Impact of Social Accountability Mechanisms on Service Delivery and

Human Development Outcomesin Satara District of Maharashtra

Presented By

Yashwantrao Chavan Academy of Development Administration

December 16, 2009, Jaipur

Section I

Context&

Accountability Interventions

Local Governance & Service Delivery Setup

• Panchayats are primarily accountable for delivery of crucial services under the flagships such as National Rural Health Mission, Integrated Child Development Scheme, Total Sanitation Campaign, etc.

• Three-tier Panchayati Raj and its health care delivery system in Maharashtra:

Zilla Parishad (District)

Panchayat Samiti (Block)

Gram Panchayat (Village) Village Health Committee

Primary Health Centre

Block Health Office

District Health Office

Health Sub-CentreCluster of Villages

• Poor targeting of beneficiaries and under-utilization of funds due to a lack of:

Demand for services by the communities

Dialogue between communities, service providers and government functionaries

Structured mechanisms for assessment of service quality and efficacy at various levels

• Result: Poor indicators of basic human development such as child and maternal mortality, nutrition, sanitation, school education, etc., in spite of relatively better economic status of Satara district

Problem

• Drawing from the rich experience of Village Microplanning in Maharashtra: Partnership of Unicef, YASHADA, NGOs and Youth Networks

• Integrating the tool of Community Score Card with Microplanning

• Strong support and ownership by Zilla Parishad

• Generous support of the World Bank

Genesis of Accountability Initiatives

Accountability Initiatives• Village Microplanning: Creating a strong demand for

services through participatory community mobilization• A five-day process consisting of PRA exercises• Participatory stock-taking, problem-analysis, solution-

seeking and intervention-planning• A village action plan owned by the community• SHGs, youth groups and village committees

• Community Score Cards: Creating a dialogue between communities, service providers and government functionaries for more accountable service delivery• Input tracking• Independent rounds of service assessment by

communities and service providers• Common discussion on scores in a gramsabha

Accountability Process

Sr. Sector Groups CBOs

1 Health All families, especially pregnant women, sick persons, BPL families

Village Health Committee

2 Nutrition 0-6 years children, pregnant & lactating mothers and adolescent girls

Village Health Committee

3 School Education

6-14 years children Village Education Committee

4 Water & sanitation

All families, especially the marginalized sections of the community

Village Water Supply and Sanitation Committee

Focus Sectors

Achievement of total sanitation in every village;

Improving nutritional levels in children, total eradication of acute

malnutrition;

Bringing every child in 6-14 age group to school;

Eradicating the water borne diseases by creating awareness about safe drinking water and the monitoring of water quality

Halving the Infant Mortality Rate in three years.;

Reducing maternal deaths;

Ensuring 95% institutional deliveries and 100% deliveries by

trained personnel.

Ensure that all marriages take place only after the legal age of

marriage.

Outcomes Envisaged

Village Microplanning

• Village level Micro Planning is a five day activity carried out by NGO facilitators from local area

• It includes a package of PRA activities, community games, IEC activities targeted towards creating awareness, analysing the situation on various HD parameters, identifying the resources of the village, enlisting the problems, prioritising and setting up an action plan for solving these problems.

Village MicroplanningMicro planning is a strategy for communication. Communication can be mass communication, group communication and one to one communication.

Micro planning is a package of PRA tools, IEC tools, surveys, community games.

Micro planning attempts at mobilizing the communities to take ownership of the community assets, programs, services, etc and become responsible for the protection and maintenance of the assets, delivery of the services and implementation of the programs.

Micro planning culminates in the final village plan with community priorities and an action plan to implement this plan.

Themes In Microplanning

Haemoglobin assessment especially of women Weighing of children in presence of mothers Creating awareness regarding sanitation, water quality, solid and liquid waste management, use of iodised salt,

nutrition, education, renewable energy sources, health issues, etc. Construction of soak pits, toilets, water conservation structures, vermiculture pits, etc. Group reflections of adolescent girls, self-help groups, women and other such groups Gender analysis to reveal gender bias Creating an action plan for achieving HD goals

Tools for Microplanning Transect walk to understand the situation in the village regarding water, sanitation, resources Social mapping to throw light on social distribution of resources, amenities and problems Time line to analyse the issues of population, availability

of water, development of social infrastructure Seasonality chart related to diseases, work, school

attendance, etc. Household survey to prepare a baseline on various HD parameters Venn Diagrams to understand the relative utility of

various service providers Marble game to understand accessibility to government schemes and discrimination . Human knot to discover the key to solutions of all

problems.

