Community Score Card
Impact Evaluation of the G-SAM Project in Ghana: Midline Report
USAID/Ghana’s Strengthening Accountability Mechanisms program (G-SAM) focuses on the district level of governance in Ghana, the Metropolitan, Municipal, or District Assemblies (MMDAs) democratically elected by residents. The following two activities are currently ongoing:
• Performance audits: The central government collects revenue and shares it with MMDA governments based on a revenue sharing formula. Prior to G-SAM, the Ghana Audit Service (GAS) conducted only a financial audit to ensure that this money was properly spent. Over the course of 2015 and with G-SAM funding, the GAS engaged in performance audits of 50 districts. In these audits the auditors went well beyond checking for receipts for purchases to assess the nature of project planning and contracting, the quality of service delivery outcomes and development
project outputs. This information has been used to develop citizen scorecards that were presented at district assemblies in April and May 2016; the scorecards are now being presented and discussed in public forums across the 50 districts.
• Civil society-led information campaign: Citizens struggle to hold their MMDA officials accountable, partially because they have very limited information about MMDA-level government budgets and activities. As such, a civil society-led effort under contract to CARE International and a coalition of Ghanaian CSOs has been conducting social audits on district capital projects and education and health service quality. This information will be used to develop citizen scorecards that will be presented and discussed in public forums over the course of the summer of 2016.
THE MIDLINE RESEARCH DESIGN
The G-SAM research design involves random assignment of 150 districts into one of three groups: a treatment group that has now received central government performance audits; a second treatment group that is now receiving civil-society led social audit; or a control group that will not receive either intervention. Given delays in the civil society organization (CSO)-led programming, this midline report only covers the 50 GAS performance audit districts and the 50 control districts. Moreover, while the baseline report provided data on citizen attitudes toward district governance and capital projects, the midline was carried out before any of the major citizen outreach efforts that will occur in both treatment arms in Summer 2016. The data collection only occurred among district administrators and politicians with the goal of determining if the GAS audits unto themselves, and without any significant citizen outreach, have had any effect on the planning, contracting and implementation of district capital projects.
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• Performance audits: The central government collects revenue and shares it with MMDA governments based on a revenue sharing formula. Prior to G-SAM, the Ghana Audit Service (GAS) conducted only a financial audit to ensure that this money was properly spent. Over the course of 2015 and with G-SAM funding, the GAS engaged in performance audits of 50 districts. In these audits the auditors went well beyond checking for receipts for purchases to assess the nature of project planning and contracting, the quality of service delivery outcomes and development
project outputs. This information has been used to develop citizen scorecards that were presented at district assemblies in April and May 2016; the scorecards are now being presented and discussed in public forums across the 50 districts.
• Civil society-led information campaign: Citizens struggle to hold their MMDA officials accountable, partially because they have very limited information about MMDA-level government budgets and activities. As such, a civil society-led effort under contract to CARE International and a coalition of Ghanaian CSOs has been conducting social audits on district capital projects and education and health service quality. This information will be used to develop citizen scorecards that will be presented and discussed in public forums over the course of the summer of 2016.
THE MIDLINE RESEARCH DESIGN
The G-SAM research design involves random assignment of 150 districts into one of three groups: a treatment group that has now received central government performance audits; a second treatment group that is now receiving civil-society led social audit; or a control group that will not receive either intervention. Given delays in the civil society organization (CSO)-led programming, this midline report only covers the 50 GAS performance audit districts and the 50 control districts. Moreover, while the baseline report provided data on citizen attitudes toward district governance and capital projects, the midline was carried out before any of the major citizen outreach efforts that will occur in both treatment arms in Summer 2016. The data collection only occurred among district administrators and politicians with the goal of determining if the GAS audits unto themselves, and without any significant citizen outreach, have had any effect on the planning, contracting and implementation of district capital projects.
Read More...
