Reprogram
Report
on
Citizen’s
Rating Report
Period : June-August-2012
Funded by : World Bank
Through by : The Asia Foundation (TAF)
Implemented by : National Prosperity Association (NAPA)
CITIZENS’
RATING REPORT ON
HEALTH and CIVIL
REGISTRATION:
Five communes in
Kampong Speu province
I.
Abstract
National Prosperity
Association (NAPA) initiated the Citizens’ Rating Report project (CRR) in 2010
to promote civil society dialogue and participation with local authorities to
assess and inform service delivery for improvement, with a focus on health
care. The project received grant under Demand For Governance (medium and large
grant round I), the period life of the project implementation is 16 months from
December 2010 to May 2012 in 15 communes, two districts, Kampong Speu province.
However, the project life has extended another three months oversight those public
service providers after the CRR’s result on March 7, 2012.
The scope of works
in three months period is collected citizen feedback on health center and civil
registration and disseminated the findings to the people and Commune Councils
and Health Centers in order to measure what reform so far has been improved. NAPA selected five health centers in five
communes such as Chung Ruk, Veal, Maharosey, Vor Sor, Roleang Kreul to conduct
CRR’s evaluation that comes through with two main activities are
self-evaluation and observation.
With preliminary
result of CRR on March 7, 2012, ten indicators were chosen out of 43
suggestions to be evaluated the citizen satisfaction levels of service
delivery. Four indicators refer to health center’s services, four with regards
to commune’s services, and two are both health and commune.
The report
evaluation was widely presented in each target communes and local government. The
report will increase public awareness and social accountability to make local
government particular health center and commune councils more responsive. There
are 50 participations, 15 females in the result dissemination workshop on 23-August-2012
and represents commune councils are 6 males and 9 health center staffs, 1
female.
The result of
evaluation provided a comparative assessment to the result of CRR of the NAPA’s
project since December 2010 to May 2012. A partial improvement in quality of
services was noted over the period of time.
II. Background
The enactment of the Laws on the Management and Administration of
Commune/Sangkat (LMAC) in 2001 by the “Royal Government of Cambodia (RGC) was a
major step toward decentralization reform at local levels. Commune councils
must actively promote and coordinate the process of democracy by setting up a
process of consultation with residents, civil society and communities,
especially with regard to the provision of services in a transparent and
accountable manner”. To join the process of administration reform NAPA plays a
role in developing local service delivery by strengthening service provider
both in health centers and commune (promote civil registration).
However, in the 2000s,
the health center and communes’ service were characterized by inadequate and
low-quality public services in Kompong Speu. Lack of staff, insufficient of
material, lack medicine, and staff behavior problem in health centers. Low of civil registration,
extra cost to make an ID card, and domestic violence in commune. After three
national commune elections, those services have been reformed but the problem
still remains.
By highlighting the
improvement of the quality of services, the report evaluation was perceived to
serve as social accountability mechanisms that would generate awareness of the
poor performance of service providers. More specifically, the initiative sought
community people, health center, commune councils evaluate themselves through
those ten indicators as follows:
1- Commune Councils
should conduct monitoring on health center services more often to identify the
lack of service provision;
2- Commune Councils
should improve its’ alternative resolution dispute mechanism and disseminating
to their local people;
3. Increase the
dissemination of village/commune safety policy to community people;
4. Civil
Registration officials should have transparency mechanism on services;
5. The price of the
health services should discuss among people and health center;
6. The Heath Centers
staff should wear the uniform;
7. The police
administration should have transparency mechanism in producing family book;
8. Commune Councils
and Health Centers should share contact list to citizens;
9. Commune Councils
should arrange monthly meeting with Health Center to keep update the
availability of medicines;
10. The midwife should stay around the office for all day.
The result
of Citizen Rating Report (December 2010 to May 2012)
The result was captured on the relevance answer to the
ten indicators. In the report card result sought six out of ten indicators to
be taken comparative assessment in Table 1 as follows:
Table 1: The average of CRR’s result percentage in
five communes
|
Indicator#
|
Relevance indicator
|
Average
|
Type
|
|
Indicator 1
|
Councils conduct monitoring at health
centers on service
|
84%
|
Health
|
|
Indicator 4
|
Civil Registration officials should have
transparency mechanism on services.
|
86%
|
Commune
|
|
Indicator 5
|
The
price of the health service should be discussed among people and health
center
|
83%
|
Health
|
|
Indicator 8
|
Commune
Councils and Health Centers should share contact list to citizens
|
84%
|
Commune & Health
|
|
Indicator 9
|
Commune
Councils should arrange monthly meeting with Health Center to keep update the
availability of medicines.
|
84%
|
Commune & Health
|
|
Indicator 10
|
The midwife should stay around the
office for all day
|
87%
|
Health
|
The result
of project follow-up by indicator (May to August 2012)
Six out of those ten indicators in Table 2 will be assessed
the quality of services providers.
