Deploying Common Social Accountability Platform to enhance transparency during COVID-19 in Nairobi

Public participation is a critical component of the Constitution of Kenya 2010 (CoK, 2010). The process entails informing members of the public to help comprehend issues, consulting them to get their views on various matters of governance, and finally collaborating with them by placing final decision making authority in their hands. 

Even though public participation is entrenched in the CoK (2010), citizens’ ability to be involved in decision making and the consideration and inclusion of their views by duty bearers remains an open question, with many legal experts describing the process as a “rubber stamping” exercise. 

To bridge this gap, with support from UNDP, AVF implemented the Strengthening Public Accountability and Integrity Systems (SPAIS) pilot project. We deployed our approach to civic engagement through the “Common Social Accountability Platform” (CSAP). The CSAP uses interactive radio shows (radio dialogues in combination with SMS feedback) to enable citizens to hold their leaders to account by asking the hard questions. By enabling citizens to text their views to a free short code, the approach allows for large-scale consultations and provides evidence of citizen’s opinions. AVF analyses these views using rigorous social science research and presents them in a form that supports policy action by authorities. 

We conducted eight (8) weeks of interactive radio shows across 3 radio stations, covering topics pertaining to corruption, transparency and healthcare service delivery more explicitly, within the backdrop of Covid-19 reality. This covered a period of 2 months (8 shows per station for a total of 24 broadcasts over 8 weeks). 

We generated topics and questions for each week. In a nutshell, in week one we sought to understand participants’ experiences in accessing healthcare services during COVID-19. We asked the following question: 

What are your experiences in accessing healthcare services during COVID-19? |“Je, Una maoni gani kuhusu huduma za afya wakati wa Covid-19?”

In week one participants reported on poor service including slow service which some attributed to health workers low salaries and poor resourcing, people feeling rushed due to prioritisation of potential Covid patients as well as need for social distancing and lack of adequate personal protective equipment. 

In the second week, we covered improving healthcare services, almost half of participants underscored the need to provide ample resources for hospitals, including equipment, drugs and recruitment of more doctors. Key insights from week 3 indicate that there is a need for practical information on the National Hospital Insurance Fund (NHIF) service. More than half of participants texted to make general inquiries relating to the NHIF, fielding questions on the registration process, payment process, re-registration after defaulting, membership update, etc. 

A total of 2,296 participants sent in a total of 5,490 messages in the radio discussions hosted over four weeks. 78.5 per cent of respondents said the radio shows improved their understanding of county decision-making processes, while 77.2 per cent said they thought the interactive radio public dialogue made them feel more included in decision-making.

One of the focus of the SPAIS pilot was on the urban poor settlements of Nairobi but the radio shows conducted by both (Radio Citizen and Ghetto Radio) had a national reach and collected opinions from 46 counties.

The project aimed  to strengthen citizen engagement in the monitoring of healthcare service delivery in the context of the COVID-19 pandemic and to provide trusted spaces for an exchange on matters related to the provision and quality of healthcare services. 

The final report seeks to increase the scope and quality of citizen engagement, provide a canvass for citizen feedback and influence on decision-making, and enable public dialogue between citizens and duty bearers. It will also advance accountability of authorities for informed decision-making and commensurate action thereafter. 

Conclusion and recommendations 

• Participants raised issues related to health care access and delivery. These range from bad service
  due to poorly equipped facilities and strained healthcare workers to issues of access, lack of
  drugs in public hospitals and the related cost of drugs;
• Participants also raised issues of corruption and misuse of funds. Participants highlighted the
  need for the tenets of transparency & accountability to be upheld, speaking to the need for duty
  bearers to further be held to account for executing their mandates, for instance, through
  heightened public participation drives at community level;
• Participants exhibited awareness of their constitutionally-guaranteed right to access healthcare
  and delivery. Public participation ought to be strengthened to ensure citizens across Kenya, not
  only Nairobi, can play a role in providing feedback and demanding better services.
• Participation via SMS was skewed-negatively against women. Yet, women were more likely than
  men to raise issues of poor service and infrastructure in healthcare facilities. There continues to
  be a need to sustain gender-mainstreaming in both urban and rural contexts and ensure that
  spaces of consultation and public participation can include all genders. This will effectively
  ensure that women are afforded spaces to articulate issues of greater importance to them,
  especially in the healthcare context where they play the crucial role of being primary caregivers

The project full report can be accessed here.