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South Africa

Citizen-Based Monitoring (ZA0016)

Overview

At-a-Glance

Action Plan: South Africa’s Third National Action Plan 2016-2018

Action Plan Cycle: 2016

Status: Inactive

Institutions

Lead Institution: Department of Planning, Monitoring and Evaluation

Support Institution(s): South African Police Service, Department of Health, South African Social Security Agency; Good Governance Learning Network, Seriti Institute, Canadian International Development Agency, local community organisations specific to the government facilities were work is being done

Policy Areas

Capacity Building, E-Government, Justice, Policing & Corrections, Public Participation, Public Service Delivery

IRM Review

IRM Report: South Africa Mid-Term Report 2016-2018

Starred: No

Early Results: Marginal

Design i

Verifiable: Yes

Relevant to OGP Values: Civic Participation , Technology

Potential Impact:

Implementation i

Completion:

Description

Status quo: Routine accountability mechanisms, particularly at the point of service delivery, are weak, with insufficient feedback from community and frontline staff in the mechanisms for allocating resources and setting targets and measuring performance.

Main objective: Support government departments to strengthen the citizen voice in monitoring service delivery.

Brief description: DPME will work with 3 service delivery departments to strengthen the voice of citizens in their monitoring and planning. DPME will provide a knowledge broker service w.r.t citizen based monitoring by hosting workshops and discussions with government and civil society partners, aimed at strengthening the voice of citizens in monitoring and planning.

Challenges: Civic Participation, Public Accountability, Technology and innovation for openness and accountability

Intended results: This commitment is relevant to :
(1) Civic Participation: The citizen-based monitoring model advanced by DPME includes developing a set of actions and commitments for addressing service delivery challenges. This is done through discussion groups made up of officials and community leaders/members and these commitment charters are further shared and refined at a public meeting. The model also includes reporting and accounting for progress to community forums such as ward committees, community police forums and other community structures.
(2) Public Accountability: The use of community surveys/audits of service delivery is a key part of the citizen-based monitoring method. These involve community members conducting the surveys and participating in the sense-making and feedback step.
(3) Technology and innovation for openness and accountability: An on-line reporting platform has been developed for capturing and reporting citizen feedback. This is in its early stages of development, but in its current iteration it provides a portal for producing citizen feedback reports. This system will evolve based on demand and use. Innovation is central to the evolution of the CBM method, with action learning cycles driving the process.

Ambition: The Department of Planning Monitoring and Evaluation, a department in the Presidency is tasked to promote citizen-based monitoring (CBM) within government. The CBM programme supports the achievement of a Cabinet resolution (2013) that all departments that delivery services to the public must introduce citizen- based monitoring. Following an intensive two year action learning process with four service delivery departments and 34 government facilities (police stations, health facilities, grants offices and social welfare service points), DPME is now moving into a strategic support role to advance the routine use of citizen (and frontline staff) feedback and engagement to drive continuous improvement. The approach that DPME is following is to build capacity in selected service delivery departments through providing hands-on support to officials in service delivery departments to adapt and scale DPME’s 3-step CBM model (get feedback, use this feedback to develop commitments for improvements; monitor these commitment with civil society and community structures). This is aimed to progressively grow a cadre of officials and civil society participants who been part of developing the tools and knowledge of how to use feedback and community participation as a contribution to building capable and developmental state working in concert with an active citizenry. Improving the responsiveness of government is the key objective. DPME intends to host discussion that will bring government and civil society together to discuss planning and monitoring on an on-going basis.

IRM Midterm Status Summary

Salud y bienestar

36. Indicadores de calidad de los Institutos de Medicina Altamente Especializada

Texto del compromiso como aparece en el plan de acción:

Disponibilizar a los usuarios del Sistema Nacional Integrado de Salud (SNIS) indicadores de calidad de los procedimientos realizados por los Institutos de Medicina Altamente Especializada (IMAE) y financiados por el Fondo Nacional de Recursos (FNR). Se incluirán indicadores de calidad por IMAE que reflejen información generada a partir de las auditorías de los mismos, las cuales se realizan por el FNR, así como indicadores del proceso y del resultado asistencial. Los indicadores podrán ser generales para cada IMAE o específicos para los procedimientos realizados en cada uno de ellos. Los usuarios del SNIS podrán utilizar esta información para la evaluación y elección de los IMAE.

