Diakonia - People change the world
Paula Monjane Paula Monjane is the director of Diakonia's partner organization CESC in Mozambique.

Social accountabilty improves conditions in health sector

– Citizens and state institutions need to be closer to each other, says Paula Monjane, the director of CESC, Civil Society Capacity Building Center in Mozambique. The organization promotes social accountability in the areas of public health and education, and they do it in a rights-based manner that empowers people. The last few years they have seen a progress.


– The beauty of this method is that it informs and engages people on grass root level, it provides oversight of authorities and it empowers those that perform the oversight. People are drawn in to the process, says Paula Monjane.

A cheap and effective method

She adds that it is also a relatively cheap method in comparison to other methods such as budget tracking for example.

CESC was founded in 2009. Paula Monjane and colleagues had done some research and found that in Mozambique the civil society organizations were strong on service provisions, complementing state services, but weak when it came to state institution scrutiny. At the same time, there were reports on corruption and mismanagement of public resources of the country.

– Citizens were not informed of their rights and did not know how to engage. So our idea was to provide information and knowledge, and to promote active citizenship to make sure that state institutions are accountable to the people and not to the donors of development cooperation.

Paula Monjane says there is a discrepancy between what the legal framework states and the implementation.

– For example, in the case of domestic violence, the law says it is a legal issue, but the police say it is a domestic one.

No room for mass movements

She points out how the history of her country led to a very passive civil society.

– After the independence in 1975 Mozambique was linked to the Soviet Union, we only had one party and no free civil society movements, no mass movements that weren’t linked to the ruling party. Everything was controlled. There was no space to talk about human rights.

Paula Monjane is the director of CESC and she explains how social accountability is done in three steps. The first step is mobilization: service providers are informed about the rights holders’ rights and provided with an opportunity to discuss issues of interest for the community with rights holders. During the second step groups (for example community leaders, women, children, chronically ill, adult men) come together and they evaluate the services provided, assess them on basis of a score card and define challenges. The third step brings the different groups, including the service providers, together and a facilitator helps them discuss what can be improved, solutions and to develop a joint action plan.

– In this way, citizens are informed and educated about their rights. For me it is the only manner that makes change happen, says Paula Monjane.

Mozambique still counts on 25 per cent of its state budget from foreign aid.

- Our government should be accountable to its citizens, not only to foreign donors. Our  people are used to being recipients, not used to question those in power, but in the last years it has been changing, people are realizing that they have their rights.

Improvement in health sector

The last three years CESC has also seen how there has been improvement on a number of the indicators that CESC has put up regarding the health and education sectors. For example, the behavior of the hospital staff towards patients, and transparency regarding school budgets has improved. The annual follow-up of the community score card on the quality of health services in the communities, showed progress between 2012 and 2014. The users perceive that the quality of the health service has improved. CESC also admits, according to Paula Monjane, the challenges related to work; one is that to be able to advance on structural problems the national level authorities have to get involved. For this purpose, the work at local level is systematized and used for advocacy work at national level.

Paula Monjane says the society will change when more and more are empowered and demand for accountability. - If everyone talks about, and raises important issues, then the leaders will care about what we think.