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