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Mosomo-health: fighting corruption in local health projects by empowering citizens as mobile social monitors
Challenges:
Why Mosomo-health?
Development experts have long pointed out that corruption at local level is a major impediment to development and poverty reduction. The consequences of embezzlement, sub-standard, overpriced work, cronyism and bribery are particularly devastating with regard to local health projects. Buildings remain unfinished or are in dilapidated conditions, doctors and nurses do not turn up for work, citizens have to pay bribes to get services they should get for free, local powerbrokers pocket health funds or collude with corrupt contractors (for details see Global Corruption Report 2006: Corruption and Health). The consequences are devastating for the health and livelihoods of entire communities, thus directly affecting MDGs 4 and 5, as well as indirectly also the MDGs on poverty reduction, primary education and gender equality. Local residents stand little chance to stem the corruption tide. They are often ill-informed about what facilities and services they are entitled to or how much money has been allocated to their local clinic. Complaints at local level to the very bureaucrats that benefit from the corrupt system are likely to fail, while getting heard by the central government is prohibitively expensive and time-consuming for many victims of corruption.
What is Mosomo-health and how will it work?
A wave of new mobile applications empowers citizen journalists or social monitors to report on emergencies, track the integrity of elections or comment on the quality of services. Mosomo - health builds on these successes and brings social monitoring via mobile phones to an area of crucial importance to development and poverty reduction in many countries. It will harness the power of mobile phones to enable citizens to monitor their local health services more effectively.
In a nutshell, it will consist of two main activities:
- the compilation of a basic information database on local health projects and services in a pilot country (e.g. easily understandable, meta-tagged and geo-coded information on rural health facilities under construction and in operation with details on planned facilities, completion timetable, number of doctors and nurses, related budget allocations);
- the design and establishment of a mobile information hub that makes it possible to narrowcast by sms targeted information from the health database to citizens at local level who have registered as social monitors and also tp give these social monitors the option to retrieve information on specific health facilities or projects on demand from the database .
The rapidly evolving tools for mobile social media provide a wide range of additional functionalities that could be considered for the Mosomo testbed. Such functions include multimedia capabilities (project information available as voice recordings, photos, video snippets in addition to text), automated targeted retrieval and narrowcast with the help of geo-coding and geo-identification, time-programmed narrowcasts as sms alert systems, peer-to-peer alert systems and coordination of monitoring activities, voice controlled information retrieval etc. Specific design and implementation features will be decided in close consultation with the technology partners and the national chapters of Transparency International that commit to pilot the tool.
What is the expected impact?
The immediate outcome of Mosomo-health will be that social monitoring of local health projects by citizens at local level will be much more informed, targeted, effective and accessible. Once citizens know that their new local health clinic under construction is meant to be completed at a certain date or that existing facilities have received money for a certain number of doctors and services available they will find it much easier to document and report discrepancies and shortcomings. In turn, this will make it more difficult to misappropriate and embezzle money for local health projects, skimp on implementation or service quality or extort bribes from vulnerable clients.
In the medium term, however, the impact of the Mosomo pilot will be much broader and deeper.
Once fully operational the Mosomo system provides an extremely flexible, scalable and replicable information hub that can be expanded from monitoring health projects to other local development challenges and that can be flexibly tailored to the context of specific countries.
Moreover, Mosomo-health is envisioned to be a self-standing building bloc of a broader social accountability ecosystem that Transparency International, the project sponsor, is developing. It is envisaged that this comprehensive system will also provide a collaborative information clearing-house in the form of a wiki website. This site will compile and map the observations and tracking reports (voice, text, images, video footage) submitted by local citizens. It will present these reports alongside project plans, service specifications and budget allocations for a wide range of essential public services and infrastructure projects. Such a comprehensive public visualization of the implementation gap - the divergence between what facilities and services should exist according to plan and what is actually observed on the ground will maximize the pressure for local accountability and provide vital empirical information for advocacy and local governance reform.
