Community voices is an attempt to:

1. “Community Voices”Annual Score Card on Civil Society Monitoring of Pro-poor Policies & Programs under Ghana’s Poverty Reduction Strategy, 2004Prepared by:Dr. Sulley GaribaJonathan LangdonIssifu LampoInstitute for Policy Alternatives, Ghanawww.ipaghana.org

2. Community voices is an attempt to: • Use a social accountability tool ommunity SCORE CARD -- to interrogate the implementation of pro-poor policy • From the perspective of rural and impoverished communities • Facilitated by organizations of civil society • Who have a potential to catalyze advocacy at Local Government level, with Parliament, at the level of central government

3. Civil Society Monitoring of Poverty Reduction Using Community Scorecard What were the main issues? What did we do? & What did we find?

4. Context: • Policy environment which legitimizes participation in formulation, implementation and oversight of pro-poor policies • Legitimacy and rights of organizations of civil society to set-out unique and independent monitoring of poverty reduction policies

5. Conceptual Framework • Monitoring for efficiency of public policies – were the targets of GPRS met? APR • How effective are the policies and programs – Impact Evaluations of GPRS (not yet initiated in Ghana) • How accountable are these policies to the rights and responsibilities that citizens have vis-à-vis the state?

6. Social Accountability defined as: • Process of balancing citizen leadership and capacity to demand their rights, while fulfilling their responsibilities; with the capacity and willingness of the state to facilitate the fulfillment of these rights and responding to citizen demand. • When applied to poverty reduction policies, social accountability has an added dimension of the fulfillment of the rights of the vulnerable and the marginalized society

7. Therefore, we were challenged by GPRS to Assess: • Health Exemption Policies for the Poor • Education that is pro-poor • Resource Allocation as it applies to District Assemblies

8. National Scope • Together, as a grouping of over ten civil society organizations we covered: • 13 Districts in Ghana • 8 Regions out of the 10 administrative regions • 76 communities • Over 5,000 community leaders and members, local government officials, service providers and managers of health and education delivery

9. National Coverage Bawku East Jirapa/Lambusie Builsa Wa Savelugu/Nanton West Mamprusi Zabzugu/Tatale East Gonja Sekeyre East Kpandu Afram Plains Cape Coast Dangme East

10. What did we do? • The Three key themes of Health, Education and Resource Allocation were looked at, with a number of district covering each theme: • Health 4 Districts • Education 5 Districts • Resource Allocation 4 Districts

11. Health for the Poor through Exemptions? • What did we Find? • Communities, especially stakeholders of the poor and the vulnerable, want the right to quality and affordable health care, and a health service that respects them and their rights as “human beings”

12. Indicators of Pro-poor Health • 79 % of communities selected Staff Attitude and Quality Care as a major indicator assessing health services to the poor • 75% selected Availability and Affordability of Drugs

13. Health Grades, at a glance

14. Staff Attitude and Quality of Care They do not give the needed attention to patients – they sometimes completely refuse to attend to poor people who are sick people at times (particularly during the night and weekends), insult and shout at these patients. – Afram Plains District, Eastern Region Drug Affordability and Availability Bad; we buy the expensive drugs from the drug stores – Danku, Wa District, Upper West Region Pregnant Women Many mothers prefer to deliver at home or with TBAs due to poor attitudes of nurses. This sometimes results in complications and death. The needed attention and care is also not given at clinics. . – Afram Plains District, Eastern Region Awareness I paid for my wife who went to deliver, only to hear from some one that I was not supposed to pay but I could not go back for my money. – Boli, Wa District, Upper West Region Community Voices - Health

15. Some more Voices Women in Bugiya, West Mamprusi, speak out about exemption policy & access to drugs

16. Another Voice A chief in West Mamprusi adds his voice to the discussion. He concludes that health service has led him to believe, “to die is honey and to live is salt.”

17. In Education… • What did we find?: • Communities are living up to their responsibilities as parents and as students, but GES and Government are not providing the support they need: • There is a national crisis over the adequacy and quality of teaching in rural communities, considered to be the poorest • The textbooks needed for rural students to have an opportunity to compete with their urban counter parts are not there • The right to education for girls are denied

18. What Indicators did communities use to assess Education? • 100 % of communities selected Adequate, Qualified and Effective Teaching • 96% selected Textbook access

19. Education Grades, at a glance

20. Adequate, Qualified and Effective Teaching You send your child to school because you want him to be somebody in future, now this is not possible because there are no teachers – woman, Suke Textbook In the rainy season, a farmer without a hoe benefits nothing from the rains; so is a student without text book. – woman, Chetu School Building Building not protected so rainfall, sunshine and animals interfere and interrupt children’s attention during classes. Blackboards are pasted on walls instead and this creates inconvenience. Samankwae Community Voices - Education

21. How resources are allocated for Pro-poor development at District level • What did we Find?: • Communities do not have the information about resources already committed to their development; feel their elected representatives are denied this information, and want the right to be involved in resource allocation decisions that affect their lives. They are tired of being under-valued and under-consulted when something is brought into their villages and towns.