Community Scorecard for COVID-19 Vaccines in Malawi
The significant amount of misinformation surrounding COVID-19 has deteriorated trust in governments and health systems, leading the World Health Organization to claim it as an “infodemic.” As the massive vaccine roll-out efforts launch, systematic trust-building and social accountability approaches are vital to ensure that civil society can hold governments accountable for equitable and people-centered vaccine roll-out that reaches the last mile. CARE knows that epidemics, like COVID-19 and Ebola, start and end with communities, which is why we are working to build meaningful citizen engagement into national vaccine roll-out frameworks to increase trust, accountability, and information dissemination.
CARE’s Community Score Card
The Community Score Card (CSC) was developed by CARE Malawi in 2002 and has been effectively used in a wide range of settings and sectors to ensure that public services are accountable to the people and communities they serve. CSC has demonstrated impact on power-shifting and improving service quality and trust building within and between communities and government actors. When COVID-19 arrived in Malawi during March 2020, CARE adapted CSC for remote use. The remote CSC includes an SMS platform and WhatsApp groups through which groups of men, women, youth, community and religious leaders, and service providers could voice their concerns and hesitancies about the vaccine and other health services. The CSC helped to identify major concerns around the vaccine and aided stakeholders in creating locally-driven solutions to combat vaccine hesitancy and misinformation.
Building on these early experiences, from May to June 2021, CARE further implemented a pilot project designed to support efficient and equitable COVID-19 vaccine roll-out in three locations in Malawi: Kandeu and Chigodi health facility catchment populations in Ntcheu district and the New Hope Clinic health facility catchment population in Ngolowindo in Salima district. In all three locations, key stakeholders included groups of women, men, youth, community leaders (chiefs and religious), district health management teams, and health personnel (including health surveillance staff, health facility staff in-charge, and the health center management committee). CARE Malawi’s CSC team led the implementation of the pilot with support from CARE USA and digital support from Kwantu. Read More...
CARE’s Community Score Card
The Community Score Card (CSC) was developed by CARE Malawi in 2002 and has been effectively used in a wide range of settings and sectors to ensure that public services are accountable to the people and communities they serve. CSC has demonstrated impact on power-shifting and improving service quality and trust building within and between communities and government actors. When COVID-19 arrived in Malawi during March 2020, CARE adapted CSC for remote use. The remote CSC includes an SMS platform and WhatsApp groups through which groups of men, women, youth, community and religious leaders, and service providers could voice their concerns and hesitancies about the vaccine and other health services. The CSC helped to identify major concerns around the vaccine and aided stakeholders in creating locally-driven solutions to combat vaccine hesitancy and misinformation.
Building on these early experiences, from May to June 2021, CARE further implemented a pilot project designed to support efficient and equitable COVID-19 vaccine roll-out in three locations in Malawi: Kandeu and Chigodi health facility catchment populations in Ntcheu district and the New Hope Clinic health facility catchment population in Ngolowindo in Salima district. In all three locations, key stakeholders included groups of women, men, youth, community leaders (chiefs and religious), district health management teams, and health personnel (including health surveillance staff, health facility staff in-charge, and the health center management committee). CARE Malawi’s CSC team led the implementation of the pilot with support from CARE USA and digital support from Kwantu. Read More...
Community Scorecard in Emergencies Learning Brief
To be effective and equitable towards global populations, humanitarian organizations must adhere to the core standards and principles on quality humanitarian response. Since the inception of ideas on the centrality of local participation in aid in the early 2000s and the more recent evolution of that concept into accountability towards affected populations, the humanitarian community has sought to turn this doctrine into reality.
Accountability in humanitarian response requires that organizations carry out their efforts in an ethically and legally responsible manner that is inclusive of the communities they are seeking to serve. Of UNICEF’s nine Core Humanitarian Standards (depicted here to the right), three specifically refer to mechanisms of accountability towards affected peoples: response is based on communication, participation and feedback; complaints are welcome and addressed; actors continuously learn and improve. In practice this could include centralizing the voices of affected peoples by engaging communities in needs and performance assessments and decision-making. Achieving this is often hindered by the constraints inherent to conflict settings such as lack of localization of assistance, communication between actors, and exploration of needs.
