Session 9: Power of Citizen’s Voice in Africa

Date: 05 July 2012
Time: 11:30-12:30
Venue: Tunis, Tunisia

SESSION AIM
Engage finance and health ministers in promising innovations which can improve citizen’s voice and accountability for commitments and results by governments, development partners, service providers, communities and civil society.

BACKGROUND
The 2004 World Development Report defined four relationships of accountability within a country - of politicians to citizens; of the service provider to the state; of front line professionals to the service provider; and of the provider to the citizen. At the international level, relationships of accountability can be described in terms of fulfilment of specific commitments for improved health outcomes by governments and their development partners. This session will provide an opportunity for Ministers to consider both global and local accountability mechanisms.

In 2011, the UN Secretary General’s Commission on Information and Accountability, jointly chaired by the President of Tanzania and the Prime Minister of Canada, issued detailed proposals to enhance accountability of governments, development partners, civil society and parliamentarians for specific commitments and goals established in the 2010 Global Strategy for Women and Children’s Health. The ten proposals cover better information for better results, better tracking of resources for women and children’s health and better oversight of results and resources nationally and globally. An independent expert review group (IERG) has been created to report regularly between 2012-2015 to the UN Secretary General on the results and resources related to the Global Strategy and on progress in implementing the Commission’s recommendations. The Commission and the IERG represent reinvigorated efforts at the international level to increase transparency and accountability for commitments and results. The expert group is expected to present its first report later this year.

At the same time, demands by citizens and consumers of health services have led to a variety of innovations to develop indicators of service delivery and to better hold governments, financial institutions and health providers accountable for the cost, quantity and quality of health services. Citizen Report Cards are participatory surveys that provide quantitative feedback on user perceptions on the quality, adequacy and efficiency of public services. They exact public accountability through the extensive media coverage and civil society advocacy that accompanies the process. Community Score Cards are qualitative monitoring tools that are used for local level monitoring and performance evaluation of services, projects and even government administrative units by the communities themselves. The community score card (CSC) process is a hybrid of the techniques of social audit, community monitoring and citizen report cards. Like the citizen report card, the CSC process is an instrument to exact social and public accountability and responsiveness from service providers. However, by including an interface meeting between service providers and the community that allows for immediate feedback, the process is also a strong instrument for empowerment. These mechanisms can be introduced as free standing components, or preferably as part of system wide reforms, such as performance based budgeting.

Other innovations are being tried out in a variety of settings. The increasingly ubiquitous use of mobile technology and social media provide opportunities to increase information flow, transparency and accountability. Health care workers can quickly transmit data up the line and receive on the spot advice. Community organizations can monitor the attendance of health workers. Mobile technologies can be used to verify manufacturer’s bar codes on pharmaceutical packages to prevent counterfeiting and fraud.

KEY DISCUSSION TOPICS

• What is the experience to date at the international and country levels?
• What are the most promising tools and what are the challenges? How can accountability be integrated into health reform processes?
• How can best practice be shared amongst countries, and which agencies can assist?

CHAIRS & SPEAKERS

Chair: Dr. Alan Alwan, Regional Director, EMRO, WHO
Co-Chair: Dr. Paul R. Fife, Director, Department for Global Health, Education and Research, NORAD

Hon. Abdellatif Mekki, Minister of Health, Tunisia (10 mins)

Mrs. Joy Phumaphi, Executive Director, Africa Leadership Malaria Alliance, and co-chair, Commission on Information and Accountability (COIA) (10 mins)

Mr Olusoji Adeyi, Health Sector Manager, The World Bank (10 mins)

Hon James Afedzi, Chair of Ghana Finance Committee (10 mins)

Lola Dare, Chief Executive Officer, Centre for Health Sciences, Training, Research and Development (10 mins)

Open discussion 10 min