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10/18/2018 1
Equity monitoring in a post-disaster
context in Nepal: building local ownership,
listening to community voice...
2
Why?
Massive impact of 2015
earthquakes: 9,000 deaths, 8
million affected, destruction of
health infrastructure and
home...
3
Key principles of equity monitoring
Equity action
Evidence
and Voice
Ownership
Build ownership.
Participatory process:
l...
Where and when • Dolakha, Ramechap and Sindupalchowk
• January-July 2016
• Sample of VDCs in each district:
6 Accessible
6...
The equity monitoring approach
Analysis at District level
District Integrated
Action Plan
VDC findings
HMIS
Stakeholder
co...
Results: Evidence, voice and facilitation…
Led to local action
• Created space for
community, providers
and local leaders ...
7
Reflections
Government ownership of
the process was essential.
Brokering role
Trust in local NGO and data
produced encou...
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Equity monitoring in a post-disaster context in Nepal: building local ownership, listening to community voices and service provider challenges

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Equity monitoring in a post-disaster context in Nepal: building local ownership, listening to community voices and service provider challenges

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Equity monitoring in a post-disaster context in Nepal: building local ownership, listening to community voices and service provider challenges

  1. 1. 10/18/2018 1 Equity monitoring in a post-disaster context in Nepal: building local ownership, listening to community voices and service provider challenges Deborah Thomas, Sitaram Prasai, Rekha Rana, Mohammad Daud
  2. 2. 2 Why? Massive impact of 2015 earthquakes: 9,000 deaths, 8 million affected, destruction of health infrastructure and homes. Deeply embedded gender inequality, social and geographical exclusion. Risk of leaving the most vulnerable out of the health recovery effort. Government’s social audit method not suited to a post- disaster context.
  3. 3. 3 Key principles of equity monitoring Equity action Evidence and Voice Ownership Build ownership. Participatory process: listen to community people, local leaders and health providers on barriers to, and bottlenecks in service delivery and health risks. Strong focus on the experience of vulnerable populations. Stimulate local action. Provide evidence to district authorities so they can address gaps. Strengthen partnership.
  4. 4. Where and when • Dolakha, Ramechap and Sindupalchowk • January-July 2016 • Sample of VDCs in each district: 6 Accessible 6 Remote 6 Highly earthquake affected
  5. 5. The equity monitoring approach Analysis at District level District Integrated Action Plan VDC findings HMIS Stakeholder consultations Community monitoring Sharing findings, VDC action plan Health Facility monitoring District dissemination and decision- making Local VDC level District responds to gaps and monitors actions NGO feeds findings to district
  6. 6. Results: Evidence, voice and facilitation… Led to local action • Created space for community, providers and local leaders to discuss and plan action together. • Raised funds, cleared rubble, provided temporary facility. • Strengthened connection with and demands on District management. Informed DHOs • Reached areas DHOs find difficult to monitor. • Provided nuanced picture of ground realities and reduced the blind spots from relying on HMIS. • Brought gender inequality and social exclusion alive. • Justified targeting resources to underserved areas. Empowered DHOs to act • Rapid response to staff gaps and drug stock- outs. • Increased public dissemination of information. • Equity targeted activities included in annual district plan and budget and 80% completed. • Improved coordination of development assistance. • Increased demands on the Ministry to close equity gaps. No evidence that recovery efforts favoured some areas but contextual factors (lack of roads and transportation) impeded access in remote and highly affected areas
  7. 7. 7 Reflections Government ownership of the process was essential. Brokering role Trust in local NGO and data produced encouraged use by authorities. Local contextualized understanding of exclusion. Low capacity of local district NGOs; competing demands post disaster. Prune package of tools. Approach relevant for post- disaster recovery and other high priority settings such as remote areas; part of Ministry social audit toolbox.

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