CARE’s Community Score Card
Seeking to actualize these principles of community participation and accountability into our programming, CARE developed the Community Score Card as part of a project aimed at developing innovative and sustainable models to improve health services. Working in crisis settings requires an understanding of the lived experiences of people, the power dynamics, and micro-politics that inform humanitarian response approaches. It also requires bridging the gap between civil society organizations, local and national governments, international non-governmental organizations, and impacted communities. Social accountability approaches do this by connecting citizens with those responsible for providing services. The Community Score Card (CSC) is a participatory social accountability mechanism for assessment, planning, monitoring and evaluation of services. Designed for ease of use and adaptation into any sector with a service delivery scenario, the CSC brings together users and providers of a particular service or program to jointly identify service utilization and provision challenges, mutually generate solutions, and work in partnership to implement and track the effectiveness of those solutions in an ongoing process of quality improvement. The CSC has five phases: (I) planning and preparation; (II) conducting the scorecard with the community; (III) conducting the scorecard with service providers; (IV) interface meeting where the all parties present their findings in the presence of duty-bearers and then jointly develop action plans; and (V) monitoring of the action plans and evaluation of overall process. Read More...
Accountability in humanitarian response requires that organizations carry out their efforts in an ethically and legally responsible manner that is inclusive of the communities they are seeking to serve. Of UNICEF’s nine Core Humanitarian Standards (depicted here to the right), three specifically refer to mechanisms of accountability towards affected peoples: response is based on communication, participation and feedback; complaints are welcome and addressed; actors continuously learn and improve. In practice this could include centralizing the voices of affected peoples by engaging communities in needs and performance assessments and decision-making. Achieving this is often hindered by the constraints inherent to conflict settings such as lack of localization of assistance, communication between actors, and exploration of needs.
CARE’s Community Score Card
Seeking to actualize these principles of community participation and accountability into our programming, CARE developed the Community Score Card as part of a project aimed at developing innovative and sustainable models to improve health services. Working in crisis settings requires an understanding of the lived experiences of people, the power dynamics, and micro-politics that inform humanitarian response approaches. It also requires bridging the gap between civil society organizations, local and national governments, international non-governmental organizations, and impacted communities. Social accountability approaches do this by connecting citizens with those responsible for providing services. The Community Score Card (CSC) is a participatory social accountability mechanism for assessment, planning, monitoring and evaluation of services. Designed for ease of use and adaptation into any sector with a service delivery scenario, the CSC brings together users and providers of a particular service or program to jointly identify service utilization and provision challenges, mutually generate solutions, and work in partnership to implement and track the effectiveness of those solutions in an ongoing process of quality improvement. The CSC has five phases: (I) planning and preparation; (II) conducting the scorecard with the community; (III) conducting the scorecard with service providers; (IV) interface meeting where the all parties present their findings in the presence of duty-bearers and then jointly develop action plans; and (V) monitoring of the action plans and evaluation of overall process. Read More...
Support for Service Delivery Integration- Services (SSDI-Services) Endline
SSDI-Services was the flagship project for USAID/Malawi’s health office. The project was implemented from November 8, 2011 to March 7, 2017 under a cooperative agreement, valued at USD 89 million. Active project implementation occurred over a 4.5-year period from April 2012 to December 2016, with the preceding and following months focused on startup and closeout activities respectively.
SSDI-Services provided financial and technical assistance to the Malawian Ministry of Health (MoH) to deliver, refine, and scale up high-impact interventions contained in the Essential Health Package (EHP). The EHP includes globally proven and cost-effective interventions to address key causes of illness and death in Malawi. SSDI-Services implemented interventions under the following program areas: maternal, newborn, and child health (MNCH); family planning (FP); malaria; nutrition; HIV/AIDS; and sanitation and hygiene.
