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Community VoicesAnnual Score Card on Civil
Society Monitoring of Pro-poor Policies
Programs under Ghanas Poverty Reduction
Strategy, 2004Prepared byDr. Sulley
GaribaJonathan LangdonIssifu LampoInstitute
for Policy Alternatives, Ghanawww.ipaghana.org
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Community voices is an attempt to

• Use a social accountability tool ommunity SCORE
  CARD -- to interrogate the implementation of
  pro-poor policy
• From the perspective of rural and impoverished
  communities
• Facilitated by organizations of civil society
• Who have a potential to catalyze advocacy at
  Local Government level, with Parliament, at the
  level of central government

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Civil Society Monitoring of Poverty Reduction
Using Community Scorecard

• What were the main issues?
• What did we do?
• What did we find?

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Context

• Policy environment which legitimizes
  participation in formulation, implementation and
  oversight of pro-poor policies
• Legitimacy and rights of organizations of civil
  society to set-out unique and independent
  monitoring of poverty reduction policies

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Conceptual Framework

• Monitoring for efficiency of public policies
  were the targets of GPRS met? APR
• How effective are the policies and programs
  Impact Evaluations of GPRS (not yet initiated in
  Ghana)
• How accountable are these policies to the rights
  and responsibilities that citizens have vis-à-vis
  the state?

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Social Accountability defined as

• Process of balancing citizen leadership and
  capacity to demand their rights, while fulfilling
  their responsibilities with the capacity and
  willingness of the state to facilitate the
  fulfillment of these rights and responding to
  citizen demand.
• When applied to poverty reduction policies,
  social accountability has an added dimension of
  the fulfillment of the rights of the vulnerable
  and the marginalized society

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Therefore, we were challenged by GPRS to Assess

• Health Exemption Policies for the Poor
• Education that is pro-poor
• Resource Allocation as it applies to District
  Assemblies

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National Scope

• Together, as a grouping of over ten civil society
  organizations we covered
• 13 Districts in Ghana
• 8 Regions out of the 10 administrative regions
• 76 communities
• Over 5,000 community leaders and members, local
  government officials, service providers and
  managers of health and education delivery

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National Coverage
Bawku East
Jirapa/Lambusie
Builsa
Wa
Savelugu/Nanton
West Mamprusi
Zabzugu/Tatale
East Gonja
Sekeyre East
Kpandu
Afram Plains
Cape Coast
Dangme East
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What did we do?

• The Three key themes of Health, Education and
  Resource Allocation were looked at, with a number
  of district covering each theme
• Health 4 Districts
• Education 5 Districts
• Resource Allocation 4 Districts

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Health for the Poor through Exemptions?

• What did we Find?
• Communities, especially stakeholders of the poor
  and the vulnerable, want the right to quality and
  affordable health care, and a health service that
  respects them and their rights as human beings

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Indicators of Pro-poor Health

• 79 of communities selected Staff Attitude and
  Quality Care as a major indicator assessing
  health services to the poor
• 75 selected Availability and Affordability of
  Drugs

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Health Grades, at a glance
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Community Voices - Health

• Staff Attitude and Quality of Care
• They do not give the needed attention to patients
  they sometimes completely refuse to attend to
  poor people who are sick people at times
  (particularly during the night and weekends),
  insult and shout at these patients. Afram
  Plains District, Eastern Region
•  Drug Affordability and Availability
• Bad we buy the expensive drugs from the drug
  stores Danku, Wa District, Upper West Region

• Pregnant Women
• Many mothers prefer to deliver at home or with
  TBAs due to poor attitudes of nurses. This
  sometimes results in complications and death. The
  needed attention and care is also not given at
  clinics. . Afram Plains District, Eastern
  Region
• Awareness
• I paid for my wife who went to deliver, only to
  hear from some one that I was not supposed to pay
  but I could not go back for my money. Boli, Wa
  District, Upper West Region

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Some more Voices
Women in Bugiya, West Mamprusi, speak out about
exemption policy access to drugs
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Another Voice
A chief in West Mamprusi adds his voice to the
discussion. He concludes that health service has
led him to believe, to die is honey and to live
is salt.
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In Education

• What did we find?
• Communities are living up to their
  responsibilities as parents and as students, but
  GES and Government are not providing the support
  they need
• There is a national crisis over the adequacy and
  quality of teaching in rural communities,
  considered to be the poorest
• The textbooks needed for rural students to have
  an opportunity to compete with their urban
  counter parts are not there
• The right to education for girls are denied

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What Indicators did communities use to assess
Education?

• 100 of communities selected Adequate,
  Qualified and Effective Teaching
• 96 selected Textbook access

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Education Grades, at a glance
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Community Voices - Education

• Adequate, Qualified and Effective Teaching
• You send your child to school because you want
  him to be somebody in future, now this is not
  possible because there are no teachers woman,
  Suke
• Textbook
• In the rainy season, a farmer without a hoe
  benefits nothing from the rains so is a student
  without text book. woman, Chetu

• School Building
• Building not protected so rainfall, sunshine and
  animals interfere and interrupt childrens
  attention during classes. Blackboards are pasted
  on walls instead and this creates inconvenience.
  Samankwae

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How resources are allocated for Pro-poor
development at District level

• What did we Find?
• Communities do not have the information about
  resources already committed to their development
  feel their elected representatives are denied
  this information, and want the right to be
  involved in resource allocation decisions that
  affect their lives. They are tired of being
  under-valued and under-consulted when something
  is brought into their villages and towns.

