The Community Monitor for Health Service Quality - Eghospitals.com
eghospitals.com is a community-monitoring platform for hospitals in Egypt. Through this people-driven tool, we engage, inform and empower citizens to reclaim ownership over their healthcare services by carrying out community-assessments of public hospitals and displaying the results of these assessments to hold officials accountable and present executives with clear information about what needs to improved.
The aim of this project is to promote active citizenship and social accountability through community monitoring of health service provision in Egypt with a special focus on government-run public hospitals.
The project has the following main goals:
1. Empowering patients to make informed decisions about their choice of health service providers.
2. Mobilizing citizens, especially youth, to use systematic and scientifically-reliable community monitoring tools for public services on a local and national level.
3. Holding health authorities accountable to their main stakeholders through community-based service monitoring.
4. Supporting grass-root data collection that would enable proper research-based advocacy.
HOW THE OBJECTIVES WERE ACHIEVED
The project team mobilises and trains local active citizens to carry out hospital patient-centered performance appraisals through simple, user-friendly tools.
These community assessments are made available to the masses through the community-monitoring portal eghospitals.com, which empowers people to hold providers accountable and enables them to make better, informed decisions about their health service providers for a sustainable improvement of their quality of life.
The web portal allows citizens to request assessment of specific hospitals, participate in hospital assessments, report problems they have faced and get a detailed overview about how the hospitals perform, whether they are improving or regressing and whether the allocated public funds have translated into improvement of services or not.
The assessments also provide a detailed roadmap for public officials on the areas of needed improvements that would tangibly yield raised satisfaction of citizens.
The project is based on belief that citizen engagement and community participation are the main prerequisites to ensure success of any intervention.
The role of the citizens should not stop at involvement in concept design but should extend to participation in implementation and its monitoring. By empowering non-expert citizens to lead the changes they want to see in their healthcare system, and by opening channels of direct communication and feedback provision, citizens become a motor in the process instead of an obstacle that needs confrontation. They become more aware of the available resources and more vigilant to poor quality and waste of resources.
1. Health service users, especially those with limited resources who rely mostly on public hospitals now have access to data collected from a community monitoring process, to guide their decisions with respect to health care.
2. Active local community youth are given the ability to participate in an organised community monitoring process, that promotes active citizenship and restores ownership to the public health facilities.
3. This tool is also enabling us to track the progress of any quality improvement process and to hold health authorities accountable for the services they provide.
The first phase has been completed in August 2015 and has yielded 1) a set of patient-centered performance appraisal indicators and measures, 2) the online platform and assessment tool, 3) assessment of 16 hospitals around Egypt through trained local community members. A total of 539 hospitals are planned to be covered in the upcoming 18 months.
Encountered and foreseeable challenges include resistance to change from policy-makers and service providers, insufficient funds and difficult cultural transitions towards the notion of “empowered citizens leading impact” in contrast with top-down development approaches.
These obstacles can be overcome respectively through, engagement of policy-makers and service providers in the process and demonstrating its short and long-term benefits to them, the reliance on solid and sustainable business model and demonstrating palatable positive changes in the health service quality that were made possible through citizens engagements.
One of the main lessons learnt is that, surprisingly, managers of public hospitals were willing to provide us with information to carry out the performance appraisal as they believe that by doing this, they will be able to attract policy-makers attention to the problems their hospitals face and therefore securing funding and resources to fix these problems.
We learnt that managers, if properly engaged, can be helpful in our community-monitoring process rather than an obstacle.
So far, in our audits of public hospital, when presented to the management as an effort to improve the service quality of the hospital, managers were proactive in showing us and telling us what is hindering the performance of the hospital and were rushing in showing us where the defects are. We read this as the managers, knowing the hospital is not providing optimal services, were simply keen on renouncing responsibility for these pitfalls by showing us the problems instead of defending their position.