Public Services: Health

Background:

On 25 September 2018, our team held a public consultation on how to represent the theme of health in OGP’s upcoming flagship report. (For more background and justification, see here.) Our aim was to present our preliminary research and to hear what we were missing, who we should talk to, and how we should frame the topic. We also received written feedback. The goal of this page is to summarize what we heard and to establish another channel for feedback.

What we heard from you:

Data:

• World Vision has data on community scorecards / action plans and social audits
• Everyone Counts: initiative between World Vision, CARE International, and Kwantu to leverage citizen-generated data to monitor progress against SDGs
• Leave No One Behind project by International Civil Society Centre is also incorporating community-based data to identify, support, and empower marginalized communities
• Worth reaching out to the Global Partnership for Sustainable Development Data

Important issues to consider:

Social Accountability

• Citizen Voice and Action: World Vision is using community scorecards and social audits in over 50 countries and 600 communities
  • Community scorecards are a tool for the community to evaluate the government’s performance as compared to the community’s ideal services
  • Social audits assess performance based on government policy
    • Link with SDG Goal 16.6.2 on satisfaction with public services

• This work is rarely funded by nationally / locally financed mechanisms. The question is how to institutionalize these approaches. OGP action plans could help.
• It would be great for the OGP flagship report to address questions of how to scale social accountability. Vertical integration is missing and has been recognized worldwide as a gap. Key questions include how to achieve economies of scale, involve experts, institutionalize this work, and ensure local / national linkages.
  • A whole-of-government approach is important here
• OGP countries need to commit to engaging citizens, linking engagement to key planning and budget cycles, and closing the feedback loop

Inclusion

• Inclusion is vital not only in access to services, but also in design and monitoring
  • People need to have a say in quality, i.e. if a service is working for them or not
• OGP countries need to first make commitments to identify those who are left out

Decentralization of health services

• Overcentralization: often supplies may not reach rural populations
• Blockages in supply chain: drugs, vaccines, and other supplies can up on the market rather than in health facilities, particularly in fragile contexts

Ideas on framing

• Important sub-themes within health include infrastructure, staffing, drugs, health worker attitudes (particularly for women), and access to services
• It’s not just about anti-corruption, it’s about using open government for impact in different ways (e.g. involving people in designing better services)
• Public/private partnerships: Important issue to highlight is improving accountability for services that governments outsource to the private sector
• SDGs: Important to align report with current discussions on SDGs

How we plan to address / incorporate your feedback:

• We will explore how we can integrate citizen-generated data into our data model, either through data on community scorecards / social audits or citizen surveys. We will reach out to the stakeholders mentioned on the call during our research phase.
• We will focus part of our research on social accountability initiatives in health. In particular, we will explore the important questions of how to scale these initiatives and begin to institutionalize them through OGP action plan commitments.
• As it relates to inclusion, we have updated our framing to focus not only on access to services, but on citizens having a voice throughout the process. As a result, we hope to broaden our approach and highlight innovative practices of citizen engagement during the full life cycle of public services in health.
• We will take a look at new health subthemes that surfaced during the call, including health worker attitudes, infrastructure, and public/private models of health.

What’s next?

• We will update our approach and framing, which is currently in the “Thematic Strawmen” document linked above.

• We welcome your feedback below (in the public comment box) or sent to our email at research@opengovpartnership.org. We are going to close comments on Wednesday 31 October. If you would like to talk to us again, please reach out to the email above to schedule a phone call.
• For the areas that require further research, we will commission research by partners to help inform the final report.

Thank you to everyone who participated in the consultations during the live sessions and in writing!