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CITIZENS AS DRIVERS OF CHANGE Practicing Human Rights to Engage with the State and Promote Transparency and Accountability JULY 2017 REPORT NO: ACS21097 i TABLE OF CONTENTS Acknowledgments........................................................................................................................ iii Overview....................................................................................................................................... iv Learning from three case studies of corruption in service delivery............................................................................... iv A framework for analysis: WDR 2017 and a human rights lens.................................................................................... iv Key research findings.................................................................................................................................................... vi Lessons for international actors..................................................................................................................................... ix Navigating this report................................................................................................................................................... x Abbreviations ............................................................................................................................... xi CHAPTER 1: Citizen engagement, human rights, and development........................................... 1 Analytical framework..................................................................................................................................................... 4 Research design and case study methodology............................................................................................................. 5 CHAPTER 2: A brief literature review........................................................................................... 11 Emergence of citizen engagement in development practice and research.................................................................. 13 Citizen engagement in World Bank practice and research........................................................................................... 14 Citizen engagement in the health and education sectors............................................................................................. 15 Citizen engagement, anticorruption, and collective action........................................................................................... 16 Citizen engagement, fragile contexts, and peacebuilding ........................................................................................... 17 Rights begetting rights: Using citizen engagement to improve development outcomes............................................ 18 CHAPTER 3: Case studies............................................................................................................. 21 Afghanistan: Improving education outcomes through community-based monitoring of schools .............................. 23 SPOTLIGHT 1: Current challenges in the education system in Afghanistan .....................................................25 Paraguay: Engaging in youth-driven contestation to gather resources for education.................................................. 31 SPOTLIGHT 2: Current challenges in the education system in Paraguay .........................................................33 Serbia: Reducing corruption and improving publicly funded public health care services through citizen agency...... 46 SPOTLIGHT 3: Current challenges in the health care system in Serbia ............................................................48 CHAPTER 4: From analysis to action............................................................................................ 61 Key messages and takeaways........................................................................................................................................ 63 Lessons for international actors..................................................................................................................................... 69 APPENDIXES ............................................................................................................................... 73 APPENDIX A: Integrity watch Afghanistan’s CBM-S framework...................................................... 74 APPENDIX B: Serbia on the move’s manifesto............................................................................... 76 References.................................................................................................................................... 77 ii CITIZENS AS DRIVERS OF CHANGE List of Boxes O.1: Summary of three case studies of citizen engagement..................................................................................................................v 1.1: Summary of three case studies of citizen engagement..................................................................................................................6 2.1: Terms related to citizen engagement..............................................................................................................................................13 2.2: Human rights and citizen engagement..........................................................................................................................................18 3.1: Recollections of an IWA provincial coordinator...............................................................................................................................28 3.2: Monitoring teacher absenteeism and “ghost teachers”..................................................................................................................29 3.3: The National Public Investment and Development Fund (FONACIDE)...........................................................................................35 3.4: Targets of government engagement, reAcción...............................................................................................................................40 3.5: ReAcción recommendations incorporated into OGP Independent Review Mechanism 2016 Mid-Term Report............................41 3.6: Exposing FONACIDE corruption in Ciudad del Este........................................................................................................................42 3.7: Serbia on the Move’s project structure............................................................................................................................................50 List of Figures O.1: Role of social organizations through the lens of the WDR 2017 framework..................................................................................vi 1.1: WDR 2017 framework: Governance, law, and development..........................................................................................................4 1.2: Role of social organizations through the lens of the WDR 2017 framework..................................................................................6 1.3: Space for civil society and citizen engagement: Afghanistan, Paraguay, and Serbia......................................................................8 1.4: Power asymmetries and their manifestations: Afghanistan, Paraguay, and Serbia........................................................................9 3.1: Afghanistan’s governance score rankings, 2000 and 2015............................................................................................................24 3.2: Paraguay’s governance score rankings, 2000 and 2015................................................................................................................32 3.3: Historical trend in corruption in Paraguay, 2009–16 (CPI ranking)................................................................................................33 3.4: Corruption Perception Index 2016: Paraguay in comparative perspective.....................................................................................33 3.5: Corruption, education outcomes, and clientelism in Paraguay......................................................................................................34 3.6: Examples of data visualizations of FONACIDE funding allocations................................................................................................38 3.8: Serbia’s relative levels of corruption and societal engagement......................................................................................................46 3.7: Serbia’s governance score rankings, 2000 and 2015.....................................................................................................................46 3.9: Outcomes in Serbia’s health sector, 2014–15.................................................................................................................................47 B3.7.1: Citizen engagement project structure of Serbia on the Move...................................................................................................50 List of Tables O.1: Application of rights: Integrity watch Afghanistan, reAcción (Paraguay), and Serbia on the move................................................vii 1.1: Broad economic and governance comparison of case study countries...........................................................................................7 3.1: Common problems observed by IWA local monitors in 2016 and their fix rate.............................................................................29 3.2: Application of human rights, Integrity Watch Afghanistan.............................................................................................................30 3.3: Application of human rights, reAcción............................................................................................................................................44 3.4: Altering elites’ incentives on the ground: Five SoM projects..........................................................................................................52 3.5: Selected questions and results from patient perception surveys, Hospitals without Corruption project .......................................57 3.6: Application of human rights, Serbia on the Move..........................................................................................................................58 List of Photos 3.1: Honorary badge: “I am not on the take, I work for the salary”........................................................................................................53 3.2: SoM’s anticorruption tool poster in hospital, Hospitals without Corruption project.......................................................................56 iii Acknowledgments T his report is part of an effort to document the relationship between citizen engagement and human rights through the lens of the framework of the World Development Report Afzali (executive director, Integrity Watch Afghanistan), Ana Babović (executive director and co-founder, Serbia on the Move), David Riveros García (executive director and found- 2017: Governance and the Law (WDR 2017). The Bank team er, reAcción Paraguay), Kowsar Gowhari (former manager of is led by Marco Larizza (task team leader) and includes Le- programs, Integrity Watch Afghanistan), Khadija Mehmood anne Bayer, Shaazka Beyerle, David Bulman, Ann-Sofie Jes- (program officer, Integrity Watch Afghanistan), Mohammad persen, Joseph Mansilla, and Berenike Schott. The report’s Naser Sidiqee (former program manager, Integrity Watch principal authors are Shaazka Beyerle, David Bulman, and Afghanistan), Predrag Stojičić (co-founder, Serbia on the Berenike Schott, with contributions from Matilda Brolin Move), and Mo-hammad Naser Timory (advocacy manager, (Harvard University), Alina König, Marco Larizza, Ser- Integrity Watch Afghanistan). The authors would also like to gio Martinez (Catholic University of America), and Daniel thank Sabra Ledent and Duina Reyes for their excellent edito- Natkie (Harvard University). The team has benefited from rial and production support. valuable inputs, comments, and guidance from Anna Autio, Stephen Commins, Florencia Guerzovich, Asli Gurkan, Fab- Finally, the authors are grateful to the Nordic Trust Fund rice Houdart, Simon Carl O’Meally, Nicolas Perrin, Vincent (NTF) for supporting the activities under this initiative. The Roquet, Jeff Thindwa, Lotta Valtonen (Ministry for Foreign findings, interpretations, and conclusions expressed in this Affairs of Finland), Åsa Wallendahl (Ministry for Foreign Af- report are entirely those of the authors and should not be fairs of Finland), Jan Weetjens, and Anders Zeiljon. attributed in any manner to the World Bank, to its affiliated organizations, or to members of its Board of Executive Direc- This report would not have been possible without the con- tors or the countries they represent. tributions and invaluable insights provided by Sayed Ikram iv CITIZENS AS DRIVERS OF CHANGE Overview S ince 2014, the World Bank Group (WBG) has formally mainstreamed citizen engagement in its strategy to end extreme poverty and share prosperity, building on 25 years Learning from three case studies of corruption in service delivery of emerging practice and research. Indeed, since the 1990s the WBG has sought to fight corruption and poverty by em- This report analyzes citizen engagement to reduce corruption powering the poor, leading to a shift from focusing primarily in service delivery in three diverse settings: in Afghanistan, on the client—that is, the borrowing state entity—to focusing improving education outcomes through community-based increasingly on the ultimate project beneficiaries and citizens monitoring of schools; in Paraguay, monitoring sovereign more broadly. In the early 2000s, the WBG issued guidance wealth fund resources allocated to education to improve the on multistakeholder engagement to strengthen accountabili- infrastructure of marginalized schools; and in Serbia, pro- ty relationships through citizen participation and ensure that moting transparency and the integrity of physicians to reduce the benefits of development projects reached the poor. Most corruption in the health sector (box O.1). Citizen engagement recently, the development community has acknowledged that can have particularly strong positive effects on service deliv- development outcomes improve when citizens participate in ery, including health care and education, by giving voice to development, leading to the WBG mandate to mainstream the less powerful and in turn improving the accessibility, cov- citizen engagement across sectors and countries. This fol- erage, and quality of service delivery. lowed popular movements in 2010 and 2011, particularly in the Middle East and North Africa (MENA), that led World All three cases are examples of successful bottom-up citizen Bank president Robert Zoellick to argue for a “new social engagement initiatives at the nexus of corruption and essen- contract for development” because 2011 was “the year we tial public services. Citizen engagement is organic rather than learned that civic participation matters to development.” induced by external actors; citizens, working on a voluntary basis, help select and design initiatives. In addition, in all cas- Although citizen engagement has become increasingly im- es citizens employ multiple institutional and noninstitutional portant to WBG operations, many gaps remain in under- collective actions over an extended period rather than one-off standing how it can be effectively harnessed and supported. actions or spontaneous public outbursts. These actions help The research described in this report, made possible through to achieve the social organizations’ stated goals. Yet, these the Nordic Trust Fund (NTF), a multidonor knowledge and three cases differ significantly in context across region, in- learning program on human rights for World Bank staff, aims come level, fragility, polity, corruption level, and the sector to deepen understanding of citizen engagement in the devel- targeted by the citizen initiative. This diversity helps capture opment arena through in-depth study of three grassroots ini- the wide variety of citizen engagement permutations and en- tiatives in which empowered citizens played a central role. All hances general lessons for development actors. three initiatives embraced the anticorruption, transparency, accountability, and citizen-state interface as they sought to A framework for analysis: WDR 2017 improve the quality and delivery of essential public services. The research complements existing approaches by explicitly and a human rights lens adopting a human rights perspective, as well as focusing on organic citizen-led initiatives rather than WBG- or client-ini- To draw broader lessons about how to harness citizen en- tiated projects. In analyzing these cases, this report applies gagement to improve development outcomes, this report ap- the framework of the World Development Report 2017: Gov- plies the WDR 2017 analytical framework as well as a human ernance and the Law (WDR 2017) to understand how citizens rights lens to these three citizen-led initiatives. The WDR effectively disrupted the persistent power asymmetries that 2017 approach compelled consideration of the underlying undermined development outcomes (World Bank 2017b). power asymmetries that undermine the functional effective- ness required for service delivery, and it pointed to ways in which citizens act collectively and engage strategically with OVERVIEW v Box O.1: Summary of three case studies of citizen engagement Afghanistan Founded in 2005, Integrity Watch Afghanistan (IWA) conducts community-based monitoring programs in several sectors aimed at increasing transparency, accountability, and integrity in Afghanistan. In July 2014, IWA launched the Community-Based Monitoring School (CBM-S) program, which seeks to (1) improve the quality of education in Afghanistan; (2) increase contact and coordination between communities and officials by bringing together stakehold- ers in the education of Afghan children; (3) increase the responsiveness of school officials to citizens; (4) encourage communities to take the initiative in addressing education-related problems in their locales; and (5) use the results of community-based monitoring in policy advocacy at the local and national levels. Paraguay ReAcción Paraguay is a registered youth anticorruption organization that was first launched in 2010 as an informal anticorruption group composed of young people in Ciudad del Este, the second largest city in Paraguay. Its mission is to empower citizens to prevent corruption and improve the provision of public services, particularly public education. The group works primarily to monitor the sovereign wealth fund expenditures allocated to education in Paraguay and increase transparency and citizen engagement to ensure that these funds reach their intended targets. Serbia Serbia on the Move (SoM) seeks to reduce corruption in Serbia’s health sector by strengthening prevention mechanisms, transparency, and accountability through citizen engagement. The organization was founded by a group of young professionals and officially launched as a registered association in July 2009. Its objectives are to (1) raise citizens’ awareness about how to fight corruption in publicly funded health care; (2) formulate new transparency and accountability mechanisms to reduce corruption in health care; (3) build the capacity of citizens to actively push for the adoption and implementation of these new transparency and accountability mechanisms; and (4) build a coalition of stakeholders (citizens, civil society organizations, state institutions, public health practitioners) interested in reducing corruption in the health sector. Serbia on the Move has carried out five projects targeting corruption in publicly funded health care, working with health care practitioners, regular citizens, and elites to improve integrity. elites and international actors to rebalance power and shape change often requires multiple sets of actors, including elites, elites’ incentives and preferences.1 The human rights–based citizens, and international actors. Acting individually, citizens approach helped demonstrate mechanisms through which are largely ineffective, but they can organize to apply pressure citizen groups ensure voluntary commitment to their causes, in the policy bargaining process. Power is thus at the heart of as well as complementary strategies whereby citizen groups citizen engagement initiatives, and the WDR 2017 framework use the availability of certain rights to help fight for additional helps elaborate how citizens can shift power asymmetries rights. through collective action and social organization. According to WDR 2017, power asymmetries between so- Although WDR 2017 explains how citizens can affect out- cietal actors can undermine the functional effectiveness of comes in the policy arena through social organization, it policies by preventing commitment, coordination, and coop- does not explore how citizens can overcome their substantial eration. An understanding of power——the ability of groups collective action challenges through social organization, nor and individuals to make others act in their interest and bring does it delve deeply into the strategies employed by social or- about specific outcomes—and power asymmetries is essential ganization to effect change. The analysis in this report seeks to understanding whether policies are designed and imple- to fill these gaps, drawing on the transparency and social ac- mented to support development outcomes. Negative manifes- countability literature as well as the application of a human tations of power asymmetries are capture, clientelism, and ex- rights lens. Citizen engagement is a powerful tool through clusion. Fortunately, three levers of change can change power which people can help fulfill their social and economic rights, dynamics so that governance plagued by capture, clientelism, such as to health care or education, by exercising their civ- and exclusion moves toward governance that serves the pub- il and political rights. Citizen engagement is linked, in par- lic interest. These levers consist of changing incentives to pur- ticular, to the freedoms of association, assembly, expression, sue particular goals; changing the underlying preferences and and information, and the right to participate in government. beliefs of relevant actors; and increasing contestability—that These rights enable people to become knowledgeable about is, who participates in the policy arena. Using these levers for public problems, voice their concerns even if contrary to 1. For the purposes of this report, “elites” are defined as those persons who have the ability to directly influence the design and implementation of a certain policy (World Bank 2017b); “international actors” are entities such as foreign states, multinational corporations, development agencies, or transnational non- governmental organizations (World Bank 2017b, 257). vi CITIZENS AS DRIVERS OF CHANGE Figure O.1: Role of social organizations through the lens of the WDR 2017 framework OVERCOMING SOCIAL CHANGING THE POLICY OBSTACLES TO ORGANIZATION ARENA: INCENTIVES, COLLECTIVE STRATEGY AND PREFERENCES, ACTION TACTICS CONTESTABILITY CONTEXT: EXISTING LAWS AND SOCIAL NORMS Source: Based on WDR 2017. those of the elites, and organize peacefully to tackle these ficulty in challenging these entrenched power asymmetries, problems. under-the-table bribes in exchange for medical services have become an entrenched norm in Serbian society. The case studies begin by exploring how three organizations overcame collective action challenges through bottom-up ef- Eventually, though, citizen-driven collective action helped forts to enhance citizen voice through the power of numbers. shift power asymmetries and gave citizens a seat at the table The studies then explore how these social organizations em- through their power of numbers, enhancing contestability. ployed strategies and tactics that relied on a variety of tools Change was brought about most effectively by strategically and coalition-building strategies (figure O.1). When success- combining institutional with extrainstitutional engagement. ful, these strategies and tactics were able to mitigate power Extrainstitutional pressure is especially needed when elite- asymmetries by shifting elite incentives, reshaping prefer- led institutional policies do not support the rules and policies ences and beliefs, and enhancing contestability. All of these needed for transparency, accountability, and development stages of social organization were shaped in part by the local outcomes. Examples of such pressure are the communi- context within which the organizations operated, particularly ty-based monitoring undertaken by Integrity Watch Afghan- existing laws and societal norms. istan (IWA), reAcción’s student monitoring in Paraguay, and the grassroots campaigns organized by Serbia on the Move Key research findings (SoM). As for responses, after organizing silent protests and a petition drive that delivered 3,000 signatures to authorities, Collective action can shift power asymmetries SoM received a request from the Ministry of Health to jointly undertake a text messaging service that would enable citizens In all three cases, power asymmetries drove the underlying to securely report corruption. functional challenges that spurred citizen action, resonating with the WDR 2017 framework. In Afghanistan, the high Human rights are an effective tool for collective levels of corruption that were undermining the access to and action quality of education were driven by the exclusion of citizens and communities from addressing education-related prob- The case studies suggest two main ways in which the active lems in their communities, and teacher quality was under- use of human rights helped achieve goals. First, the absence of mined by clientelism and patronage. In Paraguay, problems rights served as a focal point for collective action. Human rights of local clientelism and capture meant that funds from the are more than abstract aspirations and moral imperatives; National Public Investment and Development Fund (FON- their presence or absence is experienced in daily life. For ex- ACIDE) were targeted to politically favored schools rather ample, citizens are denied the right to development through than marginalized ones, as intended. The would-be recipients the ill effects of corruption, the insufficient and low-quality were excluded from the allocation process and indeed were provision of vital public services, marginalization, poverty, often unaware they should be receiving funds. In Serbia, the and poor governance. Imagine, for example, being a parent effective