Participatory development is the most important approach towards enabling communities to help themselves and sustain efforts in development work. Communities are critical stakeholders and have an important role to play in the management of programmes and projects in their areas. Community participation has been the key element in almost all PAC Projects and the details of such community projects are given below.
- Enhancing Community-Centered Governance in Climate-Change affected Coastal Areas
This 2010 project initially began as a two year project with the objective of developing a social accountability tool called the Climate Change Score Card (CCSC) to facilitate dialogue between the vulnerable communities of the coastal villages of Tamil Nadu with the local governance structures in order to raise their concerns and safe guard their livelihoods. This was an effort to enhance accountability and community participation in environmental governance of coastal areas. This was further extended till 2013 to take the findings of the CCSC further and influence the key policy makers to address the issues of the fishing and Palmyrah communities of the coast. The project covered two districts of Ramanathapuram and Tuticorin from the Gulf of Mannar region of Tamil Nadu and was funded by Affiated Network for Social Accountability-South Asia Region (ANSA-SAR). Our partners People’s Action for Development carried out the field activities for the project.
- Closing the Loop
In 2000 Public Affairs Centre had conducted a Citizen Report Card study of maternal health services offered by the Bangalore City Corporation in its Maternity Homes and Urban Family Welfare Centres and found that the quality of service delivery was far from satisfactory. Along with other NGOs in the city, certain reform measures were recommended. In 2010, PAC decided to study the quality of service delivery once again in these Maternity Homes to understand the impact. A Citizen Report Card study was conducted in 12 out of 24 Bruhut Bengaluru Mahanagara Palike (BBMP) Maternity Homes in the city and even after 10 years the quality of service still remained poor. PAC decided to investigate this further to understand if lack of funds were responsible for poor quality of services and took up detailed budget analysis of BBMP maternal health budgets. Some initial efforts on tracking some of the funds like User Fee, free food for in-patients were also made in selected Maternity Homes to understand the issues further.
These exercises revealed that there were some gaps in supply of medicines, issue of receipt for User fee collected, procurement of sufficient quantities of milk for in-patients etc. In order to address some of these issues, PAC decided to partner with local NGOs and mobilize communities to demand for better services. Through the use of Community Score Cards in selected Maternity Homes, the users of these health units were empowered with knowledge on their maternal health entitlements through massive information sharing workshops. Informed communities were asked to rank the services and prioritise the service delivery gaps that need immediate, mid-term and long term attention. An informal platform called Maternity Home Monitoring Committees (MHMC) consisting of these users was created for each of these Maternity Homes.
The observations and experiences of users gathered during interactions are presented to the Officials of BBMP health department in a formal meeting that happens once in every 2 months at the Maternity Homes and joint actions are taken for improvement. The project which started with 3 MHMCs today has spread further and such committees exist in 6 Maternity Homes and 2 Referral hospitals today. This project demonstrates that empowered communities can stand up and demand for better services and put enough pressure on the system to deliver better.