UNDP'S ONLINE COURSE ON ANTI-CORRUPTION IN THE HEALTH SECTOR

Participatory budgeting (PB) is an innovative financing mechanism that gives citizens a bigger say in how money is spent by the government for local development. The PB process started in Porto Alegre in Brazil in 1989, and a World Bank report concluded that it has resulted in improved facilities for the people of Porto Alegre. For instance, sewer and water connections increased from 75% of total households in 1988 to 98% in 1997. However, lack of representation of very poor people in the process is a potential shortcoming which needs to be addressed. 

In recent years, as many as 50,000 citizens of Porto Alegre have participated annually, to decide as much as 20% of the city budget. Since 1989, PB has spread to over 1,500 cities in Latin America, North America, Asia, Africa, and Europe. 

Since 2009, social witnesses are required to participate in all stages of public tendering procedures above certain thresholds as a way to promote public scrutiny. In 2014, these thresholds were MXN 336 million (approximately USD 25 million) for goods and services and MXN 672 million (approximately USD 50 million) for public works.

Social witnesses are non-government organizations and individuals selected by the Ministry of Public Administration (SFP) through public tendering. SFP keeps a registry of the approved social witnesses and evaluates their performance; unsatisfactory performance potentially results in their removal from the registry. When a federal entity requires the involvement of a social witness, it informs SFP, who designates one from the registry. As of January 2014, SFP had registered 39 social witnesses, five civil society organizations and 34 individuals for public procurement projects. This number of social witnesses grew from five social witnesses in 2005 to almost 40 in 2014. 

SFP notes that “the monitoring of the most relevant procurement processes of the federal government through social witnesses has had an impact in improving procurement procedures by virtue of their contributions and experience, to the point that they have become a strategic element for ensuring the transparency and credibility of the procurement system.” A 2006 OECD-World Bank Institute study indicated that the participation of social witnesses in the Federal Electricity Commission (Comisión Federal de Electricidad) procurement processes created savings of approximately USD 26 million in 2006 and increased the number of bidders by over 50%.

Monitoring Social audit and community monitoring are forms of citizen participation that focus on government performance and accountability. The central objective of each measure is to monitor, track, analyze, and evaluate government performance, thus making public officials accountable for their actions and decisions.

This project collected information on the quality and quantity of health services from service users and healthcare providers using citizen report cards. The information was disseminated back to the citizens to enhance their ability to monitor healthcare providers. This intervention proved effective to improve both the quantity and quality of services, leading to increased service utilization and better health outcomes.