exclusion of patients from using institutional means whose sick child is refused treatment because you cannot af- of controlling corruption in the health care sector and pun- ford the requested bribe, or attending a school where classes ishing wrongdoers resulted in doctors possessing asymmetri- are regularly cancelled because teachers do not show up to cal power relative to that of their patients. Because of the dif- work. Notions about claiming rights informed these civic ini- OVERVIEW vii tiatives: the right to education (IWA, reAcción), health care citizens about such rights—from the general public (Serbia) (SoM), and information (all cases). The experience of be- to youth (Paraguay), communities (Afghanistan), and pa- ing denied rights, combined with awareness of those rights, tients (Serbia). Meanwhile, the introduction of right to in- served as motivation for collective action. formation laws in Paraguay and Serbia helped citizen groups access the information they needed to expose and combat Second, human rights were used to gain other rights. All three corruption (table O.1). cases are examples of the active practice of human rights for instrumental purposes. The practice of certain rights, such Intangible motivators and participation benefits as freedom of association or the right to information, helped citizens in all three cases fulfill other rights, such as to health can spur effective collective action care and education. Exercising rights related to citizen voice All three case studies of organic citizen engagement highlight and action (often through monitoring and evaluating elites the importance of volunteerism and agency in overcoming and services) was also prominent. The nongovernmental or- collective action problems, adding depth to the WDR 2017 ganizations (NGOs) catalyzing citizen engagement educated framework. Highly structured, induced social accountability Table O.1: Application of rights: Integrity watch Afghanistan, reAcción (Paraguay), and Serbia on the move Application of right Integrity Watch Afghanistan (IWA) reAcción (Paraguay) Serbia on the Move (SoM) Association Creating community-based monitoring Creating a grassroots youth group that evolved Creating a formally registered NGO; creating initiatives with local monitors who are into a formally registered nongovernmental volunteer-based national and subnational SoM elected by citizens organization (NGO) committees Assembly Conducting public meetings, Conducting public meetings and workshops Conducting public meetings, workshops for monitoring, local monitor training, for citizens and municipalities, monitoring, citizens and medical professionals, recruitment local monitor peer-to-peer monthly hosting WhatsApp and Facebook groups, activities, digital monitoring, and evaluations of gatherings, and stakeholder and increasing public awareness about how medical professionals capacity-building workshops, thereby FONACIDE works and its entitlements mobilizing communities to overcome problems identified during monitoring Expression Circulating monitoring reports, Publishing monitoring reports on FONACIDE, Publishing citizen-generated medical answering questions in the baseline data visualization, blogging, Tweeting, and assessments, reports, and surveys about and endline surveys, and expressing hosting Facebook and WhatsApp groups corruption, irregularities, and health care demands and views in meetings with services; publishing policy recommendations education officials and assessments of the adoption and implementation of policies by the Ministry of Health; providing citizens with the information needed to report corruption and irregularities in public hospitals Information Requesting information from Requesting information about FONACIDE from Providing access to information about education elites, gathering information state officials at the national and subnational the licenses of medical practitioners and through monitoring, and canvassing levels, utilizing government data portals, and citizen-generated information about medical community members for the baseline interviewing high school principals practitioners and health care facilities; survey educating patients about their rights and citizens about their rights to health care Participation in Providing monitoring results to school Providing government officials with Providing citizen-generated monitoring and governance management and education officials monitoring results, policy recommendations, evaluation results and policy recommendations to improve the quality of education, and accountability tools to improve FONACIDE to government officials and nonstate rectify problems, and prevent administration and prevent corruption; professional medical bodies in order to reduce corruption; participating in community raising awareness and educating government corruption and increase transparency and development councils, school officials about FONACIDE at the national accountability in the public health care sector management shuras, and provincial and subnational levels; and combining and to improve the provision of publicly funded education sector group meetings extrainstitutional collective action with health care services institutional action, such as submitting formal, legal complaints about corruption uncovered by monitoring viii CITIZENS AS DRIVERS OF CHANGE interventions in which elites identify the problem, objectives, and would equip them with new skills. For example, reAc- and desired outcomes and choose the modes of engagement ción’s core team applied themselves to learning, adapting, with elites and nonelites are not conducive to volunteerism contextualizing, and applying new technologies. None of the and initiative, whereas citizens voluntarily contribute their youth making up the core team had a background in comput- time, energy, effort, and other resources. Citizens choose to er science, and yet they taught themselves and made use of participate in part because they connect to the grievance or MOOCs (massive online courses) to learn how to code and problem, share objectives, are able to overcome inhibitions use visualization tools. They now do all of their own digital (such as fear and apathy) to act, and begin to feel a collec- work, from social media networking to mobile/web app and tive sense of responsibility, ownership, and identity—the so- website development. called intangible motivators (Beyerle 2014). Effective engagement strategies combine These intangible motivators foster commitment, cooperation, and coordination, help overcome fear and apathy, and build pressure, collaboration, and coalition building and sustain participation. Before moving to the action phase All three organizations were particularly effective at achieving of their citizen engagement efforts, all three organizations in change when they combined pressure with positive induce- this study crafted tailored narratives about the value of cit- ments and collaboration rather than focusing exclusively on izens improving their lives and how they could go about it. exposing corrupt behavior. When civil society groups chal- IWA built a narrative around “our” rights to education and lenge a corrupt, inequitable status quo and seek to increase how “we [the community] can play a role.” ReAcción cultivat- contestability in the policy arena, they can end up challenging ed collective responsibility by emphasizing how corruption the benefits and interests of elites, which can preclude con- and misuse of FONACIDE funds were affecting citizens and structive engagement, at least at the outset. A solely confron- their schools. In Serbia, SoM found that citizens avoid civic tational relationship with the elite actors who ultimately are activities in part because they are fearful of interacting with in charge of policy formulation and implementation can be fellow citizens. To counter this atomization, SoM created a counterproductive. narrative that strengthened the sense of collective identity and that shared stories of “us” and how “we” (collectively) are These social organizations, however, managed to demon- the hope to change Serbia. This narrative was reinforced by strate that citizen engagement can bring elites benefits, even badges and T-shirts, which served as symbols to help people though such organizations are often perceived as antagonistic recognize each other and bolster the sense that they were not to government and elite interests. At times, the organizations alone in wanting to reduce the role of corruption in health used positive inducements and collaborative relationships to care. change the incentives of the elite actors they needed to engage. Because elites in a sector or institution are not monolithic, In addition, all three social organizations stressed that partic- those who champion pro-development and anticorruption ipants should have a role in planning and decision making, policies or seek to implement them may need the support of helping to create a sense of collective ownership. In Afghan- citizens to overcome obstacles or resistance from other elites. istan, working with volunteers and building collective own- SoM’s “I’m not on the take, I work for the salary” campaign ership based on community engagement helped IWA avoid provided such backing for doctors who wanted to say “no” the problem encountered by previous interventions when to corruption. Meanwhile, elites also benefited from citizens school management councils became inactive after funding serving as the government’s eyes and ears in identifying cor- and attention from international donors moved elsewhere, or ruption, poor-quality public services, and mismanagement. the interventions were captured by prominent nonstate com- The information these social organizations publicized had le- munity elites. Working instead with volunteers and building gitimacy precisely because it came from the grassroots. ReAc- collective ownership helped to foster sustainability, and col- ción’s two-tier mapping and data visualizations of FONAC- lective ownership increased the legitimacy of the communi- IDE allocations were the first of their kind in Paraguay and ties’ demands. are being used today by government officials and the media. The organizations also built and sustained citizen engagement Meanwhile, when certain elite groups resisted cooperation, by providing more concrete benefits for participation such these social organizations built coalitions with other actors as useful skills, confidence, dignity, and social recognition. and institutions and selectively engaged with other sets of IWA sought to bring local monitors together for networking elite actors to increase pressure. Organizers in all three or- events and increased their local status through officiation ganizations made deliberate efforts to map and navigate in- ceremonies and awards. The opportunity to gain transferable stitutions and elite actors. This involved cultivating alliances skills also served as a motivation for participation. All three with elite state and nonstate actors and institutions that over social organizations provided specialized training that could time perceived these actors and institutions as stakeholders. help participants become effective in the organization itself For example, IWA has developed what it calls a “holistic ap- OVERVIEW ix proach to enhancing stakeholder involvement.” The policy ic, home-grown solutions than induced participation, which and governance landscape in war-torn Afghanistan is par- is often seen as illegitimate. Effective collective action rests ticularly confusing because of its complex layers of national, on a sense of collective ownership, responsibility, and iden- subnational, and local levels of institutions and authorities tity, which are more likely to be found in organic rather than and its weak rule of law. IWA initially secured a memoran- induced participation. The three organizations described dum of understanding with the Ministry of Education, a seal here— Integrity Watch Afghanistan, reAcción, and Serbia of approval that gives it credibility to engage with other elites on the Move—defy conventional classifications. On the one throughout the education system at different stages of the hand, presently they are all formal, registered NGOs. On the community-based monitoring initiatives. Through its “Focal other hand, they have a strong grassroots base that gives them Points” (local staff), IWA traverses these channels to identify legitimacy, resources (volunteers, in-kind donations, and elite interlocutors at the relevant national, provincial, and lo- support), and numbers (people power). For international ac- cal levels, all the way to oversight of individual schools. tors, a key lesson is that citizen engagement “projects” can in- corporate the strategic analysis and dynamic elements of bot- Finally, these social organizations shifted power asymmetries tom-up campaigns. International actors could extend support through collective action that wielded pressure and disrupt- to the hybrid NGOs and informal groups that are beyond the ed the corrupt status quo. Thus their approaches helped to traditional, often technocratic organizations operating largely change elites’ incentives through both pressure and positive in capital cities and unconnected with the grassroots. Civil inducements. In addition, these case studies reveal that suc- society groups can lose credibility in the eyes of citizens when cessful strategies change over the course of engagement, ne- they appear to be following a foreign agenda and getting paid cessitating an ability to learn and adapt. handsomely for their efforts, including citizen engagement. Lessons for international actors Create spaces to convene and deliberate. International actors have an important role to play in supporting social organi- Lessons can be drawn from these case studies for internation- zations financially, but they may be most effective at creating al development practitioners. Because the “operationalization spaces for social groups to convene, both among themselves note” issued in conjunction with this report fleshes out les- through peer-to-peer exchanges (horizontal) as well as with sons for the World Bank, this section is devoted to a list of elite actors (vertical). In these case studies, the social organi- broad takeaways rather than specific operational messages zations benefited from financial support from external actors, (Jespersen and Schott 2017). but also benefited considerably from international interven- tions to create spaces for deliberation. For example, in late Support citizen engagement in all contexts. Even in fragile con- 2015 reAcción learned that FONACIDE transparency was texts and highly corrupt environments social organizations among the government’s 2014–16 Open Government Part- can be effective. Indeed, especially in these environments nership (OGP) commitments, and it was accepted into Mesa grassroots movements may be essential to gaining legitima- Conjunta, the group of civil society organizations monitoring cy, building trust, and partnering with the state. International the government’s OGP action plan commitments, along with support for citizen engagement may then be particularly rele- representatives of the public institutions responsible for ful- vant in the more “difficult” contexts. In this research, organic filling those commitments. Through this forum, supported by citizen engagement initiatives emerged in spite of less than the Democracy and Governance program within the U.S. De- ideal settings in all three cases. The three countries share a partment of International Development (USAID), reAcción recent history of grim starting points and collective trauma. presented its monitoring system and findings and contributed They have endured authoritarian rule, replete with brutal re- input on FONACIDE’S education commitments to the up- pression of dissent, human rights abuses, and, in Afghanistan coming OGP 2016–18 action plan. and Serbia, violent conflict. They presently face entrenched corruption and social insecurity resulting from this legacy. Focus on process, not “best practice.” Rather than replicate a Overall, IWA, reAcción, and SoM report similar starting technique, method, tool, or social accountability interven- points vis-à-vis citizen mobilization—principally, minimal tion, international actors should support assistance that scales engagement with elites, general apathy and cynicism, lack of up processes. The conventional view in development is that awareness of entitlements and rights, deficiencies in rule of a technique, method, tool, or social accountability interven- law, and lack of transparency and information, in particular tion should be widely replicated. The underlying assumption about policies and responsibilities related to public welfare is that what works in one context can work in another. The and services. WDR 2017 framework points to the conceptual weakness of this assumption because power asymmetries vary and each Build on organic structures and bottom-up solutions. Organic, policy arena has its own interplay of drivers of policy effec- bottom-up citizen engagement can help enhance participa- tiveness, levers for change, and drivers of change. The ques- tion and is also more effective at generating context-specif- tion is not “What works?” but “What are the dynamics and x CITIZENS AS DRIVERS OF CHANGE pathways towards change?” (Fox 2016, 32). Rather than scal- zen engagement by extending project horizons or supporting ing up interventions, international actors should scale up the consecutive initiatives that build on one another. They can approaches and processes through which solutions are devel- also provide seed funds for new initiatives that enable organi- oped (Walji 2016). This form of scale-up is evident in IWA’s zations to test out new approaches and learn from them. And community-based school monitoring program. From 2014 to they can support the flexibility and adaptability required by 2016, 180 communities/schools participated voluntarily, and forward-looking social organization strategies by becoming plans are to expand to 270 in 2017. IWA has developed a clear more judicious in defining success and failure. framework with contextually driven interactions and tools, but each initiative has its own unique characteristics, and the communities themselves drive solutions to the problems Navigating this report identified by the local monitors. This report proceeds as follows. Chapter 1 describes the ana- lytical framework of WDR 2017 and use of the human rights Support flexible arrangements and incremental outcomes. It lens. It also explains the evolution of citizen engagement re- often takes time to build power in the policy arena. Effec- search and practice within the World Bank and the develop- tive citizen engagement cannot be achieved in one-off in- ment community. Chapter 2 then puts this research in context terventions, but rather contributes to development through by offering a brief literature review. The three case studies are nonlinear processes over time. The three case studies reveal discussed in detail in chapter 3. It describes the country and that social change is discontinuous and outcomes are incre- service delivery sector context; explains how social organiza- mental, building modestly over time with interim objectives tions overcame collective action problems to build and sus- and small victories. Looking at citizen engagement initiatives tain citizen engagement and enhance contestability through in isolation rather than holistically over time, one may miss the power of numbers; describes the strategies these organiza- the longer-term power shifts. For example, had this research tions used to effect change by changing elite incentives, pref- concentrated on just one SoM effort in Serbia or just one erences, and beliefs; and discusses how human rights were CBM-S initiative in Afghanistan, the conclusions would be used in achieving social organization goals. The concluding much different. It is the cumulative impact of initiatives over chapter 4 builds on these cases to distill key messages and les- time that can lead to general improvements in governance sons for international actors. and development. International actors can best support citi- xi Abbreviations AIGA Alliance for Open Government CBM-S Community-Based Monitoring School (program) CDD community-driven development CMU country management unit CSO civil society organization DALP Democratic Accountability and Linkages Project DfID Department for International Development (U.K.) EU European Union FONACIDE Fondo Nacional de Inversión Pública y Desarrollo (National Public Investment and Development Fund) GDP gross domestic product GPSA Global Partnership for Social Accountability ICCPR International Covenant on Civil and Political Rights ICT information and communications technology IWA Integrity Watch Afghanistan MEF Monitoreo de Ejecución Física (Physical Implementation Monitoring) MENA Middle East and North Africa MOOC massive open online course NGO nongovernmental organization NTF Nordic Trust Fund OECD Organisation for Economic Co-operation and Development OGP Open Government Partnership SDG Sustainable Development Goal SMO social movement organization SMS school management shura (council) SoM Serbia on the Move TPA transparency, participation, and accountability UNDP United Nations Development Programme UNESCO TERCE United Nations Educational, Scientific and Cultural Organization Third Regional Comparative and Explanatory Study USAID U.S. Agency for International Development V-Dem Varieties of Democracy WDR World Development Report WGB World Bank Group In this report, all dollar amounts are U.S. dollars unless otherwise indicated. CHAPTER 1: Citizen engagement, human rights, and development, CITIZEN ENGAGEMENT 3 CHAPTER 1 Citizen engagement, human rights, and development I n 2013 the World Bank adopted a strategy calling for end- ing extreme poverty and increasing shared prosperity in a sustainable and inclusive manner. Integral to this strategy is components related to citizen engagement, as well as by highlighting ways to extend and develop the WDR’s cen- tral lessons. citizen engagement, which “entails empowering citizens to 3. Contribute more broadly to the literature on citizen en- participate in the development process and integrating cit- gagement—that is, how citizens can mobilize effectively, izen voice in development programs as key accelerators to wield power, and promote “change” and human rights. achieving results” (Manroth et al. 2014, 1). In 2014 the Bank released a strategic framework to mainstream citizen engage- 4. Demonstrate how external actors can support citizen ment in the institution’s operations (Manroth et al. 2014).2 engagement—engaging with and empowering citizens to support inclusive development and governance—at The research project described in this report furthers this a time when civic space is shrinking around the world agenda by exploring citizen engagement policy and imple- (World Bank 2017b, 235). mentation in two related ways. First, it examines the human rights elements of citizen engagement, specifically the core To better understand how citizens and citizen engagement rights and principles underpinning citizen action, as well can more effectively improve development outcomes, the re- as their active use in tackling development and corruption search team sought to answer questions in the four areas that challenges on the ground. Second, because the rollout of the underpinned the research and the questions that they in turn Bank’s citizen engagement policy is under way, the project raised: aims to complement the institution’s knowledge and inform 5. Human rights, citizen engagement, and development. operationalization through in-depth study of three grassroots What key human rights are exercised in citizen engage- initiatives in which empowered citizens are playing a central ment initiatives involving grassroots collective action to role. In all three initiatives, the emphasis is on fostering the obtain basic and improved services, transparency, and anticorruption, transparency, accountability, and citizen-state accountability? interface in order to improve the quality and delivery of es- sential public services. 6. Citizen collective action. Extending the WDR 2017 framework, how do civil society organizations cultivate The 2017 edition of the Bank’s World Development Report commitment, cooperation, and coordination among cit- provides a conceptual framework that is ideally suited to this izens? How does this relate to the concept of “intangible research project (World Bank 2017b). The World Develop- motivators” for collective action in the nonviolent social ment Report 2017: Governance and the Law (WDR 2017) ex- movement field? How is human rights language used to amines how governance determines development outcomes motivate participants? How are information and com- and how power asymmetries can undermine the effectiveness munications technology (ICT) and other types of tech- of policies. In doing so, WDR 2017 addresses the roles and nology used in grassroots citizen engagement initiatives capacities of citizens and, in particular, the ways in which cit- to mobilize citizens? izens can act collectively to shape governance and develop- 7. Citizen coordination with elites. How do citizens alter the ment outcomes. Based on those considerations, this project balance of power through mobilization, collective action, has four main objectives: coalition building, and engagement with elites to pro- 1. Contribute to the Bank’s corporate agenda by outlining mote change? What tools do they use? How are ICT and ways to effectively mainstream human rights and citizen other technologies used by civil society organizations to engagement in its operations. engage state and nonstate elites? 2. Inform operationalization of WDR 2017 by demonstrat- 8. Role of external actors. How do external actors directly or ing the applicability of its conceptual framework and key indirectly support grassroots citizen engagement initia- 2. The term citizen is used in a general sense to refer to people residing within a defined territory or nation. This research project follows the definition used by McGee and Greenhalf (2011, 26) “We define [citizens] here not in terms of voting rights, birthplace or country of residence, but as people with rights—all those covered in the Universal Declaration of Human Rights and ensuing treaties and conventions.” 