Training on Community Score Card Nepal, September 1820, 2012 Om Prakash Arya & Amar Deep Singh CUTS-International, India

Why does poor accountability exist? Service users or citizens are mostly at receiving end, less informed, unheard, in poor relationship with service providers Despite rules and regulations for civil servants, there is still a wide area of administrative discretion Political leaders and supervisors of service providers who would like the service providers to be accountable to them The service providers themselves, whose objectives and interests often differ from those of supervisors and service recipients Distance between the people and the government servants Both service providers & recipients take demand of accountability as a misdeed

Citizens Service Providers Less informed, at distance, Unheard, at receiving end, excluded from decision making process, Have no in/direct power to hold them accountable Imbalance Without being equally aware & attentive as service providers, how the recipients can demand accountability?

Pressure from both sides Have own interests Work overload No clearly defined functions Can service providers perform effectively without support from community and supervisors? Stretched

How to enhance accountability? Creating room for citizens to engage with Enhancing awareness level through information sharing Building communication channels Building trust & relationship Raising voice of unheard Cluster demand instead of individual demand Collective solutions and joint implementation

A beautiful hybrid tool Relatively easy to use and flexible in application. Mechanism of direct feedback Strengthens citizens voice Enhances confidence of both service users and providers Engage people and thus build local capacity About Community Score Card…

Measure quality of services Kills several birds with single stone Generate and shares information on important issues Ensure inclusion of all groups Make heard the unheard voices Generate performance criteria Promote dialogue and consensus building Emphasizes on joint decision making Build trust, communication & partnership among all stakeholders Brings solution from the bottom & through mutual dialogue What does community score card do?

Critical success factors Strong skills to facilitate the process Deep knowledge of the services to the facilitator Strong information and dissemination effort to ensure maximum participation from all the stakeholders Strong social mobilization process An understanding of the local socio-political governance context; a technically competent intermediary to facilitate the process; participation/buy-in of the service provider Coordinated follow up.

6 steps of CSC Process

CSC Process Community Gathering Input tracking Performance Scorecard Self-Evaluation Interface Meeting Feedback and Dialogue Immediate Improvements Issues for Follow-up Accountability Transparency Socio-economic development Preparatory Groundwork Better Services Instit. Reforms

Steps of community score card

Preparatory Groundwork Identifying the scope of the assessment Identifying and training of facilitators Involve other partners Divide into groups by use of service Mobilize community Invite key persons from outside community Community gathering to explain stages of process

Steps for Preparing the Groundwork Step-1: Identifying the scope of the CSC Decide on the geographical scope and location for each exercise. Ideally, this should be a village. Decide what facilities and services are to be evaluated (i.e. infrastructure, Village Saving and Credit Society; etc.) Step-2: Get Basic Data on Community Population data/ Services of GP (Entitlements, Timing, quantity, quality etc.)/Poverty profile / Social profile- Poor, marginalised, living area etc. Step-3: Community gathering to explain stages of process Awareness Building and Mobilization Ensuring Participation of Poor and Vulnerable Groups

Step-4 : Identifying and training of facilitators The CSC depends on the quality of the facilitation and mobilization undertaken. Ideally, people or groups with experience in facilitating participatory methods should be engaged for the task. These facilitators need to be trained on the CSC process and how to organize the exercise. Step-5: Orientation Meeting with Service Providers Service providers need to be oriented about the process and outcomes mainly how they will be benefitted Step-6: Invite key persons from outside community Local leaders, facility staff, NGO workers, etc. will also need to be invited. A decision on how the exercise will be scheduled has to be taken. The choice will determine when to call the outside parties, and what kinds of arrangements will be required for their participation The organization of the meeting involves decisions about logistics including: Deciding the venue for the gathering based on a sense of the number of participants that will take part. Ensuring materials for the gathering – paper, pencils, megaphone/PA system (optional), blackboard (optional), etc.

“Listening to each other” An opportunity for participants to learn about each other’s experiences in Social Accountability Tools implementation including results and challenges; share their respective vision of Social Accountability Tools and challenges; share their respective vision and receive feedback from their peers

Input Tracking: Why & How Why do we use it? To gather information on the status of inputs in the service and shows whether it has what it needs (inputs) to deliver and operate as planned. To get a rough snapshot of inefficiency and possible leakages at the local level. How is it done? A discussion is facilitated in the staff or those responsible for and knowledgeable about the facility, service or project to get information (i.e., inventory of equipment, receipts, budget allocation and expenditure reports, delivery invoices, transect walk) on what should be there and what is there.

Identification of the inputs required for a particular service or project ( Participatory ) Decide and explain which inputs are to be tracked/ monitored ( It is better to track few inputs well than to track many ineffectively ) Compile Supply-side information on what the inputs were planned and actually received ( receipts, budget allocation and expenditure reports, delivery invoices ) Finalize a set of Measurable Input Indicators ( Bringing together different people in a participatory process to identify indicators reveals their different needs and expectations ) Fill in the input tracking matrix Transact walk to gather more information on input Compiling suggestions for action Gathering such information is in itself a empowering process Steps for Input Tracking/Monitoring

Sample Inputs for an activity ActivityName of the InputUnit we use to measure input Implementing Infrastructure project Material like Cement, bricks Number, weight, length, volume, etc. Labor, engineering support Number of days Community contribution Number of persons contributing, amount/kind/ labor Project fundAmount Time spendMonths

Capacity Building activities Material such as office equipments, furniture, stationery Number Training programme Number of participants, days of training Resource personsNumber of days Preparations/ coordination Number and person months Project fundsNumber of installments, amount received Sample Inputs for an activity

