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 COPASAH 11/19/2014 1
WHAT is COPASAH’s idea of accountability Why engage with the Marginalized Communities for Accountability? How to engage? COPASAH 11/19/2014 2
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. COPASAH 11/19/2014 3
Representative Democracy ◦ Feudal relationships Fatalism, ◦ Kinship relationships Subservience Agency, Participatory Agency, Agency, Democracy Voice, ◦ Accountability Voice, Relationships Influence Influence COPASAH 11/19/2014 4
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 COPASAH 11/19/2014 5
IS NOT NOT An isolated event A Participatory PROCESS NOT Tool centric COMMUNITY CENTRIC Tool is NOT an end Tool is a medium NOT a limited project NOT led by experts EMPOWERING End-product is NOT a GIVING VOICE AND report LEGITIMACY TO PEOPLE NOT top-down Bottom-up, Grounded NOT a mere academic exercise Action oriented COPASAH 11/19/2014 6
MMR 277 (India 178) Govt hostile to community monitoring Primary Health Centres not optimally functioning Lack of access to ANC & PNC COPASAH 11/19/2014 8
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 of 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 COPASAH 11/19/2014 9
Capacity building in communities on maternal health entitlements COPASAH 11/19/2014 10
To Tools s of Communi mmunity ty Enqui uiry ry
Process of community enquiry – discussions with the communities COPASAH 11/19/2014 12
JSSK- transport Name of Health ANC ANM Village JSY benefits & Facility VHND services services visits based services Anuppur Ashoknagar Bhind Bhopal Chhindwara Hoshangabad Sagar Satna Sehore Shahdol Sheopuri Vidisha District wise situation of village level Maternal Health services- MP
o Narratives on maternal deaths, infant and child deaths, informal payments, discrimination faced by marginalized women in accessing health services o Testimonies by women from communities o Attended by top health authorities COPASAH 11/19/2014 14
• 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 COPASAH 11/19/2014 18
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