Community based monitoring of health services

Publication year: 2009

Publication type: Conference presentation – Oral

Citation: Bhojani U, Devadasan N. Community-based monitoring in health: lessons from practice. Karnataka Association of Community Health 21st Annual Conference,  Mysore October 2009

Abstract:  To ensure that the services reach the beneficiaries, the National Rural Health Mission proposed ‘community monitoring of health services’ as a key strategy to establish an accountability framework for health services. NRHM has for the first time institutionalized a community-based monitoring process by piloting it in nine states across India. However, community-based monitoring is not a new concept and has been in practice, though at a very small scale in India. We reviewed such examples of community-based monitoring in health across the country in order to learn operational lessons. From literature review and interviews with public health experts, seven initiatives of community-based monitoring in health were identified. Case studies of these initiatives were prepared based on project documents and evaluation reports. Interviews were conducted with project managers and the community in four of these seven initiatives. Government staff were also interviewed to understand their perceptions of community monitoring. We learnt that monitoring system works effectively only when data collected is utilized and is meaningful for people at all the levels. Community members can effectively collect and analyze data when data elements, data collection, reporting and analysis is made simple and demystified. Involvement of health service providers right from the beginning is helpful in providing legitimacy and acceptance to the monitoring process. Handholding of community members and service providers over the time is crucial for smooth and meaningful evolution of the process. Demands of community and service providers may not overlap and these differences need to be accommodated for while designing the monitoring tools.