Input Tracking: Outline

INPUT INDICATOR ENTITLEMENT/ BUDGET/ RECORDED AMOUNT ACTUAL AMOUNT REMARKS/ COMMENTS A. Coverage or Distribution A.1 Number of Hand-pumps108- A.2 Number of public taps1513Water supply only 4 hours per day A.3 Number of wells44Poor Water quality B. Equipment B.1 Expenditure on pipes, tubes, valves, water meters INR 10 lakhsINR 8 lakhs- B.2 Expenditure on Tools & Machinery for water lifting etc. INR 15 lakhsINR 12 lakhs- Hypothetical Input Tracking Matrix

It is a participatory tool used for evaluating the performance of a service or project by the Communities themselves. The community members do this by: Identifying issues to assess Identifying assessment indicators Scoring the indicators based on their own perceptions Suggesting changes to improve performance and/or conduct Performance Score Card

Step-1: Divide Gathering into Focus Groups Step-2: Develop Performance Criteria Step-3: Decide Standard/Benchmark Performance Criteria Step-4 : Narrow Down and Finalize Criteria Step-5: Scoring by Focus Groups Step-6: Securing Explanation/Evidence to Back Rankings Step-7: Obtaining Community’s Suggestions for Reform/Improvement Steps for Performance Score Card

Project/ Sub-Project Performance Criteria/ Indicator Score (scale of 1-10) Reasons for the Score Recommenda tions Timing for executing performance score card in consent with community Take one indicator at a time Reasons ( Specific ) are more important to bring out Provide chances to speak especially poor and marginalized Recommendations ( Specific ) will consider both community and service providers for improvement Performance Score Card : Outline

The facilitator may ask the group to illustrate very high and low scores. All the scorecards need to be documented properly so that the community can maintain a record of the results and use it for the interface meeting and follow up. The results must be recorded in such a manner to ensure durability and easy access. Facilitators should guide and help participants to score, but should avoid influencing the process. The scores from different groups should not be added Prepare for interface meeting before winding up

Hypothetical Performance Scorecard S. No. Performance Criteria Reasons/Remarks Score (1-10) 1.Positive Attitude of Staff 1.1Punctuality of staff5 Start late, but some work after hours 1.2Polite behaviour4 Many staff shout at patients, rude to children 1.3 Respect for patients 3 Disrespectful 2.Management of the health facility 2.1Cleanliness7 Centre is clean, rooms mopped 2.2Observing working hours4 Open on time, but come late, long lunch 3.Quality of services provided 3.1Adequate supply of drugs3 Drugs mostly not available 3.2Adequate equipment2 No admission wards, other rooms not functional, no dental, surgery services… 3.3Adequate and qualified staff2 Health workers qualified but not enough in number and they are not dedicated 3.4 Emergency services available 24 hours 1 Serious cases don’t get services they deserve, no admission wards for serious cases

Self-Evaluation Score Card Self evaluation score card refers to the evaluation carried out by the service providers on their own performance. The indicators for this evaluation are generated in a participatory process by the service providers themselves. The self-evaluation scorecard is carried out by the service providers at the service by all the staff working at that particular facility/unit. The self-evaluation scorecard enables the service providers to generate their won indicators, and to realize that their objectives are not very different from those of the service users. It enables discussion with the community scorecards.

Self-Evaluation Scorecard Step -1: Generating the list of indicators Step -2: Carrying out the self-evaluation Step -3: Discuss the high and low scores Step -4: Prioritizing for action Step -5: Discussing the input-tracking scorecard Step -6: Preparation for the interface meeting Project/ Sub-Project IndicatorScore (scale of 1-10) Reasons for the Score Recommenda tions

Andhra Pradesh, India: Improving Health Services through Community Score Cards

An interface meeting is a public forum or meeting where the service providers and users gather in order to present their respective scorecards and discuss ways in which the service can be improved. This platform enables the service users to present their evaluation of the service performance, along with their concerns and priorities regarding the service. The service providers also get an opportunity to present their views, concerns, constraints, and priorities. Through the dialogue, the users and the providers negotiate and prepare a mutually agreed upon action plan to improve the service, for which they share responsibilities. Interface Meeting

Indicator ScoreSuggestionsResponsibilityTime Frame Common Indicator CI 1 CI 2 Community Indicator SI 1 SI 2 Service Provider Indicator PI 1 PI 2 Action Plan: Outline

Repeat Score Cards: Process The main purpose of the repeat scorecard is to review progress and provide inputs for a revised action plan by: Scoring the same indicators again to reflect any changes in performance Reviewing progress related to implementing the action plan Discussing any changes experienced in service delivery RSC is repeated after a mutually agreed upon period of time. The process should be easier and faster since everyone has prior experience. All the previous scorecards and participants, if possible, should be present for the RSC. The action plans are also reviewed. If the progress has been good, new ideas are selected for the next action plan. If the progress has not been satisfactory, the participants have to devise other ways to achieve their aims from the first action plan.

Repeat Score Cards: Outline

Challenges and Lessons Service providers and policy makers may feel threatened by the CSC initiative. It is not guaranteed that service providers/government officials will be receptive to the problems identified by ‘common’ people and their suggestions for change. Service providers at local level do not always have the capacity or leverage to make decisions or implement change. It is important to help community members develop an understanding of the constraints faced by service providers, so as to avoid creating unrealistically high expectations. There is a risk that the CSC process could result in disillusionment on the part of community members and service providers if proposed solutions

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