Community Based Monitoring System for Access to Basic Minimum Services, Kerala D Narayana Slim Haddad Smitha Aravind Katia Mohindra Access to Health Care.

Community Based Monitoring System for Access to Basic Minimum Services, Kerala

D Narayana

Slim Haddad

Smitha Aravind

Katia Mohindra

Access to Health Care and Basic Minimum Services

in Kerala, India

Sali, 18 June, 2004

SH/2003

Two Objectives

Intervention: Health Solidarity Scheme

Monitoring: Community Based Monitoring System

SH/2003

Implications of Panchayati Raj/ Municipalities as the Third Tier of Governance in India's Federal Structure

State

Panchayat Raj

Zylla P.

Block P.

Gram P.

Gram Sabha

Municipality

M. Corporation

M. Council

Nagar P.

Ward meetings

Autonomous Councils for Tribal Areas

Union

Source: Figure 2, Mathew, G and Mathew, A (2003)

SH/2003

Salient Features of Local Governance

Persons chosen by direct election to fill seats

Seats shall be reserved for Scheduled Caste/Scheduled

Tribes

One-third the number of seats reserved for women

Offices of chairperson shall also be reserved for

women / SC or ST

Plan for economic development and social justice

SH/2003

Planning and monitoring at panchayat level

Development projects identified from Gram sabha

Working groups formulate projects and monitor

implementation

Need to go beyond- to monitor impacts

Sectoral allocation of funds

In most of the cases equal distribution of fund among

wards irrespective of the needs

SH/2003

Planning/Monitoring without data

India has an elaborate statistical system

But hardly any data available below the district level

Decentralized governance calls for database

at the local level

Line departments carry out regular surveys

But hardly any database at the Panchayat level

SH/2003

Community Based Monitoring System for

Access to Basic Minimum Services- Outcome

Set of relevant information and available longitudinal

measures through population-based information systems.

Increased knowledge of characteristics of vulnerable

populations- poor, women and tribes.

Improved evidence-based planning and skills.

Feedback on implemented programs

SH/2003

Distinguishing Features- Partnership Development/ Participation

Participation as the foundation

Steering Committee representatives from state/district governments,

local govt., local NGO, research team

discusses all issues and approaches

Local Coordination Committee representatives from local government, NGO,

women’s groups, research team all issues placed before the committee, discussed,

suggestions taken in

SH/2003

The need for a database in the Panchayat

Survey of surveys showed lack of a database

Many surveys but hardly any

systematic use of data

How a survey became a census

A database built up, analysis going on

SH/2003

Interaction with the Working Groups

Preliminary results of the census presented before WG members

Encouraging response- general recognition that information was of great value

The challenge of transferring the know how of building database and using

Decision to set up a Resource Group (KRG)

SH/2003

The Kottathara Resource Group (KRG)

KRG set up but met after 5 postponements and delay of six months.

The meeting aiming at familiarizing the members

with the database did not take place after two

postponements

Current thinking of LCC- KRG not workable

SH/2003

Interaction in Gram Sabha (Village Assembly)

Presentation of indicators:

First time the population were exposed to such process

Very well received.

The database seen as an important input for planning

Gathering information on a regular basis seen as very useful for local planning Monitoring?

Questions repeatedly asked: What can be done with the data? What is next?

SH/2003

Working Reports

7 Profiles:

1. General Profile;

2. Poverty Profile

3. Health Profile

4. Access to Basic Services

5. Gender Profile

6. Tribal Profile

7. Financial Protection

Sources

Database

Other available secondary sources

Project Products (reports)

CBMSCBHSS

Working group report

Review oftribal

schemes

« Goat »report

Guiding principles

CBHSS

Survey of Health facilities

Health information

system

Survey of colonies

ProfilesSurvey

of surveys

Working group meeting on CBMS

Monitoring population needs and

project impacts: a practical example.

Kottathara Panchayat Office

November, 13, 2003

Access to Health Care and Basic Minimum Services

in Kerala, India

SH/2003

Case study

Database: CBMS Household survey (April, 2003)

Data available to date: wards 2, 3, 4, 5, 6.

Indicator used for the example: Households receiving any of the following benefits:

Agricultural, Widow, Old Age, Child, Disability, Other

SH/2003

The monitoring process

Part 1: What is the current situation? How many households?

Where are the households that are receiving benefits?

Who are the households that are receiving these benefits?

Part 2: What is the progress? Monitoring changes

in needs, inequalities

Part 1: What is the current situation?

SH/2003

Households receiving benefits

Households receiving benefits

Households not receiving benefits

Total households

Number

387

1284

1671

Percentage

23%

77%

100%

SH/2003

Where are the households receiving benefits?

W2 W3 W4 W5 W6 Total

Receiving benefits 86 75 75 80 78 387

Total number of HH 345 350 328 340 308 1671

Percentage of HH receiving benefits

25% 21% 23% 24% 25% 23%

Distribution of the HH receiving benefits

22% 19% 19% 21% 20% 100%

SH/2003

Who are the households receiving benefits?

Group

Paniyas

Other tribes

Non tribes

Total

67

Number

258

387

63

24%

% of population

21%

23%

38%

SH/2003

Who and where?

Group W2 W3 W4 W5 W6Group

incidence

Paniyas 0% 36% 54% 31% 38% 38%

Other tribes 18% 30% 28% 18% 31% 24%

Non tribes 26% 19% 17% 24% 21% 21%

Ward incidence 22% 19% 19% 21% 20% 100%

Percentage of households receiving benefits

Graph. presentation

19%

17%

24%

21%

0%

36%

54%

31%

38%

18%

30%

28%

18%

31%

26%

0% 10% 20% 30% 40% 50% 60%

W2

W3

W4

W5

W6

Other tribes

Paniyas

Non tribes

Percentage of households receiving benefits

Part 2: monitoring change

Monitoring progress: the before – after approach

Percentage of households receiving benefits by ward: 2003 - 2006 (hypothetical)

0% 10% 20% 30% 40% 50% 60%

W2

W3

W4

W5

W6

Total

After

Before

THANK YOU