Author: Izabela Chmielewska
During Open Gov Week in May 2022, Global Integrity and our COVID-19 Transparency and Accountability Project (CTAP) partners in Nigeria, Kenya, Ghana, and Cameroon gathered for a conversation about advancing primary health in Africa through the Open Government Partnership (OGP) and its multi-stakeholder processes.
The event gave firsthand insights from four CTAP Leads on pathways to improving government commitments and health outcomes in each country. This blog highlights the frontline actors’ event remarks on utilizing tools for government accountability, organizing civil society coalitions, and encouraging citizen mobilization to follow the money tied to COVID-19.
Explore the insights from four CTAP leads in Kenya, Nigeria, Ghana, and Cameroon below.
As an OGP Member, Kenya has made specific health-related commitments in its Action Plans. The moderator, Yeukai Mokorombido (Global Integrity’s Learning & Research Manager) posed the first set of questions to the CTAP Lead in Kenya – Evelyn Mathai (Head of Programs at the Slums Information Development & Resource Centers – SIDAREC), inquiring about the status of these commitments and the role of CSOs.
Mokorombido asked what progress has been made thus far against the commitments in Kenya? And how can civic actors make the case for improving health systems in the wake of the pandemic via open governance and multi-stakeholder approaches, like OGP?
In her response, Evelyn Mathai emphasized that the commitments, laws, and policies in Kenya have extensively encoded open government principles already, but those standards alone do not sufficiently meet the needs of the people in practice. “We need to capitalize on existing structures: we have public participation policies, the issue is just implementation.” This is particularly true at the country level, with varied regional results.
Mathai mentioned that one practical follow the money tool has been a platform called Budget Talk, which breaks down the budget process to keep the public informed. “It’s one thing to allocate resources towards a particular department, but we need to know who is benefiting from these services” since there has been a lot of misappropriation of funds. As a part of the CTAP project, SIDAREC and partner CSOs have been able to visit healthcare facilities in some countries to verify if the allocated budget was spent appropriately on equipment line oxygen plants – though sometimes they were met with hostility or lack of data.
Thanks to CSO coalitions that have been tracking the COVID-19 disbursements, the CSOs in Kenya have seen a greater government response and have become a partner in addressing implementation gaps. The national OGP Action Plans have been collaboratively created in much greater cooperation than before becoming a member. Nonetheless, more cooperation from the sub-national county governments is needed to take the OGP process further.
Like Kenya, Nigeria is also an OGP member and has made specific health sector commitments, especially in regards to financial investments and service delivery. In his overview of the issues facing Nigeria, The CTAP Lead there, Iyanuoluwa Bolarinwa (Senior Program Officer at BudgIT), remarked that the OGP process opened a window of opportunity to make sure there are health-specific commitments are included and implemented through the OGP Action Plans.
The actualization of the promised policies and the intended budgets for improved healthcare service delivery too often does not measure up to the policy parameters outlined in the Action Plans. BudgIT and other CSOs thus play an important role in tracking funds and monitoring procurement practices, especially with the use of open data such as Nigeria’s Open Treasury Platform.
“We have been able to gather data coalitions asking the same questions: how much was spent, what was it spent on…and who were the beneficiaries of these funds,” Bolarinwa recounted. Despite these advancements, some information regarding emergency spending during COVID-19 was still hidden from the public. As highlighted in this CTAP report, the complex challenges of weak institutions and inadequate fiscal policy creates ripe ground for corruption.
To achieve greater accountability, it’s important for Nigerian citizens to understand what was allocated, spent, and delivered for primary healthcare services, especially vaccines, with easy access to the right information. In Nigeria, “the civil society and the government are working to institutionalize the national Action Plans,” and the window of opportunity for the next plan is to put health sector accountability as its own commitment to ensure that it’s a priority. More needs to be done, especially as we emerge from the pandemic.
“We need to prepare for the next health emergency…we have seen Ebola, we have seen COVID,” Bolarinwa underscored. Yet, safety nets for citizens remain fragile in Nigeria and across Africa. “The CTAP project is going to put us a step forward to institutionalize health sector accountability across our countries” – especially with two more countries joining in the ongoing second phase of the project.
Like Kenya and Nigeria, Ghana is likewise an OGP Member, but with an Action Plan that is up for renewal in 2023. The COVID-19 crisis, coupled with the current recession and the impacts of the war in Ukraine, has “increased people’s appetite for accountability,” Ghana’s CTAP Lead, Ray Nkum (BudgIT Ghana Country Lead) shared. Social media is an effective method to inform the public and put pressure on officials to uphold government commitments, especially in regards to the healthcare crisis exacerbated by the pandemic.
“Social media was the key technology that was quite influential in this process,” Nkum remarked. “We had a campaign with the hashtag #fixthecountry and, in a single day, there were 400,000 posts on Twitter.” People on social media were “showing their displeasure with the government and the management of the economy.” Nkum underlined the importance of “raising the level of consciousness about the need for accountability” and balancing that with combating misinformation on social media platforms.
There is a delicate balance between accountability and misinformation. Fact-checking is an absolute necessity. BudgIT Ghana responded to this need by training 60+ local accountability networks with fact-checking skills. They also trained them with effective posting methods, such as using social media images that illustrate complex problems in simple ways. Such infographics can be easily shared with trending hashtags across platforms, like #fixthecountry campaign. This boosts public access to accurate information and increases engagement.