4 CITIZENS AS DRIVERS OF CHANGE tives for transparency, accountability, and development lations, or institutional designs), the WDR 2017 approach be- outcomes? What are the limitations of such support? gins by asking what functional goals policies aim to achieve. Sometimes, reforms must ensure a credible commitment to This report explores these questions by applying human policy choices in the face of changing circumstances; at other rights analysis and the WDR 2017 analytical framework to times, interventions seek to enhance coordination to change three cases: (1) in Afghanistan, improving education out- the expectations of a group of actors and elicit socially desir- comes through community-based monitoring of schools; (2) able actions by all; and some policies seek to encourage co- in Paraguay, monitoring sovereign wealth fund resources al- operation to prevent free-riding and induce voluntary com- located to education in order to improve the infrastructure of pliance. It is through these functions that actors and actions marginalized schools; and (3) in Serbia, promoting transpar- in the policy arena determine development outcomes (figure ency and doctor/hospital integrity to reduce corruption in the 1.1). public health sector. In the WDR 2017 framework, power—the ability of groups Analytical framework and individuals to make others act in the interest of those groups and individuals and bring about specific outcomes— As highlighted in WDR 2017, governance is crucial for un- is a crucial determinant of policy effectiveness. Indeed, efforts derstanding development outcomes. Governance is defined as to enable commitment, coordination, and cooperation are af- the process through which state and nonstate actors interact fected by the distribution of power. The unequal distribution to design and implement policies within a given set of for- of power in society—power asymmetries—is a critical deter- mal and informal rules that shape and are shaped by power. minant of whether policies are designed and implemented in These interactions occur in what can be called the policy are- ways that support development outcomes. Although power na—that is, the setting in which policies are formulated and asymmetries are not necessarily detrimental, negative man- implemented. Governance can take place at different levels, ifestations of these asymmetries can include capture (rules from international bodies to national state institutions, all the benefiting narrow interests), clientelism (short-term benefits way down to local government agencies and context-specific at the expense of long-term, socially desirable goals), and ex- customary entities. clusion (sidelining those who do not share the same self-serv- ing objectives). All three of these manifestations of power WDR 2017 highlights a functional approach to analyzing asymmetries can undermine policies that positively affect policy effectiveness, and it argues that the major function- large groups of citizens. Development outcomes themselves al drivers of policy effectiveness for development outcomes often support the status quo because policies are designed to consist of ensuring commitment, enhancing coordination, and benefit those in power, leading to persistence of ineffective inducing cooperation. Rather than approaching development policies (figure 1.1). by seeking to achieve particular “forms” (such as laws, regu- Figure 1.1: WDR 2017 framework: Governance, law, and development POWER POWER ASYMMETRIES ASYMMETRIES RULES POLICY DEVELOPMENT ARENA OUTCOMES COMMITMENT COORDINATION COMMITMENT COORDINATION COOPERATION COOPERATION Source: World Bank 2017b. Note: Rules refers to formal and informal rules (norms). Development outcomes, in the context of WDR 2017, refers to security, growth, and equity. The actors in the policy arena can be grouped into elites, citizens, and international actors. CITIZEN ENGAGEMENT 5 Although most development thinking considers only the ef- ƒƒ Enhancing contestability by reducing the barriers of entry fects of policy design and implementation on outcomes, what into the policy arena and allying with actors (elites and WDR 2017 calls the “outcome game” (the right-hand loop in nonelites) to challenge other elites and reduce their re- figure 1.1), decisions in the policy arena also determine the spective bargaining power. rules by which policies themselves are designed and imple- Although WDR 2017 explains how citizens can affect out- mented, or what WDR 2017 calls the “rules game” (the left- comes in the policy arena through social organization, it hand loop in figure 1.1). Power asymmetries can be persistent does not explore how citizens can overcome their substantial and self-reinforcing, undermining equitable development collective action challenges through social organization. In a outcomes, but WDR 2017 argues that changes in the “rules of sense, elections themselves overcome collective action chal- the game” are indeed possible. lenges—they are a means of aggregating preferences, but their Three levers of change can reshape the policy arena: changing introduction ultimately requires the approval of state author- incentives to pursue particular goals; changing the underlying ities. Similarly, deliberation and participation help citizens preferences and beliefs of the relevant actors; and increasing enter the policy arena, but citizens must first gain a seat at contestability—that is, who participates in the policy arena. the table. Social organization does rely on citizens themselves, Often, change comes about when the circumstances that un- but the barriers to collective action loom large. derpin elite bargains evolve, thereby changing the interests of elites themselves. In these cases, reforms are often intended to Research design and case study methodology strengthen certain groups of elite actors or to provide insur- ance against a loss of power. Although elites directly shape the content and implementa- This report analyzes citizen engagement in two sectors in tion of policies, citizens, and in some instances, international three diverse settings—education in Afghanistan and Para- actors, acting alone or together, can also effect change through guay and health care in Serbia, and the efforts described con- the three entry points or levers of change just described. Act- tributed to reducing corruption in service delivery. Box 1.1 ing individually, citizens are largely ineffective, but they can provides a brief summary of the three case studies, which are organize in order to apply pressure to influence the outcome presented in detail in chapter 3 of this report. of bargains in the policy bargaining process. International ac- This analysis, based on the WDR framework, focuses on (1) tors can strengthen or alter the incentives of elites and citizens the country context and functional challenges (commitment, by providing resources (monetary and nonmonetary); they coordination, and cooperation), and how power asymmetries can shift the preferences of elites and citizens, often through drove these challenges; (2) how citizens acted collectively longer-term engagement; and they can even affect contest- through social organizations, building power to contest in ability in the policy arena by providing alternative sites for the policy arena through grassroots volunteers; and (3) how contestation or by entering the domestic policy arena them- these social organizations used strategic pressure and engage- selves. ment to change the incentives, preferences, and beliefs of elite Citizen-based collective action in the WDR framework in- actors in the policy arena. In taking this approach based on cludes elections, political organizations such as parties, social WDR 2017, the team drew on concepts from nonviolent col- organizations (ranging from social movements to campaigns lective action and the evolving transparency, participation, to grassroots civic initiatives driving organic participation), and accountability (TPA) field, and it devoted considerable and direct participation and deliberation (through both infor- attention to the ways in which the social organizations used mal and induced formal state interventions). However, WDR human rights—both language and the rights themselves—to 2017 argues that these four modes of citizen engagement are achieve their goals. all imperfect and work best when combined strategically. Figure 1.2 summarizes this approach visually. The case studies Citizen engagement through social organization is the prima- begin by exploring how the organizations overcame collective ry focus of this research project. Social organization can affect action challenges through bottom-up efforts and attention the three levers of change by to intangible motivators for participation (often such moti- vators both implicitly and explicitly involved human rights ƒƒ Altering elites’ incentives by increasing the political costs language). The case studies then explore how these social or- of inaction or opposition to particular policies ganizations engaged in strategies and tactics using a variety of ƒƒ Reshaping the preferences and beliefs of actors (elites and tools and coalition-building strategies. Often, these strategies nonelites) by bringing new interests into the policy arena, depended on the existence of particular human rights to help creating alternate or new collective identities, or forming fight for other human rights, or what is called here “rights new coalitions with elites begetting rights.” When successful, the tactics and strategies employed by these organizations were able to change the pol- 6 CITIZENS AS DRIVERS OF CHANGE Box 1.1: Summary of three case studies of citizen engagement Afghanistan Founded in 2005, Integrity Watch Afghanistan (IWA) conducts community-based monitoring programs in several sectors aimed at increasing transparency, accountability, and integrity in Afghanistan. In July 2014, IWA launched the Community-Based Monitoring School (CBM-S) program, which seeks to (1) improve the quality of education in Afghanistan; (2) increase contact and coordination between communities and officials by bringing together stakehold- ers in the education of Afghan children; (3) increase the responsiveness of school officials to citizens; (4) encourage communities to take the initiative in addressing education-related problems in their locales; and (5) use the results of community-based monitoring in policy advocacy at the local and national levels. Paraguay ReAcción Paraguay is a registered youth anticorruption organization that was first launched in 2010 as an informal anticorruption group composed of young people in Ciudad del Este, the second largest city in Paraguay. Its mission is to empower citizens to prevent corruption and improve the provision of public services, particularly public education. The group works primarily to monitor the sovereign wealth fund expenditures allocated to education in Paraguay and increase transparency and citizen engagement to ensure that these funds reach their intended targets. Serbia Serbia on the Move (SoM) seeks to reduce corruption in Serbia’s health sector by strengthening prevention mechanisms, transparency, and accountability through citizen engagement. The organization was founded by a group of young professionals and officially launched as a registered association in July 2009. Its objectives are to (1) raise citizens’ awareness about how to fight corruption in publicly funded health care; (2) formulate new transparency and accountability mechanisms to reduce corruption in health care; (3) build the capacity of citizens to actively push for the adoption and implementation of these new transparency and accountability mechanisms; and (4) build a coalition of stakeholders (citizens, civil society organizations, state institutions, public health practitioners) interested in reducing corruption in the health sector. Serbia on the Move has carried out five projects targeting corruption in publicly funded health care, working with health care practitioners, regular citizens, and elites to improve integrity. Figure 1.2: Role of social organizations through the lens of the WDR 2017 framework OVERCOMING SOCIAL CHANGING THE POLICY OBSTACLES TO ORGANIZATION ARENA: INCENTIVES, COLLECTIVE STRATEGY AND PREFERENCES, ACTION TACTICS CONTESTABILITY CONTEXT: EXISTING LAWS AND SOCIAL NORMS Source: Based on WDR 2017. icy arena by shifting elites’ incentives, reshaping preferences standardized set of questions was applied to each case study and beliefs, and enhancing contestability. All of these stages to gather comparable data. The data were then used in turn to of social organization were shaped in part by the local context answer a set of specific research questions. Although the sam- within which the organizations operated, particularly existing ple size was modest, thereby qualifying generalizations, the laws and social norms. diversity of contexts, sectors, and types of citizen engagement studied facilitated the extrapolation of lessons learned. In technical terms, this study falls in the category of a struc- tured, focused comparison (George and Bennett 2005). It is The selection of the three case studies ensured consistency based on an applied, action-oriented methodology, which across the following four criteria: Gaventa and Barrett (2010, 10) describe as “empirical- ly grounded case study research, designed to examine core 1. The citizen engagement initiatives are at the nexus of cor- questions, and to generate findings ‘upwards.’” A structured, ruption and essential public services, including quality and delivery. CITIZEN ENGAGEMENT 7 2. Citizen engagement is organic rather than induced by ex- Afghanistan’s level of income, whereas Serbia “outperforms” ternal actors. Citizens provide input into what initiatives on these metrics. Paraguay, despite a relatively low score on are selected and how they are designed, engage in a va- voice and accountability, has a much more open press than riety of peaceful actions, and participate on a voluntary the other two countries. basis. The change intermediaries are civil society entities, ranging from registered nongovernmental organizations The space for citizen engagement is largely shaped in these to less formal civic groups. countries by power asymmetries. In all three countries, but to varying degrees, power tends to be distributed by socioeco- 3. Multiple extrainstitutional (as well as institutional) col- nomic position (panel a, figure 1.4); citizens without wealth lective actions are employed over an extended period of have less power to influence political decisions. This factor time in contrast to one-off actions or spontaneous public translates into the manifestations of power asymmetries dis- outbursts. cussed earlier: capture, loosely proxied by public sector cor- 4. The citizen engagement yields successful outcomes, with ruption (panel b); exclusion, proxied by a low degree of con- success defined as achievement of the objectives outlined sultation in policy making (panel c); and clientelism (panel by the civil society organization (CSO) behind the ini- d). Across these categories, all three countries tend to under- tiatives. perform, with corruption particularly high in Afghanistan The case studies differ significantly, however, in context—by and Serbia and clientelism particularly high in Paraguay. region, income level, fragility, polity, corruption levels, and the sectors targeted by the citizen initiative (see table 1.1). The research process, from case study identification to data Diversity was sought to capture the wide variety of citizen gathering and analysis, was collaborative. The case studies engagement permutations, as well as to enhance the general were identified by the team, who subsequently consulted lessons for development actors—something that is particular- with the respective country management units (CMUs) of the ly relevant to the World Bank, which works in a broad variety World Bank for their approval. The leaders of the three citi- of contexts. zen initiatives were then sent an extensive, in-depth question- naire that they filled out and returned. These were followed by Beyond income, social progress, and political system, the se- a series of face-to-face or Skype interviews and written corre- lected countries differ considerably in terms of the space de- spondence to elicit supplemental data and provide clarifica- voted to citizen engagement and participation. As shown in tions. The research design and questionnaire were informed figure 1.3, civil rights, level of government censorship of me- by a literature review of previous studies in the field, in partic- dia, civil society participation, and a broader index of voice ular on social accountability, citizen engagement in the health and accountability vary widely. Although all of these metrics and education sectors, and the links among human rights, cit- are positively correlated with income per capita, the case izen engagement, and development. The questionnaire was countries often vary beyond what their income level would designed not only to document the particulars of each case, imply. For example, civil rights and civil society participation but also to capture the inner workings and dynamics of the in Afghanistan are ranked lower than would be expected for citizen engagement initiatives, including grievances and iden- Table 1.1: Broad economic and governance comparison of case study countries Corruption Political Case study Social Levels - Control of Rights and Civil country Region Sector Income Level Fragility Polity Progress Perception Corruption Liberties Afghanistan SAR Education Low income Yes Open 36/100 169th 4.81% 24/100 Anocracy Paraguay LAC Education Upper middle No Democracy 67/100 123rd 15.87% 64/100 income Serbia ECA Health Upper middle No Democracy 72/100 72nd 50.96% 78/100 income Sources: Fragility: World Bank, Harmonized List of Fragile Situations; polity: most recent Polity IV score; social progress: Social Progress Index (on a scale of 0–100 where 100 indicates highest level of progress; data are from 2016); corruption levels—perception: Transparency International, Corruption Perception Index (ranking of 176 countries, where 1 is least corrupt and 176 is most corrupt); control of corruption: World Bank, Worldwide Governance Indicators (percentile rank from 0 to 100 percent where 100 percent is least corrupt; most recent data are from 2015); political rights and civil liberties: Freedom House, Freedom in the World ratings (on a scale of 1–100 where 100 is freest). Note: ECA = Europe and Central Asia; LAC = Latin America and the Caribbean; SAR = South Asia. 8 CITIZENS AS DRIVERS OF CHANGE tification of the problem, articulation of objectives, recruit- The cases were then analyzed through the lens of the WDR ment and sustainability, organization and decision making, 2017 analytical framework (see chapter 3), and the findings strategic analysis, nonviolent collective actions carried out by were compared across the three cases (chapter 4) to identify the initiatives, intangible collective action motivators (collec- patterns and key lessons learned and to produce recommen- tive responsibility, collective ownership, collective identity), dations for effective citizen engagement relevant to the World education and training, technology, elite engagement, inter- Bank’s citizen engagement policy mandate and operational- action with international actors, and elite reprisals against ization. First, however, chapter 2 offers a brief review of the citizens. literature in this area. Figure 1.3: Space for civil society and citizen engagement: Afghanistan, Paraguay, and Serbia a. Civil rights b. Government censorship effort - media 10 4 8 3 6 Index value Index value 2 4 1 2 0 0 6 8 10 12 6 8 10 12 Log GDP per capita Log GDP per capita Afghanistan Paraguay Serbia Afghanistan Paraguay Serbia c. Civil society participation d. Voice and accountability 10 2 8 1 6 Index value Index value 0 4 -1 2 -2 0 6 8 10 12 6 8 10 12 Log GDP per capita Log GDP per capita Afghanistan Paraguay Serbia Afghanistan Paraguay Serbia Sources: Civil rights and civil society participation scores: Bertelsmann Transformation Index (BTI); government censorship of media: V-Dem (Varieties of Democracy) Version 5.2; voice and accountability index: World Bank, Worldwide Governance Indicators; GDP per capita: World Bank, World Development Indicators (database). CITIZEN ENGAGEMENT 9 Figure 1.4: Power asymmetries and their manifestations: Afghanistan, Paraguay, and Serbia a. Power distributed by socioeconomic position b. Public sector corruption 4 1 .8 3 .6 Index value Index value 2 .4 1 .2 0 0 6 8 10 12 6 8 10 12 Log GDP per capita Log GDP per capita Afghanistan Paraguay Serbia Afghanistan Paraguay Serbia c. Range of consultation d. Clientelism 5 4 4 3 3 Index value Index value 2 2 1 0 1 6 8 10 12 6 8 10 12 Log GDP per capita Log GDP per capita Afghanistan Paraguay Serbia Afghanistan Paraguay Serbia Sources: Power distributed by socioeconomic position, public sector corruption, and range of consultation: V-Dem (Varities of Democracy) Version 5.2; clientelism: Democratic Accountability and Linkages Project (DALP), https://sites.duke.edu/democracylinkage/data/; GDP per capita: World Bank, World Development Indicators (database). Note: For power distribution by socioeconomic position, 0 indicates that those with economic wealth monopolize political power, while 4 indicates that all citizens have equal power regardless of wealth. The DALP database has no data on clientelism for Afghanistan. CITIZEN ENGAGEMENT 11 CHAPTER 2: A brief literature review: A BRIEF LITERATURE REVIEW 13 CHAPTER 2 A brief literature review This chapter briefly reviews the literature related to citizen joined by related terms, from civic engagement to social ac- engagement, World Bank policy, and the conceptual and re- countability (see box 2.1). What these concepts have in com- search links between citizen engagement and human rights. mon is seeing regular people as agents and as a necessary and constructive force for development. This is a paradigm shift Emergence of citizen engagement from the traditional notions of citizens as either the victims of poverty, disease, and natural disasters or as the beneficiaries in development practice and research of elite-driven efforts and interventions. The present research builds on the range of World Bank practices and research that Citizens are now firmly rooted in the lexicon and change have emerged over the last 25 years. It complements the ex- frameworks of development practitioners. Terms such as isting approaches by explicitly adopting a human rights per- voice and participation are not only common in development spective, as well as focusing on organic, citizen-led initiatives discourse, but also reflected in policies and practices, such as rather than Bank- or client-initiated projects. the World Bank’s citizen engagement mandate. And they are Box 2.1: Terms related to citizen engagement Terms related to citizen engagement and citizen participation have proliferated in recent years, but they do not necessarily share common definitions. For purposes of clarity, we present the following definitions, and in some instances their limitations. Voice is the capacity of citizens to express their preferences to state actors through formal or informal channels and to be heard by them (GSDRC 2014, 4). Voice can also target nonstate actors or both sets of actors at the same time. Voice is about harnessing and exercising power derived from the grassroots. The World Development Report 2017 recognizes the importance of voice by incorporating power analysis and examining citizens as drivers of change in its framework. Citizen participation encompasses the wide range of bottom-up activities. At one end are circumscribed feedback mechanisms such as citizen report cards or community scorecards assessing public services and state activities. Further along the spectrum are participatory budgeting and planning, and monitoring of budgets, spending, institutions, services, and social programs. At the other end are organized grassroots campaigns and social movements. Citizen engagement, often used interchangeably with citizen participation, is the term used principally in this report. For World Bank purposes, it is a “two-way interaction between citizens and governments or the private sector within the scope of WBG [World Bank Group] interventions—policy dialogue, programs, projects, and advisory services and analytics—that gives citizens a stake in decision-making with the objective of improving the intermediate and final development outcomes of the intervention” (Manroth et al. 2014, 8). Ideally, this interaction underscores power and information sharing, as well as mutual respect between officials and citizens, rather than merely inviting highly structured input from citizens on programs, policies, or other matters, with limited opportunities for the public to participate in designing these programs (Sheedy 2008). Civic engagement is when “ordinary citizens, civil society organizations, or both participate directly or indirectly in exacting accountability” (Grandvoin- net, Aslam, and Raha 2015, 1). What is generally implied is that a certain degree of organization and mobilization on the side of the citizens is involved, and that typically pressure is exerted on the state (as well as nonstate entities) to comply with its duties and responsibilities. Social accountability is a fuzzy concept with no generally accepted definition about the range of actions that fall within its domain, which has been defined as “the extent and capability of citizens to hold the state accountable and make it responsive to their needs” (World Bank 2012). Social movements refers to citizen mobilization clusters that use collective action, have change-oriented demands and goals, are sustained over time, and involve some degree of unity building and organizing. Such movements can use a variety of tactics, including extrainstitutional tactics that are some- times combined with institutional measures (Stephan, Lakhani, and Naviwala 2015). Social movements can involve multiple campaigns. Civic campaigns are a form of citizen mobilization consisting of “highly energized, intensely focused, concentrated streams of activity with specific goals and deadlines” (Ganz 2013, 44). 