TAP Blog

Woman and Baby in Health Center in Indonesia

A closer look at what is happening in the world of governance, corruption, transparency, and accountability worldwide.

News, Opinion, Commentary from the TAP Team and Partners.

Civil Society- The Missing Link In Development
Saturday, April 10, 2010 - 05:00

“One thing is certain: When medicines aren’t available, people will die.”

So said Dennis Kibira at the Global Health Council event, “Civil Society: A Missing Link in Development”. As health policy and advocacy manager at HEPS – Uganda, Kibira has led Ugandan efforts in a multinational campaign to stop stock-outs across the region. A stock-out occurs when pharmacies run out of medicine on the shelf – supply does not meet demand. The average stock-out in Uganda in 2008 was 2.5 months each year. And less than 50% of public health facilities had a set of necessary medications.

How, then, to stop the stock-outs and save lives? On this question, Kibira echoed many of the event’s speakers: “If there has to be change, it has to come from the people.”

To counter the problem, civil society groups developed a plan: they built an extensive campaign for public awareness and coupled it with targeted policymaker and media outreach. They worked with MPs and local artists. They held press conferences, rallies, and forums. They developed an SMS message reporting system that involved the public in monitoring stock-outs across the region. And they were successful. The media took notice, and the Ugandan government embraced the issue, changing the funding model for the National Medical Stores to reduce shortages. The President has spoken out about the problem, and created a Drug Monitoring Unit to check up on pharmacies.

Stop Stock-outs, just one project of the several discussed at the event, is at the forefront of a growing conversation about accountability and transparency– two integral pieces of a meaningful civil society. All three civil society organizations (CSOs) presenting were grantees of the Results for Development Institute’s Transparency and Accountability Program (TAP), which awards grants to expand the capacity of CSOs and build a more powerful civil society. Its focus: demand-side interventions that allow CSOs to argue effectively for improvements at the local and national level. By directing funding at this “missing link” in accountability, TAP looks to answer a fundamental yet challenging question – why is development spending in areas like health, education, and water not translating into improved results? And what tools can civil society, NGOs and others use to create meaningful change that lasts?

Another example comes from South Africa, where there is a tendency to treat accountability as a personal favor, not as a fundamental right. In the Eastern Cape Province, 60% of the population lives in poverty – less than $1 each day. This is where, in 2003, the government signed a $95 million contract for emergency medical services – a contract that made no impact. Reports of ambulances arriving late or not at all remained steady. The contractors weren’t doing their job, and they weren’t being held to account. And that wasn’t all: in 2005, 47% of all EMS helicopter trips were for members of the provincial executive council (MECs).

This is where the Public Service Accountability Monitor (PSAM) came in. PSAM took to the airwaves, publicizing the exorbitant equipment and service costs charged to the government, and exposing the rampant use of EMS helicopters by the executive council. And the outcry they sparked created change: The government reviewed and renegotiated its EMS contract was in 2005. And MECs are now banned from using EMS helicopters. Empowered with information, civil society successfully held government to account.

At the end of the seminar, the Global Health Council’s CEO Jeffrey Sturchio quoted Einstein’s famous definition of insanity: doing the same thing over and over and expecting different results. Too often, though, the development field seems caught in exactly this trap. The event’s presenters demonstrate that civil society groups are starting to experiment with new programs – and that they are achieving results. They show that transparency and accountability can begin with the people. They are going beyond the role of mere watchdogs, to become collaborators and partners with government. The question is this: How can we nurture these examples of capacity building, extend them, and create better health results worldwide?
 

Civil Society- The Missing Link In Development
Saturday, April 10, 2010 - 05:00

“One thing is certain: When medicines aren’t available, people will die.”

So said Dennis Kibira at the Global Health Council event, “Civil Society: A Missing Link in Development”. As health policy and advocacy manager at HEPS – Uganda, Kibira has led Ugandan efforts in a multinational campaign to stop stock-outs across the region. A stock-out occurs when pharmacies run out of medicine on the shelf – supply does not meet demand. The average stock-out in Uganda in 2008 was 2.5 months each year. And less than 50% of public health facilities had a set of necessary medications.

