It is about two years since the idea of a community of practitioners on accountability in health emerged from an enriching discussion in 2011 held in Johannesburg (South Africa). The collective thinking process on the need of building learning from practice led to measures such as enhancing capacities of practitioners in citizen centric accountability framework, promoting peer learning and producing literature based on practice. The processes of practice based knowledge building and learning are inbuilt into COPASAH‘s vision to nurture, strengthen and promote collective knowledge towards promoting active citizenship to make health systems responsive, equitable and people-centred.
COPASAH has now started to reflect on the value addition of its own knowledge building and learning trajectory. The framework for assessing value creation in learning proposed by Etienne and Beverly Wenger-Trayner could offer some valuable insights into this.1 This evaluative framework is well suited for analysing the value addition in any given learning process. It offers number of variables to look at the value addition to the learning process in its components and also to the process as a whole. Each of the proposed variables such as immediate value, potential value, applied value, realised value and transformative value, itself could be taken up for an indepth analysis for the value addition while the entire framework could also be used for such an evaluation.
Learnings of COPASAH
Immediate value:
This refers to significant events, projects, enquiries that are being undertaken in the process of learning. The practitioner oriented capacity building workshops of COPASAH, facilitated learning exchanges, events of technical targeted assistance to accountability practice in health has been of great importance in all the three regions of South America, Eastern & South Africa and South Asia. The collective thinking, meetings and brainstorming across continents in formal and informal forums as a community of practice would stand COPASAH in good ranking as far as the immediate value is concerned.
Potential Value:
The mix of tangibles and intangibles such as documents, insights, relation-ships, energy generated, hopes and promises are conceptualised as potential value in learning. The issue papers and the case studies, the newsletters, the communication platform that has been instrumental in anchoring all the learnings, exchanges through listserv and more importantly the collective energy generated by building relationships has offered new insights and promoting the shared value of human rights based community monitoring. All these collectively would make an apt case for the potential value that they signify. The practice based literature and exchanges have offered the possibility of an alternative discourse to the dominant expert driven frameworks of accountability which do not prioritise the potency and agency of the community. One could say the energy created by COPASAH and the relationships forged are an indication to a great potential value that COPASAH holds.
Applied Value:
The new practice, collaboration, different approach or any change that has occurred through the learning process is considered an applied value. The discourse on citizen /community centric and practitioner based accountability practice in health has emerged as the common voice through COPASAH discourse foregrounding the centrality of the community to lead the accountability practice and the capacity to bring about the social change. This is an important contribution to the countervailing discourse in the era of knowledge and digital divide. Collaborative actions such as providing technical support to each other across cultural contexts, putting together an abstract for Health System Research Symposium (Sept 30-Oct 4, 2014), applying the tools of capacity building and community monitoring in different contexts illustrate the growing solidarity.
Realised value:
As an idea which is evolving, it would be a hard task to pin-point on any one or two standalone improved performance indicators or outcomes of COPASAH from the lens of the realised value. One of the important outcomes is the global presence of the community of practitioners in health with its unique contribution of well-grounded practice across countries. Learnings from challenges and failures form the integral dimension of learning as a realised value. The realisation of being a global community of practice of a subaltern perspective itself is a great learning for COPASAH. The predominance of English in the medium of communication is certainly a great challenge to reach out and learn from communities of different ethnolinguistic settings especially in the non-English speaking areas such as the Americas. While the best evolved technology of the internet is not able to give us a meaningful translation, South Asia in general and India in particular offers a lived solution to overcoming such challenges. The digital divide presents another uphill barrier across cultural and political settings between accountability practitioners and academics (researchers) in terms of access and reach to knowledge making and learning processes. Realisation of the dream of being a community of practice depends heavily on creative leaderships, owner-ship of the idea and local (regional) initiatives to nurture the process beyond stipulated and formulaic projects.
Transformative value:
COPASAH‘s emerging identity as a unique space for foregrounding community -centric accountability practice in health, with the praxis of continued learning and social action with a cross-cultural solidarity could be identified as a transformative value in this learning cycle. The community of practice has been able to provide a framework for challenging the dominant techno-centric accountability practice with a more grounded experience of community monitoring – social action and learning praxis upholding the agency of the community for empowerment and change. Through this perspective COPASAH offers a more grounded and bottom up discourse on accountability that could have a transformative breakthrough within the tensions of seeing accountability either from the lens of empowerment and democracy or that of governance and corruption.
As a global learning community, many challenging questions are before COPASAH. It is time for COPASAH to look at its own strengths, challenges and opportunities. Has COPASAH fully exploited the potential of collective strength and solidarity? Have we been successful in reaching out to various practitioners in specific regions to embolden and to enrich the community of health accountability practice? What are the challenges before us and what lessons do we draw from what has not worked? What is the intensity of the collective energy and what are our strategies to sustain this in the future? These and such other critical questions might help us to make this global learning community stronger and much more vibrant .
1Wenger-Trayner, Etienne and Beverly, Evaluation Framework, available at
http://wenger trayner.com/resources/publications/evaluation-framework/ (accessed: 21 March 2014).
E. Premdas Pinto, CHSJ
South Asia Region Coordinator – COPASAH
(This is a reproduction of the editorial in the COPASAH Communiqué, edition 5 which was circulated recently. For the newsletter please visit www.copasah.net)