14 CITIZENS AS DRIVERS OF CHANGE Citizen engagement in 2001). Three years later, in 2004, the report analyzed how ser- vice delivery for the poor could best be improved, finding that World Bank practice and research enhancing accountability is central to that effort (World Bank 2003). By the end of the first decade of the new millennium, Since the 1990s, the World Bank has sought to actively address social accountability and citizen engagement had become corruption and fight poverty through empowerment of the widely recognized as the cornerstones of successful develop- poor. These efforts have led to a shift from focusing primarily ment interventions. on the client—that is, the borrowing state entity—to focusing The popular movements of 2010 and 2011, most notably but increasingly on the ultimate project beneficiaries and citizens not limited to countries in the Middle East and North Africa more broadly. Building on the work of a Bank-wide learning (MENA), underlined the urgency of the accountability and group on participatory development launched in 1990, the participation agenda and demonstrated that it was not merely Bank issued the paper “The World Bank and Participation” a a change in the technical approach to development but in fact few years later, stating, “The Bank needs to broaden its busi- a pressing demand by citizens themselves. The World Bank ness practices to encourage the participation of a much wid- president at the time, Robert Zoellick, consequently called er range of stakeholders, in order to improve and sustain its for a “new social contract for development” that would de- development efforts” (World Bank 1994, i). Participation was mocratize “development economics so that all can play a part recognized as central to both the effectiveness and sustain- in designing, executing, and continually improving develop- ability of development outcomes. ment solutions.” He then reminded his audience that 2011 In line with this shift to more participatory development, the was “the year we learned that civic participation matters to World Bank began supporting community-driven develop- development.” In line with this change in approach, the De- ment (CDD) projects, which soon constituted $3 billion of mand for Good Governance agenda was launched in 2010 the Bank’s portfolio (Mansuri and Rao 2004). These projects and the Global Partnership for Social Accountability in 2012, allowed the Bank to gather experience on the benefits as well which is directly funding civil society organizations working as the pitfalls of locally driven development. This shift toward toward strengthening accountability. Meanwhile, the United participatory development occurred at about the same time Nations 2030 Agenda for Sustainable Development and its that World Bank president James Wolfensohn declared at the 17 Sustainable Development Goals (SDGs) are emphasizing Bank’s 1996 annual meetings, “We need to deal with the can- the link between poverty eradication and participation and cer of corruption.” accountability. Goal 16 on just, peaceful, inclusive societies incorporates corruption reduction, accountability, partici- Recognition of the value of participatory development and patory and representative decision making, and the right to the urgent need to deal with corruption lay the groundwork information.4 for a shift toward increasingly engaging beneficiaries and cit- izens in order to improve development outcomes. In the early Research undertaken by the World Bank has identified con- 2000s, the Bank produced a Social Development Strategy and text specificity and a nuanced understanding of existing a Governance and Anticorruption Strategy that argued for country systems and dynamics as crucial factors enabling ef- the need to strengthen accountability relationships through, fective and sustainable citizen engagement. The recent policy among other things, citizen engagement to curb corruption research report Making Politics Work for Development: Har- and ensure that the benefits of development projects in fact nessing Transparency and Citizen Engagement emphasizes the reach the poor and serve the public interest (World Bank 2005, political nature of participation (Khemani et al. 2016). The 2007, 2012). Building on these strategies, the Bank issued a authors find that political context significantly affects the guidance note on Bank multistakeholder engagement—in potential for healthy engagement by citizens and civil soci- particular, engagement with civil society, media, and govern- ety and thus the positive impact that participation can have ment—and launched the Communication for Accountability on development outcomes. The report echoes the need for and Governance Program, which focused on communication context specificity expressed in Opening the Black Box: The and access to information as the driving and enabling con- Contextual Drivers of Social Accountability by Grandvoinnet ditions needed to create demand for accountability.3 Around and her colleagues (2015). They develop a framework that the same time, two World Development Reports emphasized identifies the capacity for and effectiveness of civic mobiliza- the need to increase accountability and participation. In 2001 tion and citizen action, in addition to state action and access the WDR argued for supporting empowerment and strength- to information, as among the key drivers of social account- ening accountability in order to “attack poverty” (World Bank ability. The importance of understanding power relation- 3. The Communication for Governance and Accountability Program (CommGAP, 2006–11) focused on communication and access to information to create demand for accountability (World Bank 2009). 4. http://www.un.org/sustainabledevelopment/. A BRIEF LITERATURE REVIEW 15 ships and building on organic structures as well as the need gagement can help mitigate these challenges through im- to pay deliberate attention to the inclusion of marginalized proved social accountability and inclusion by giving voice to groups for successful social accountability approaches have the less powerful. The World Development Report 2004: Mak- also been raised by other researchers such as O’Meally (2013). ing Services Work for Poor People devotes an entire chapter This finding resonates with the warning by Mansuri and Rao to citizen voice and ways to increase accountability in order (2013) that capture of local development initiatives and lack to support pro-poor policies in service delivery (World Bank of inclusion are threats. In Localizing Development: Does Par- 2003, chap. 5). In addition to using elections, it identifies var- ticipation Work? Mansuri and Rao (2013) stress the need to ious citizen initiatives as successful examples, especially those develop a nuanced understanding of the existing local struc- that generate and share specific information about budgetary tures and organic initiatives and build on them rather than allocations and service delivery outputs (World Bank 2003, implement conventional blueprints for citizen engagement 87–88). and social accountability. Although many studies have found a positive link between The current president of the World Bank, Jim Yong Kim, engagement and development outcomes in the two sectors, continued to expand this agenda by introducing the citizen not all studies have found a significant impact. The latter engagement mandate in 2014. By fiscal year 2018, all invest- finding has been attributed to the role played by context as ment lending projects, across regions and sectors, will have well as to the specific operational modalities of the interven- to engage citizens. As guidance for its teams, the Bank de- tions, such as the limited effect of public information cam- veloped the Strategic Framework for Mainstreaming Citizen paigns where government responsiveness is low (Manroth et Engagement in World Bank Group Operations (Manroth et al. al. 2014, 71). Multiple case studies and randomized control 2014). It lays out the rationale for mainstreaming citizen en- trials have assessed the impact of citizen engagement on de- gagement, focusing on improved development outcomes, es- velopment outcomes in the health and education sectors.5 pecially in service delivery. Citizen engagement in design, im- Successful interventions have, for example, included social plementation, and monitoring of projects is thus considered justice committees in Gujarat, India, that advocated for pub- not only the right thing to do but also the smart thing to do. lic service delivery to Dalit communities (Mohanty 2010); public deliberations on health policy in Brazil (Cornwall and Citizen engagement in the health and Shankland 2008); and increased avenues for parent participa- tion in school management in Mexico (Shapiro and Skoufias education sectors 2006). Some of the strongest evidence of the positive impact of citi- Khemani (2008) compares the findings of a study on commu- zen engagement on development outcomes is in service deliv- nity monitoring in the health sector in Uganda and a study ery, including in the health and education sectors (Manroth on community monitoring in the education sector in India, et al. 2014, 2, 10, 71). Citizen engagement has been shown and he attributes the differences to the influence of the so- to improve the accessibility, coverage, and quality of service ciopolitical context.6 Khemani et al. (2016) stress the impor- delivery, particularly when service delivery is affected by tance of healthy political engagement and the local political corruption (Manroth et al. 2014, 11, 71). Service delivery is environment to successfully inducing citizen engagement.7 unique in that it provides multiple routes of accountability Citizen engagement undertaken in the context of develop- between the state and the citizen: the “long route” between ment projects or programs should be designed with a keen policy makers and citizens and the “short route” between ser- awareness of politics. It has to be safeguarded from capture vice providers and service users (World Bank 2003, 79). A by local leaders as well as given teeth by demanding account- recent study on service delivery in the MENA region showed ability from elected leaders. This finding resonates with the that citizens’ level of trust in the state is heavily influenced observation that social accountability initiatives in the health by the quality of service delivery (Brixi, Lust, and Woolcock sector are successful if they actively contest power relations, 2015). especially when the power structures are marked by social inequality and the exclusion of marginalized groups. Further- Among the biggest challenges to meeting development goals more, context matters to the impact that citizen engagement and improving the quality of service delivery in the health can have on outcomes in health and education because of the and education sectors are corruption and lack of access by differing levels of access to information (George 2003; World marginalized groups (World Bank 2014, 6–7). Citizen en- Bank 2014, chap. 4). 5. A more detailed overview with summaries of key studies can be found in Manroth et al. (2014, 71–74). 6. Based on studies by Banerjee et al. (2008) and Björkman and Svensson (2009). 7. See the following presentation (especially slide 52): http://pubdocs.worldbank.org/en/708901464210579739/PolicyResearchTalkonPRRMakingPoli- ticsWorkforDvlp.pdf. 16 CITIZENS AS DRIVERS OF CHANGE Citizen engagement, anticorruption, tion, and accountability, practitioner-scholars such as Gauri, Woolcock, and Desai (2012, 160) indirectly attest to their and collective action importance through the related concept of intersubjectivity— that is, “the extent to which relevant actors share a common Effective strategies for citizen engagement can build on les- understanding of the problems they face and possible solu- sons not only from research on citizen engagement itself, but tions to those problems.” The importance of these intangible also from collective action and work on transparency, par- motivators also resonates with the findings of Mansuri and ticipation, and accountability (TPA). “Social accountability Rao (2013) as they distinguish the characteristics of organic efforts may have a lot to learn from political accountability participation from those of induced participation, emphasiz- initiatives,” posits Fox (2016, 7). One dimension is what he ing that the former is driven by intrinsically motivated local describes as a move from a tactical to a strategic approach. actors, while the latter is extrinsically promoted, typically by The tactical approach is what Fox calls “bounded” inter- a large bureaucracy. They furthermore highlight the role of ventions to disseminate localized information about public leaders in organic participation efforts: “Organic participa- service delivery and state resource allocation. The strategic tion is driven by self-motivated leaders who work tirelessly, approach involves multiple coordinated tactics, actionable with little compensation, often at a high opportunity cost. information for citizens, measures to enable collective action, They are constantly innovating, networking, and organizing service provider incentives, and cultivation of synergies be- to get the movement to succeed” (Mansuri and Rao 2013, 32). tween citizen voice and government policy shifts and reforms (Fox 2016). In operational terms, the objectives of strate- Research on collective action and social movements also high- gic citizen engagement for accountability and development lights the importance of power and its distribution, which res- are not limited to frontline service delivery outcomes; they onates with the World Development Report 2017 (WDR 2017) also include vertical outcomes “up the policy process supply framework. In a series of three publications, the collaborative chain” (Fox 2016, 4). Learning from the Global Partnership Transparency and Accountability Initiative has examined the for Social Accountability (GPSA) application process, Guer- role and relevance of social movements to the transparen- zovich and Poli (2014) also advance a strategic approach to cy and accountability field (Halloran and Flores 2015; Joyce social accountability. 2015; Joyce and Walker 2015). In the first of these publica- tions, Halloran and Flores (2015, 1) conclude: “Citizens can These more holistic approaches recognize that poverty, mar- successfully pressure and support government accountability ginalization, corruption, fragility, impunity, and injustice through collective mobilization strategies that require capa- are linked rather than parallel challenges requiring distinct ble, autonomous and representative grassroots organizations efforts. Beyerle (2014) analyzes 12 social movements, cam- and movements.” Citizen-based collective action can have a paigns, and community initiatives targeting corruption and dual function. On the one hand, it can pressure elites, thereby finds that regular people do not view graft in a vacuum. shifting power asymmetries, to enact or implement policies. Rather, it is connected to other injustices or deprivations, On the other hand, it can support actors and institutions, from poverty and marginalization to police abuse, absent or seeking to reduce corruption or improve development out- low-quality public services, or large-scale elite malfeasance, comes, thereby building coalitions to change the incentives of often perceived as contempt for the citizenry. “Accountabil- elites. In the latter case, elites and citizens can play synergistic ity” consists of outcomes such as preventing or rectifying roles to foster positive outcomes. For example, in their strate- shoddy reconstruction and development projects (Afghani- gic, vertical integration analysis of the well-known Textbook stan); reopening an HIV dispensary that was shuttered when Count initiatives in the Philippines, Fox and Aceron (2016) the municipal land on which it stood was sold illegally (Ken- highlight the constructive relationship between civil society ya); obtaining the needed state documents, utilities, and pub- and the Department of Education (national, subnational, and lic services to which citizens are entitled (India); or protecting local) in seeking to tackle both the causes and the symptoms an effective anticorruption commission (Indonesia). of corruption and bottlenecks in public school book produc- tion and distribution (Fox and Aceron 2016; Guerzovich and Citizen engagement strategies can also draw on research that Rozenzweig 2014). has been conducted on collective action and social move- ments, in particular on what creates motivation and enables Power is central to citizen engagement and social accountabil- mobilization of citizens, on the one hand, and what supports ity by way of its asymmetries (World Bank 2017b), shifts (Mc- the success and sustainability of those movements, on the oth- Gee and Gaventa 2011), relationships (Halloran 2016), verti- er. Effective collective action is typically stimulated by intan- cally integrated power structures (Aceron and Issac 2016; Fox gible motivators (Beyerle 2014). Among these are collective 2016), and dynamics (Beyerle 2014). Power emanating from identity, collective responsibility, and collective ownership. citizen-based collective action, also called people power, re- Even though intangible motivators have not been the direct fers to the social, economic, political, and psychological pres- focus of traditional scholarship on transparency, participa- sure that is placed on state and nonstate elites by significant A BRIEF LITERATURE REVIEW 17 numbers of individuals organized around shared grievances er of numbers, one of the three collective action dynamics. It and goals and engaging in a variety of nonviolent actions such incorporates the notion of scaling up citizen engagement as a as community monitoring initiatives, demonstrations, cultur- source of pressure on elites. al expressions, and solidarity with state integrity champions and reformers (Beyerle 2014). Citizen engagement, fragile contexts, Three main underlying dynamics of citizen-based collec- tive action matter for the transparency, participation, and and peacebuilding accountability context: (1) disrupting systems of graft and Citizen engagement and social accountability can also pos- abuse—that is, interfering in their smooth functioning; (2) itively affect development outcomes in fragile contexts and engaging with power holders and the public to shift their loy- even contribute to peacebuilding and conflict prevention. En- alties and positions and pull them toward a citizen engage- gagement and accountability help to build trust in a context ment initiative, campaign, or movement; and (3) applying that is marked by distrust and divisions; participation gives nonviolent pressure through the “power of numbers” (Beyer- citizens an opportunity to voice their concerns and engage le 2014). These three collective action dynamics complement politically through nonviolent means; and community-based the conceptualization of power asymmetries in WDR 2017 by organizations and citizen-led initiatives often play a crucial adding the “how” to citizen engagement manifested through role in contexts in which the state is unable to provide effec- social organizations—that is, how citizens wield power to af- tive governance. fect the policy arena through the three levers of change. De- pending on the policy arena, these collective action dynamics Citizens in fragile countries, whether emerging from a con- can alone or in tandem shift elites’ incentives, reshape prefer- flict or in danger of falling into a conflict, typically display ences and beliefs, and increase contestability. lower levels of trust in their government (World Bank 2011, 100). However, rebuilding trust is central to rebuilding peace. Finally, recent literature on social accountability points to an As laid out in WDR 2017, the goals of governance are achiev- evolving notion of scaling up. The greater focus on the rele- ing security, growth, and equity (World Bank 2017b, 4). vance of context for the success of development and citizen When the state appears unable to provide these, citizens are engagement challenges the conventional view of scaling up, less likely to trust the elites. As noted earlier, a recent analysis which consists of widely replicating a technique, method, of service delivery in the MENA region following the upris- tool, or social accountability intervention. The conventional ings of 2011 links the level of trust citizens have in the state view was built on the assumption that what works in one con- to its performance in service delivery, the accountability of text can work in another. In the WDR 2017 framework, the institutions, and citizen engagement and voice (Brixi, Lust, focus on power reveals that this assumption is conceptually and Woolcock 2015). These factors can form either a vicious weak because power asymmetries vary and each policy arenas cycle in which poor services and the absence of voice erode has its own unique interplay of drivers of policy effectiveness, trust or a virtuous cycle in which greater opportunities for levers for change, and drivers of change. Citizen engagement participation help to build trust. Institutional legitimacy is takes place in complex contexts and involves complex pro- central to stability (World Bank 2011, xi). Because such legit- cesses (Wajli 2016). Thus social accountability actions “need imacy and citizens’ trust in the state are easily undermined by to resonate with the existing culture and values in the particu- corruption, strengthening social accountability and voice is lar society, and provide motivational and emotional resources key to building more stable societies and repairing the social to those who engage in them and those who react to them” contract. (Beyerle 2014, 271). Meanwhile, providing opportunities for civic engagement in Research on scaling up of social accountability initiatives has fragile states and involving civil society in peacebuilding de- also uncovered weak results. For example, the World Bank crease the risk of violent action and support the sustainability study by Mansuri and Rao (2013) on localizing development of peacebuilding efforts. Several scholars such as Chenoweth found that scaled-up induced community participation tend- and Stephan (2011) have in recent years compared the effec- ed to be captured by local elites. Rather than scaling up in- tiveness of nonviolent resistance and violent resistance. Coun- duced interventions or solutions, Wajli (2016) proposes scal- tries that experienced nonviolent resistance were found to be ing up the approaches and processes through which solutions at least 50 percent more likely to qualify as a democracy five are developed. Fox (2016, 13) distinguishes between scaling years after a conflict than those in which change was brought up and taking scale into account through vertical integration about violently. Even some groups that previously engaged that links “citizen action at the grassroots with action at the in violence shifted to nonviolent tactics when it promised national level, while seeking to broaden their coverage hori- greater chances of success (Dudouet 2015). These findings zontally in terms of the geography and social inclusion of ex- demonstrate the importance of an environment responsive to cluded citizens.” In terms of power, scale is related to the pow- nonviolent action. If nonstate actors in conflicts have a great- 18 CITIZENS AS DRIVERS OF CHANGE er chance of achieving their goals nonviolently, a strong argu- gral to the fundamental principles guiding the entirety of the ment can be made that there are strategic incentives to choose human rights framework: indivisibility of rights, universality nonviolent tactics over the harmful and less successful path of rights, nondiscrimination and equality, and principles re- of violent resistance. More broadly, involving civil society in lated to good governance. The way a society is governed is conflict transformation and peacebuilding promises greater also essential for the realization of human rights (World Bank success and sustainability of peace agreements by reflecting a and OECD 2013, 74). Adherence to the rule of law ensures wider range of perspectives and helping to forge a consensus equality and nondiscrimination in the application of rights. across societal groups (Fischer 2011). Transparency allows monitoring the implementation of rights, and accountability ensures that those responsible for Engaging citizens and civil society in social accountability in protecting and promoting rights do so correctly. Citizen en- fragile contexts has proven useful when the state falls short gagement then ensures that rule of law, transparency, and ac- (Grandvoinnet, Aslam, and Raha 2015, 206). Even in con- countability are actually used as tools for ensuring that rights texts in which a country is divided or levels of institutional are respected and fulfilled. legitimacy are low, community-based organizations have the potential to strengthen a sense of citizenship (Gaventa and The right to development conceptually and practically links Barrett 2010). The case study of Integrity Watch Afghanistan human rights and development in a way that creates mutual in this report demonstrates the unique and fruitful role that gains for both fields. It is defined as “an inalienable human a civil society organization engaged in social accountability right by virtue of which every human person and all peoples efforts can play in a context marked by profound divisions are entitled to participate in, contribute to, and enjoy eco- and high levels of fragility. nomic, social, cultural and political development, in which all human rights and fundamental freedoms can be fully real- Rights begetting rights: Using citizen ized.”8 The right to development provides a holistic approach that integrates aspects of both human rights and development engagement to improve development by defining development as an economic, social, cultural, and outcomes political process, not just as growth.9 It also encompasses all human rights—civil, political, economic, social, and cultur- al—and combines the rights of peoples with the rights of in- Citizen engagement, inherent in the human rights framework, dividuals in a way that makes it a more suitable framework is a powerful tool through which people can, among other for the global problems of today. The right to development things, improve the fulfillment of their social and economic framework therefore requires a comprehensive, human-cen- rights, such as health or education, by exercising their civil tered development policy with strong participatory develop- and political rights. Citizen engagement is linked especially ment processes, including the active, free, and meaningful to the freedoms of association, assembly, expression, and in- participation of affected right holders. In line with the ratio- formation and the right to participate in government (see box nale of the World Bank’s citizen engagement mandate, em- 2.2). These rights relate to people’s opportunities to be knowl- powering citizens to participate in the development process edgeable about public problems, voice their concerns even and integrating the voice of citizens in development programs if contrary to those of the elites, and organize peacefully to are key contributors to achieving better results. tackle these problems. In addition, citizen engagement is inte- Box 2.2: Human rights and citizen engagement Basic human rights are laid out in the Universal Declaration of Human Rights and codified into international law through nine core instruments, among them the International Covenant on Civil and Political Rights (ICCPR). Citizen engagement is related to the following rights: ƒƒ Freedom of expression and right to information (ICCPR, Article 19) ƒƒ Freedom of assembly (ICCPR, Article 21) ƒƒ Freedom of association (ICCPR, Article 22) • Right to participate in government (Universal Declaration, Article 21). These rights are guided by a set of principles, including universality and nondiscrimination, recognizing that all people hold them and should be able to enjoy them without discrimination. 