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Case Study 1: Andhra Pradesh, India: Improving Health Services through Community Score Cards

By: Vivek Misra

Social accountability refers to a broad range of actions and mechanisms that citizens, communities, independent media, and civil society organizations use to hold public officials and public servants accountable.    Social accountability tools include participatory budgeting, public expenditure tracking, citizen report cards, community score cards, social audits, citizen charters, people’s estimates, and so forth.  These mechanisms are being increasingly recognized world-wide as a means of enhancing democratic governance, improving service delivery, and creating empowerment.

The state government of Andhra Pradesh provides primary,  secondary, and tertiary level health care services to a rural population of 5.5 million through a chain of institutions under allopathic and other systems of medicine.  The Center of Good Governance, Hyderabad, in partnership with the World Bank-sponsored Andhra Pradesh RuralPoverty Reduction Project (APRPRP), undertook a pilot project in which the community score card (CSC) was applied to assess the performance of two primary health centers (PHCs) in two Mandals of Visakhapatnam District, Andhra Pradesh, in the context of primary health care service delivery.