Increasing Accountability of Government through Citizen Reporting Card:
What is
a Citizen Report Card?
The Citizen Report Card (CRC) is a tool to
assess the performance of service providers, in this case health service
providers, by comparing performance across service providing organizations
and generating a database of feedback on services provided to the
public. This study found conducted found that the CRC process has built
a bridge between health service providers and the communities they serve by
gathering and publicly presenting citizens’ opinions of health care services
in selected districts of Badakhshan province. The Citizen Report Card (CRC) is a tool to;
- Collect citizen feedback on public
services from actual users of a service (and not opinions from the general
public)
- Assess the performance of individual
service providers and/or compare performance across service providers and
- Generate a database of feedback on services that is placed in the public domain.
Most
governments are responsible for providing essential services to the people.
Governments spend huge amounts of resources to provide following services:
•
drinking
water
•
education
•
health
care and
•
transportation
In some
instances, governments give contracts to private entities to provide services.
Some central and state governments have also decentralized service provision to
local units of government.
Citizen Reporting Card is a simple and participatory process
whereby citizens are empowering to assess quality and effective of public services
provided by government.
What
issues will a Citizen Report Card address?
The CRC
addresses critical themes in the delivery of public services such as access to
services, quality and reliability of services, problems encountered by users of
services and responsiveness of service providers in addressing these problems,
transparency in service provisions like disclosure of service quality standards
and norms, and costs incurred in using a service including hidden costs such as
bribes. The CRC also provides a supportive score that captures the totality of
critical service-related parameters.
What
kind of institutional capacity would need to conduct a Citizen Report Card?
CRCs work
best when there is an explicit recognition within an organization on the need
to conduct a user feedback led diagnostic or assessment exercise. Some critical
institutional capacities required to make CRCs effective are:
- Analytical staff well-versed in
quantitative methods. Since a large part of the CRC
- involves sample surveys and analysis
of data, a major pre-requisite is that the organization should have either
in-house capabilities to understand and interpret numbers or have
resources to locate external support.
- Dedicated resource to anchor and
manage the CRC processes.
- Dedicated resources for communication
and outreach.
- Support from the senior management
Methods
The tools of the study were jointly developed
with the provincial health department of Badakhshan.
During the first stage, district health centers
were selected as primary sampling units
by considering geographical locations and accessibility. In the
second stage, approximately community 560 respondents were selected randomly. Their
opinions on quality of service, satisfaction rate and main areas of
improvement for health services available to them were recorded. The study
was conducted by staff of Aga Khan Foundation and members of District
Development Assemblies (DDAs). Selection of respondents have
taken placed randomly, the interviewer waited near to the center of Clinic
while patients were examining by doctor and taking prescribed medicines
from the clinic then he/she selects two male and tow female out of 15 up
to 20 patients and asking respective questions which were already determined by
interviewer. Badakshan colleagues to take an action of this training at least
let us start from one District Level Hospital in the region.
Results:
Based on a variety of questions that were aimed at
finding out the primary reasons for visiting health centers, what kind of
services were available to citizens, and the quality of services received, some
of the key results were highlighted. Results
demonstrated that 67% of respondents visited their respective health care centre
with the primarily to obtain medicine free of charge. A small number of
visitors (11%) noted that they were able to access information about health
services available at centers on information boards or displays at centers.
A majority of service users (78%) reported that their registration was
completed within two hours. Most of the respondents (92%) visited doctors
within an hour or less after completing registration
process. However, a significant number of respondents (41%) also reported
that the center's laboratory equipment were not functional.
Approximately, 65% respondents said that the health
services were had improved in comparison to the previous year. They also
reported satisfaction rates on different services. The proportion of the respondents
who were very satisfied or satisfied with the registration process and the
health centers’ staff’s attitudes are 66% and 53%. A significant percentage of
respondents reported being dissatisfied with the laboratory facilities (43%)
and treatment facilities (30%) of the centers.
Conclusion
This CRC tool was introduced by AKF
Afghanistan for the first time in the country primarily to
create transparency, engender citizen sense of engagement in the service
delivery process, and enable the health system of the government to
be more accountable towards their respective citizens. In doing so, the
CRC aims to improve the quality of service delivery by engendering a
supply-demand relationship between government and citizens for public services.
The majority of patients reported positive experiences and
overall improvement of health facilities in comparison to the previous
year but felt the level of services at present did not satisfy them properly
providing a crucial baseline assessment of public opinion on health service
delivery in Badakhshan province.