SSDI-Services was implemented by a consortium comprising Jhpiego as lead, CARE, Plan International, and Save the Children. The project focused on increasing access to, and strengthening the delivery of, EHP services both at the health facility and in the community. It leveraged the work of both SSDI-Communication and SSDI-Systems to improve health-seeking behavior and the quality of health services by addressing the informational needs of both service providers and their clients. It also addressed systems issues that may hinder the provision of high-quality Read More...
SSDI-Services provided financial and technical assistance to the Malawian Ministry of Health (MoH) to deliver, refine, and scale up high-impact interventions contained in the Essential Health Package (EHP). The EHP includes globally proven and cost-effective interventions to address key causes of illness and death in Malawi. SSDI-Services implemented interventions under the following program areas: maternal, newborn, and child health (MNCH); family planning (FP); malaria; nutrition; HIV/AIDS; and sanitation and hygiene.
SSDI-Services was implemented by a consortium comprising Jhpiego as lead, CARE, Plan International, and Save the Children. The project focused on increasing access to, and strengthening the delivery of, EHP services both at the health facility and in the community. It leveraged the work of both SSDI-Communication and SSDI-Systems to improve health-seeking behavior and the quality of health services by addressing the informational needs of both service providers and their clients. It also addressed systems issues that may hinder the provision of high-quality Read More...
Ghana Strengthening Social Accountability Mechanism (GSAM) final
USAID/Ghana contracted Social Impact, Inc. to conduct an impact evaluation of USAID’s Ghana Strengthening Accountability Mechanisms (GSAM) program, which aims to increase accountability of local District Assemblies in Ghana. This randomized-controlled trial, impact evaluation tests the effect of two distinct efforts to increase accountability and improve service delivery outcomes at the district level. One-hundred and fifty of Ghana’s districts were matched and randomized into one of three groups: a top-down treatment group that received performance audits conducted by the central government Ghana Audit Service (GAS); a bottom-up treatment group that received civil-society organization (CSO) led scorecard campaigns; and a control group that did not receive either intervention.
Through surveys with citizens, local administrators, and local politicians and through a review of administrative data, we find that both CSO and GAS programming generally reduce citizen satisfaction with projects and services, but this is largely driven by districts that receive negative audit reports. That citizens are correctly attributing bad audit performance to poor-performing DAs is encouraging from the point of view of accountability. This progress with citizens has not, however, translated into many substantial changes in how administrators or politicians manage projects or project budgets. Neither GAS nor CSO programming improve transparency or corruption. GAS programming does reduce the incidence of partisan manipulation of public resources by politicians, and it also increases the perception of partisan manipulation among administrators. This is consistent with GAS sensitizing administrators to partisan manipulation and reducing its actual incidence among DA politicians.
CSO programming increases citizen-reported consultation on recent development, and administrators in CSO districts spend, on average, three hours more responding to constituents. Reasons that the intervention did not have a stronger impact on district officials includes (1) natural limits to the number of citizens reached by the intervention, (2) limited district government capacity and frequent turnover, and (3) local government dependence on federal budget transfers. Read More...
Through surveys with citizens, local administrators, and local politicians and through a review of administrative data, we find that both CSO and GAS programming generally reduce citizen satisfaction with projects and services, but this is largely driven by districts that receive negative audit reports. That citizens are correctly attributing bad audit performance to poor-performing DAs is encouraging from the point of view of accountability. This progress with citizens has not, however, translated into many substantial changes in how administrators or politicians manage projects or project budgets. Neither GAS nor CSO programming improve transparency or corruption. GAS programming does reduce the incidence of partisan manipulation of public resources by politicians, and it also increases the perception of partisan manipulation among administrators. This is consistent with GAS sensitizing administrators to partisan manipulation and reducing its actual incidence among DA politicians.
CSO programming increases citizen-reported consultation on recent development, and administrators in CSO districts spend, on average, three hours more responding to constituents. Reasons that the intervention did not have a stronger impact on district officials includes (1) natural limits to the number of citizens reached by the intervention, (2) limited district government capacity and frequent turnover, and (3) local government dependence on federal budget transfers. Read More...
