Health care centre responding to the needs of the community with the aid of the community scorecard
Mr. San is the Health Centre Chief at Boeng Preav Health Centre in Srae Ambel District, Koh Kong Province. He has been working as Health Centre Chief for more than three years. The health centre is the main access point for a total of 16 villages and is made up of a team of seven nurses. CARE introduced the community scorecard to the health centre in 2013 and since this time the health centre has been proactive in responding to the needs of the community. This has considerably reduced the number of complaints previously received by the health centre in reference to poor hygiene, staff attitude, consultation fees and information about staff working hours.
The community scorecard is a two-way and ongoing participatory tool for assessment, planning, monitoring and evaluation of health care services and brings together both the community and health centre staff to jointly analyse underlying service delivery problems and find a common and shared way of addressing those issues. As Mr. San explains to CARE, “the community scorecard is a way to collect feedback from the community and to bring this together with health centre
Mr. San explains that before the community scorecard activity was introduced at the health centre they received a lot of complaints from the community because they were unhappy with the level of service. This included cleanliness of toilets, sometimes unfriendly staff and lack of information about health centre opening hours. Before the community scorecard, the community had no official way to provide feedback and the health centre had no way to record or monitor these issues.
After more than one year of using the community scorecard tool, Mr. San says the health centre has been responsive to the concerns of the community and has implemented a number of important changes to improve their services. This has included: introducing regular weekly meetings for health centre staff to discuss action plans and ensure follow through of responsibilities; educating patients about hygiene and cleanliness so that toilets are kept clean; ensuring more information is disseminated to communities about opening hours through village health support groups, and ensuring staff are friendly and welcoming.
Despite some challenges outside of the health centre’s control, the community scorecard is an example of how the support of NGOs can make a considerable difference by providing a platform for communities and health providers to work together. “The community score card is a good tool to bring the community and stakeholders together to hear problems and find solutions,” says Mr San. “Now we have a lot of support from NGOs like CARE to work more closely with communities and this has meant we have been able to make improvements to our health centre”.
The community scorecard is only one aspect of CARE’s work to improve the level of health care in Cambodia. Understaffed health centres and health workers being underpaid often makes this work more challenging, leading communities to be dissatisfied with the over level of health care provided. Staff regularly advocate to provincial and national government for them to provide greater support to the health sector in Cambodia, such as increasing wages and providing incentives to attract high-quality staff to the sector.