8. Article 1.1, Declaration on the Right to Development. 9. http://www.un.org/en/events/righttodevelopment/pdf/rtd_at_a_glance.pdf. A BRIEF LITERATURE REVIEW 19 Citizen participation to reduce corruption and improve de- grievances and goals, coalition building, and joint action— velopment outcomes can be viewed as the active practice of by their nature tend to incorporate human rights principles. human rights for three reasons. First, it involves both claim- Third, positive outcomes enhance the achievement of rights. ing and exercising fundamental rights through voice and The next chapter explores how this plays out on the ground action at the grassroots. Second, the collective processes in- and in the policy arena through three case studies. volved in citizen engagement and action—including shared CHAPTER 3: Case studies: CASE STUDIES 23 CHAPTER 3 Case studies Afghanistan: Improving education traction operations in 2011, and in July 2014 it launched the Community-Based Monitoring School (CBM-S) program.10 outcomes through community-based The CBM-S program reflects widely shared and growing public concerns about education. In the 2014 “National Cor- monitoring of schools ruption Survey” conducted biennially by IWA, corruption ranked second and education seventh among the most seri- The challenges to better governance in the Afghan education ous problems facing Afghanistan. In the 2016 survey, access sector are many, and the obstacles to citizen engagement are to education moved to second place and corruption moved to significant. The country remains fragile, suffers from high third place. Meanwhile, the Ministry of Education was ranked rates of corruption, and is struggling to overcome capacity as the seventh most corrupt institution in 2012 and moved to constraints. Moreover, the vast quantities of development aid third place in the 2014 that have flowed into the country for almost two decades have and 2016 surveys.11 “We want to involve only ramped up the opportunities for corruption and aggra- Primary and second- citizens and help them vated the threat of capture. ary public education was rated the most understand that they have The mission accessible government to take responsibility service in the same and find solutions. We Often, citizens are hesitant to become involved in the poli- surveys, with over 90 want to enhance a culture cy arena because they feel ill-equipped or not entitled to do percent of the popula- tion directly interact- of oversight, of asking so and doubt their engagement will bear fruit. Meanwhile, elites tend to hesitate to engage with citizens, who are often ing with it. Working questions, so that officials thought to be more troublemakers than constructive collabo- from the bottom up by should feel they need to be rators. Integrity Watch Afghanistan (IWA), a nongovernmen- targeting corruption tal organization (NGO) seeking to increase transparency, ac- and mismanagement accountable and responsive.” countability, and integrity in the country, has been working to in schools thus prom- Kowsar Gowhari, former manager of programs, change that perception through its community-based mon- ised to be of direct rel- Integrity Watch Afghanistan itoring programs. The programs depend on harnessing the evance to citizens and power of numbers by overcoming people’s hesitation to leap to provide them with opportunities for incremental and tan- into the fray. They do so by cultivating collective responsibili- gible achievements. ty and collective ownership. IWA trains citizens in local mon- itoring, equipping them with the tools and networks needed The main goal of the community-based monitoring program to become involved and work constructively toward tangible in schools is to improve the quality of education—a key pub- change in their communities. The organization also acts as a lic good that is a foundation of development. Monitoring of facilitator between communities and elites by working with schools is designed to facilitate improvements by, on the one elites from the national to the local level, sharing with them hand, identifying and rectifying problems stemming from data and promoting their interaction with communities. corruption, mismanagement, insufficient resources, insecu- rity, or a combination of them, and, on the other, preventing IWA conducts community-based monitoring programs in corruption and mismanagement. sectors that are particularly plagued by corruption. Founded in 2005, IWA began its citizen engagement efforts with com- Although fragile states such as Afghanistan face many of munity-based infrastructure monitoring in 2007 (Beyerle the same corruption challenges as other developing nations, 2014). It then expanded to monitoring trials and resource ex- fragility compounds the risk of malfeasance (Chene 2012). 10. IWA, https://iwaweb.org/wp-content/uploads/2016/12/NCS__English__for-web.pdf p.30. Supplemental information, clarifications, and data were gath- ered from IWA through Skype or in-person interviews and e-mail communications between July 2016 and April 2017 with Kowsar Gowhari, former program manager, IWA; Khadija Mehmood, program officer, CBM-S; and Naser Sidiqee, former program manager, CBM-S. 11. IWA surveys: 2012, https://iwaweb.org/wp-content/uploads/2016/02/national_corruption_survey_2012_english.pdf, p. 29; 2014, https://iwaweb.org/ wp-content/uploads/2016/12/NCS-2014-English.pdf, p. 22; 2016, https://iwaweb.org/wp-content/uploads/2016/12/NCS__English__for-web.pdf, p. 30. 24 CITIZENS AS DRIVERS OF CHANGE Corruption can occur at all levels, from policy to the central Figure 3.1: Afghanistan’s governance score rankings, 2000 and government, from the regional government to the local ad- 2015 ministration and schools (Hall 2012). In Afghan schools, cor- ruption is manifested in many ways such as teachers who pay 18 bribes to receive salaries, ghost teachers (nonexistent, absent, 16 or double-registered educators), unqualified teachers and 14 other personnel, embezzlement from budgets, procurement 12 Percentile rank leakages, shoddy or neglected infrastructure and facilities, 10 and extortion of parents (Hall 2012; Sigsgaard 2009). On the 8 ground, such corruption results in large class sizes and teach- 6 er absences (because there are fewer teachers), substandard 4 teaching, insufficient supplies, and inadequate infrastructure 2 and sanitation (Hall 2012). These are the types of problems 0 identified in IWA’s community-based school monitoring pro- Control of Government Political Regulatory Rule of law Voice and corruption effectiveness stability quality accountability gram. 2000 2015 Other goals of the program are (1) to increase contact and Source: World Bank, Worldwide Governance Indicators. coordination between communities and officials by bringing Note: Scores are cross-country rankings for 2000 and 2015. Values correspond to global percentile together all those who have a stake in the education of Afghan rank. Zero is the lowest rank and 100 the highest rank. Afghanistan has seen improvement in all six children; (2) increase the responsiveness of school officials to governance categories covered by the World Bank’s Worldwide Governance Indicators. citizens; and (3) encourage communities to take the initia- community support and implemented over a wider area have tive in addressing their own education-related problems. Yet been found to be relatively more successful (Kapstein 2017). another goal is to use the results of community-based moni- Meanwhile, corruption is undermining progress across the toring in policy advocacy at the local and national levels be- board, from posing a disincentive to private sector invest- cause problems identified in schools are often the result of ments to lowering the quality of public service delivery. The corruption and mismanagement originating upstream at the World Bank’s new country strategy (2017–20) therefore seeks provincial and national levels (Hall 2012). IWA envisions a to support the government in tackling corruption and build- national program within the Ministry of Education that is implemented through the school management shuras (par- ing more accountable institutions in order to fight poverty ent-teacher associations)—see Sidiqee (2016). Consequently, and reduce inequality.12 IWA’s CBM-S program is fundamentally about improving The Afghan government recently signaled its intention to be- governance for public school education. come a member of the multilateral Open Government Part- The rest of this case study describes how IWA has forged col- nership (OGP) as a step toward strengthening its fight against lective action, increased contestability, and contributed to corruption and improving transparency and accountability. creating incentives and shaping the preferences of elites in or- Such efforts to improve governance and build an enabling en- der to improve access to quality education across the country, vironment for development are much needed. The evidence but first it looks at the setting and the challenges it poses. is that Afghanistan continues to score poorly on a range of indicators. It was rated as an “open anocracy” by Polity IV Background context and challenges (2013); deemed “not free” by Freedom House (2016); and re- ceived a 5 percent (out of 100 percent) rating by the World Afghanistan is a low-income country suffering from wide- Bank (2015) on its control of corruption (figure 3.1).13 Free- spread fragility and corruption, both of which are jeopar- dom House cites in particular the obstacles to free media, dizing its development. Decades of war and oppression have and the fulfillment of civil liberties and political rights more shaped Afghan politics, and instability continues to pose a broadly, because of insecurity and the threat of harassment significant risk to development efforts. Ongoing violence and violence. The Access to Information law passed in June constrains where programs can be implemented and how 2014 is a noteworthy step toward improved transparency and sustainable they are. In that context, smaller projects with accountability.14 12. World Bank, Afghanistan Overview: Strategy, 2017, http://www.worldbank.org/en/country/afghanistan/overview#3. 13. Center for Systemic Peace, Polity IV Project, 2013, http://www.systemicpeace.org/polity/afg2.htm; Freedom House, 2016, https://freedomhouse.org/ report/freedom-world/2016/afghanistan; World Bank, World Governance Indicators, http://info.worldbank.org/governance/wgi/index.aspx#reports. 14. Despite this progress, implementation of the law faces several challenges on the supply side, such as lack of cooperation among ministries and agencies and poor technical and financial resources to train public officials, as well as on the demand side, such as limited awareness among ordinary citizens (Over- sight Commission on Access to Information 2015–16). IWA recently launched a “Request for Information” campaign at the national and provincial levels (IWA 2017). CASE STUDIES 25 SPOTLIGHT 1: Current challenges in the education system in Afghanistan The public education system in Afghanistan suffered decades of upheaval in the 1980s (Soviet occupation) and 1990s (civil war and the emergence of the Taliban’s movement). Since 2002, however, education has been one of Afghanistan’s success stories. In 2001 no girls attended formal schools, and boys’ enrollment was 1 million. By 2014 the total net enrollment rate in primary schools (ages 7–13, grades 1–6) was 86 percent. Despite this progress, coverage in secondary education (ages 13–19, grades 7–12) remains a major problem with a net enrollment rate of 48 percent. Fur- thermore, access to education in Afghanistan still suffers from significant disparities across gender, geographical location, and household income. In 2014 girls’ enrollment reached 71 percent for primary education and 35 percent for secondary education, and girls’ dropout rates are high in the secondary grades. In addition, the higher education enrollment ratio is about 5 percent, which is one of the lowest participation rates in the world, and it contributes to the adult literacy rate, which is one of the lowest in the world, about 38 percent (World Bank 2016). The education sector in Afghanistan faces a number of challenges, including poor infrastructure, poor-quality teachers, and lack of resources. Infrastructure. In 2015, of the total registered schools only about half had proper buildings (the rest were operating as home-based schooling—in tents, houses, and under trees). Furthermore, most schools had inadequate facilities—that is, 62 percent lacked surrounding walls, 31 percent lacked drinking water, 33 percent lacked functional sanitation facilities, and 76 percent lacked electricity, all of which negatively affected access and retention (Ministry of Education 2015, 2016; World Bank 2016). Poor quality and shortage of teachers. Only 38 percent of all teachers meet the requirements of becoming a teacher (14th grade graduate). The remaining who have not yet met the criteria to be professional teachers are recruited as contact teachers in remote areas. The shortage of teachers is evidenced by the high pupil-teacher ratio of 45:1 (2013). Only 28 percent of the total number of teachers are female. They are located primarily in urban areas, which has important implications for female student attendance. In 2012 about 31 percent of schools were running on multiple shifts and consequently on reduced teaching hours. Absenteeism from the classroom—by both teachers and students—necessarily interrupts and shortens learning time (Ministry of Education 2015; World Bank 2016). Low expenditure on education. As of 2015, the government expenditure in the education sector in Afghanistan as a share of GDP remained low at 3.2 percent, falling from 3.46 percent in 2010 to 2.53 percent in 2012 and 3.32 in 2015. Sources: Data on enrollment: World Bank, World Development Indicators (database), http://databank.worldbank.org/data/reports.aspx?source=world-development-indicators; data on expenditure: UNESCO Institute for Statistics, http://uis.unesco.org/en/country/af. Over the last 15 years, Afghanistan has made impressive respondents in IWA’s National Corruption Survey have con- progress in achieving better education outcomes, and yet the sistently ranked the Ministry of Education among the three challenges remain large because of high dropout rates, lack most corrupt public institutions in the country.16 of qualified teachers, and missing infrastructure (World Bank 2016). Since 2001, the country has moved from zero enroll- In Afghanistan, among the many obstacles to citizen engage- ment of girls in the formal education system to a female stu- ment are citizens’ lack of awareness and interest, as well as dent population of almost 40 percent in universities. At the the poor security and violence that undermine the feasibil- same time, however, almost half of all schools lack buildings, ity of such initiatives in some regions. Often, people do not and adult illiteracy rates remain high—only 38 percent of Af- understand how their involvement in community monitor- ghans above the age of 15 are literate, and only 23 percent ing, for example, can bring about change and reform. They of adult women.15 Education in Afghanistan has suffered not see corruption and inferior public services as problems for only from the many years of war as well as Taliban rule, but state elites to tackle, not citizens. This pattern stems in part also from high rates of corruption, resulting, among other from the international reconstruction and development pro- things, in teacher absenteeism, inappropriate procurement in cess in which huge amounts of funding were poured into the construction and equipment, and payments for grades (Hall country, corruption was rampant through shoddy projects, 2012; Sigsgaard 2009; USAID 2009). The problem is so acute and communities and local authorities were not usually con- that, according to the NATO Civilian-Military Fusion Cen- sulted about their needs, particularly in the early years.17 As ter’s 2012 report, corruption is perceived to be a key obstacle for security, on the ground it is unstable. For example, citizen to education development (Hall 2012). Indeed, since 2014 engagement initiatives by IWA in two schools in the Enjil dis- 15. World Bank, Worldwide Governance Indicators, http://info.worldbank.org/governance/wgi/index.aspx#reports. 16. IWA, https://iwaweb.org/wp-content/uploads/2016/12/NCS-2014-English.pdf, p. 22; https://iwaweb.org/wp-content/uploads/2016/12/NCS__English__ for-web.pdf, p. 30. 17. For documentation on corruption in reconstruction and development, see SIGAR (2016). 26 CITIZENS AS DRIVERS OF CHANGE trict in Herat had to be halted because of worsening security. from the Ministry of Education down to the local monitors, the organization secures buy-in across levels of hierarchy. The Further obstacles are norms and practices normalizing graft CBM-S program follows an eight-stage model that recognizes and caution about upsetting established hierarchies. Although the importance of gaining the support of the authorities (it graft is roundly condemned, some citizens (unwillingly or begins by securing a memorandum of understanding from willingly) still take part in corrupt transactions, often benefit- the Ministry of Education and coordinating with officials at ing from them. Meanwhile, because of the country’s societal the provincial, district, and local levels), as well as creating norms about gender and its strong patriarchal system, women genuine interest within the grassroots (such as through ca- have not played a prominent role in monitoring activities. pacity- and community-building activities)—see appendix A. As noted, elites are often hesitant to engage with citizens, and Establishing formal cooperation with the ministry and other citizen engagement initiatives can be easily captured by local authorities and forging working relationships with them are elites. Community monitoring in the Afghan context takes essential for building credibility as well as for leveraging it to perseverance and patience because government officials are create pressure to address the issues identified through the not necessarily forthcoming and willing to cooperate. Initial- monitoring initiatives. Formal cooperation helps to generate ly, there was little enthusiasm for community-based moni- institutional and social pressure for government elites to en- toring by either citizens or elites. In the words of IWA’s for- gage with communities. On the side of the communities, it mer program manager Kowsar Gowhari, “officials from the helps to overcome apprehension about challenging the sta- Ministry of Education didn’t want to cooperate because they tus quo through monitoring and interacting with authorities. see them [citizens] as a nuisance. Community members saw Furthermore, problems on the ground identified through no point, and school management didn’t want trouble-mak- community monitoring can require action from different ing.”18 Another challenge was to avoid disturbing local power elites at different levels, thereby fostering a vertical scale of and resource balances or unintentionally tilting the program’s accountability. support in favor of particular individuals or subgroups in the community. As several experts on local development and so- Also at the local level, IWA is respecting and utilizing estab- cial accountability have pointed out, it is essential to be aware lished hierarchies, thereby securing support from entire com- of these nuanced dynamics on the ground and to prevent elite munities. It recruits communities rather than individuals, as community members from hijacking an initiative for their is common for many grassroots campaigns and social move- own personal gain (Fox 2014; Mansuri and Rao 2013). ments, and it establishes the support of the community before launching an initiative. IWA Focal Points (district-level staff Power asymmetries in the education policy arena also ham- working with communities and engaging with subnational per meaningful citizen participation and lead to the exclusion and local elites) approach communities by speaking with re- of marginalized communities in particular. These communi- spected members such as elders and mullahs, the local school ties, which can be found in urban, rural, and periurban en- management, as well as regular citizens in informal gather- vironments, typically lack access to well-functioning schools ings. and resources for school buildings and infrastructure, and they are rarely included in decision making. The exceptions IWA encourages communities to take ownership of the mon- are some of the induced citizen-state deliberation bodies cre- itoring process, which makes it meaningful to them. If a com- ated in the context of development projects, following poli- munity is interested in participating in the CBM-S program, cy recommendations by international actors. The exclusion the local community development council elects a local mon- of such communities is exacerbated by country’s recent and itor.19 By ensuring that the monitors are elected locally, IWA ongoing experiences with violent conflict, Taliban rule, and increases the legitimacy of their work, which is done on be- state collapse. half of the community. Local volunteer monitors have includ- ed community elders, farmers, shopkeepers, university grad- Collective action to enhance contestability uates, and students. The majority have been men, but IWA is trying to include more women by giving them additional IWA uses a carefully designed approach to community mon- support to help them overcome safety concerns and social itoring. It is built around collective responsibility and collec- pressures. Among the 150 active local monitors in 2016, 88 tive ownership and is aimed at overcoming the significant were male and 62 were female. The volunteers are not paid obstacles to better governance and citizen engagement just for their time and only receive a modest monthly stipend described. Working steadily with all the relevant stakeholders, of 1,000 Afghanis (about $15) to cover transportation and 18. Personal communication, Kowsar Gowhari, former program manager, IWA, July 2016. 19. Community development councils are a feature of the Afghan government’s National Security Program. The objectives are to improve rural villages’ access to basic services and support democratic village governance and female participation. Outcomes and longevity are mixed (Beath et al. 2013). CASE STUDIES 27 communication expenses during their monitoring activities. IWA’s work has been facilitated by tangible assistance from Volunteerism, a pillar of IWA’s citizen engagement initiatives, international actors. Since 2007, IWA has had a productive helps to avoid distorting the incentives for becoming involved relationship with Integrity Action, an international NGO and and strengthens ownership. “When money is involved, peo- network of practitioners, scholars, and policy makers. It has ple don’t take ownership,” maintains Gowhari. been a source of funding and informed discussion for the CBM-S program. IWA is active in its network and has par- At first, the CBM-S program followed a pilot community ticipated in peer-to-peer workshops that have helped to build scorecard program focused on empowering school manage- knowledge and skills and have led to creative ideas on how ment shuras to evaluate education services, identify school to develop CBM-S. For example, IWA has taken inspiration problems, and encourage locally driven solutions. However, from Palestinian social audits led by students, and it is look- IWA found that scorecards were reactive in nature and lacked ing into how to better include and empower youth in com- a regular monitoring system. Moreover, IWA observed that munity-based monitoring (Darby 2017). In August 2016, in many such councils became inactive after funding and atten- conjunction with the CBM-S program, IWA began launching tion from international donors shifted, or they were captured youth integrity clubs in schools, and as of March 2017, there by prominent nonstate community elites. The latter outcome were 90 active groups. In 2014 IWA received three-year core has been documented by scholars in other contexts (Fox funding from the Swedish International Development Coop- 2014; Mansuri and Rao 2013). Working instead with volun- eration Agency (SIDA), which enabled it to build the CBM-S teers and building collective ownership have helped to foster program (SIDA 2015). sustainability. Capacity building and peer-to-peer exchanges are also used Initiatives to change elites’ incentives and to encourage citizens to participate and to overcome the preferences hopelessness and helplessness that tend to prevent them Community-based monitoring of schools has helped to cre- from becoming involved in public matters. For example, at ate incentives for elites to engage with communities and work the district level IWA organizes monthly meetings for local to improve the quality of education as well as to reshape elite monitors to enable peer-to-peer exchanges and learning, preferences. Monitoring and identifying tangible problems in support network building, and foster unity across commu- some of the target schools have altered elites’ incentives by nities. “Meeting every month has brought them so close to increasing the social cost to them. Particularly in close-knit each other that they now deem themselves as one family,” re- settings and at lower levels of government, collective action ports Naser Sidiqee, former program manager of the CBM-S could wield strong social pressure. Collective ownership program. Training provides citizens with concrete pathways has increased the legitimacy of the communities’ demands to become involved and with a network. Local monitors also to elites and has been a source of power by creating social participate in monthly school management shura meetings, pressure. “When people [local monitors] represent the de- where they update community members and local school of- mands of the community, authorities feel compelled to listen. ficials on their findings and seek cooperation to address the When it’s presented as top-down, they don’t feel so obligated,” problems. Finally, IWA also facilitates monthly coordination Gowhari notes. Monitoring has changed elites’ incentives by meetings for the community at large. These gatherings help to providing positive political and social benefits derived from incorporate accountability and legitimacy in the citizen en- visibly taking action or supporting particular policies. In the gagement initiative because local monitors report back to fel- CBM-S program, IWA surmises that some government elites low citizens. The meetings are