Throughout Latin America, civil society groups are using report cards as
a tool to gather citizen feedback on the quality and coverage of public
services. This Brief focuses on the use of report cards to assess health
services, in particular. Through these report card exercises, civil
society has been able to highlight problems citizens face in accessing
quality health care, such as lack of medical supplies or personnel, or
long waiting times to see a physician. By then bringing these findings
before public health agencies and the media, citizens have succeeded in
achieving concrete improvements in both health care access and quality.
This Brief analyses three different report card experiences, from
Colombia, Mexico and El Salvador, emphasising the outcomes of these
exercises and the contextual factors enabling their success.
The relevance of report cards lies in their potential to promote
accountability at the local government level, both vertically to other
governmental entities, and horizontally to citizens, ultimately
enhancing the access and delivery of public health care services. The
experiences presented here show how the use of report cards facilitated
concrete improvements in health services.
The use of community report cards seems to work best when implemented as
a process that includes an interface meeting between community members
and service providers that allows for immediate feedback. Considering
this, it has the potential to be a strong instrument for empowerment and
for modifying the relationship between citizens and local government.
Latin American experiences show that changes in the delivery of public
health services are more likely to happen if civil society is able to
undertake strategic advocacy actions such as publishing the report card
results and proposals through the media and engaging local authorities
and health policymakers in the process.
Chacón Fregoso, G. ELLA Policy Brief: Citizen Participation in Evaluating Health Services: The Latin American Experience. ELLA, Practical Action Consulting, Lima, Peru (2012) 6 pp.