service providerType of hospital visited in last I year State
governmentCorporation Private
% respondents (multiple responses possible)
89 10 12
Government hospitals (% respondents)Quality of staff service % satisfied Time to attend 83Overall behaviour of doctors 86Overall behaviour of nurses 100Overall behaviour of other staff 83Helpfulness of staff 75Service quality for in-patients % satisfiedCleanliness of room 31Quality of food 12Cleanliness of linen 12Overall satisfaction with service % satisfied Completely satisfied 37Partially satisfied 36Dissatisfied 2Bribe demanded 100%*Bribe paid 2%
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Bangalore- Public Hospitals Bangalore- Public Hospitals 1999 (slum households)1999 (slum households)
CRC, Public Affairs Foundation, Public Health Watch (PHW) Community Monitoring Workshop, March 23-25, 2010
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Service provider (Public Hospitals) IndicatorSpeed Money Phenomenon
Percentage of those who paid 53Average amount paid (in Rupees) 640
Percentage of persons from whom bribe was demanded * 63Willingness to pay more for improved service
Percentage willing to pay more for better services 53Percentage willing to pay over and above the current payment 32
Improvement in services over last three years –peoples’ perception
Overall Quality of Services (%) 79Behaviour of Staff (%) 74Ease of interaction (%) 67
Client satisfaction with agency interactionsPercent satisfied 1994 80Percent satisfied 1999 73Primary health centre available
Percentage of respondents saying it is available 56Percentage of respondents saying they use it 84
Bangalore- Public Hospitals Bangalore- Public Hospitals 2003 (slum households)2003 (slum households)
CRC, Public Affairs Foundation, Public Health Watch (PHW) Community Monitoring Workshop, March 23-25, 2010
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Indicator Service providerType of hospital visited in last I year State
governmentCorporation Private
% respondents (multiple responses possible)
86 16 14
Government hospitals (% respondents)Quality of staff service % satisfiedTime to attend 69Overall behaviour of doctors 72Overall behaviour of nurses 73Overall behaviour of other staff 70Helpfulness of staff 67Service quality for in-patients % satisfiedCleanliness of room 80Quality of food 73Cleanliness of linen 70Overall satisfaction with service % satisfiedCompletely satisfied 55Partially satisfied 33Dissatisfied 12Bribe demanded 85%*Bribe Paid 9%
CRC, Public Affairs Foundation, Public Health Watch (PHW) Community Monitoring Workshop, March 23-25, 2010
Bangalore Government Bangalore Government Hospitals-Quality/ReliabiliHospitals-Quality/Reliabili
tytySome Findings 99% slum respondents report doctor’s chamber as
clean. 34% report presence of doctors at the time of visit. 37% said all the required medicines were available. 11% report issue of expired medicines. 69% completely satisfied with the time taken. by the
government hospital staff to attend to them.Follow up Board of visitors constituted. Help desk for patients. Constant internal reform from the health department and
health authorities. 31
CRC, Public Affairs Foundation, Public Health Watch (PHW) Community Monitoring Workshop, March 23-25, 2010
POWER OF DIAGNOSISPOWER OF DIAGNOSIS
SECTOR Governance was better this year
Governance was worse this year
Cannot Comment
Farmers/ Cultivators
19 6644 17
Labourers 14 47 39
Entrepreneurs/ Industrialists
7744 19 07
Rural 20 60 20
Overall 24 52 24
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CRC, Public Affairs Foundation, Public Health Watch (PHW) Community Monitoring Workshop, March 23-25, 2010
Corruption & The Urban PoorCorruption & The Urban Poor(SURVEY IN BANGALORE, 1999)(SURVEY IN BANGALORE, 1999)
SERVICE / AGENCY
PERCENT PAYING BRIBES
AVERAGE AMOUNT (RUPEES)
PERCENT CLAIMING BRIBE WAS DEMANDED
WATER SUPPLY
04 200 50
MUNICIPAL SERVICES
34 270 73
ELECTRICITY 10 250 100
RATION SHOPS
11 84 83
POLICE 46 4193 88
PUBLIC HOSPITALS
53 640 63
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CRC, Public Affairs Foundation, Public Health Watch (PHW) Community Monitoring Workshop, March 23-25, 2010
POST SURVEY ACTIONSPOST SURVEY ACTIONS
Pre-launch presentations to the providers & elected representatives
Inter agency workshop to stimulate learning and sharing good practices
Public release of findings & public forum – “open house” with agency heads
Sustained media advocacySupporting local champions
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CRC, Public Affairs Foundation, Public Health Watch (PHW) Community Monitoring Workshop, March 23-25, 2010
INSTITUTIONAL FORMSINSTITUTIONAL FORMS
Individual Civil Society Organizations – PAC & TIB
Civil Society Partnerships – People’s Voice Project, PANE
Independent Multi-Stakeholder Consortiums – Kenya, Tanzania
Governments – Internal (Vietnam) & Open (Delhi)
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CRC, Public Affairs Foundation, Public Health Watch (PHW) Community Monitoring Workshop, March 23-25, 2010
Counting and discussing instead of just shoutingPresenting strengths and weaknesses – “pat” &
“slap”Enables policy makers set policy prioritiesHelps agency managers assess service efficiencyProvides a bridge for civil society to dialogue on
citizens’ priorities Transmits the voice of the poor without
intermediation by representatives
MAJOR POINTS OF INFLUENCEMAJOR POINTS OF INFLUENCE
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CRC, Public Affairs Foundation, Public Health Watch (PHW) Community Monitoring Workshop, March 23-25, 2010
VARIETY IN IMPACT OF CRC’SVARIETY IN IMPACT OF CRC’S AGENCIES DISCUSS PERFORMANCE WITH CITIZENS IN OPEN
FORA IN BANGALORE SYSTEMATIC CITIZEN WATCH DOG ROLE IN LOCAL GOVT. IN
TERNOPIL, UKRAINE FORCING POLITICAL ACCOUNTABILITY IN MUMBAI SLUMS INDEPENDENT APPROACH TO MONITOR PRO-POOR SERVICES
IN ZANZIBAR, ETHIOPIA & TAJIKISTAN LOWER LEVEL OFFICIALS CITE FINDINGS TO SEEK FUNDS &
SUPPORT IN MUMBAI, INDIA POLITICAL LEADERSHIP ASKS FOR MORE DIRECT FEEDBACK
IN DELHI, INDIA REGULATORY BODIES SEEK INDEPENDENT VOICES IN KENYA BENCHMARK LOCAL SELF GOVERNMENTS IN INDIA
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PLANNING FOR A CRCPLANNING FOR A CRCACTIVITY REQUIRED COMPETENCY TIME FRAME
Identifying Scope Knowledge of service provisionAccess to technical resources
2 Months
Conducting the survey Field work managementTrained pool of enumeratorsSupervising quality of survey
2 weeks - 2 months
Post survey analysis Data Entry & AnalysisAnalytical Report writing
2-3 months
Dissemination of findings & Advocacy
Stakeholder analysisCommunicating to different groups
1-2 months
Improving Services Ability to work with different stakeholdersImagination & creativity
2-6 months
CRC, Public Affairs Foundation, Public Health Watch (PHW) Community Monitoring Workshop, March 23-25, 2010
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