Community Scorecard for Health
Community Scorecard is a community-based monitoring mechanism to foster improvements in the health centers. Community Scorecard is founded on focus group methodologies that facilitate participatory monitoring of the strengths and weaknesses of these health centers. Villages within the health center's catchment area hold meetings to discuss openly the quality of the health center, the staff, and service provision. The villagers assess the health center on specific criteria and decide on a score in each category for the health center. The health center staff also holds a meeting to discuss and assign themselves a score based on the same criteria. Following this assessment, an interface meeting is held with representatives from both groups to create a compiled score derived from all the villages and the health center. The interface meeting is a venue for community members to voice their concerns and for health center staffs to address the concerns and initiate plans for improvements. Resulting from the interface meeting is an action plan that serves as a contract between the community and the health center staff to establish the necessary improvements. Trained district facilitators organize, administer, and report on the meetings to compile pertinent information to rely to health center management committees and local authorities. The entire process serves as a tool to gather the community's assessment of the health center and foster discussion about concerns deterring community members from utilization of the health center. Community Scorecard encourages communities to increase involvement in their local health service provision and also strengthen their capacity to hold their local health providers accountable. The program addresses both quantifiable issues and the accountability concerns within the health system.
Health Center Management Committee
Health Center Management Committee (HCMC) is an advocacy group established to provide linkages between health facilities, local authorities and community. RACHA serves as the supporting actor to ensure effective functioning of HCMC in the community. HCMC is comprised of selected members from the commune council, health center staff, and one community representative, typically a Village Health Support Group volunteer. HCMC members advocate for the community's needs and support to foster changes to improve the health of its constituency. During trainings, HCMC member acquire new and up-to-date Ministry of Health's policies. As representatives of the community, they work to increase community participation in health improvement projects. HCMC is a mechanism developed to empower the community to demand essential needs of the health centers and community.
Commune Investment Program
The Commune Investment Program (CIP) functions to empower local authorities to develop and strengthen their own communities and address specificl local needs. Commune councils are the representatives to the government to voice the concerns and needs of the community. The national government allocates budgets for each commune to create and maintain programs for community development. However, health is a peripheral focus among local authorities and therefore RACHA works diligently to advocate for integration of community health service needs into the local government planning. RACHA educates the community and commune council that health is at the root of social and economic development. Over time, RACHA has successfully established health as a top priority for development within the commune council.
One component of the CIP is budget allocation for community development projects. In order to ensure community health program sustainability, RACHA advocates for funds for essential health services in the community. Together with the National Committee for Sub National Democratic Development and other relevant government bodies at the provincial level, RACHA educates Commune Councils about community health problems and solutions. Specifically, RACHA collaborates with technical advisors and staff at the district level to build the capacity of the Commune Council in analyzing health situations and developing an annual action plan and budget to respond to relevant health concerns.