Director Research & Advocacy , Centre for Health and Social - - PowerPoint PPT Presentation

Webinar for GPSA partners facilitated by COPASAH

• E. Premdas Pinto –

Director Research & Advocacy, Centre for Health and Social Justice, Delhi, India

Gl Global Secretari riat at – COPAS PASAH AH

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 WHAT is COPASAH’s idea of accountability  Why engage with the Marginalized

Communities for Accountability?

 How to engage?

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 Global Community of

Accountability practitioners

 Vi

Visio ion - Communities are actively engaged in promoting accountability and transforming health systems towards the realization of social justice.

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 Representative

Democracy

• Feudal relationships
• Kinship relationships

 Participatory

Democracy

• Accountability

Relationships

Fatalism, Subservience Agency, Voice, Influence Agency, Agency, Voice, Influence

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 Health – part of well-being and dignity  Health is a fundamental human right  Recognizes People’s Struggle for health in the

context of privatization and corportization of health care

 Accountability in health is a citizen led and

community centric process

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IS NOT

 A Participatory PROCESS  COMMUNITY CENTRIC  Tool is a medium  EMPOWERING  GIVING VOICE AND

LEGITIMACY TO PEOPLE

 Bottom-up, Grounded  Action oriented  NOT An isolated event  NOT Tool centric  Tool is NOT an end  NOT a limited project  NOT led by experts  End-product is NOT a

report

 NOT top-down  NOT a mere academic

exercise

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 MMR 277 (India 178)  Govt hostile to

community monitoring

 Primary Health

Centres not optimally functioning

 Lack of access to

ANC & PNC

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CBM Proce cess ss as Stra rateg egy y fo for Empo powe wermen rment

• Evidence based community based monitoring as

strategy

• CBM approach, focused on evidence based feedback,

informed and empowered participation

• f

the community and negotiation at different levels of health care system

• The process was used for building capacities of

community leaders

• 25 CSOs, CBOs and local governance members were

drawn into the process

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 Capacity

building in communities

• n maternal

health entitlements

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To Tools s of Communi mmunity ty Enqui uiry ry

 Process of

community enquiry – discussions with the communities

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District wise situation of village level Maternal Health services- MP Name of Health services JSY benefits JSSK- transport & Facility based services ANC services ANM Village visits VHND Anuppur Ashoknagar Bhind Bhopal Chhindwara Hoshangabad Sagar Satna Sehore Shahdol Sheopuri Vidisha

• Narratives on

maternal deaths, infant and child deaths, informal payments, discrimination faced by marginalized women in accessing health services

• Testimonies by

women from communities

• Attended by top

health authorities

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• Systematic CBM process raised the entitlement awareness
• Citizens were empowered to speak to authorities
• Civil Society Alliance (Maternal Health Rights Campaign) became

stronger in the state

• Oral testimonies supported by a strong documentation of cases of

denial of care

• Government ordered an enquiry – the problems were fixed at the

local level

• State level as well as local level officials appreciated the evidence

based feedback

• Media got data to play the ‘watchdog’ role
• Paved the way for further interaction of the civil society with health

providers at multiple levels

PROCESS

• Community monitoring is a potential medium to

empower citizens for accountability

• It is a process – needs constant follow up
• Various communities need to be connected to be able

to talk to higher level authorities

• Communities need critical support from trained

personnel

• CBM process, if backed by larger level coalition to

facilitate engaging with the officials, ensures quick and effective response and remedial action at the lower levels

 COPASAH - www.copasah.net  Centre for Health and Social Justice

www.chsj.org

 Community Monitoring Resource Pack

www.copasah.org

THA HANK NK YOU

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