intended to harness grassroots likely came on board to build up their reputations. support and encourage collective action to address problems identified by the local monitors. During the third quarter of The program also works toward reshaping elite preferences 2016, for example, 16 coordination meetings were held with and beliefs by bringing new interests into the education pol- communities in Parwan province. icy arena, creating spaces for elites from the national to the local level to interact with citizens, and encouraging coalition IWA uses its ability to coordinate citizens to bring forward building. Although it is difficult to assess success in changing previously underrepresented demands and interests—one of preferences, IWA’s approach is clearly geared toward that goal, the key abilities of a social organization (Heller 2013; World and anecdotal evidence suggests that bringing actors together Bank 2017b). As of December 2016, 150 community monitor- and providing space for them to solve problems collectively ing initiatives under the CBM-S program were coordinating has altered prior conceptions (see box 3.1). Local monitors action among citizens around specific problems uncovered in engage with elites at various levels, from school management target schools by monitoring and raising demands to rectify shuras to provincial education sector groups. IWA initially these problems. In addition to these demands, they were find- created provincial monitoring boards for education, bringing ing creative solutions in conjunction with elites. together all stakeholders, from community representatives 28 CITIZENS AS DRIVERS OF CHANGE Box 3.1: Recollections of an IWA provincial coordinator Ali Ahmad Mashal Afroz, IWA provincial coordinator, Kapisa: I remember when my friends and I saw the Sher Khan High School in Kohistan-e-Awal for the first time in 2015; there were no walls except the one where a door had once been. At first all we saw were classrooms in ruins and without students. A few steps further there were some students studying in an open area who complained to us about the school’s condition. During social gatherings and talks with community members we were able to make them aware of how they could make a difference. We encouraged them to identify the specific problems with their school and encouraged them to engage with the Education Department. It is worth mentioning that the local people had already complained to the Education Department authorities but without success. Today, after two years, there have been huge changes at Sher Khan High School: 750 meters of school walls have been constructed thanks to a $60,000 grant from the Education Department’s budget and a contribution of 228,000 Afghanis (about $3,500) from the community. These walls now protect both students and staff. The local people and the local management shura (SMS) also provided the school with potable water at a cost of approximately 41,000 Afghanis (about $600). The people connected the deep well, located about 1.5 kilometers north of the school, to the school with pipes. The SMS will invite representatives of the government to the inauguration of this project in the near future, and large participation is expected. There are now regular monthly meetings of the SMS, hygiene and security have improved, all teachers have teaching plans, student discipline is good, and the interaction between the school administrators and the students’ parents has improved significantly. Source: IWA Newsletter, October 2016. and local monitors to education officials, to address problems ceptivity of elites, particularly at the local level but also high- that go beyond local school management or require coor- er up the provincial authority chain. In the Sher Khan High dination and resources at the provincial level.20 But it then School in Kohistan-e-Awal, for example, communities had changed course after finding that a range of subnational ed- tried in the past to interact with education officials but to no ucation entities already existed in the three provinces where avail. Through the CBM-S program, they contacted the offi- the CBM-S program operates. It has since worked to estab- cials again, and this time they received a response. lish links with these bodies, particularly the education sector groups in Parwan and the provincial education directorates Collective action and engagement with elites have also helped in Kapisa and Herat, and convene meetings involving them to foster social cohesion and opened opportunities for collec- as well as other education stakeholders and decision makers tive problem solving. Anecdotal evidence suggests the variety of ways in which CBM-S initiatives have helped communi- such as those from the provincial councils and governors’ of- ties find solutions to the problems they detected. They have fices. Since 2016, local monitors have been participating in included fundraising campaigns, in-kind donations such as these higher-level meetings. of land, and carrying out repairs, sometimes together with teachers and students. In a fragile and low-capacity environ- Conclusion ment, initiatives that help build a community are particularly Summary of outcomes important. The CBM-S program has mobilized citizens to become in- Local monitors have identified numerous problems in the volved in improving education in their communities and to schools they are monitoring, and in 37 percent of cases were help establish working relationships with stakeholders, in- able to report back that the problem was solved (box 3.2). In cluding communities, local officials, and provincial education 2016 the monitors identified 988 observable problems (see authorities. From 2014 to 2016, 180 schools were monitored table 3.1).21 Among the most common were lack of drink- in Parwan, Kapisa, and Herat provinces. Of the 150 CBM-S ing water, dirty latrines and facilities, inadequate security initiatives in 2016, half were girls’ schools. In 2017 IWA is arrangements, and nonfunctioning science labs. Over 50 expanding the program to nine provinces and 270 schools. percent of problems were grouped into an “other” category, From 2014 to 2016, the program involved 180 volunteer local ranging from absent teachers to insufficient teachers, class- monitors chosen by their communities, of whom 150 were rooms, equipment, desks, chairs, and textbooks and damaged still active as of March 2017 (88 male, 62 female). IWA’s role or missing blackboards, windows, and walls. Communities as a convener of stakeholders has helped to improve the re- thus detected an average of 6.6 problems and were able to solve between two and three of them. These problems mirror 20. These bodies are an IWA innovation, originally created to foster communication and problem solving among state and citizen stakeholders for recon- struction and development projects. 21. These data were not disaggregated by individual community monitoring initiative and thus do not reveal the number and severity of the problems per target school or the difficulties in overcoming them. Integrity Action recommends that fix rates be used in conjunction with other data and qualitative infor- mation. CASE STUDIES 29 Box 3.2: Monitoring teacher absenteeism and “ghost teachers” Nazeera was a local monitor, chosen by her community for the Ishaq-Abaq Girls High School in Parwan province. In the course of her regular monitoring, she uncovered “ghost teachers,” also known as “paper teachers,” who were regularly absent for long periods of time but still drawing salaries. One of them was the husband of the school principal. Although the school list indicated that there were enough teachers for every subject, in speaking with students Nazeera heard complaints about the shortage of teachers. She then shared her findings with the school management, but the principal told her to keep quiet and threatened her with reprisals if she revealed the information. The monitor told her husband what had transpired, and he encouraged her to tell the community through the local shura. She shared her discovery with local female shura members, other community members, as well as with the Department of Education at the Jabal Saraj district level. “Local community members and local female shuras went to the school, all together as one body and conducted a meeting with the school management and informed the school management to remove all the ghost teachers names from the list,” reports Khadija Mehmood, program officer for CBM-S. News of this achieve- ment led to changes at other schools. Local monitors informed IWA that other ghost teachers were cleared from school lists, and teachers are now arriving on time and are signing attendance sheets. When interviewed for this case study, Nazeera avowed, “My commitment is to my work, which I learned in the training conducted by Integrity Watch Afghanistan to fight corruption and establish accountability. I promised to myself to deal determinedly with every problem that faces me.” Source: Summary based on an interview conducted by IWA, April 2017. Table 3.1: Common problems observed by IWA local monitors in 2016 and their fix rate Problem Frequency (observed) Frequency (solved) Fix rate Presence of staff on time 21 6 29% Not using lessons log 1 1 100% Lack of teaching material 27 9 33% Classrooms not in order 40 9 23% Unavailability of drinking water 122 42 34% School management shura (SMS) meetings not conducted 7 4 57% School assembly not being held daily 22 7 32% School not clean and tidy 46 25 54% Science laboratory not functioning 58 25 43% Security arrangements not in place 27 12 44% Teachers with no lesson plan 11 8 73% Teachers absent 13 8 62% Toilets not clean and tidy 110 62 56% Usual number of teachers not present and on time 1 1 100% Usual numbers of students not present and on time 9 4 44% Other 473 146 31% TOTAL 988 369 37% the types of corruption-related results in the education sector Evidence suggests that parents can be uncomfortable sending discussed earlier in this case study. They create an inhospita- their girls to school if there are no suitable toilets, perimeter ble learning environment and can inhibit female enrollment. walls and gates, and security personnel (Saunders 2015).22 22. It is notable that these problems correspond to some of the priority categories to be addressed among the intermediate results indicators of the 2016 Bank EQUIP Implementation Status and Results Report (Lahire 2016). 30 CITIZENS AS DRIVERS OF CHANGE Table 3.2: Application of human rights, Integrity Watch Afghanistan Right Application of right Association Creating community-based monitoring initiatives with elected local monitors Assembly Conducting public meetings, monitoring, local monitor training, local monitor peer-to-peer monthly gatherings, and stake- holder capacity-building workshops, thereby mobilizing communities to overcome problems identified during monitoring Expression Circulating monitoring reports, answering questions in the baseline and endline surveys, and expressing demands and views in meetings with education officials Information Requesting information from education elites, gathering information through monitoring, and canvassing community members for the baseline survey Participation in governance Providing monitoring results to school management and education officials to improve the quality of education, rectify problems, and prevent corruption; participating in community development councils, school management shuras, and provincial education sector group meetings Challenges accountability interventions. International and even national staff based in the capital may not be fully cognizant of these A cornerstone of anticorruption is prevention, and monitor- context-specific local spoilers of citizen engagement. ing is recognized as a method of deterrence (Langseth 1999; Osche 2004; Richards 2006). Proposing an “anticipatory strat- Evaluating the success of the CBM-S program in preventing egy” to address corruption in education sector development, corruption, one of its key goals, is another challenge. The data Tanaka (2001, 163) recommends that prevention programs gathered through the surveys conducted within the frame- include measures to “secure the quality of goods, services, work of the program may point, for example, to missing or personnel resources, etc., which have implications for student defunct equipment, and while a link to corruption or at least protection.” IWA’s strategy aligns with this prescription. The mismanagement is typically implicit, the data do not allow for challenge for development practitioners is that prevention a definite conclusion. Similarly, the absence of more blatant cannot be measured. However, voices from the World Bank cases of corruption in the data gathered by the monitors may are hailing the importance of prevention. A report on fight- point to the fact that the program is acting as a deterrent, yet ing corruption in Afghanistan notes that prevention “is an all the data again do not allow for a definite conclusion. too often neglected dimension of an anti-corruption strategy” (Ishihara and Byrd 2009). In a blog on social accountability to Rights begetting rights address fragility and help societies rebuild, Jeff Thindwa, head of the Bank’s Global Partnership on Social Accountability By exercising their rights to association, information, and (GPSA), calls on the Bank to “invest in prevention” (Thindwa participation, communities involved in the CBM-S program 2017). Given the baseline of extensive graft in Afghanistan’s are working to improve the fulfillment of their right to edu- education sector, IWA’s qualitative reports of improvements cation. Through realizing their civil and political rights, they in school administration and education provision as a result are thus supporting the state in promoting a right that falls of ongoing community-based monitoring initiatives indirect- into the category of social, economic, and cultural rights. “As ly suggest a degree of corruption prevention and increased beneficiaries of public education services,” explains Sidiqee, accountability. the former CBM-S program manager, “Afghan citizens have the right to demand high quality education and hold gov- However, monitoring in the Afghan context takes persever- ernment officials responsible as well as accountable if these ance and patience because government officials are not nec- services fail to meet the needs of Afghan school children.” By essarily forthcoming and willing to cooperate. Another chal- seeking to improve state responsiveness through collective lenge is to avoid disturbing local power and resource balances action and elite engagement, communities are pressing for or unintentionally tilting the program’s support in favor of better education for their children. As the previous section particular individuals or subgroups in the community. For described, these efforts have at least in some cases borne fruit. IWA, it is essential to be aware of these nuanced dynamics In addition, through the local monitor training, IWA is show- on the ground. The organization is careful to prevent elite ing citizens how to exercise their rights in order to improve community members from hijacking its initiatives for their education and development in their communities (table 3.2). own personal prestige (Fox 2014; Mansuri and Rao 2013). Its local Focal Points play an essential role in preventing or at Community-based monitoring of schools has created incen- least navigating these pitfalls. This is a critical lesson for ex- tives that function as both sticks and carrots. Revealing the ternal actors seeking to design and implement induced social often-lagging quality of schools has placed pressure on offi- CASE STUDIES 31 cials to act. At the same time, encouraging elites to participate engagement for transparency in public education and seek- and collaborate with communities in the framework of the ing to harness citizen engagement for greater contestability. program has created opportunities for elites to gain a better Its overall strategy until 2016 was to channel citizen outrage reputation among the communities by visibly supporting over corruption in FONACIDE into collective action through their efforts. organized, grassroots monitoring.23 In the short term, reAc- ción aims to empower students to gain social accountability The program has also worked toward reshaping elite prefer- for FONACIDE entitlements, increase FONACIDE’s trans- ences and beliefs by convening citizens and elites. By facil- parency, and educate stakeholders about the fund’s annual itating interaction and encouraging coalition building, the distribution process. In the longer term, it seeks to strengthen program helps to shape their views about each other and the mechanisms of inclusion and social participation and alter problems they can tackle collaboratively. common perceptions that corruption is an unavoidable part of Paraguayan culture. Finally, the CBM-S program helps to enhance contestability by providing citizens with the tools they need to engage with To accomplish these goals, reAcción has had to overcome elites in the education policy arena and to mobilize as com- collective action obstacles that previously had prevented cit- munities, thereby giving their demands additional legitimacy izens from entering the public education policy arena. They and weight. Indeed, IWA’s program has enabled communities have done so by using FONACIDE as a focal point for en- to interact and cooperate with elites, especially at the local gagement, emphasizing tangible benefits for student partic- and provincial levels. Through the data they gather as moni- ipants and cultivating three intangible motivators: collective tors as well as their responses to IWA surveys, their voices are identity, collective responsibility, and collective ownership. In heard all the way up to the national level. pursuing these intangible motivators, reAcción generated an environment of collective identity and collective responsibil- Paraguay: Engaging in youth-driven ity, often using human rights language as a tool for motiva- tion. Cultivation of the intangible motivators was facilitated contestation to gather resources for by more tangible assistance, including training, international education funding, and effective use of technology. Today, reAcción is a comprehensive, volunteer-driven NGO Paraguay has faced challenges in following through on com- that can bargain directly in the policy arena to change the mitments to deliver quality education to all of its citizens. incentives facing officials and policy makers in public educa- Since its transition to democracy nearly 30 years ago, Para- tion, particularly at the Ministry of Education and municipal guay has made considerable progress toward more transpar- government levels. ReAcción has engaged with the relevant ent and accountable government, but the country remains stakeholders in government, applying both carrots and sticks. plagued by high levels of corruption, inequality, and clien- Its repertoire has included direct engagement with elites, telism. In recent years, Paraguay committed itself to greater information gathering through collective action, open data transparency by joining the Open Government Partnership analysis and visualization, media relationships, coalitions and promised to use revenues from electricity sales to Brazil with other NGOs, and legal strategies. Through these strat- to finance infrastructure in local schools through the Nation- egies, reAcción has reshaped the incentives of government al Public Investment and Development Fund (FONACIDE) actors, making it more difficult for municipal and national created in 2012. However, there is a low level of commitment officials to ignore its pressure to make the FONACIDE pro- to delivering these funds for the intended purposes. Driven cesses more transparent and inclusive. by local clientelism and capture, funds are sometimes direct- ed to politically favored schools rather than marginalized Background context and challenges ones, as intended, and the targeted recipients are excluded from the FONACIDE process and often unaware they should Paraguay is a young democracy, still marked by the legacy of a be receiving funds. 35-year dictatorship. Since 1989 and the end of Alfredo Stro- essner’s rule and beginning of the transition to democracy, The mission Paraguay has made significant improvements in governance and, as of the early 2000s, economic growth.24 Since 2000, the Challenges in the implementation of FONACIDE funds set Paraguayan economy has grown at over 4 percent annually the stage for the founding of reAcción, a youth anticorrup- in constant terms after growing at only 2.6 percent annual- tion organization emphasizing civic education and citizen ly in the 1990s. Meanwhile, over the same period Paraguay 23. The organization has actively promoted nonviolent collective action, and in situations in which other actors were turning to violence. For a recent exam- ple, see https://www.nonviolent-conflict.org/blog_post/defending-paraguays-constitution/. 24. Based on Polity IV scores. See Center for Systemic Peace, Polity IV Project, http://www.systemicpeace.org/polity/par2.htm. 32 CITIZENS AS DRIVERS OF CHANGE Figure 3.2: Paraguay’s governance score rankings, 2000 and 2015 lenges remain: according to the Transparency International’s Source: World Bank, Worldwide Governance Indicators. 2016 Corruption Perception Index (CPI), Paraguay still ranks 123rd out of 176 countries (figure 3.4), the fifth worst posi- tion among LAC countries—ahead only of Venezuela (166), 50 Haiti (159), Nicaragua (145), and Guatemala (136). Likewise, 45 in the World Economic Forum’s Global Competitiveness In- 40 dex (GCI) 2015, Paraguay ranks 139 out of 140 economies 35 on the ethics and corruption dimension; 136 out of 140 on 30 Percentile rank the undue influence dimension; and 136 out of 140 on the 25 wastefulness of government spending indicator. One-third of 20 15 the population (37 percent) has experienced corruption; 43 10 percent consider corruption to be “highly generalized” in the 5 government; almost 84 percent report that the government is 0 led by few powerful groups acting in their own interest; and Control of Government Political stability Regulatory Rule of law Voice and 66.3 percent still believe there is no or little transparency in corruption effectiveness quality accountability government. Changing these perceptions requires further ef- 2000 2015 forts to advance implementation of policy reforms, thereby strengthening the credibility of the government’s commit- Note: Scores are cross-country rankings for 2000 and 2015. Values correspond to global percentile ment to tackling corruption. rank. Zero is the lowest rank and 100 the highest rank. Paraguay has seen improvement in all six governance categories covered by the World Bank’s Worldwide Governance Indicators. Despite widespread perceptions of corruption, Paraguay has become relatively open in terms of the space for citizen en- has seen its international rankings improve across multiple gagement. According to the 2013 Global Corruption Barom- aspects of governance (figure 3.2). eter, 86 percent of its citizens believe that ordinary people Despite this progress, the country still lags behind the region- can make a difference in the fight against corruption. 27 This al average on all governance dimensions captured by the 2015 is largely a result of the political and civil rights and political Worldwide Governance Indicators. In particular, Paraguay freedoms gained after the transition to democracy, combined ranks in the lowest 20th percentile on control of corruption, with the government’s efforts to promote transparency in the government effectiveness, and the rule of law. The govern- public administration. The first transparency law was enact- ment’s weak institutional capacity for planning, implement- ed in 2014 (Law No. 5189/14) requiring all public offices to ing, and monitoring policies directly affects the performance disclose information about the use of public funds to pay sal- aries. A few months later, the government adopted the land- of the public administration and undermines its ability to ef- mark Access to Information and Government Transparency ficiently improve the delivery of basic services to its citizens, Law (Law 5282/2014).28 especially the poor and most vulnerable. As a result, although access to primary education and electricity is almost uni- One major cause of citizens’ discontent is public education. versal,25 the quality of basic public services remains low and They find that generally it is low in quality and highly un- needs to better target people living in poverty. equal, often as a result of corrupt and clientelistic behavior by public authorities. Article 85 of the 1992 constitution man- Historically, weak accountability and low transparency in dates that 20 percent of the national budget be allocated to ed- Paraguay’s public administration have created a social envi- ucation, and public funding for education reached 19.6 per- ronment in which perception of corruption continues to per- cent of the budget in 2012.29 Paraguay now grants free access meate public affairs. In 2009 Paraguay was ranked the second to basic education, but implementation remains a challenge. most corrupt country in the Latin America and Caribbean re- The 2013 Global Corruption Barometer found that 11 percent gion, ahead of only Haiti.26 The adoption of new transparency of Paraguayan respondents reported having paid a bribe for and anticorruption laws and regulations have contributed to education services.30 remarkable improvements in Paraguay’s ranking since 2014 (figure 3.3). Despite this progress, however, important chal- In 2015 high school and university students protested the 25. This is true for urban areas. In remote areas, availability of water and electricity is often limited to a few hours a day. 26. Transparency International, Corruption Perception Index. 27. Transparency International, 2016 Corruption Perceptions Index, https://www.transparency.org/news/feature/corruption_perceptions_index_2016#table; Transparency International, Global Corruption Barometer, https://www.transparency.org/gcb2013/country/?country=paraguay. 28. “Ley No. 5.282/2014 ‘De Libre Acceso Ciudadano a la Información Pública y Transparencia Gubernamental,’” Dirección de Publicaciones Oficiales, 19 Set. 2014, Web. 5 Mar. 2015, http://www.gacetaoficial.gov.py/gaceta.php?action=show&id=2549&num=180. 