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Usefulness of Microplanning

• Rights based self-help approach of microplanning leads to community empowerment and self reliance

• Strengthen Panchayati Raj System and active participation of women in decision making

• Active collaboration between communities and government agencies

• Social inclusion of underprivileged and youth • Unique, flexible and highly effective IEC device with wider

replicability• Social Audit of service delivery system• Strengthening administrative functioning through Block

Response Plan and District Plan • Create conducive environment for decentralized

community managed programming - NRHM, Jalswarajya, NREGS, SSA and ICDS

Community Score Card

Four-Step Process

Input Tracking

Performance Assessment

Self-Evaluation

Community Scorecard Process

Interface Meeting

Partnerships and Alliances

YASHADA&

UNICEF

ZillaParishadSatara

NGOs

VillageCommunities

TheWorldBank

Tie-Ups

World Bank - YASHADA

YASHADA - ZP Satara

ZP Satara - NGOS

NGOs - Youth Facilitators

•The CSC process finally culminates in an action plan prepared by the community and the facility staff to correct the gaps in the delivery system.

•The actions may be required to be taken by the community or by the local authorities, or by the district administration or by the government. Whichever the agency for carrying out the requisite action the community has to set up a team to follow up the progress of the action.

•Repeat the process of CSC periodically to monitor the progress in the delivery systems.

The Follow Up

Section II

Impacts

Changed Outlook through MP and CSC

• The role of each individual vis a vis government is clearly understood. The message of Microplanning:

" the outside agencies cannot solve our problems which we have ourselves created, they can be solved together by the individuals and the community. Government is the facilitator not the solution provider“.

• The message of the CSC is Government is a service provider and accountable

for what it provides. The community has a right to demand and assess what it is entitled to get. Mutual interaction improves service delivery.

Impact Cycle

Impact Milestones

Information Seeking

Accountability Seeking

Development Seeking

Institutional Change

Process Change

Policy Change

Accountable Governance & Development

Behavior Change System Change

Mother & Child Health• Proactive seeking of ANC• Regular intake of iron tablets• Strong preference to

institutional delivery• Enhanced breast feeding• Monitoring of immunization• Better Anganwadi enrollment• Monitoring of child weighing• Better child feeding practices

Sanitation• Regular cleaning of

water sources• Regular use of chlorine• Regular upkeep of

drainage• Ban on open defecation• Regular use of toilets• Use of soap for hand-

wash• Village cleanliness

drives

Sense of Empowerment• Continuous community dialogue and action• Ability to mould community practices• Information & accountability seeking• Community contribution to programme funds

Behavior Change

Service Strengthening• Swift action on staff shortages• Stocktaking of medicines,

vaccines, nutrition supplements• Regular health checkups, home

visits, immunization rounds• Door-to-door search for needy• Toilet construction drive• Special counseling centres• Capacity building of service

providers

Accountability• Dialogue of service

seekers & providers• NGOs/ volunteers as

neutral monitors• Formal recognition to

community data• Regular review of

corrective actions• Tracking of outcomes

rather than inputs

More Responsive System• District & block taskforces for monitoring• Block response plans based on felt needs• Service strengthening using CSC feedback• Ownership of accountability through

investing ZP’s own funds in interventions

System Change

Human Development Outcomes

• Per village cost of accountability interventions: Approximately Rs. 7000

• Cost of accountability interventions for district: Rs. 7000 x roughly 1000 villages = Rs. 7 million

• Average district development budget: Well over Rs. 700 million

• Cost of accountability interventions: Barely 1% of the development budget

Costs and Benefit

Costs and Benefit…

Average AnnualDistrict Budget

Cost ofAccountability

Processes

Saving of financial, social

and human costs caused by a lack

ofaccountability

• Creative mobilization of funds for accountability interventions: Sources are not fixed

• Continuous follow up: Maintaining the tempo

• Sustainability: Community initiatives, NGO partnerships, ownership by administration

Challenges

• Village microplans are now a mandatory requirement for district planning as per Planning Commission’s Manual for Integrated District Planning (January 2009)

• Block and district budgets are to be actually based on community demands

• Annual bottom-up planning: An avenue for institutionalization of MP and CSC

Solution: Institutionalization

Thank You!