Los hitos de este compromiso son:

  • Definir indicadores que serán presentados al público.
  • Diseñar procedimientos para el análisis. Procesar, analizar y generar el primer reporte.
  • Publicar indicadores de calidad de los Institutos de Medicina Altamente Especializada en una sección del portal A Tu Servicio.

Nota editorial: El texto completo del compromiso se encuentra en el Cuarto Plan de Acción Nacional de Gobierno Abierto de Uruguay 2018-2020, disponible aquí: https://goo.gl/XAMbNr

Fecha de inicio: Octubre 2018               Fecha de término: Octubre 2019

 

Contexto y objetivos

El Fondo Nacional de Recursos (FNR) [145] es una institución creada por ley que tiene como objetivo asegurar el acceso de toda la población a un conjunto de prestaciones médicas que se consideraron como de alta especialización e impacto económico y a medicamentos de alto precio, para toda la población radicada en el país que sea usuaria del Sistema Nacional Integrado de Salud (SNIS).

Los actos médicos financiados por el FNR se realizan en los Institutos de Medicina Altamente Especializada (IMAE). Estos institutos pueden ser públicos o privados y en la mayoría de los casos, se ubican en el ámbito de las Instituciones de Asistencia Médica Colectiva (IAMC). La medicina altamente especializada es la que requiere una gran concentración de recursos humanos y materiales, y está destinada a un escaso número de pacientes en los que está en juego el pronóstico vital o funcional.

Para acceder a las prestaciones que cubre el Fondo Nacional de Recursos, el médico tratante del paciente debe realizar la indicación y el paciente siempre tiene la libertad para elegir el IMAE [146].

Este compromiso busca poner a disposición, de manera periódica, indicadores de calidad actualizados y comprensibles para que los usuarios puedan tomar una decisión informada respecto a qué IMAE elegir. Esta información se publicará en una sección del portal A Tu Servicio [147], de manera coordinada entre el Ministerio de Salud Pública (MSP) y el FNR con el apoyo de la organización de la sociedad civil DATA.  

El portal A Tu Servicio, en funcionamiento desde 2015, pone a disposición un conjunto de datos sobre las instituciones que integran el Seguro Nacional de Salud, para que el usuario pueda comparar los valores de cada atributo en cada una de las instituciones y tomar decisiones informadas.

La persona referente de DATA [148] informó a las investigadoras del IRM, que lo que se va a publicar en el portal son los tiempos de espera de cada uno de los IMAE y las estadísticas de actos realizados. También se está evaluando la posibilidad de publicar los datos de los centros de diálisis. En este caso se estaría llegando con un servicio en línea a un grupo de población altamente vulnerable, lo que puede hacer una diferencia grande.

DATA hace una muy buena evaluación del uso del portal A Tu Servicio que hasta ahora ha sido sostenido. De acuerdo a DATA: “En 2018 fueron 40.000 los usuarios, comparado con 72.000 en febrero de 2017 cuando existió la posibilidad de cambio de prestador, lo que no fue posible el año pasado [149]. Es un número de usuarios importante a pesar de no haber existido acciones de difusión”. [150]

El compromiso plantea una serie de metas claras cuyo cumplimiento se puede evaluar objetivamente. Este compromiso avanza en el acceso a la información, poniendo a disposición nuevos conjuntos de datos que habilitan a la ciudadanía a tomar decisiones de manera informada. Tomando en cuenta el alcance y el tipo de datos que se publicará, se considera que el compromiso tendrá un impacto moderado en la apertura del Gobierno, ya que no transforma una práctica, sino que se suma a una iniciativa en marcha.

Siguientes pasos

A Tu Servicio, surge de un trabajo coordinado entre la sociedad civil y el Estado, lo que demuestra la potencialidad que el trabajo conjunto entre ambos sectores puede tener en la vida diaria de las personas.

Las investigadoras del IRM recomiendan que este ejemplo se comparta con otros organismos estatales, tengan o no compromisos de gobierno abierto, y con la sociedad civil para que sirva de modelo, tanto en lo que respecta a su objetivo, como al desarrollo y tipo de información y atributos que se comparten.  Asimismo, se recomienda continuar identificando en consulta con usuarios, nuevos conjuntos de datos del MSP que se puedan integrar a este servicio.