Ghana is in the middle of its OGP Action Plan, which is seen as advantageous from Nkum’s point of view. It gives CSOs more time to build up coalitions and involve more stakeholders that have not been a part of the process – “and that’s really the point of OGP: to have all the various stakeholders involved” throughout the process, both the Ministry of Finance and local community leaders. The lessons learned during the COVID-19 crisis can also help to envision what “mainstreaming health” in the future Action Plans can look like.
As a part of CTAP, BudgtIT Ghana has worked with regional health accountants to understand shortcomings, and is also looking to involve traditional leaders at the grassroots level to improve the project implementation in its second phase. The harsh reality, as the moderator Yeukai Mokorombido remarked, is that “the cost of corruption costs lives, and most negatively impacts vulnerable populations” due to the lack of adequate resources to respond to the health needs caused by the pandemic.
While Cameroon is not an OGP Member, the CTAP Lead there, Nancy Saiboh (Founder and CEO of Actions for Development and Empowerment – ADE) has been adamantly advocating for joining the OGP and raising its eligibility score, along with other Cameroonian CSOs. As part of the campaign, they have been “sensitizing the public about the importance of budget transparency, access to information, declaration of assets of elected members, and citizens participation.”
Being a part of OGP could provide a useful policy framework to improve the proper management of health funds, which could in turn help address current and future health crises and improve the citizens’ trust in their government. Saiboh highlighted that issues of “misappropriation of funds, corruption, and embezzlement” are deepened due to the “lack of access to information and low citizen participation” in the political process, which are important pillars of viable public policy implementation and effective project monitoring.
Currently, Cameroon faces a combined health crises of cholera and COVID-19, which is exacerbated by the lack of open government standards like access to information, which has given the CSOs more fuel for advocacy. This further elevates the urgency of addressing complex health sector issues. “We are using this crisis as an opportunity to advocate for the importance of Cameron becoming an OGP member” because it would ease some of the challenges that the country is currently facing, such as access to information.
While Cameroon is not yet a part of OGP, the CTAP project has provided a venue to inform citizens in an effort to keep the government accountable. During the first phase of the project, the CSOs “tracked COVID funds and the state of the primary healthcare centers in five regions in Cameroon” – seeing the reality of living in remote areas during the pandemic firsthand, and reporting on the conditions to raise public awareness.
ADE has also implemented a project called Know Your Budget, which provides access to clear information with tools like simple infographics, and engages people in the political processes through various social media campaigns. This helps citizens understand their country’s budget – with emphasis on health, education, as well as water and sanitation. Typically, these sectors get a lot of supportive attention in OGP Action Plans, and thus could provide a valuable toolkit for addressing many challenges.
While each country faces different health system challenges and governance complexities, multi-stakeholder collaboration through OGP and projects such as CTAP are effective leveraging tools to improve the delivery of primary health services across Africa. Having the right combination of political will and public pressure can help turn sound commitments into implementable policies that can positively affect people’s lives. As demonstrated by the CTAP Leads during this event, this cannot be done without CSO coalitions that push for greater accountability in healthcare and utilize the painful lessons of COVID-19 to fix broken systems. They are the engine of change.
See the whole event here:
This conversation was part of the COVID-19 Transparency and Accountability Project (CTAP) led by BudgIT, Connected Development, and Global Integrity. The event described above took place on May 20th, 2022 and was a part of the 2022 Open Gov Week, organized by the Open Government Partnership, more info here.
CTAP is led by Global Integrity, Connected Development, and BudgIT. The 9 country partners are: Cameroon, Ghana, Kenya, Liberia, Malawi, Nigeria, and Sierra Leone. Learn more about the project in the recently published CTAP Phase 1 Lesson Report.
More about the CTAP organizations:
Kenya | Slums Information Development & Resource Centers (SIDAREC) is a Kenyan grassroots communication NGO operating in three major informal settlements in Nairobi. In addition to being the lead country partner coordinating the implementation of the CTAP project in Kenya, SIDAREC is also the lead coordinator for the Follow the Money (FtM) Kenya Chapter. In February 2021, SIDAREC officially launched the CTAP project and has been able to bring together local actors working on Covid transparency to exchange information/resources and agree to a collective advocacy agenda. Learn more about this organization here.
Nigeria | BudgIT is a civic organization in Nigeria that applies technology to intersect citizen engagement with institutional improvement, to facilitate societal change. A pioneer in the field of social advocacy melded with technology, BudgIT uses an array of tech tools to simplify the budget and matters of public spending for citizens, with the primary aim of raising standard of transparency and accountability in government. They partner with civil society, public institutions and the media, chiefly in the areas of fiscal analysis, civic technology and data representation. They are leading CTAP along with CODE and Global Integrity. Learn more about this organization here.
Ghana | BudgIT Ghana is coordinating the implementation of the CTAP project in Ghana since BudgIT Foundation started operations in Ghana in September 2019. In March 2021, BudgIT Ghana officially launched the CTAP project and has since convened a diverse range of local stakeholders to engage in immersive discussions on how Ghana can build a resilient PFM that enables the government to deal with the pandemic response in a more open and accountable manner. Learn more about this organization here.
Cameroon | Actions for Development and Empowerment (ADE) is a non-profit, grassroots, and youth-driven organization founded with the aim of empowering citizens, especially young people, to hold the government accountable to its service-delivery obligations through informed demands. ADE is currently spearheading the local chapter of the Follow the Money (FtM) in Cameroon. ADE launched the CTAP project in Cameroon in February 2021 and has since convened a diverse range of local stakeholders to facilitate collaborative action for improving the state of Covid transparency in the country. Learn more about this organization here.