Community Score Card
Interact Worldwide Community Score Card Approach: A participatory project monitoring tool.
The Community Score Card (CSC) approach enables communities to first understand their rights and entitlements and, secondly, find ways to engage with service providers and Governments and hold them accountable for the services they provide.
The CSC approach is a simple and cost effective tool, which comprises of three stages:
o Firstly, service users (SU) and service providers (SP) hold separate and then joint meetings to identify Sexual and reproductive health and HIV and AIDS related issues. They also discuss what entitlements the service users have and what services are available for them, and score them against the indicators they came up with themselves.
o Secondly, they identify joint recommendations that are taken to the local leaders, other health local stakeholders and decision makers i.e. local government for their follow up.
o Lastly the different Community Score Card processes are pulled together to identify advocacy issues on sexual and reproductive health and HIV and AIDS services which can be brought to attention at the national level.
With support of the World Bank, Interact Worldwide has successfully trained partner organisations in Malawi, Uganda, Ethiopia, Tanzania, India and Pakistan to use the Community Score Card. The approach has been effective in promoting accountability, fostering community engagement, identifying gaps and weaknesses in service provision and building community capacity to work with Government and health service providers so as to bring about lasting improvements to health service delivery. Exchange visits and ongoing lessons learning between the different partners ensure that the effectiveness of the approach is maximised.
Community Score Card in Action
As a result, in Tanzania for example, community members and service providers have reported how they now feel more able to work together to improve the quality of services without pointing an accusing finger at each other. In effect, in one of the communities two dispensaries were upgraded to health centres, meaning that the community was entitled to more and improved services. In another community a doctor was posted to the local health centre. In addition a voluntary, counselling and testing room was also built. Previously community members had to walk 24 kilometres to get a doctor or get voluntary, counselling and testing services.
In Uganda community members have reported a greater sense of empowerment and ownership as a result of understanding some of the challenges and constraints felt by the district government and they also reported a greater sense of self-worth as a result of their participation in the process.
As a result following meetings between government and communities a health centre received a CD4 machine and staff were trained to dispense medication and monitor the physical well being people living with HIV. In another, a health centre that previously had no lighting was fitted with solar panels.