[148] Entrevista realizada a Daniel Carranza, DATA, 15/3/2019
[149] En febrero de 2018 y de 2019 el Gobierno no habilitó el período de movilidad regulada entre prestadores de salud, también llamado apertura del corralito mutual.
[150] Entrevista realizada a Daniel Carranza, DATA, 15/3/2019

IRM End of Term Status Summary

1. Strengthening citizen-based monitoring

Commitment Text:

Routine accountability mechanisms, particularly at the point of service delivery, are weak, with insufficient feedback from community and frontline staff in the mechanisms for allocating resources and setting targets and measuring performance.

 

DPME will work with 3 service delivery departments to strengthen the voice of citizens in their monitoring and planning. DPME will provide a knowledge broker service with regard to citizen-based monitoring by hosting workshops and discussions with government and civil society partners, aimed at strengthening the voice of citizens in monitoring and planning.

Milestones: Citizen-based monitoring model implemented in nine police stations as a first wave of CBM in South African Police Service. Conference to share lessons, experience and shape discussion on citizen-based monitoring with government and civil society. Citizen based monitoring toolkit and video published.

Responsible Institution: Department of Planning, Monitoring and Evaluation (DPME)

Supporting Institutions: South African Police Service, Department of Health, South African Social Security Agency

Start Date: November 2015

End Date: October 2016

Commitment Aim

This commitment aimed to improve public service delivery at the sites of three government entities: The South African Police Service (SAPS), the Department of Health, and the South African Social Security Agency (SASSA), by implementing a Citizen-Based Monitoring (CBM) Process. Specifically, the commitment planned to increase CBM implementation points, develop a CBM toolkit and video, and require the Department of Planning, Monitoring and Evaluation (DPME) to convene a government-civil society CBM conference.

Status

Midterm: Complete

This commitment was completed by the midterm. At that time, the DPME had implemented the CBM model in 17 police stations, 20 service points of the SASSA (in partnership with Making All Voices Count, a project coordinated by the NGO Black Sash in partnership with 20 community-based organisations), and a pilot sample of health facilities in the province of Mpumalanga (in partnership with the Mpumalanga Department of Health). The DPME convened an ‘Advancing Citizen-Based Monitoring Workshop’ on 20–21 September 2016 in Johannesburg, published a CBM Toolkit, and produced a CBM video.[1]

By October 2018, the national executive of the SAPS had not yet decided on a national roll-out of the CBM model, and staff changes at the National Commissioner’s office meant that the champions of the project no longer occupied the same positions.[2] Similarly, there has been no decision on the part of national health authorities to extend the roll-out of CBM to other health facilities following the pilot in Mpumalanga.[3]

Through the work of Black Sash, however, CBM has helped transform the payment system at SASSA service points,[4] along with service delivery at a couple of local government service points and health facilities. Black Sash maintains a dedicated website for CBM[5] which includes information on CBM resources (including the DPME’s Citizen-Based Monitoring Toolkit), details of 54 CBM sites,[6] details of 43 community partners,[7] and the results of CBM surveys undertaken at various CBM sites from June 2015 to May 2018.[8] The goal is to survey at least 300 participants at each site, with data gathered by trained monitors and captured on a central database.[9] Findings are reported to the facility and its users and serve as the basis for dialogue to develop an improvement plan to address concerns.[10]

Did It Open Government?

Civic Participation: Marginal

At the start of the implementation period, CBM had been piloted in four service delivery departments and 34 government facilities, including police stations, health facilities and SASSA sites.[11] By the end of action plan, CBM has gained traction in the social security sector, where it is being used to improve service delivery, in addition to providing feedback on policy decisions such as transitioning payment systems for social security grants.

For service delivery improvements at SASSA sites, the CBM tool provides the government, civil society and the public with invaluable information on the types of grants for which people are applying at a facility, service preferences (e.g. whether the grant applicant would switch to another method of payment), methods of accessing payment facilities (distance from service point as well as time and cost of travel), the quality of facilities (e.g. adequate toilet facilities and safety at the paypoint), the quality of service (e.g. time queuing), and possible corruption (e.g. whether anyone had asked the grant applicant for money or a favour).[12]

However, the CBM methodology has not yet improved civic participation in health facilities, and early indications for a broad-scale adoption of CBM on the part of the SAPS have not materialised.

Carried Forward?

