Copasah

Issue Papers

Title: Who Are We To Care? Exploring The Relationship between Participation, Knowledge And Power in Health Systems 
Authors: Barbara Kaim

This paper is dedicated to those many people who live in countries where health systems are failing to meet the needs of the majority, and where people with less power – whether health care providers, individuals, families or communities – have few structured opportunities to express their concerns openly and critically. It is aimed at those who work as health facilitators and activists at community level, civil society organisations, government personnel and anyone else interested in the rights of ordinary citizens to participate in decisions and have access to the resources that determine the way their country’s health system functions.
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Title: How Do We Know We Are Making A Difference? Challenges Before the Practitioner of Community Monitoring Processes in Assessing Progress and Evaluating Impacts 
Authors: Dr. Abhijit Das

Community based monitoring is emerging as a promising practice for improving programme effectiveness and as a key component of rights-based implementation of health programmes. One of the challenges of this approach is to demonstrate that it is yielding results. Community based monitoring is often seen as a process intensive intervention, which may not yield results in terms of changes in health ‘services’ and health ‘outcomes’ in the short term. However, it is very important in ‘empowering’ communities and in building their capacities in engaging with service providers and to negotiate better services for themselves. This paper discusses the different conceptual dimensions of community monitoring and then explores the difficulties of monitoring and assessing progress and results.
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Title: Ethical Issues in Community Based Monitoring of Health Programmes: Reflections from India 
Authors: Renu Khanna

This paper explores the different sets of power relationships and resultant ethical dilemmas that arise when developing community monitoring systems. Community Based Monitoring and Planning, as part of the Government of India’s strategy to achieve quality health care within the National Rural Health Mission, is used as an exploratory case study. The exploration hopes to benefit and protect the interests of those who are most vulnerable and powerless. The discussions – emerging from a series of conversations between a few community monitoring practitioners in India — are targeted at a wider community of practitioners who are involved in designing and implementing such programmes. It is hoped that these discussions can be taken further by practitioners and can assist them in ensuring practice which is underlined by a clear set of ethical principles.
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Title: Developing an Approach Towards Social Accountability of Private Healthcare Services
Authors: Anant Phadke, Abhijit More, Abhay Shukla, Arun Gadre

The paper mainly deal with social accountability of private healthcare services in developing countries, with a focus on India as an example. The idea of social accountability of private healthcare services is discussed as follows‐ 

• Firstly, the rationale and perspective related to need for social accountability of private healthcare services
• Secondly, propositions about likely steps and processes by which social accountability of private healthcare services could be developed in developing countries
• Thirdly, examples of some efforts made towards building social accountability of private healthcare services in developing countries and lessons learnt from them.
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Title: Social Accountability in Health in East and Southern Africa

Authors: Giulietta Luul Balestra, E. Premdas Pinto

This paper summarises the findings of research undertaken with the aim of mapping the field of social accountability in health in East and Southern Africa (ESA) from a practitioners’ perspective. The research was conducted on behalf of the Community of Practitioners for Accountability and Social Action in Health (COPASAH).
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