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

1. Access to Health Care and Basic Minimum Services in Kerala, India Community Based Monitoring System for Access to Basic Minimum Services, Kerala D NarayanaSlim HaddadSmitha AravindKatia Mohindra Sali, 18 June, 2004

2. Two Objectives • Intervention: Health Solidarity Scheme • Monitoring: Community Based Monitoring System

4. Implications of Panchayati Raj/ Municipalities as the Third Tier of Governance in India's Federal Structure Union State Panchayat Raj Municipality Zylla P. M. Corporation Block P. M. Council Gram P. Nagar P. Gram Sabha Ward meetings Autonomous Councils for Tribal Areas Source: Figure 2, Mathew, G and Mathew, A (2003)

5. 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

6. 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

7. 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

8. 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

9. 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

10. 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

11. 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)

12. 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

13. 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?

14. Working Reports • 7 Profiles: • General Profile; • Poverty Profile • Health Profile • Access to Basic Services • Gender Profile • Tribal Profile • Financial Protection • Sources • Database • Other available secondary sources

15. Review of tribal schemes Working group report Survey of surveys Survey of colonies Health information system CBMS CBHSS Profiles Survey of Health facilities Guiding principles CBHSS « Goat » report Project Products (reports)

16. Access to Health Care and Basic Minimum Services in Kerala, India Working group meeting on CBMS Monitoring population needs and project impacts: a practical example. Kottathara Panchayat Office November, 13, 2003

17. 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

18. 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

19. Part 1: What is the current situation?

20. Households receiving benefits

21. Where are the households receiving benefits?

22. Who are the households receiving benefits?

23. Who and where? Percentage of households receiving benefits

24. Graph. presentation Percentage of households receiving benefits

26. Part 2: monitoring change

27. Monitoring progress: the before – after approach

28. THANK YOU