22. Community-driven indicators for assessing Resource Allocation • 100 % of communities selected Consultation and involvement in Resource Planning • 100% selected Information, including budgets, on resources allocated

23. Resource Allocation Grades, at a glance

24. Consultation “We have no value, else they would have consulted us before sighting this culvert” – woman, Agbedrafor, Dangme East Information (including budgets) If They have nothing to hide, why we don’t know the costs of projects so as to appreciate how they value us.” – Elder, Nakomkope Quality Can a Marginalized person of this community begiven anything of value? – Elder Salom Felt Need Who knows what you may need, when planning is done in their big offices? – Youth, Toflokpo Participation When they look mean on us, how can they allow us to participate? – Woman, Bonikope Transparency Construction works on the road are done at night ïf you are not stealing, why do you not work during the day? Community Voices – Resource Allocation

25. Implications of these Findings for Pro-poor Policies and Programs: • Review of GPRS (currently on-going) • On-going implementation, monitoring and evaluation • Policy changes needed

26. GPRS Review: • The initiatives in previous GPRS that were explicitly pro-poor must be retained and expanded • Ring-fencing of these specific pro-poor initiatives is needed in order that organizations of civil society representing the poor can focus on the accountability of these policies and programs to the poor

27. Policy Change: • This assessment has revealed 4 main elements of rights of the poor that must be up-held: • The right to information about policy priorities and resources devoted to these on behalf of the poor • The right to participate in decision-making • The right to be “valued” and, • The right to question policies and programs (demand of accountability from officer bearers and service providers) Any pro-poor policy and program initiative in GPRS must now include how these rights will be fulfilled by office bearers and service providers

28. Continuing Community Voices: • This is the first, we are committed to doing this annually • Indicators that are determined by communities themselves need to inform the “objectively verifiable indicators” determined from the “top” • In time, we foresee a monitoring and evaluation regime that has two sides of the same coin – what the state has provided, and what communities have said about these

29. Dissemination Strategies: • Dissemination within Districts • Dissemination at the national level

30. District-level Dissemination: • Interface as the first stage in dissemination • Production of reports in popular version comprising: • One issue summaries with graphics • Illustrated local language versions • Radio talk shows on the issues • Media coverage of community meetings to discuss issues arising from the poverty monitoring

31. National Level Dissemination • Validation and refinement of composite analyses and report • Final Preparation of “Community First • National Launch of the Community First outlining the results and their implications • Akontabuo -- Newsletter on Social Accountability • Video documentary on Poverty Monitoring and Social Accountability • National Talk-show on radio and television

32. Policy Implications and dialogue: • Briefing sessions with key sector Ministries of Health, Education, Common Fund Administrator • Briefing sessions with the Multi-donor Budget Support Group • Engagement of Ministry of Finance and also NDPC to review the key findings vis-à-vis the Annual Progress Review (APR) of GPRS

33. Advocacy with Parliament: • IPA is developing an agenda for advocacy with Parliament to be funded partly by the Parliamentary Center, Canada • Will be launched in April, to coincide with the next session of Parliament

34. Afram Plains Dev’t Organization (E.Region) Amasachina (Northern) Community Partnership for Health & Development (Northern) ISODEC (Ashanti) Radio Ada (Greater Accra) Civic Response (Central & Western) Pronet-North (Upper West) SimliAid (Northern Region) Rural Media Network (Northern Ghana) Northern Ghana Network for Development (3 Northern Regions) Partnership for Sustainable Development (Bawku) Municipal Action Foundation (Volta Region) Who are we?

35. The 3 Cs: • Competence – in engaging citizens, in understanding the policies and programmes and in conducting the research • Credibility – seen as advocates of the poor, engaged in programmes ourselves, and also a close recognition of the officials and the communities as partners in the same process • Confidence – ability of the CSO to articulate the process and the findings of the monitoring process

36. How Process is Governed: • An 8-member Reference Group of Peers drawn from: • Civil Society • Academic • Private Sector • Government • Legal profession • A volunteer group that reflects and advises; challenging ourselves to carve autonomous spaces where civil society can take initiatives and assume leadership

37. Who is coordinating this? • Institute for Policy Alternatives (IPA) provided: • Training services in social accountability • Supported the implementation of the social accountability initiatives – through monitoring and field support • Managed a social accountability fund provided by DfiD • Undertook community monitoring initiatives in 2 Districts, focusing on health exemption in one and mutual health insurance in another

38. Appreciation: • DfiD-Ghana provided funding to see these initiatives to fruition • Civic Engagement Group of the World Bank provided early methodological support and supported refinement of tools and training of trainers • Communities provided the energy and the resolve • CSO partners undertook the journey • Public officials grew in tolerance…and hopefully will grow in confidence to facilitate and hear the “Community Voices”

39. An invitation to go North, to IPA: • Whether you a MP from Uganda or Tanzania

40. An invitation to go North, to IPA: • Seeking engagement at the village

41. An invitation to go North, to IPA: • Or simply to attend training training on monitoring, evaluation and policy analysis…at our training center in Tamale, Ghana