At the time of writing this report (September 2018), the South African government has not finished its next action plan. To build on the momentum of CBM at SASSA service points, the next action plan could include a commitment to extend CBM monitoring to an additional 20 – 30 SASSA sites to track improvements over time, alongside extending this model to more local government service points, health facilities and stations of the SAPS.

[1] Independent Reporting Mechanism (IRM): South Africa Progress Report 2016 – 2018, 29 – 30, https://www.opengovpartnership.org/wp-content/uploads/2001/01/South-Africa_MidTerm-Report_2016-2018.pdf.

[2] Jonathan Timm (Director: Citizen-Based Monitoring, Department of Planning, Monitoring and Evaluation), email correspondence with IRM researcher, 3 October 2018.

[3] Ibid.

[4] Ibid.

[5] Black Sash, ‘Community-based Monitoring’, https://cbm.blacksash.org.za

[6] Black Sash, ‘Community-based Monitoring: Sites’, https://cbm.blacksash.org.za/sites

[7] Black Sash, Community-based Monitoring: Community Partners’, https://cbm.blacksash.org.za/partners

[8] See the links at Black Sash, ‘Community-based Monitoring: Sites’, https://cbm.blacksash.org.za/sites

[9] Black Sash, ‘Community-based Monitoring: Sites: About Community-based Monitoring’, https://cbm.blacksash.org.za/learn-about-cbm

[10] Ibid.

[11] Independent Reporting Mechanism (IRM): South Africa Progress Report 2016 – 2018, 29, https://www.opengovpartnership.org/wp-content/uploads/2001/01/South-Africa_MidTerm-Report_2016-2018.pdf.

[12] See, for example, the survey results for the JHB Metro SASSA paypoint, https://cbm.blacksash.org.za/sites/taaibos/results/96


Commitments

  1. Open Data

    ZA0024, 2020, Access to Information

  2. Transformative Fiscal Transparency

    ZA0025, 2020, Fiscal Openness

  3. Beneficial Ownership Transparency

    ZA0026, 2020,

  4. Citizen-Based Monitoring

    ZA0016, 2016, Capacity Building

  5. Open Budgeting

    ZA0017, 2016, Access to Information

  6. Back to Basics Programme

    ZA0018, 2016, Access to Information

  7. Environmental Management Information Portal

    ZA0019, 2016, Access to Information

  8. Institutionalisation of Community Advice Offices as Part of the Wider Justice Network

    ZA0020, 2016, Access to Justice

  9. Department of Public Service and Administration

    ZA0021, 2016, Access to Information

  10. OGP Awareness Raising Campaign

    ZA0022, 2016, E-Government

  11. Implement the G20 High Level Principles on Beneficial Ownership Transparency 2. Implement a Register of Legal Persons and Arrangements

    ZA0023, 2016, Access to Information

  12. Develop and Implement an Accountability/Consequences Management Framework for Public Servants

    ZA0009, 2013, Anti-Corruption

  13. Service Delivery Improvement Forums (SDIFs)

    ZA0010, 2013, E-Government

  14. Mainstream Citizen Participation in the Public Sector

    ZA0011, 2013, Capacity Building

  15. Develop an Integrated and Publicly Accessible Portal of Environmental Management Information

    ZA0012, 2013, Environment and Climate

  16. Development of an On-Line Crowdsourcing Tool That Will Allow the Public to Submit Data on Protected Areas and Conservation Areas.

    ZA0013, 2013, Environment and Climate

  17. Schools Connectivity

    ZA0014, 2013, Education

  18. Implement a Know Your Service Rights and Responsibilities Campaign

    ZA0015, 2013, Capacity Building

  19. Accountability/ Consequences Management Framework

    ZA0001, 2012, Anti-Corruption

  20. Service Delivery Improvement Forums

    ZA0002, 2012, Public Participation

  21. Know Your Service Rights and Responsibilities

    ZA0003, 2012, Capacity Building

  22. National Anti-Corruption Forum and Anti-Corruption Hotline

    ZA0004, 2012, Capacity Building

  23. Guidelines for Corruption-Related Sanctions

    ZA0005, 2012, Capacity Building

  24. Develop a Citizen Participation Guideline

    ZA0006, 2012, Capacity Building

  25. Enhance Involvement of Civil Society in the Budget Process

    ZA0007, 2012, E-Government

  26. Environmental Management Portal Feasibility Study

    ZA0008, 2012, E-Government

Open Government Partnership