-COPASAH at the Learning Exchange: Transparency/Accountability Strategies & Reproductive Health Delivery Systems- Accountability Research Centre, School of International Service (American University), Washington DC
A Learning Exchange on Transparency/Accountability strategies and reproductive health delivery systems was recently held on June 27 and 28, 2016. This learning exchange was convened by Accountability Research Center, School of International Service, American University along with the Evidence Project, International Planned Parenthood Federation and Reproductive Health Supplies Coalition, Advocacy and Accountability Working Group. COPASAH was represented at the learning exchange meeting by two Steering Committee members including Walter Flores (CEGSS, Guatemala) and Renu Khanna (SAHAJ, India ) – and E. Premdas Pinto from t h e COPASAH Global Secretariat, Centre for Health and Social Justice(CHSJ, India
The learning exchange was convened in the background of systemic weaknesses, vulnerabilities and biases which at different points in health systems form bottlenecks for the reproductive health (RH) supplies to reach the last mile. Practitioners, researchers and persons involved in the field of Transparency, Participation and Accountability (TPA) participated in the learning exchange. The goal of this learning exchange was to inform and identify practical strategies to address unidentified and unmeasured bottlenecks in the process of procuring and moving commodities through the supply chain into health facilities at different levels as well as the barriers that impede citizens’ enacting of full, free and informed contraceptive choices. One key proposition for discussion was the issue of public monitoring which can inform problem solving and policy advocacy, while problem-solving or advocacy strategies can in turn inform monitoring strategies.
The objectives of the learning exchange were set as follows:
- Share analytical insights, key concepts and practical developments both from transparency, participation and accountability and the reproductive health systems, including commodity security;
- Learn from experiences by addressing issues of supply chain challenges in various sectors
- Identify research gaps and/or questions for addressing the monitoring challenges involved in tracking the determinants of access to contraceptive services;
- Contribute to practical research agendas;
- Discuss possible strategies for improved monitoring through collaboration and sharing between RHSC and TPA sectors.
Presentations: COPASAH members made presentations on various experiences of practice of citizen empowerment and monitoring. In the session ‘Key concepts and lessons from the emerging field of Transparency, Participation and Accountability’ which was chaired by Kelsey Wright, Evidence Project, E. Premdas Pinto from COPASAH Global Secretariat, CHSJ, made a presentation and shared the experiences of COPASAH strategies of bottom up accountability practice, networking of practitioners, using ICT for networking and advocacy for the citizen centric accountability practice. This session introduced some key concepts and lessons emerging in the TPA field and used concrete examples of how they have been applied in different sectors and to what effect. This included approaches to advocacy, problem solving and policy monitoring.
E. Premdas Pinto, COPASAH Global Coordinator, in his presentation highlighted the issue of bottom up knowledge generation from practice to countervail the top-down model of knowledge making and policy making. The contributions of COPASAH in terms of issue papers, case studies, stories of practice from various countries were highlighted. COPASAH knowledge products were also distributed to participants.
Renu Khanna, COPASAH Steering Committee member, from SAHAJ Society for Health Alternatives (India) presented her reflections on challenges faced in independent monitoring of maternal and reproductive issues. These challenges were encountered in initiatives dealing with social autopsies of maternal deaths, monitoring negligence and denial of services to women through various community based efforts. This presentation was made as part of the session on ‘Challenges of independent monitoring and advocacy’. The session aimed at sharing experiences and reflections of practitioners who have been combining monitoring and advocacy to advance health rights. This session was chaired by Sono Aibe, Pathfinder.
Walter Flores, COPASAH Steering Committee member, from Center for the Study of Equity and Governance in Health Systems (Guatemala) presented the citizen monitoring and community ethnography undertaken in Guatemala. The process was presented through a documentary followed by a presentation. Both visual presentations brought out the centrality of citizen empowerment, forming collectives and strengthening citizen voice as a sine qua non for monitoring and people centred advocacy. They also highlighted that when citizens voice critical questions, the system is likely to resist and also that there is possibility of back lash.
Conclusion: The small group discussions from the learning exchange deliberated on the critical research that would bolster the monitoring of reproductive health care and access to services. The themes of power, the research questions to be asked, various strategies that could be combined both at the grass roots as well as policy making level for improving access to reproductive health care, were also discussed.
About the Authors
- Premdas Pinto coordinates the Global Secretariat for COPASAH.
Renu Khanna and Walter Flores are the Steering Committee members of COPASAH Global.