STORIAN BLONG YUMI PROJECT EVALUATION
The purpose of this evaluation is “to assess whether or not the Community Scorecard (CSC) approach as adapted to Vanuatu through the Storian Blong Yumi pilot (SBY) project offers a viable model for community-centred social accountability in Vanuatu and to document lessons from the pilot for future application”.
The Storian Blong Yumi project (SBY) tested the Community Scorecard approach for the first time in the Pacific, applying the CSC to Sexual and Reproductive Health services delivered by Vanuatu MoH health facilities serving 4 communities in Tafea Province.
The Storian Blong Yumi pilot of the CSC model in Vanuatu demonstrated results in the following areas, most strongly in the first two areas:
Stimulating dialogue between service providers and communities and overcoming social taboos to open up discussion within the community on SRH issues. Across all groups, including young men, who were the group that proved most difficult to engage, participants valued the process of community discussion. This dialogue appears to have been the basis for establishing better understanding and relationship between service providers and community members. This in turn seems to have laid the foundations for increased access to services by community members and responsiveness by service providers.
Increasing awareness of the SRH services available within their local health facility. Across groups of older and younger men and women in all locations people were aware of what family planning and STI services were available to them and what the role of the health staff were. in all locations, people who participated in the evaluation were more aware of what family planning and STI services were available to them and what the role of the health staff were. Men in all locations reported that they didn’t previously know what happened in the health centre regarding SRH, but now they have a better understanding. Read More...
The Storian Blong Yumi project (SBY) tested the Community Scorecard approach for the first time in the Pacific, applying the CSC to Sexual and Reproductive Health services delivered by Vanuatu MoH health facilities serving 4 communities in Tafea Province.
The Storian Blong Yumi pilot of the CSC model in Vanuatu demonstrated results in the following areas, most strongly in the first two areas:
Stimulating dialogue between service providers and communities and overcoming social taboos to open up discussion within the community on SRH issues. Across all groups, including young men, who were the group that proved most difficult to engage, participants valued the process of community discussion. This dialogue appears to have been the basis for establishing better understanding and relationship between service providers and community members. This in turn seems to have laid the foundations for increased access to services by community members and responsiveness by service providers.
Increasing awareness of the SRH services available within their local health facility. Across groups of older and younger men and women in all locations people were aware of what family planning and STI services were available to them and what the role of the health staff were. in all locations, people who participated in the evaluation were more aware of what family planning and STI services were available to them and what the role of the health staff were. Men in all locations reported that they didn’t previously know what happened in the health centre regarding SRH, but now they have a better understanding. Read More...
Journey for the Advancement of Transparency, Representation, and Accountability (JATRA)
This 39 page report highlights the final evaluation findings from the Journey for Advancement for Transparency, Representation and Accountability (JATRA) project, which aimed to strengthen participatory governance processes in the public finance management systems of 15 Union Parishads in Nilphamari and Gaibandha districts of Northwest Bangladesh so that they are more transparent and accountable. This project was funded through the Global Partnership for Social Accountability (GPSA), established by the World Bank. Read More...
Keeping Girls At School Program Impact Evaluation rwanda edoag care final report
The Keeping Girls At School (KGAS) program is an initiative of CARE Rwanda aimed at reducing the number of girls who drop out of secondary school and increasing the share of girls that transit from lower to upper secondary education. CARE Rwanda and its implementing partners worked in 30 schools, across three districts in the Southern Province. The KGAS initiative has three main channels through which it aims to reduce dropout rates among adolescent girls: i) Providing mentorship opportunities for girls within the context of Girls Clubs; ii) Engaging girls in voluntary savings and loans (VSL) and income-generating activities; and iii) Establishing a Community Score Card (CSC) system that allows girls to comment on and influence institutions affecting their education
experience. [This 86 page document highlights the results of the KGAS program] Read More...
experience. [This 86 page document highlights the results of the KGAS program] Read More...