Little decision, massive Impact: social accountability improves healthcare delivery at Kpormetey.

Hope for Future Generations is an implementing partner of the USAID-funded Ghana’s strengthening Accountability Mechanisms (GSAM) project and it is responsible for activities in the Awutu Senya East Municipal and the Agona East District in the central region. The project seeks to strengthen citizens’ oversight of capital projects to improve local government transparency, accountability, and performance in the delivery of social services. It is also to increase citizens’ participation in the local governance of the country.

The main implementation strategy used by the GSAM Activity has been the Community Scorecard (CSC) process. CSC is a citizen-driven accountability approach for the planning, assessment, monitoring, and evaluation of service delivery. It is designed to enable citizens and service providers to work together to identify and overcome development challenges – such as quality, coverage, distribution, and equity obstacles. The approach, though simple, can systematically pinpoint and help address specific challenges inherent in the service delivery process.

One of the Community Scorecard processes was initiated at a Community Health-Based Planning Services (CHPS compound) centre in Kpormetey, a Muslim-dominated community in the Awutu Senya Municipality in the 4th quarter of 2021. At an interface meeting, the Municipal Development Officer and the Ag. Municipal Health Director as service providers as well as duty bearers came up with opinion leaders and members of the community. One of the issues that came up strongly was the low patronage of the facility by inhabitants of the community.

The chief, elders and the Assembly member of the community were not happy that the facility was wasting away.
“I have regretted giving the land for this project, I may have to let the facility close down for it to be used for another important purpose”, the chief remarked at the meeting. Other community members were also not happy.
“In fact, the facility has not been beneficial to us at all, the staff should have remained under the tree to provide their services”, another opinion leader said.
When suggestions were being made to resolve the issue, one of the nurses hinted that a community member had indicated to him that the facility has no Muslim nurse and that is making the community members not to patronize the facility. It was also learnt from a participant that the community members frown on a non-Muslim diagnosing them as it is not acceptable to them.
The Municipal Health Director then promised that a Muslim nurse would be posted to the facility and that was done the next day.
Data from the facility and the Kasoa North Sub-District indicates that attendance has improved tremendously since the Muslim nurse was posted to the facility, as indicated in the table shown below. The staff at the facility were very instrumental in the COVID-19 vaccination.
“We are satisfied with the attendance now and will serve them professionally”, a nurse indicated to the writer during his routine monitoring visit to the facility.
This has prompted the Awutu Senya East Municipal Assembly to supply the facility with additional medical equipment and renovate it. The improvement in attendance has made the Health Directorate promise to elevate the facility to a health centre very soon.
This is an indication that social accountability should be embraced and institutionalized for the people to benefit greatly from capital infrastructural projects implemented by local government authorities.