How, then, to stop the stock-outs and save lives? On this question, Kibira echoed many of the event’s speakers: “If there has to be change, it has to come from the people.”

To counter the problem, civil society groups developed a plan: they built an extensive campaign for public awareness and coupled it with targeted policymaker and media outreach. They worked with MPs and local artists. They held press conferences, rallies, and forums. They developed an SMS message reporting system that involved the public in monitoring stock-outs across the region. And they were successful. The media took notice, and the Ugandan government embraced the issue, changing the funding model for the National Medical Stores to reduce shortages. The President has spoken out about the problem, and created a Drug Monitoring Unit to check up on pharmacies.

Stop Stock-outs, just one project of the several discussed at the event, is at the forefront of a growing conversation about accountability and transparency– two integral pieces of a meaningful civil society. All three civil society organizations (CSOs) presenting were grantees of the Results for Development Institute’s Transparency and Accountability Program (TAP), which awards grants to expand the capacity of CSOs and build a more powerful civil society. Its focus: demand-side interventions that allow CSOs to argue effectively for improvements at the local and national level. By directing funding at this “missing link” in accountability, TAP looks to answer a fundamental yet challenging question – why is development spending in areas like health, education, and water not translating into improved results? And what tools can civil society, NGOs and others use to create meaningful change that lasts?

Another example comes from South Africa, where there is a tendency to treat accountability as a personal favor, not as a fundamental right. In the Eastern Cape Province, 60% of the population lives in poverty – less than $1 each day. This is where, in 2003, the government signed a $95 million contract for emergency medical services – a contract that made no impact. Reports of ambulances arriving late or not at all remained steady. The contractors weren’t doing their job, and they weren’t being held to account. And that wasn’t all: in 2005, 47% of all EMS helicopter trips were for members of the provincial executive council (MECs).

This is where the Public Service Accountability Monitor (PSAM) came in. PSAM took to the airwaves, publicizing the exorbitant equipment and service costs charged to the government, and exposing the rampant use of EMS helicopters by the executive council. And the outcry they sparked created change: The government reviewed and renegotiated its EMS contract was in 2005. And MECs are now banned from using EMS helicopters. Empowered with information, civil society successfully held government to account.

At the end of the seminar, the Global Health Council’s CEO Jeffrey Sturchio quoted Einstein’s famous definition of insanity: doing the same thing over and over and expecting different results. Too often, though, the development field seems caught in exactly this trap. The event’s presenters demonstrate that civil society groups are starting to experiment with new programs – and that they are achieving results. They show that transparency and accountability can begin with the people. They are going beyond the role of mere watchdogs, to become collaborators and partners with government. The question is this: How can we nurture these examples of capacity building, extend them, and create better health results worldwide?
 

Answering the "So What"
Thursday, March 18, 2010 - 16:59
Courtney Tolmie

Approximately once a year, we at TAP have the exciting opportunity to take part what we call "the peer learning process." Civil society organizations that have been working for many months at critical issues like teacher absenteeism and the availability of pharmaceuticals at health clinics come together to share their work, provide feedback to each other, and talk about the "So What?"

The "So What" question is one that we all struggle with ...

· Researchers find out that teachers don't come to class on Fridays ... so what?

· A CSO uncovers that money coming from the government to improve the schools is earmarked for a fence - but there is onyl enough money for it to partially surround the school. So what?

· Another organization finds that patients at clinics have to wait hours to be seen because doctors are not coming to the office. So what?


We at TAP love coming together for the peer learning workshops because we start to see the "so what" question get answered. It is a challenging task. But together with CSOs from around the world struggling with similar issues, we get the chance to see those demanding good governance respond to the "so what" with "so this is what we need to do to fix it."

For more information on how you can learn more about the "So What" from CSOs doing this work, visit the Results for Development website for recent news.

 

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