Health RBF programs typically evaluate patient satisfaction quarterly to verify the information declared by health centers about the services offered. Every quarter, a sampling of patients who visit the health facility are interviewed usually by Community-Based Organizations (CBO). Once data has been collected, a “community satisfaction score” is calculated for each provider, which impacts the payment/bonus allocated to that provider. In most countries, this process is paper-based.
Over the last decades, the health system in Zimbabwe has been confronted with a double crisis: an economic collapse and the AIDS pandemic. This destabilized the health system at its core. And overall life expectancy dropped from 61 years old in the 1990s to 48 years old in 2005, before climbing back up to 58 years old in 2012.
Most of the time, projects are developed without taking the community’s voices and their everyday realities into account. Moreover, many surveys are addressed to communities without seeking their feedback or adjusting programs to meet the local needs. Putting communities in the driver’s seat implies an understanding of their needs and giving them opportunities to express themselves. To fill this gap, more and more donors, NGO’s, and governments are becoming willing to integrate social accountability as an essential component of future public systems.