The past few months have been busy ones for the Transparency and Accountability team. We are excited to have the launch of our new publication Lives in the Balance next Monday at the Brookings Institution. The launch should be a great opportunity to learn and share more about the future of supporting the demand for good governance from some people doing great work in this field.
In addition, we are only a week away from launching our newest grant round. We have had the privilege of working with some incredible CSOs over the past 4 years that have made great strides in improving health and education in their countries. The new TAP grant round will continue this work, focusing on 8 countries in sub-Saharan Africa.
We will be launching the new Request for Proposals on November 15, so watch your inbox for the latest!
“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?
“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?
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.
Pictured: a sign from Machakos District in Kenya advertising all of the recipients of the secondary education bursary scheme in the district, including the names of students and the amount received.
Although researchers have found mixed evidence regarding the effectiveness of information in reducing local corruption, it is still comforting to see that an office (with no electricity or computers) at least makes this information public for anyone interested.
This week's Economist had a great article about school uniforms in Britain (September 24, 2009 - "Badge of Honour?"). While the focus was on the pricey uniforms that private school students had to purchase to even enter the school grounds, they included a small section on how the practice extends to state schools as well. Even in places where government-run or public schools are lauded as "free," non-tuition costs rarely keep the pricetag for parents of education a child at zero.
But another story this week highlighted a different, more disturbing way in which free education does not always live up to its name. Kenya's Ministry of Education is currently scrambling to explain why 5.8 million textbooks are missing and are turning to school heads to explain what happened. Kenya's 2003 free education program outlined that schools should achieve a 1:1 pupil-textbook ratio, a goal that few schools have achieved to date. In a school where necessary supplies for educating students (such as textbooks) are not being supplied by the government or are disappearing along the expenditure or procurement chain, the responsibility falls on parents. One more way that "free education" starts to look like a misnomer.
And one more reason to support independent monitoring of expenditures and procurement. The Ministry of Education is asking for audits from school heads dating back to 2003, implying that the breakdown in the chain may have been happening for the past 6 years. Given access to the budget and procurement data for the texbook program, many civil society organizations are well-qualified to follow the money and identify the broken links and recommend ways to fix the system. By monitoring the purchase and release of textbooks to schools and students, CSOs could help make education a little bit closer to "free."
One constant obstacle that budget-focused civil society organizations face is making budgets accessible and interesting to the general public. Since TAP began in 2007, our team has seen many examples of innovative ways to help people make the connection between line items for pharmaceuticals or school construction projects and their daily use of public services. A recent visit to India and Uganda to meet with former and current TAP grantees provided me with an opportunity to learn about new creative methods that civil society organizations are using to get people excited about holding their governments accountable for spending and service delivery.
TAP is happy to announce the new grantees for our current grant round. These organizations will be conducting public expenditure tracking surveys and absenteeism studies on health and education:
- Institute of Social and Policy Sciences (I-SAPS) - Pakistan
- Uganda National Health Users/Consumers Organization (UNHCO)
- Zambia National Education Coalition (ZANEC)
- Independent Advocacy Project (IAP) - Nigeria
- IBIS - Ghana
- Bandung Institute of Governance Studies (BIGS) - Indonesia
- PATTIRO - Indonesia
- Coalition for Health Promotion and Social Development (HEPS) - Uganda
- Public Service Accountability Monitor (PSAM) - South Africa
- Concern for Environmental Development and Research (CEDAR) - Bangladesh
- African Network for the Prevention and Protection against Child Abuse and Neglect (ANPPCAN) - Uganda
- Transaprency International Cameroon (TI)
- ABANTU for Development - Nigeria
- Community Based Moniotring Project (CBMP) - Malawi
- Institute for Policy Analysis and Research (IPAR) - Kenya
- CUTS International - India
- Center for Democratic Development (CDD) - Ghana
- Health Oriented Preventive Education (HOPE) - Pakistan
- Public Health Foundation of India (PHFI)
- IDPMS - India
A few weeks ago, I was having a conversation with a colleague who pointed out something that had been on my mind recently. Talking about recent events and seminars around Washington, she mentioned that she had attended three workshops in the past week, and all had centered on the same general topic – what the financial crisis means for the international development and aid community.
As TAP moves into the beginning of a new phase of work, we on the TAP team have spent some time reflecting on where the transparency field is right now. It is an exciting time to be working in the areas of governance and anti-corruption. For practitioners in the field, there have never been so many resources available to monitor the progress towards a more transparent environment in which to do business and provide public services. Indexes such as the International Budget Partnership's Open Budget Index and the Global Integrity Index are among the growing list of quantitative measures of national-level transparency and corruption available to a public that is increasingly interested in holding policymakers accountable for their actions. The list of countries with Freedom of Information Acts also continues to grow, providing an additional tool for those seeking to monitor government spending and decisions related to public resource utilization. And, as technology becomes more accessible to a larger and more diverse fraction of the global population, the utilization of e-procurement and e-governance resources is becoming a more regular practice.
The innovative tools and resources discussed above could not come at a better time. The need for independent monitors of governance and corruption is indisputable, with allegations of fraud and misuse of power appearing in headlines worldwide. Politicians in South Africa and Zimbabwe and business leaders in the United States claim corruption headlines today, but no country or sector is free of these problems.
With the need for monitoring and the tools to hold government leaders available in place, the one remaining question is who will step into the role of independent monitor. Although this role has been filled by a diverse set of development agents in the past, civil society (and civil society organizations in particular) is poised to take the lead in this activity. The recent wave of democratization worldwide has opened the door for civil society to have a voice. Further, the international community has begun to recognize that civil society has a distinct advantage over other independent monitors - members of the public benefit from the public services they are monitoring and constantly observe the efficiency (or lack thereof) with which these services are delivered.
So, this is where we are. Our aim with the TAP blog is to contribute to the dialogue surrounding three important questions regarding governance and corruption - how can we monitor the actions of leaders, where is corruption still occurring, and what is civil society doing to change the State of Transparency. From teaching college students to monitor procurement online in the Philippines to watching countries shift from Not Free to Partly Free and Partly Free to Free on the Freedom House map, it is an exciting time to be working in this field. We look forward to reporting on what TAP and others are seeing and doing in the fight for good governance worldwide.