Project: Voice of Village Health Committees and social accountability of local self-government bodies on health determinants of rural communities of Kyrgyzstan
Country: Kyrgyz Republic
Executing Agency: Development Policy Institute (DPI)
Grant Amount: $598,833
Closing Date: January, 2018
Under the oversight of the Ministry of Health and national agencies, Local Self-governments (LSGs) in the Kyrgyz Republic are tasked with delivering health services in the country’s 40 rayons (districts). Officials have established 1,600 Village Health Committees (VHCs) – and consolidated them into an Association of Village Health Committees (AVHC) – to empower rural communities to advocate for their needs and interests among LSGs across rayons.
Though VHCs have some impact in promoting good health practices and behaviors, VHCs have not been effective in influencing broader public services linked to a healthy lifestyle: for example, water, sanitation, housing, and recreation services, which are often labeled determinants of health. Cooperation between VHCs and LSGs has been weak. In addition, VHCs do not fully understand how LSGs operate, and often lack capacity to collaborate with them to assess community needs, advocate for community interests, influence health budgets, and develop and implement health-related action plans.
The Development Policy Institute (DPI), a Kyrgyz NGO with a track record in community-driven development, received a grant from the GPSA to ensure community needs are accounted for in local budgeting processes. A key aim of the grant is to enable VHCs to sustainably influence and monitor budgets for services related to broader health determinant. This will be done by implementing three components that are geared towards: 1) building the capacity of VHCs and AVCH to identify health priorities, engage with LSGs, and effectively participate in budget processes; 2) collecting information on health priorities to feed planning and budget allocation; and 3) providing technical assistance to LSGs in the use of social accountability tools to monitor budgets and improve service delivery.
The project is providing technical assistance and capital to achieve important milestones and results:
40 VHCs are expected to be trained in learning how to work with LSGs, undertake Participatory Rural Assessments (PRAs), and advocate for identified community needs in local budgets. Complementary trainings will be provided to LSG staff on how to work with VHCs, and cooperate on social accountability mechanisms.
40 VHCs will implement PRAs in the field to assess community needs. LSGs will use the PRA data to determine local priorities and budgets. Public hearings on “health determinants in local budgets” will be held in 40 LSGs.
VHCs and LSGs will develop joint action plans for improving health service delivery, with an emphasis on vulnerable groups, in at least 10 LSGs.
Many VHCs will receive computers, and be provided training on how to use ICTs to engage in social accountability programs (i.e., monitoring local budgets).
The AVHC will develop a multi-year strategy for promoting “health determinants”.
Lessons of this initiative will be documented and shared with 1,600 VHCs in the country.
Lessons from this grant will be posted as they become available. However, the design of this grant benefits from lessons learned from DPI’s previous work on the importance of working within existing structures rather than creating new ones, and ensuring that project activities translate into tangible action plans and policies.