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Using Community Scorecards for Improving Transparency and Accountability in the Delivery of Public Health Services: Experience from social initiatives for health (LIFH) Project

By: Meera Kaul Shah

CARE International in Malawi initiated the Local Initiatives for Health (LIFH) project in May 2002. The project aims to develop innovative and sustainable models that seek to resolve issues of poor health standards and conditions amongst poor rural communities. To this end, it seeks to build collaborative capacity between the service users from the rural communities and partner organisations, such as the government service providers, through the adoption of an appropriate rights based framework, that considers the practical aspects of rights, equity and socio-cultural factors.

The LIFH project started with a twelve-month pilot phase in May 2002. The main purpose of the pilot was to provide sufficient time for trials that could lead to developing a model, which could be replicated on scale in the subsequent phases of the project. Two health centres were selected in consultation with the district health officials in Lilongwe district for this pilot phase. The aim was to work intensely with the staff at these two health centers, as well as the communities served by them, in order to develop a sub-district model for introducing a rights-based approach in the delivery of health services.

This paper details the experience from the pilot phase of the LIFH project. The focus is on describing how the project developed, and implemented, the community scorecard process as an input towards building a rights-based approach.