Community-based monitoring (CBM) is a form of public oversight, ideally driven by local information needs and community values, to increase the accountability and quality of social services such as health,[1] development aid,[2] or to contribute to the management of natural resources.
[6] Ultimately, CBM is a tool to facilitate more inclusive decision-making on issues that are important to members of a community, including increasingly complex aspects of social, economic and environmental factors.
The adoption of a comprehensive framework for CBM and planning at various levels under NRHM places people at the centre of the process of regularly assessing whether the health needs and rights of the community are being fulfilled.
Much of the initial work to develop an Indian model of CBM was driven by the Advisory Group of Community Action (AGCA), a group of experts specially constituted by the union health ministry to provide technical and other inputs on how to implement NRHM programmes wherever community action was envisaged.
Another important factor that contributed to the ministry’s decision was the capacity of CBM to generate information about health services that enables data triangulation.
A form of CBM has been developed by Management Science for Health (MSH) and the United Nations Children’s Fund (UNICEF) that utilizes the Monitoring Curve.
These measures are then displayed as a line graph, arranged hierarchically with availability of resources at the bottom and effective coverage at the top.
[16] Researchers from the Overseas Development Institute carried out a political economy analysis of a CBM scorecard initiative in Malawi.
[17] They found that the scorecard system demonstrated the potential to improve public service delivery, but that this was not simply due to a strengthening of citizens' voices and demand.
It appeared that the nature of the civil society organisation implementing the initiative and the quality of local leadership were also important in determining outcomes.
[21] In the Torres Strait, Australia, a CBM project called Seagrass-Watch has successfully trained community members to accurately monitor and report changes in the health of local seagrass species.
This flexibility in meaning has enabled groups with conflicting agendas to agree on its implementation but has simultaneously led to clashes or disappointment of some parties further down the line.
In the case of CBM within the NRHM, policy makers at the government level assumed that the main purpose of community monitoring would be to generate data.
[28] In contrast, civil society stakeholders (NGOs and people’s organizations) envisioned CBM as a mode of facilitating grassroots health activism.