29. World Bank, http://data.worldbank.org/indicator/SE.XPD.TOTL.GB.ZS. 30. Transparency International, Global Corruption Barometer, https://www.transparency.org/gcb2013/country/?country=paraguay. CASE STUDIES 33 Figure 3.3: Historical trend in corruption in Paraguay, 2009–16 Figure 3.4: Corruption Perception Index 2016: Paraguay in com- (CPI ranking) parative perspective 120 80 125 123 70 130 130 60 135 50 Percent 140 40 Ranking 145 146 30 150 150 150 150 20 155 154 154 10 160 0 2009 2010 2011 2012 2013 2014 2015 2016 Paraguay LAC average OECD average Source: Transparency International, Corruption Perception Index (CPI), 2016. Note: LAC = Latin America and the Caribbean; OECD = Organisation for Economic Co-operation and Development. SPOTLIGHT 2: Current challenges in the education system in Paraguay Paraguay has made progress in expanding public school enrollment. As of 2015, it had achieved universal coverage (98 percent) in primary schools. But enrollment rates are lower in the third cycle of basic education (grades 7–9). The real bottleneck in the education system, however, is secondary schools (grades 10–12), where enrollment rates were 73.8 percent in 2015. In addition, enrollment is low and dropout rates high among disadvantaged groups in rural areas, especially in secondary schools (64.5 percent net enrollment), affecting the equity of the education system. The system is also producing poor overall student learning outcomes, as evident in the results of the latest standardized national test that are available publicly. According to the Sistema Nacional de Evaluación del Proceso Educativo (SNEPE), only one in four students in the third grade have the required levels of math and communication skills, and the performance in communication is lower among students attending rural schools (De Hoyos 2013). Similarly, according to results from the Tercer Estudio Regional Comparativo y Explicativo (TERCE), Paraguay has one of the worst-performing education systems in the region, ahead of only the Dominican Republic. Moreover, student performance shows significant variations across learning areas. This is an additional challenge for the education system because it requires not only improving the average learning outcome but also achieving a more homoge- neous performance across different learning areas (UNESCO 2015). The key challenges facing the Paraguayan education system in providing high-quality education for all of its children are public schools that lack of basic infrastructure and employ poor-quality teachers. This situation is reinforced by low levels of public spending on the education sector overall and on infra- structure investments specifically (Wodon 2016). Infrastructure. All basic education institutions are required to fulfill the minimum physical infrastructure and equipment standards defined by Decree 6589. Despite the legal mandate, most schools in Paraguay fall short of this requirement: only 11 percent of urban schools and virtually no rural schools are considered to be in “good” condition (that is, have basic infrastructure) and almost two in three schools in rural areas are in “poor” condition, lacking basics facilities such as bathrooms, drinkable water, and electricity. Poor-quality teachers. Although Paraguay has made important progress in improving the quality of the teacher recruitment process, many challenges remain: (1) the pedagogical institutes (Institutos de Formación Docente) are poorly regulated and do not ensure a minimum quality for all of their graduates; (2) almost 40 percent of the in-service teachers are not certified or have qualifications that do not correspond to their teaching duties; (3) formal schemes for continual education and skill upgrades are lacking; and (4) remuneration is not based on years of experience. Government expenditure on education. As of 2015, the government expenditure on educational institutions in Paraguay as a share of GDP remained below the regional average of 5 percent—and it only increased from 3.2 percent in 2003 to 4.4 percent in 2015. However, the proportion of the total education budget allocated to capital investments remained low, at about 6 percent over the 2003–15 period, accounting for the poor conditions of the school infrastructure. Sources: Based on De Hoyos (2013). Data on enrollment: Inter-American Development Bank; CIMA (Centro de Información para la Mejora de los Aprendizajes) Education Statistics Portal, http:// www.iadb.org/en/databases/cima/home,20590.html; data on expenditure: World Bank, Education Statistics, http://databank.worldbank.org/data/reports.aspx?source=Education%20Statistics&pre- view=off; International Monetary Fund, World Economic Outlook Database: April 2017 Edition, http://www.imf.org/external/pubs/ft/weo/2017/01/weodata/index.aspx; Treasury of Paraguay, Base de datos BOOST, http://isdatabank.info/boost_paraguay/. 34 CITIZENS AS DRIVERS OF CHANGE Figure 3.5: Corruption, education outcomes, and clientelism in Paraguay a. Public sector corruption b. TERCE scores in Latin America 1 560 CHL CRI .8 540 URY MEX COL BRA .6 520 TERCE score Index value ARG PER .4 500 GTM ECU PAN .2 480 NIC HND PRY 0 460 DOM 6 8 10 12 8 9 10 11 Log GDP per capita Log GDP per capita Paraguay Paraguay c. Educational equality d. Clientelism 4 4 3 3 Index value Index value 2 2 1 0 1 6 8 10 12 6 8 10 12 Log GDP per capita Log GDP per capita Paraguay Paraguay Sources: Public sector corruption and educational equality: V-Dem (Varieties of Democracy) Version 5.2; TERCE scores: UNESCO 2014; clientelism: Democratic Accountability and Linkages Project (DALP), https://sites.duke.edu/democracylinkage/data/; GDP per capita: World Bank, World Development Indicators (database). Note: Data are for 2014, except in panel d (clientelism), which are for 2011. misuse of education funds and the poor quality of education. tural Organization (UNESCO)—see panel b, figure 3.5. Ex- This protest led to the resignation of the rector of the National pert surveys indicate that Paraguay has the fifth lowest level of University of Asunción and his arrest on corruption charges educational equality in the world, ahead of only South Sudan, (Economist 2015). In 2016 the minister of education resigned Somalia, Pakistan, and Timor-Leste (panel c, figure 3.5). after student protests erupted when a wall collapsed in a sec- ondary school. In reaction to the 2016 protests, the govern- A driving cause of educational inequality in Paraguay is clien- ment granted the student groups an advisory position on telism, a manifestation of power asymmetries in which short- FONACIDE and agreed to form a roundtable to meet month- term material benefits are exchanged for electoral behavior. ly with the government (Economist 2016). The Ministry of Of 88 countries included in the Democratic Accountability Education also created a web portal to receive complaints and Linkages Project (DALP), Paraguay ranks 84th in terms about irregular payments.31 of expert perceptions of clientelistic practices (panel d, figure The quality of education remains a concern. Test scores in 3.5). Clientelism prevents the emergence of programmatic Paraguay are well below those of other Latin American coun- policies that are likely to have broad-based positive effects on tries (except the Dominican Republic), according to the Third medium- and long-term education outcomes. The poor, with Regional Comparative and Explanatory Study (TERCE) higher discount rates for the present, are the most susceptible scores of the United Nations Educational, Scientific and Cul- to such practices, helping to explain the cross-country rela- 31. https://www.mec.gov.py/cms_v4/cobrocero. CASE STUDIES 35 Box 3.3: The National Public Investment and Development Fund (FONACIDE) The following description of FONACIDE is taken from the Inter-American Development Bank’s Country Program Evaluation: Paraguay 2009–2013 (Office of Evaluation and Oversight, IDB 2014, 5): In May 2011, the Brazilian Congress approved the agreement under which the price of power transfers from Paraguay to Brazil was renegotiated, thereby increasing Paraguay’s revenue from US$120 million to US$360 million (1.6% of GDP in 2011). . . . Given the magnitude of those additional resources, a debate ensued regarding their use, which included civil society (education NGO “Juntos por la Educacion”), which advocated using the resources to finance investments in the sector. In September 2012, the second bill was passed: Law 4758 creating the National Public Investment and Development Fund (FONACIDE). Under this law, 30% of the funds would be earmarked for a National Fund for Excellence in Education and Research (FNEEI), 28% for infrastruc- ture, 25% for departmental and municipal governments, 10% for health, and 7% to finance the Development Finance Agency (AFD). The law also provided that, under the FNEEI, a series of minimums and maximums would be distributed among various investment categories (information and communication technology, education supply, scholarships. . . . Under the FONACIDE law (Articles 14 and 15), the Fund will be administered financially by the AFD and will be governed by a board of directors chaired by the Minister of Finance and made up of the Minister of Education and Culture, the Minister of Public Health and Social Welfare, the Technical Secretary for Planning, and the President of the National Science and Technology Council (CONACYT). In addition, four education experts appointed by the President of the Republic would participate in the leadership of the board, though with no voting rights. The main function of the board is to decide on the proposed investment projects, ensuring the proper use of FONACIDE’s resources (Article 16). tionship between high levels of clientelism and educational testability, enabling greater citizen entry into the policy arena. inequality (correlation coefficient equals 0.66). The potential to improve education services received a posi- Despite these challenges, in recent years Paraguay has taken tive shock in 2012 with the establishment of FONACIDE to important steps toward battling corruption and addressing finance local education. The Paraguayan economy relies pri- power asymmetries through new laws on transparency and marily on agriculture and natural resource exploitation, most accountability. Perhaps most important, as a member of the notably through hydropower dams such as the Itaipu dam at Open Government Partnership since 2011, Paraguay has the border with Brazil. In 2012 Brazil agreed to pay Paraguay committed itself to improving transparency and increasing a higher price for the excess electricity it bought from Para- citizen participation and oversight. Along with its 2030 Na- guay’s share of the dam. Later that year, after a campaign to tional Development Plan, the government aims to increase rally public support to direct this new revenue stream into a the efficiency and transparency of public management. The fund for education, Law 4758/2012 was passed, establishing current OGP action plan explicitly links this goal to the need FONACIDE (box 3.3). Thus each year approximately $360 to guarantee the rights of citizens without discrimination.32 million is added to the fund from the revenue produced by the dam. Because the government’s goal is to reduce pover- Paraguay’s participation in the OGP has helped to shift the ty and improve services, especially for the disadvantaged as governance landscape and address the power asymmetries laid out in the 2030 National Development Plan, 25 percent that undermine transparency and accountability.33 In partic- of FONACIDE is distributed to local governments for invest- ular, the 2014 Access to Information law and the creation of ments related to education, and, of that amount, 50 percent open data portals at the Ministry of Education and the Na- is intended for infrastructure, particularly for marginalized tional Directorate of Public Procurement—commitments schools.34 filled under Paraguay’s OGP 2014–16 action plan—have moderately improved access to information. Although a right The existing power asymmetries, however, have worked to information is guaranteed in Paraguay’s constitution, no against proper implementation of the law, although the extent law regulated it before September 2014, and so public author- of the challenges was not clear prior to the citizen engage- ities could block or delay access to information. The OGP ment initiative described here. Municipal elites were captur- provides opportunities for a citizen-state interface, as well as ing policies and funding to serve their narrow interests. In citizen engagement, influence, and pressure vis-à-vis elites. Ciudad del Este, municipal officials did not follow the prior- The inclusion of citizen groups in deliberations with the gov- itization lists of public schools (elementary and secondary) ernment, along with access to elites, has opened new avenues with urgent infrastructure needs—lists that municipal repre- of communication. In essence, the OGP has increased con- sentatives helped to create. In 2015, an election year for mu- 32. Center for Systemic Peace, Policy IV project, http://www.systemicpeace.org/polity/par2.htm, p. 4. 33. See the OGP’s Independent Reporting Mechanism in its “Paraguay Progress Report 2014–2015” (Open Government Partnership 2016) 34. Law 4758/2012, Article 4, http://www.hacienda.gov.py/fonacide/. 36 CITIZENS AS DRIVERS OF CHANGE nicipalities, FONACIDE school infrastructure projects were achieve its potential. earmarked for areas more centrally located as opposed to the shanty towns on the periphery—centrally located, high- Collective action to enhance contestability ly visible school improvements were more likely to let voters see “progress,” thereby serving political purposes (reAcción ReAcción, a youth group based in Ciudad del Este, has cat- 2015). alyzed collective action through citizen engagement initia- tives that help youth enter the policy arena, where they can Overall, insufficient transparency and negligible awareness directly enhance contestability in funding for education.39 Its among beneficiaries (students, parents, teachers, and prin- initiatives highlight FONACIDE’s weaknesses, poor admin- cipals) undermined proper implementation of the law. As istration, and proclivities for corruption, providing policy emphasized in World Development Report 2017: Governance recommendations to address these problems and abuses. The and the Law (WDR 2017), laws on paper are not always en- organization’s objectives relate to FONACIDE’s transparency, forced or followed (World Bank 2017b). Law 4758/2012 es- access to information, and administration, with the goal of tablishing FONACIDE included measures for public deliber- ensuring policy compliance and implementation by the rel- ation, which can enhance contestability. According to Decree evant institutions and respective elites for the provision of 10504/2013, which regulates Law 4758/2012, beneficiaries quality education, particularly for students in schools deemed (principals, parents, and students) were supposed to identify the most in need. their school infrastructure needs and articulate them to the higher authorities, who in turn would incorporate their in- ReAcción Paraguay was launched in 2010, prior to FONAC- put.35 However, this interactive process was not always being IDE’s creation, as an informal anticorruption group com- followed, and beneficiaries were not necessarily aware of this posed of young people (mostly friends) in Ciudad del Este, opportunity or even of their entitlements under the FONAC- the country’s economic hub and second-largest city. David IDE law. In April 2016, the law was modified to incorporate Riveros García, a student council leader who had just grad- sanctions and, through an online portal, require transparency uated from high school, founded the organization, whose in the use of FONACIDE.36 overarching vision was a “transparent Paraguay.”40 Its mission has been to empower citizens to prevent corruption and im- The creation of FONACIDE was a turning point; its weak im- prove the provision of public services. Initially, the fledgling plementation reflected Paraguay’s broader governance chal- group sought to build anticorruption awareness in local high lenges, but the law itself provided possibilities for develop- schools through student councils and parent groups. Howev- ment and served as a focal point to demand better services. er, these efforts lacked a clear purpose, and reAcción found However, civil society organizations and national media soon it difficult to sustain students’ interest or to involve parents. pointed out FONACIDE’s weak transparency and monitoring mechanisms, which had created a situation ripe for corrup- The creation of FONACIDE and the subsequent national tion. This situation was also acknowledged in the OGP review discontent with its operation served as a focal point for citi- and national action plan process.37 Instances of corruption zen engagement that reAcción’s leaders were able to harness. soon began to surface in news reports, leading to broad dis- Meanwhile, Riveros García believed the government did not content. A May 2014 public opinion poll by Paraguay Debate, have much experience administering massive sums of money, a coalition of Asunción NGOs, found that 64 percent of re- particularly at the local level—25 percent of the funds were to spondents favored a centralized administration of FONAC- be distributed to the country’s 17 departments (departamen- IDE in contrast to its actual implementation.38 Meanwhile, an tos) and 250 local municipalities. FONACIDE thus tapped entrepreneurial group of young people began to seek ways to multiple concerns: transparency in new investments in the harness this discontent and make FONACIDE work better to education sector; allocations to schools based on need rather 35. Article 37 of Decree 10504/2013 sets the rules and complementary norms to execute projects using FONACIDE. It establishes a Ministry of Education mechanism for identifying and prioritizing infrastructure and development projects in schools, and it requires beneficiaries (principals, parents, and students) to work together to identify their school infrastructure needs. http://www.csj.gov.py/cache/lederes/G-15-22012013-D-10504-1.pdf. 36. Law 5581/2016 modified two articles of Law 4758/2012, which initially established FONACIDE. http://www.csj.gov.py/cache/lederes/G-66- 08042016-D-5581-1.pdf; “Cartes promulga ley para mayor control de Fonacide,” Paraguay.com, April 7, 2016, http://www.paraguay.com/nacionales/cartes- promulga-ley-para-mayor-control-de-fonacide-142635. 37. See, for example, Open Government Partnership (2016). 38. Paraguay Debate poll, May 2014, http://paraguaydebate.org.py/wp-content/uploads/2014/05/Resultados-de-consulta-sobre-Fonacide.pdf. 39. Supplemental information, clarifications, and data were gathered through Skype, in-person interviews, and e-mail communications between June 2016 and April 2017 with David Riveros García, founder and president of reAcción. 40. While he was president of the student council in his high school, Riveros García led an investigation into the use of school resources by its board of direc- tors. He and a team of students presented their evidence to the Ministry of Education, which ignored it, along with a petition to audit the school. The students then launched a three-week protest, including a classroom strike and a march to the center of Ciudad del Este. The Ministry of Education then agreed to the audit, which took four years to complete. Riveros García reports that this experience drove him to create reAcción Paraguay. CASE STUDIES 37 than political connections or pressures; and equal access to ed collective responsibility by emphasizing how students were quality infrastructure. In late 2012, FONACIDE made its first the direct beneficiaries of FONACIDE and revealing how cor- disbursement, and Ciudad del Este was slated to receive one ruption and misuse of the fund were affecting them and their of the largest transfers of funds. By June 2013, reAcción had schools. “Once they [students] learned about their right to begun to investigate what the Ciudad del Este Junta Munic- organize, associate and demand information, and once they ipal (municipal legislative body) was doing with the money knew about the amount of money schools should receive or it had received.41 In March 2014, it launched a new project, how that money was being misused at their own schools, this ParaguaYOite, with the help of a €3000 Transparency Inter- built a sense of collective responsibility and indignation,” ex- national Social Entrepreneurs micro-grant. In choosing the plains Riveros García. As a result, students became empow- name ParaguaYOite, a combination of Spanish and Guara- ered through understanding their rights, FONACIDE was no ni meaning truly Paraguayan, it sought to associate nation- longer a distant and irrelevant policy instrument, and corrup- al identity with citizen participation, honesty, integrity, and tion and mismanagement were no longer abstract problems transparency. irrelevant to their lives. ReAcción’s mapping and monitoring of FONACIDE, work- ReAcción also ensured that students would have a role in ing with open data from official sources and data collected planning and decision making (collective ownership) and during visits to targeted elementary and secondary schools, share common values and objectives (collective identity). exposed mismanagement in the use of FONACIDE and “Unity is a necessary factor for any grassroots monitoring helped to demonstrate the ill effects of power asymmetries initiative to succeed,” asserts Riveros García. Workshops in this policy arena. Through its activities in Ciudad del Este, were highly participatory, and they began by listening to and reAcción discovered that the consultative process outlined in collecting volunteers’ views and ideas about their education Law 4758/2012 was not being followed, and that beneficiaries and the condition of their schools. ParaguaYOite was itself were not aware of this opportunity or even of their entitle- designed to foster unity and collective identity through the ments under the FONACIDE law. The youth group and its association of the name (“truly Paraguayan”) with the positive volunteers learned how FONACIDE actually works, beyond values espoused by reAcción (integrity, citizen participation, the “theory” of how it should work according to the law. As honesty, and transparency). The group’s logo was laden with for FONACIDE’s disbursements for elementary and second- familiar symbols associated with Paraguay, and it was embla- ary school infrastructure, schools in Ciudad del Este slated zoned on T-shirts that members and student volunteers wore for support on the basis of need did not always receive funds, to activities. and principals, parents, and students did not necessarily have a say in deciding on the infrastructure projects to improve According to Riveros García, another key to motivating par- their respective schools. ReAcción discovered that funds ticipation was convincing citizens that they could have an im- were being channeled to schools that were not at the top of pact. For this reason, reAcción initially targeted its recruiting the official Ministry of Education prioritization list, resulting efforts to the marginalized schools in which it was seeking to in the exclusion of marginalized communities, schools, and channel FONACIDE funds. For example, in ParaguaYOite’s students from the benefits of FONACIDE. first year, three out of the four schools were in poor commu- nities. Since 2015, the organization has also reached out to And yet, despite a degree of general discontent with corrup- other schools and has brought students from the different tion in public education and particularly with the operation schools together to foster solidarity. of FONACIDE and its ineffectiveness in allocating funds to the neediest schools, reAcción faced many collective action Educating beneficiaries (students, parents, schools, munici- challenges, including public disinterest in and skepticism palities) and raising awareness about FONACIDE and why about reAcción’s motivations (there were suspicions that it it matters to them have been critical. This effort has included was being manipulated by political interests). According to face-to-face interactions, presentations with specially devel- Riveros García, the fund’s process is so labyrinthine, and the oped informational materials, and social media. An example effort to understand it is so demanding, that it left people con- of the latter was the “Common Myths about FONACIDE” fused and frustrated. Citizens simply did not understand how Facebook campaign. Subsequently, educational activities FONACIDE disbursements could improve their children’s shifted to practical information about how the fund should education and lives or the effects of corruption in use of the work, how schools should get resources, how disbursement fund. and spending procedures should be carried out, and what the responsibilities of local officials were. ReAcción has convened In its efforts to overcome these challenges, ReAcción cultivat- several “leveling up” workshops for team members, so they 41. Ministry of Housing, http://www.hacienda.gov.py/web-udm/index.php?c=373. 