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Demanding Better Healthcare

Demanding Better Healthcare. CSOs and Health Systems Strengthening. Global Health Council Seminar March 29, 2010. Courtney Tolmie , Results for Development Institute. Why CSOs?.

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Demanding Better Healthcare

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  1. Demanding Better Healthcare CSOs and Health Systems Strengthening Global Health Council Seminar March 29, 2010 Courtney Tolmie, Results for Development Institute

  2. Why CSOs? Fundamental question – why is development spending in the health, education, and water sectors not translating into improved development results? The dialogue began with supply-side reforms, with mixed results. Demand-Side interventions can fill many of the gaps left by traditional Supply-Side reforms because: • CSOs are on the ground 24-7 to monitor expenditures • CSOs are beneficiaries of the public spending • CSOs have knowledge of local context to know what will work. Transparency and Accountability Program (TAP) - designed to help CSOs strengthen their capabilities to analyze budgets, expenditures, and service delivery and to argue effectively for improvements

  3. Key TAP Activities

  4. Grantee Profile TAP’s Support Impact of TAP Phase 1 GranteesCIEN Guatemala Results and Impact • CIEN Guatemala • Policy Research Center • Interested in tracking six key spending programs (including textbooks, school supplies, and meals) in primary schools in the capital city • $50,000 grant • Technical support workshop, including individual targeted support on CIEN study topic • Review of analytical products • Found that only 28% of primary school students had books in the first school month of 2008 • Recommended that school should start after the fiscal year to improve chance that resources get to schools on time • Successfully lobbied Minister of Education for this change and have developed tools to help teachers monitor success of policy change

  5. Grantee Profile TAP’s Support Impact of TAP Phase 1 GranteesCIUP Peru Results and Impact • CIUP Peru • Policy Research Center, part of a university • Interested in tracking the flow of funds for TB programs in Peru • $50,000 grant • Technical support workshop, including individual support on access to information issues • Review of analytical products • Found significant breakdowns in communication between Health Network and facilities • Currently working with MOH and Congress to increase budget literacy of facility staff and create better channels for communications on stockouts, etc.

  6. Grantee Profile TAP’s Support Impact of TAP Phase 1 GranteesCDD Ghana Results and Impact • CDD Ghana • Public Policy-Oriented NGO • Developed study to estimate the incidence of teacher absenteeism in Ghana and identify potential causes • $50,000 grant • Technical support workshop on absenteeism study methodology • Worked with CDD on advocacy plan • Review of analytical products • Found that 47% of teachers were absent at least once during 5 school visits • Trends in absenteeism included significant increase on Fridays • Working with Ghanaian Education Service on concrete solutions to move long-distance teacher training and pay days so that they no longer conflict with Friday classes

  7. Next Steps • Increasing the sustainability of monitoring by civil society • Improving collaborations between government and CSOs to make some of this work both supply- and demand-driven • Develop better ways to measure the effectiveness and cost-effectiveness of CSO work and support programs (like TAP)

  8. For more information: • CSO reports and resources available on TAP website - http://tap.resultsfordevelopment.org • From the Ground Up – cases and lessons learned from first TAP grantees (available from Brookings Press)

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