Table 2: The average of self-evaluation percentage in
five communes
|
Ind#
|
Ten indicators
|
Average
|
Type
|
|
Indicator 1
|
Councils conduct monitoring at health
centers on service
|
84%
|
Health
|
|
Indicator 2
|
Commune Councils should improve its
alternative resolution dispute mechanism and disseminating to their local
people
|
79%
|
Commune
|
|
Indicator 3
|
Increase
the dissemination of village/commune safety policy to community people
|
77%
|
Commune
|
|
Indicator 4
|
Civil Registration officials should have
transparency mechanism on services
|
78%
|
Commune
|
|
Indicator 5
|
The
price of the health service should be discussed among people and health center
|
83%
|
Health
|
|
Indicator 6
|
The
Heath Centers staff should wear the uniform
|
75%
|
Health
|
|
Indicator 7
|
The
police administration should have transparency mechanism in producing family
book
|
61%
|
Commune
|
|
Indicator 8
|
Commune
Councils and Health Centers should share contact list to citizens
|
93%
|
Commune & Health
|
|
Indicator 9
|
Commune
Councils should arrange monthly meeting with Health Center to keep update the
availability of medicines
|
59%
|
Commune & Health
|
|
Indicator 10
|
The midwife should stay around the office
for all day
|
90%
|
Health
|
The result
of observation (July 2012)
The observation
stage was conducted nu Network to Support Good Governance (NSGG) after
self-evaluation was completed. They (NSGG) took a week of July to ask people satisfaction
in each target communes about the health and commune services. Table 3 show
further details as follows:
Table 3: The average of observation percentage in five
communes
|
Ind#
|
Ten indicators
|
Average
|
Type of
|
|
Indicator 1
|
Councils conduct monitoring at health
centers on service
|
45%
|
Health
|
|
Indicator 2
|
Commune Councils should improve its
alternative resolution dispute mechanism and disseminating to their local
people
|
85%
|
Commune
|
|
Indicator 3
|
Increase
the dissemination of village/commune safety policy to community people
|
90%
|
Commune
|
|
Indicator 4
|
Civil Registration officials should have
transparency mechanism on services
|
90%
|
Commune
|
|
Indicator 5
|
The
price of the health service should be discussed among people and health
center
|
45%
|
Health
|
|
Indicator 6
|
The
Heath Centers staff should wear the uniform
|
65%
|
Health
|
|
Indicator 7
|
The
police administration should have transparency mechanism in producing family
book
|
80%
|
Commune
|
|
Indicator 8
|
Commune
Councils and Health Centers should share contact list to citizens
|
95%
|
Commune & Health
|
|
Indicator 9
|
Commune
Councils should arrange monthly meeting with Health Center to keep update the
availability of medicines
|
60%
|
Commune & Health
|
|
Indicator 10
|
The midwife should stay around the
office for all day
|
95%
|
Health
|
III.
Impact/Results
The result will be shown with the difference impact from
those ten indicators in Table 4 below.
