Integrity Watch’s Community Based Monitoring-Health program promotes social accountability through community mobilization and social audits. The program empowers communities to monitor health facilities that are implemented in their area. The aim of this program is to empower citizens in holding authorities and aid entities accountable and to create active and responsible citizenship by decreasing the gap between the state, aid actors and the civil society. Communities engaged in local monitoring become more autonomous in solving their problems through continued dialogue as well as monitoring and reduce their reliance on external actors or parallel structures.

The program started in 2018 with 10 communities (health facility) in Kabul province of Afghanistan. The program has expanded over the years due to its success in empowering citizens to take an active role in promoting integrity and accountability. Around 70 health facilities have been monitored by 70 Integrity volunteers since 2018 in Kabul, Kapisa, Nangrahar, Herat, Balkh provinces.

Integrity Watch Afghanistan work with communities to identify Integrity volunteers who volunteer to monitor health facilities on behalf of their communities. The Integrity volunteers are trained and supported by Integrity Watch Afghanistan provisioning of knowledge and carefully designed customized monitoring tools who monitored a series of metrics and phenomenon related to integrity, which can illustrate the quality of health facilities and their impact on the targeted communities. These estimations are based on the adequacy, consistency and sustainability of the Clinics.

Integrity Volunteers are able to file complaints through the establishment of a Sectorial Monitoring group (SMG) composed of line ministry representatives, Integrity volunteers, Provincial Councils members, media and aid actors. The board triggers the accountability role of local institutions. Furthermore, regular monitoring of ongoing clinics helps to ensure that health facilities are impacting the community positively.

The methodology used empowers citizens and increases aid effectiveness at local levels through Community Based Monitoring-Health program by:

  1. Selecting Communities
    Similar to other Integrity Watch Afghanistan initiatives, the Community Based Monitoring of Health (CBM-H) draws on community participation to establish the legitimacy of its objectives. “Community” for this program is defined by Community Development Councils, civil society actors and legal service providers. Once a community is chosen, Integrity Watch Afghanistan employees meet with the community to explain monitoring and its benefits.
  2. Electing Integrity Volunteers
    Each participating community is asked to select 1 Integrity volunteer and She/ He should preferably be literate, of good reputation within the community and able to volunteer several hours each week to monitor health facilities.
  3. Training of Integrity volunteer
    After their selection, all Integrity volunteers receive technical and social training from Integrity Watch Afghanistan staff. Social training covers the basic concepts of corruption awareness, community mobilization, and problem-solving. Technical training covers (flow chart of the program, monitoring forms, guidelines, how conduct meetings, identify & solve problems). The training teaches the Integrity volunteer how to use provided monitoring tools, conduct surveys, follow checklists and collect data.
  4. Collecting Information
    Integrity volunteer then collects all necessary clinics documents by requesting from government officials and the health directorate. After collecting the clinic documents, Integrity volunteers conduct a baseline survey of the community. They interview 20 respondents who are stakeholders for their clinic. The survey helps introduce the monitoring program to the community & collects information on community knowledge and participation in the clinic.
  5. Conducting Mobile cinema show (Theatre of Oppressed)
    Integrity watch Afghanistan holding mobile cinema show for every community once in a clinic to get information about anti-corruption. This event conducted by Integrity Leaders and Integrity volunteers.
  6. Monitoring the Health Facilities 
    Integrity volunteer visits the clinic two (2) times a week, meet with the head of health facility, and check the environment, services, and cleanness and the quality of materials using for the patients. And identifying problems If problems are revealed, the Integrity volunteer, with the integrity leader and provincial Coordinator of Integrity Watch Afghanistan try to resolve the problems first then discuss the problems with the health directorate with the aim of convincing the head director to resolve them.
  7. Health Management Shura (HMS)                                                                         Monitoring of Health and overseeing the proper functioning of Health Management Shura (HMS) are the core objectives of the CBM-H Program. As previously mentioned, the IVs will visit Clinics at least twice a week and fill up monitoring forms. They will also attend monthly HMS meetings and update community representatives on the findings. In this step clinic information is collected and recorded into database. Also, weekly and quarterly monitoring forms are filled by IVs and recorded into database and monthly feedback sheet is prepared from recorded information and submitted to Health management and community representatives. In addition, assigned IVs attend HMS meetings and monitor their performance.
  8. Community Feedback Meeting
    It’s an event that Integrity volunteers provide their activity feedback to their relevant community. This event conducting once per month in clinic by their Integrity volunteers.