|Community Monitoring in Health Resources for the Practitioner|
Public Sharing/ Hearing of Evidence
Public Hearings and Public Tribunals are public fora for sharing rights violations. In a Public Hearing the rights violations are usually shared in front of an official panel of empowered officials like the National Human Rights Commission (NHRC) and its state counterparts or the National Commission of Women and its state counterparts. The Hearing is a quasi-judicial proceeding in which the members of the panel provide instructions and directions to the responsible officials to take administrative action to rectify the situation. In the case of a Public Tribunal the panel is not official, however in order to give the panel credibility it usually comprises of eminent citizens who need not be experts on the subject, but who should be known for their social concern. The Panel members should be willing to make clear and unequivocal statements based on their observations during the panel. The panel hears the testimonies and experiences of the persons whose rights have been violated and then makes its recommendations and observations which are usually directed towards the state agencies responsible for action on the subject. It is essential to prepare carefully before organising a public hearing or tribunal.
It is important to strengthen a coalition of partners who will be participating in the event. It is also necessary to prepare detailed documentation of rights violations which take place. It is necessary to highlight the common kinds of violations which take place routinely rather than exceptional cases which can be easily explained away. The documentation of cases could comprise of oral record of experiences substantiated by documentary evidence like Outpatient department tickets, indoor records, discharge certificates etc. In recording the experiences it is necessary to record the specific instances where the required services were either absent, or denied or provided in a substantially inadequate manner. Even though the testimony from victims and survivors makes the core of a public hearing or tribunal, it is often not possible to provide them justice through this mechanism. The persons making testimonies should be prepared for this. Secondary evidence on the issue is also useful in many cases.
The actual event could begin with the organisers explaining the objective and structure of the programme. This can be followed by the oral testimonies of the cases where rights denial and violations took place. In cases where the aggrieved person or the relatives want their names to be kept confidential or the organisers feel that revealing the identity of the aggrieved person could jeopardize him or her names and village should not be revealed. After the cases of denial are presented, the report based on the secondary data or survey findings, about the availability and status of health services can be presented. Then the Government Officials should be asked to respond to the issues and concerns raised during the testimonies and the presentation. In the end, the panel should give their comments. A press conference can follow the event.
Interface with Officials
Once the community leadership is aware of the different aspects of the health services that they need and what is available to them today it will be possible for them to discuss these with their health providers.
Meetings with the Health Providers
Once the community leadership is aware of the different aspects of the health services that they need and what is available to them today it will be possible for them to discuss these with their health providers. It may be necessary to build relationship with the local Multipurpose Health Worker as well as the Medical Officer of the local PHC for this purpose.
The community leadership can approach the MO or the CMO and share their problems. In case these officials are willing to acknowledge their communities own concerns it will be possible to proceed to the stage of Interface described below. In case this is not possible it may be necessary to organize public meetings and public tribunals at a later stage.
Interface with service providers
Once a bridge has been built with the health service providers there can be a sharing of concerns, problems and plans. This can lead to a preriodic review of activities at the Sub-Centre and PHC level. Sub-Centre review and planning meetings could take place monthly while PHC level meetings could be organised quarterly. Mutually agreed upon quality of care checklists could be the basis for monitoring the service provision and service uptake from both sides. These activities can strengthen the Community Needs Assessment Approach which is already part of the Reproductive and Child Health programme.