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Community-driven indicators for assessing
Resource Allocation

• 100 of communities selected Consultation and
  involvement in Resource Planning
• 100 selected Information, including budgets, on
  resources allocated

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Resource Allocation Grades, at a glance
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Community Voices Resource Allocation

• Felt Need
• Who knows what you may need, when planning is
  done in their big offices? Youth, Toflokpo
• Participation
• When they look mean on us, how can they allow us
  to participate? Woman, Bonikope
• Transparency
• Construction works on the road are done at night
  ïf you are not stealing, why do you not work
  during the day?

• Consultation
• We have no value, else they would have consulted
  us before sighting this culvert woman,
  Agbedrafor, Dangme East
• Information (including budgets)
• If They have nothing to hide, why we dont know
  the costs of projects so as to appreciate how
  they value us. Elder, Nakomkope
• Quality
• Can a Marginalized person of this community be
  given anything of value? Elder Salom

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Implications of these Findings for Pro-poor
Policies and Programs

• Review of GPRS (currently on-going)
• On-going implementation, monitoring and
  evaluation
• Policy changes needed

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GPRS Review

• The initiatives in previous GPRS that were
  explicitly pro-poor must be retained and expanded
• Ring-fencing of these specific pro-poor
  initiatives is needed in order that organizations
  of civil society representing the poor can focus
  on the accountability of these policies and
  programs to the poor

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Policy Change

• This assessment has revealed 4 main elements of
  rights of the poor that must be up-held
• The right to information about policy priorities
  and resources devoted to these on behalf of the
  poor
• The right to participate in decision-making
• The right to be valued and,
• The right to question policies and programs
  (demand of accountability from officer bearers
  and service providers)
• Any pro-poor policy and program initiative in
  GPRS must now include how these rights will be
  fulfilled by office bearers and service providers

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Continuing Community Voices

• This is the first, we are committed to doing this
  annually
• Indicators that are determined by communities
  themselves need to inform the objectively
  verifiable indicators determined from the top
• In time, we foresee a monitoring and evaluation
  regime that has two sides of the same coin what
  the state has provided, and what communities have
  said about these

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Dissemination Strategies

• Dissemination within Districts
• Dissemination at the national level

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District-level Dissemination

• Interface as the first stage in dissemination
• Production of reports in popular version
  comprising
• One issue summaries with graphics
• Illustrated local language versions
• Radio talk shows on the issues
• Media coverage of community meetings to discuss
  issues arising from the poverty monitoring

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National Level Dissemination

• Validation and refinement of composite analyses
  and report
• Final Preparation of Community First
• National Launch of the Community First outlining
  the results and their implications
• Akontabuo -- Newsletter on Social Accountability
• Video documentary on Poverty Monitoring and
  Social Accountability
• National Talk-show on radio and television

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Policy Implications and dialogue

• Briefing sessions with key sector Ministries of
  Health, Education, Common Fund Administrator
• Briefing sessions with the Multi-donor Budget
  Support Group
• Engagement of Ministry of Finance and also NDPC
  to review the key findings vis-à-vis the Annual
  Progress Review (APR) of GPRS

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Advocacy with Parliament

• IPA is developing an agenda for advocacy with
  Parliament to be funded partly by the
  Parliamentary Center, Canada
• Will be launched in April, to coincide with the
  next session of Parliament

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Who are we?

• Afram Plains Devt Organization (E.Region)
• Amasachina (Northern)
• Community Partnership for Health Development
  (Northern)
• ISODEC (Ashanti)
• Radio Ada (Greater Accra)
• Civic Response (Central Western)

• Pronet-North (Upper West)
• SimliAid (Northern Region)
• Rural Media Network (Northern Ghana)
• Northern Ghana Network for Development (3
  Northern Regions)
• Partnership for Sustainable Development (Bawku)
• Municipal Action Foundation (Volta Region)

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The 3 Cs

• Competence in engaging citizens, in
  understanding the policies and programmes and in
  conducting the research
• Credibility seen as advocates of the poor,
  engaged in programmes ourselves, and also a close
  recognition of the officials and the communities
  as partners in the same process
• Confidence ability of the CSO to articulate the
  process and the findings of the monitoring process

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How Process is Governed

• An 8-member Reference Group of Peers drawn from
• Civil Society
• Academic
• Private Sector
• Government
• Legal profession
• A volunteer group that reflects and advises
  challenging ourselves to carve autonomous spaces
  where civil society can take initiatives and
  assume leadership

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Who is coordinating this?

• Institute for Policy Alternatives (IPA) provided
• Training services in social accountability
• Supported the implementation of the social
  accountability initiatives through monitoring
  and field support
• Managed a social accountability fund provided by
  DfiD
• Undertook community monitoring initiatives in 2
  Districts, focusing on health exemption in one
  and mutual health insurance in another

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Appreciation

• DfiD-Ghana provided funding to see these
  initiatives to fruition
• Civic Engagement Group of the World Bank provided
  early methodological support and supported
  refinement of tools and training of trainers
• Communities provided the energy and the resolve
• CSO partners undertook the journey
• Public officials grew in toleranceand hopefully
  will grow in confidence to facilitate and hear
  the Community Voices

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An invitation to go North, to IPA

• Whether you a MP from Uganda or Tanzania

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An invitation to go North, to IPA

• Seeking engagement at the village

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An invitation to go North, to IPA

• Or simply to attend training training on
  monitoring, evaluation and policy analysisat our
  training center in Tamale, Ghana