Grievances and complaints about government bureaucracies, whether arising from the public or from within the organization, tend to fall on deaf ears. The legal systems that aim to address such grievances in many countries are often slow, expensive, and not user-friendly. Complaints and ombudsman’s offices, which are sometimes separate but often combined, can provide an option for addressing grievances within the local government system (González de Asis et al., 2009).
Online-based whistle-blowing platforms are more innovative solutions. Based on aggregate data from reports filed by citizens over time (decentralized mapping), these platforms can foster accountability, which puts pressure on corrupt public officials. Once well-known, such a platform can have a preventive effect.
In South Africa, district management health teams used financial data and service utilization statistics as performance indicators, providing useful information to hold public officials accountable (Vian 2008a). Accountability was increased by linking planned and actual services to the resources used to achieve them and to compare performance over time, with targets and across similar facilities. The project began by introducing a reporting system based on an annual review and analysis of health services and financial performance, including key indicators such as the number of services per day, cost per patient visit and bed day, cost of staff, maintenance, etc. These indicators were compared over three years with targets and across similar facilities. Each facility and district was required to monitor and report on its performance on a quarterly basis. Plans and annual reports were provided to municipal governments, other district teams and the provincial Department of Health, providing opportunities for external, peer and hierarchical review. Merging financial and utilization data highlighted wide variations across clinics and facilities, allowing managers to probe for potential abuse, resource diversions, inefficiencies or other grounds that could explain discrepancies.