Table 4: The average of comparative assessment in five
communes
|
Ind#
|
CRR
|
Self-evaluation
|
Observation
|
Type of
|
|
Indicator 1
|
84%
|
84%
|
45%
|
Health
|
|
Indicator 2
|
|
79%
|
85%
|
Commune
|
|
Indicator 3
|
|
77%
|
90%
|
Commune
|
|
Indicator 4
|
86%
|
78%
|
90%
|
Commune
|
|
Indicator 5
|
83%
|
83%
|
45%
|
Health
|
|
Indicator 6
|
|
75%
|
65%
|
Health
|
|
Indicator 7
|
|
61%
|
80%
|
Commune
|
|
Indicator 8
|
84%
|
93%
|
95%
|
Commune & Health
|
|
Indicator 9
|
84%
|
59%
|
60%
|
Commune & Health
|
|
Indicator 10
|
87%
|
90%
|
95%
|
Health
|
The comparative
assessment shows the average of levels of people satisfaction within health and
commune’s service performance within five communes: Chung Ruk, Veal, Maharosey,
Vor Sor, Rolaing kreul. As result, there is low level of people satisfaction
just about 45% with indicator 1 and 5 means commune councils has insufficiently
conducted monitoring at health centers and the price of the health service
still remain concern for the people. Although, indicator 9 revealed that the
CRR’s resulted 86% of people satisfaction but it has dramatically fallen down
to 59% in self-observation follow by 60% in observation which means that there
is a rare of meeting between health center and commune councils. There was
steady percentage with indicator 6 during the period of project follow up by 75%
and 65%, but it is not good enough in wearing uniform in each health centers. Others
indicators illustrate that a good level of people satisfaction when there was steadily
increase of transparency mechanism on the service by 86% from the CRR’s result
follow by 78% and 90%. No doubt commune councils and health center contact list
has been shared to people as evidence in indicator 8.
IV.
Result
dissemination
Operational District of Kampong Speu
Dr. Eng
Song, Chief of OD of Kampong Speu, I really accept with this result and I would
like to clarify that all indicators for self-evaluation and observation have
present to health centers or Health Center Management Committee (HCMC) to know
and where do indicators come from?. All indicators should set up the goal to
achieve, for example; number of pregnant women who come and deliver at health
center so health try to achieve by indicators as our goal. The health service
fee, we have discussed with HCMC, Village chiefs and Village Health Support
Group to set up health service fee and issue to use in health centers in OD
Kampong Speu.
Provincial Health Department (PHD) of Kampong Speu
Dr. Chin
Keosovan, Deputy of PHD of Kampong Speu, I have participated in dissemination
of National Evaluation of people satisfied on health services. The result is 80%
in national level that people are satisfied, but in Kampong Speu is 85%, so I
would like to thank to authorities, health staffs and community’s people have
good cooperation and try to solve the community problems. The highest score are
Kampong Cham, Siem Reap and Phnom Penh city. The evaluation tool of health
services focus on health care, building, communication and information and fee.
I would like to thank to NAPA that help in Kampong Speu since 1996 on
development, health services and other services. For 10 indicators that set up
by Provincial governors, I really support and accept with this result of
finding from NAPA today because it is similar as National Evaluation as I
present above and it is the mirror to reflect our activities. And this
evaluation is not focus on technical but on clients satisfied. I see one indicator
related to uniform of health center staffs, the result is low but I accept
because national budget are not increase but decrease of budget on uniform and
every years we have new staffs come, so we lack of the uniform for them. But if
the health center staffs do not wear uniform, are wrong and it is the mistake.
NAPA is the mirror to reflect to us as health service and also polices and we
must accept the reality. Our country is not the same as neighbor countries but
our services are acceptable until 80% that people are satisfied and other 20%
focus on health centers staffs’ attitude. Thank to NAPA, I request NAPA to
continue support and implement this activities in whole Kampong Speu.
Provincial Governors of Kampong Speu
Ms. Toem
Savat, deputy of provincial governor of Kampong Speu, in the result
presentation on self- evaluation and observation that conduct in Samrong Torng
district hall. She said “The first I would like to respect all participants in
this workshop. As you already the good governance is step by step to implement
because our government has prepared this strategic since 2002, and thankful to
NAPA that help in Kampong Speu since 1996. NAPA has good cooperation with
provincial health department to improve health services and we are being set up
new health center until one commune one health center. Now we see the 10 indicators that set up by
respond to his Excellency Pen Sambo request, and I see all these indicators for
health centers and commune on health services and civil registration are
missing quality and still the problems in community. I really accept all these
results as the key point to improve activities.”
V.
Future
plan
According
to the result CRR project, Observation and recommendation from the provincial
governor, NAPA team has discussed and we set up plan:
1- Continue the
Citizen’s Rating Report project to improve the health services and civil
registration to other target areas in Kampong Speu. This project NAPA,
Sub-national government, and local authorities request to The Asia Foundation
(TAF) to continue support CRR activities in other communes of Kampong Speu.
2- NAPA wish to work
with community people to increase good governance in local level and increase
participation from Citizen on publish services especially on health, education,
and one window services of Kampong Speu.
Issued by :
National Prosperity Association (NAPA)
Name :
Ang Chamroeun
Position :
Executive Director