38 CITIZENS AS DRIVERS OF CHANGE Figure 3.6: Examples of data visualizations of FONACIDE funding allocations INSTITUCIONES EDUCATIVAS del Municipio de CDE que recibieron reiteradas intervenciones en los años 2014 2015y 2016 INSTITUCIONES TIPO DE OBRA PRIORIDAD MEC C. N. CIUDAD NUEVA 23 02 E. B. Nº 1530 GENERAL A. GARAY 35 27 2015 2014 E. B. N° 2978 SANTA ANA 28 20 E. B. N° 2987 JUAN PABLO II 77 61 E. B. N° 5416 SAN ROQUE GONZALEZ DE S. CRUZ 55 71 E. B. N° 5449 VIRGEN MEDALLA MILAGROSA 57 28 E. B. N° 7141 VIRGEN DEL CARMEN 46 44 E. B. Nº 1524 JUANA MARÍA DE LARA 22 15 E. B. Nº 2970 VIRGEN DE FATIMA 30 06 2016 E. B. Nº 2977 8 DE DICIEMBRE 31 37 E. B. Nº 5432 SANTA CATALINA 26 49 E. B. Nº 5436 SAN FRANCISCO 32 20 E. B. Nº 5442 SAN BLAS 23 11 E. B. Nº 7081 VILLARRICA DEL ESPIRITU SANTO 32 45 REFERENCIAS NOMENCLATURA Aulas Sanitarios Colegio E.B. Escuela C.N. Nacional Básica Municipios con mayores montos transferidos en concepto de FONACIDE a nivel nacional desde el 2012 al 2016 Asunción Capiatá Ciudad del Este 45.550 Ciudad del Este Encarnación 24.987 Encarnación Asunción Capiatá 44.633 22.711 Fdo de la Mora Fdo de la Mora 17.825 San Lorenzo Hernandarias Hernandarias 16.732 25.899 Luque 29.719 Source: ReAcción. Luque Note: The first graphic reads: “Municipalities with highest transferred amount in terms of FONACIDE funds at the national level from 2012 San Lorenzo to October 2016. Shown in millions of guaranies. The size shows the total sum of transfers from 2012 to October 2016.” The second graphic reads: “Schools in Ciudad del Este that have received more than one Montos en millones de guaraníes. infrastructure project through FONACIDE funds between 2014 and 2016.” El tamaño muestra la suma total transferida desde el 2012 al 2016. The symbols indicate the type of project (classrooms or bathrooms) and the right-most column shows its position on the Ministry of Education’s Fuente: reAcción Paraguay (2016). Informe MEF 2016: Municipios con mayores montos prioritization list. This graphic demonstrates mismanagement by showing transferidos en concepto de FONACIDE a nivel nacional hasta octubre de 2016. that low-priority schools received funding from FONACIDE for infrastruc- ture projects more than once. CASE STUDIES 39 can in turn lead and train teams of volunteers, interact with gradually become more formally organized and has expand- the media, and plan public events. Figure 3.6 shows two ex- ed its membership and its goals, thanks in part to funding amples of the data visualization graphics used by reAcción to from international sources. Indeed, international mini-grants present its findings on the allocation of FONACIDE funds. have served as a lifeline.42 ReAcción reached a milestone in 2015 when together with the Center for Information and Re- ReAcción’s targets for volunteers at the grassroots level are sources for Development CIRD), an NGO based in the cap- FONACIDE’s potential beneficiaries—students and their par- ital, Asunción, it submitted a grant proposal to the National ents (who can potentially pressure school authorities), prin- Endowment for Democracy. They were jointly awarded the cipals and teachers who are not familiar with FONACIDE, as grant, sharing $22,000, which enabled the “weekend NGO” well as university students. Secondary and university students to proactively take steps toward sustainability. Riveros García are an essential source of support, team member and volun- then reorganized the core team, contending that to increase teer recruitment, legitimacy, and social pressure. its impact and influence policy making the group had to tran- scend a “club culture” and develop a more rigorous ethos of To recruit members and volunteers, reAcción has found over commitment, discipline, and collective identity that would the years that direct contact is essential. In the early days, encompass beneficiaries in general, not just those in their im- committed volunteers and student monitors were engaged mediate circles. ReAcción set up a small office with Internet through reAcción’s initial efforts to establish student clubs service and furnished it through donations from citizens, and in four high schools. As reAcción began to garner attention it hired two full-time paid staff. As part of its expansion, reAc- through media coverage and social networks, young peo- ción also created the Alliance for Open Government (AIGA), ple started contacting it. Later, it proactively put out calls a complementary initiative composed mainly of universi- for youth monitors through press releases and social media. ty students, including some of ParaguaYOite’s former high With the new recruits on board, it began holding FONACIDE school volunteers (Riveros García 2015). AIGA’s role is to events at high schools and the National University of the East, organize and develop workshops on FONACIDE for various through which it enlisted more volunteers. stakeholder groups, focusing on social technology solutions Without its base of youth members and volunteers, reAc- for the fund. AIGA also works directly with high school stu- ción could not exist. Yet managing them—their expectations, dents to transform the information they gather from moni- sustained interest and commitment, discipline, skills devel- toring into an open data format and data visualizations. opment, and even differing objectives—requires an ongoing In 2016 reAcción legally registered as an NGO. Given the re- effort. ReAcción acknowledged early on that a two-way re- alities of donor funding requirements for civil society orga- lationship is needed to build commitment to the organiza- nizations, it realized it could not apply for most grants with- tion—in other words, participants must derive benefits from out a legal identity. Its founder, Riveros García, continues to their participation. Thus ReAcción has ensured that volun- see it as a hybrid of an NGO and a grassroots anticorruption teers receive both intangible and more concrete benefits for movement that maintains a strong citizen engagement com- participation. Intangible benefits include an overall sense ponent: “We are a mix. This gives us a way of pressuring the of collective responsibility to a meaningful cause, collective government when we need to, combined with content, rec- ownership of ParaguaYOite, and collective identity as “true Paraguayans.” More concrete, tangible benefits include the ommendations, and constructive criticism arising from the acquisition of useful experiences and skills such as engaging grass-roots.” state elites and learning data visualization techniques and By overcoming collective action challenges, reAcción is now computer programming. able to directly challenge the exclusion of marginalized com- Through these efforts, reAcción has successfully recruited a munities, schools, and students from the FONACIDE allo- loyal, dedicated, and expanding group of members and vol- cation process. It has enhanced contestability by providing a unteers. During its first five years of existence, reAcción was platform for these marginalized actors to engage in the FON- completely volunteer-based. By 2014, the core consisted of ACIDE policy arena, where it is patiently pressuring elites to three (unpaid) staff, 10 regular members, and an indispens- reform the fund, increasing transparency and accountability, able cadre of students from four high schools in Ciudad del and improving its implementation in order to prevent cor- Este. In 2017 reAcción organized its first camp for 10 young ruption and benefit needy schools and students. As Riveros student leaders on the impact of corruption on education García notes, “For years the municipality ignored and under- (Vanguardia 2017). estimated us. . . . We have grown and reached a point where we are confident we can start rallying people and exercising Relying on its core group of engaged volunteers, reAcción has people power against the corrupt in the municipality.” 42. In 2013 reAcción received a $5,000 mini-grant from the Global Changemakers initiative (originally incubated by the British Council in partnership with the World Bank Institute) to empower youth-driven social change. In 2014 it received an €3,000 Transparency International Social Entrepreneurs Initiative mini-grant. And in 2016, Sumá Fraternidad, based in Argentina, awarded it a $2,500 mini-grant (Ferreira 2013). 40 CITIZENS AS DRIVERS OF CHANGE Initiatives to change elites’ incentives and about these procedures and are not communicating their needs to the Ministry of Education. preferences To achieve these goals, reAcción engages with a wide range Having entered the policy arena through citizen collective ac- of government actors, particularly at the municipal level and tion, reAcción seeks to influence policy behavior by changing in the Ministry of Education (box 3.4). It seeks to increase the behavior of government actors. The organization has ar- FONACIDE transparency, improve administration of the ticulated the following demands based on an internal partic- fund, empower needy schools to access disbursements, and ipatory process to highlight potentially effective entry points: make policy recommendations to improve transparency and increase citizen engagement on the part of beneficiary groups ƒƒ Transparency in the allocation of funds and timeliness in (students, parents, teachers, and principals). For example, it publication of these data by the Ministry of Education. The has engaged with the National Directorate of Public Procure- Ministry of Education portal is not regularly updated, so ment to improve the transparency of FONACIDE’s open data by the time reAcción can access information, the con- portal so that citizens are able to find contracts financed by tracts have already been signed by the Ciudad del Este the fund. municipality. As a result, it cannot prevent mismanage- ment and corruption; it can only expose it. Such engagement has been difficult, with considerable push- ƒƒ Municipal disbursements of resources to the schools at the back from the elites reAcción seeks to engage. At times, re- top of the Ministry of Education’s four priority lists for the Acción has experienced hostility and censorship from some city. These lists correspond to four intervention catego- school principals, teachers, and municipal officials, who are ries: classrooms, toilets, furniture, and other school spac- presumably uncomfortable or threatened by its investigations es. ReAcción discovered that, in practice, the municipal- into school prioritization and selection, FONACIDE alloca- ity does not respect these lists. tions, spending, and end results. For example, in December 2016 the Facebook pages of reAcción and ParaguaYOite were ƒƒ Provision of prioritization lists sent to the municipality by blocked simultaneously a few days after the group published the Ministry of Education. In the absence of such lists, its annual report online. The report described irregularities since 2015 reAcción’s team has been collecting data from and mismanagement in the use of FONACIDE resources by the Ministry of the Treasury, the National Directorate of the municipality of Ciudad del Este (ABC Color 2017). Public Procurement, and the Ministry of Education to determine which schools are prioritized at the top of the ReAcción has employed several strategies and tools that seek lists in order to monitor them. to influence policy by increasing public pressure on elites, al- ƒƒ Informing principals of FONACIDE’s requirement to in- tering the incentives they face. These strategies include coali- volve parents and students in identifying the needs of their tion building with other nonstate actors and exploiting divi- respective schools. The Ministry of Education’s FON- sions among government elites, and the tools used are aimed ACIDE manual states that after consultation principals at shaping opinions or employ legal measures. All these efforts should submit their request, and then the ministry to- are based on reAcción’s ability to gather and disseminate in- gether with the local municipality will prioritize schools formation. ReAcción collaborates strategically with these co- on the basis of need. In reality, not all principals know alition partners to influence policy by changing the incentives Box 3.4: Targets of government engagement, reAcción The FONACIDE policy arena consists of elites from the following institutions and other actors: ƒƒ Ministry of Education (director of planning, local supervision offices, school principals, open data portal). Interaction at all levels, from the minister of education downward, was deemed necessary because of the fund’s decentralized structure. The director of planning coordinates the entire process by which schools identify infrastructure needs and works with municipalities and submunicipal bodies to create priority lists of schools based on need. ƒƒ Ministry of the Treasury. A central player in FONACIDE, it is in charge of distributing the fund’s resources to municipalities and checking their spend- ing reports. ƒƒ Office of the Comptroller General. This body is responsible for monitoring the execution of FONACIDE, and, under the law, municipalities are sup- posed to submit documented biannual reports of their spending. ƒƒ Technical Planning Secretariat. This body is in charge of leading the Open Government Partnership initiative in Paraguay. ƒƒ Local municipal government (mayor of the municipality of Ciudad del Este, director of infrastructure and urban development, Junta Municipal). Local governments are responsible for carrying out public procurement and construction for FONACIDE. They fund education infrastructure projects and are supposed to ensure that work is conducted according to contract specifications. ƒƒ Nonstate actors (from civil society, the media, higher education, and the legal community, as well as international actors related to the Open Govern- ment Partnership). CASE STUDIES 41 Box 3.5: ReAcción recommendations incorporated into OGP Independent Review Mechanism 2016 Mid-Term Report ƒƒ Increase access to information, for example, improving the quality, reliability, and usability of government online tools and portals (for example, Public Procurement Online portal), and publishing the official criteria used by the Ministry of Education and local municipalities to prioritize which schools should receive FONACIDE resources in order to prevent corruption ƒƒ Enhance control over discretional spending at the local level by way of improving communication between the Ministry of Education and the schools so that there is increased knowledge of how the fund works ƒƒ Publicize comprehensive information about FONACIDE widely, including how it works, key actors at the local level (given its decentralized process), and online tools and portals for citizens to use to access information ƒƒ Allocate a small percentage of FONACIDE for distribution to each municipality to enable public deliberation opportunities for beneficiaries and communities regarding fund administration and allocations, as well as to train citizens in social accountability methods so they can contribute to its administration. Source: Open Government Partnership (2016, 15, 73, 76–77). of elite actors through the publication and dissemination of Because of the overlap, the top five on the four lists is usually information using print and social media, and it is beginning 12–14 schools. Thus the selection is based on the priority list to experiment with changing elites’ incentives through direct ranking, not on whether they are elementary or secondary legal strategies. schools. The young people then engage with principals and teachers in the targeted schools. They geolocate them on a In the longer term, reAcción seeks to train the public in how custom Google Map and organize visits with permission to shift the preferences and beliefs of elite actors toward pri- from the principals. On the ground, ParaguaYOite team co- oritizing investments in education in marginalized commu- ordinators (themselves students) and volunteers (also stu- nities. ReAcción has developed a variety of training sessions dents) visit and survey the schools. Among other things, they and workshops for reAcción team members, ParaguaYOite interview principals and students using prepared question- and AIGA volunteers, high schools, municipalities, univer- naires, record videos, and take photos of the schools and re- sities, and journalists. For example, in 2014 the youth orga- spective FONACIDE projects. Before leaving, they inform the nized a public panel at the National University of the East principals about the FONACIDE tools and sources of infor- entitled “Monitoring FONACIDE.” It was the first forum that mation available. Finally, the AIGA team (university student brought together the most relevant stakeholders from the lo- volunteers) digitalize the data gathered through the question- cal government, Ministry of Education, Office of the Comp- naire, analyze and match the data with open data from official troller General, parents, and students. sources, and create data visualizations that are more intuitive Information gathering is the cornerstone of reAcción. The for citizens to understand. group was the first in the country to map the entire FON- In 2015, among the schools visited not one principal knew ACIDE process, and it then developed a systematic moni- that his or her school was entitled to receive resources from toring process to document how funds were actually being FONACIDE. Among those institutions actually receiving administered in Ciudad del Este, down to contracts and con- FONACIDE improvement projects, not one principal had struction in individual schools. Four prioritization lists—for access to the contract and therefore had no way to check the classrooms, washrooms, furniture, and other spaces—are qualifications of the contracting company, specifications, established annually by the Ministry of Education for each budget, timeline, and so forth.43 In April 2017, reAcción municipality, in principle with input from schools as well as asked principals from some of the prioritized schools in Ciu- municipalities. All the public schools (elementary and sec- dad del Este to write letters to the Junta Municipal demand- ondary) are ranked in terms of need. Thus schools can have different rankings among the prioritization lists. For example, ing FONACIDE resources for their schools. The organization a school may rank first for classrooms, 10th for washrooms, presented 12 letters to the municipal body during a weekly 40th for furniture, and not be on the prioritization list at all public session and asked that it not approve the mayor’s pro- for improvements in other spaces. curement process because it would not benefit the prioritized schools with urgent needs. The youth group considers this an In 2015 reAcción focused on the top 15 schools on the pri- opportunity to exert pressure on political elites as primaries oritization list for classrooms. Since 2016, it has been moni- are being held for political parties leading up to the 2018 pres- toring the top five schools on each of the prioritization lists. idential elections.44 43. Recording of interview with principal of the Amado Benítez Gamarra School, https://soundcloud.com/reaccionpy/visita-escuela-amado-benitez-gamar- ra-cde. 44. ReAcción gave the Junta Municipal the Ministry of Education’s official prioritization list, a letter with legal arguments supporting its claim of irregulari- 42 CITIZENS AS DRIVERS OF CHANGE tional media and social media. Engagement with the media Box 3.6: Exposing FONACIDE corruption in Ciudad has had several strategic objectives: disseminate knowledge del Este about how FONACIDE works; increase exposure for Para- guaYOite’s and reAcción’s overall activities; and indirectly place pressure on government elites about transparency, cor- In August 2016, reAcción discovered that the municipality of Ciudad del Este was not following the Ministry of Education’s prioritization lists. ruption, and mismanagement. Over time, reports Riveros Vanguardia picked up the story from reAcción’s blog post and published García, journalists have begun to take reAcción’s findings se- it on its front page. The municipality’s press secretary called Vanguardia riously. In 2016 Vanguardia, Ciudad del Este’s biggest news- and, in the course of the conversation, admitted that the municipality paper (print and online), contacted the group to cooperate in had created separate priority lists. Not only was this a serious irregular- exposing FONACIDE irregularities in Ciudad del Este. The ity, but the implication was that the Ministry of Education has not been youth also conducted a workshop for the newspaper’s jour- cross-checking its lists with those of the municipality. nalists and are teaching them how to use the government’s post-2015 open data portals and create data visualizations for “data journalism.” By engaging with journalists, reAcción has been able to scale up the results of its student monitoring through media cov- erage. It has a good relationship with Vanguardia, which not only taps reAcción’s data and visualizations for stories, but also has conducted its own investigations based on the find- ings. Box 3.6 highlights one outcome. In 2016 reAcción began using social media to communi- cate with elites. It tagged its Facebook and Twitter accounts with those of the Ministry of Education and Enrique Riera, the minister of education. Thus far Riera and reAcción have had two rounds of communication.45 In the first round, Riera vowed to review reAcción’s linked documents exposing cor- ruption, retweeted some of its tweets, and publicly promised to review its MEF report and accompanying policy recom- Beyond gathering information and engaging with local mendations to improve the administration of FONACIDE. schools, reAcción seeks to have a broader and more system- However, his cooperation came to a halt once the youth atic impact by strategic dissemination of the information it has group revealed that the Ministry of Education was not fol- gathered. Information alone (transparency) without public- lowing certain procedures to check on institutions receiving ity and accountability is unlikely to be effective at shifting FONACIDE disbursements.46 In February 2017, during a power asymmetries (Beyerle 2014; Fox 2007; Halloran 2015; second round, however, the minister asked reAcción to send Joshi 2014). In 2015 reAcción began publishing an annu- him more documents, including detailed project indicators al monitoring report (Monitoreo de Ejecución Física, MEF) of success and methodology. In addition, at the end of 2016 that it disseminates publicly and submits to the OGP. The the youth organization began publishing a series of articles MEF documents irregularities in the local administration of on a blogging platform to expose irregularities documented FONACIDE and provides policy recommendations for each through the student monitoring. public institution involved in FONACIDE’s administration (reAcción 2015, 2016). As a result, in 2015 the youth group Coalition building with other nonstate actors in the policy was invited to present its methodology and findings at the arena has been essential to the effectiveness of reAcción’s en- OGP National Seminar in the capital, and several of its rec- gagement with government. ReAcción has engaged with es- ommendations for improving FONACIDE administration tablished civil society organizations (CSOs), including tech- were incorporated into the OGP Independent Review Mech- nocratic NGOs based in Asunción, CSOs working on open anism 2016 Mid-Term Report (Open Government Partner- data, and members of the OGP civil society group. ReAcción ship 2016)—see box 3.5. has benefited from cooperation with a few organizations to enhance its skills in data visualization and mapping and to Two important tools for dissemination have been the tradi- ties, and an analysis of the irregular list of schools slated to receive resources from FONACIDE, some for the second or third time. 45. https://twitter.com/search?q=%40reaccionpy%20%40riera2013&src=typd. 46. The Ministry of Education is responsible for creating the prioritization list for schools to receive FONACIDE disbursements for infrastructure projects. Apparently, it does not consistently cross-check its lists with the those sent to it by the municipalities, which leaves room for corruption because local govern- ments do not necessarily put the neediest schools on the list. CASE STUDIES 43 partner on a U.S. Agency for International Development (US- the mayor of Ciudad del Este ignored a questionnaire from AID) grant. In late 2015, reAcción learned that FONACIDE reAcción during her reelection campaign, the group invoked transparency was among the government’s 2014–16 OGP Paraguay’s Access to Information law to compel her to pro- commitments, and it was accepted into Mesa Conjunta—the vide the answers and finally published a blog revealing that group composed of civil society organizations monitoring she defied the law by not responding to the legal request. the government’s OGP action plan commitments, along with representatives of public institutions responsible for fulfilling Through coalition building and the use of information and those commitments. Through this forum, supported by US- legal strategies, reAcción has effectively changed incentives AID’s Democracy and Governance program, reAcción pre- at the level of municipal government and in the Ministry of Education itself. Outreach efforts at the Ministry of Ed- sented its monitoring system and findings and contributed ucation led the ministry to officially declare ParaguaYOite input on FONACIDE education commitments to the 2016– a project of “academic interest” for high school students in 18 action plan. 2017. This declaration was symbolic and did not come with ReAcción has leveraged its growing membership by building any institutional or financial support, but it served as lever- coalitions with institutions of higher education. As some of age for reAcción in engaging with local stakeholders. More the initial team members graduated from high school and broadly, in March 2017 reAcción achieved a breakthrough went on to university and as the group expanded its pool of with the Ministry of Education. Celeste Mancuello, the direc- volunteers and needed alternative free spaces to meet, reAc- tor of the Directorate of General Planning, the key entity for ción began to make contacts with the National University of FONACIDE administration, invited Riveros García to meet the East located in its city. Since then, the relationship has with her to explore potential cooperation. She told the youth grown: students there have joined AIGA, and the administra- leader about the ministry’s plans to improve the open data tion invited the group to conduct FONACIDE workshops on portal and open data tool. Riveros García proposed signing campus. In 2015 reAcción signed a formal agreement of co- a cooperation agreement between reAcción and the minis- operation with the university that will enable the organization try to improve its monitoring of FONACIDE and collabora- to increase its engagement with students and faculty to pro- tion to create audiovisual animations for citizens explaining mote monitoring of FONACIDE. Also, it is now actively pur- FONACIDE’s administrative process in a simple, appealing suing cooperation agreements with academic departments at manner. The director promised to present these ideas to the Minister of Education. the National University of the East. At the municipal level, reAcción’s success at changing elites’ In 2016 reAcción added legal strategies to its extrainstitu- incentives has become increasingly difficult to ignore. With tional repertoire, engaging with lawyers in an attempt to di- the passing of the Access to Information law in September rectly tackle FONACIDE elite accountability in Ciudad del 2014 and the creation of open data portals at the Ministry of Este. The same year, reAcción began working with a local Education and the National Directorate of Public Procure- association of lawyers, who provided the legal advice needed ment—commitments filled under the country’s OGP action for the youth group to become a registered entity. As a result plan— reAcción found it somewhat easier to gather infor- of this relationship, reAcción plans to file legal complaints mation. and sue elites based on the evidence of corruption the civic engagement initiative has gathered over the years. The Office In 2017 Ciudad del Este’s Junta Municipal, the city’s legisla- of the General Comptroller accepted reAcción’s first official tive body, declared reAcción’s activities to be of interest for complaint about corruption in the municipality, and subse- the city’s development. After the 2015 municipal elections— quently it replied that the complaint would be considered for and for the first time in 10 years—the Junta Municipal had inclusion in the 2017 General Auditing Plan. In early 2017, a majority of local deputies (Concejales) who opposed the reAcción assembled a volunteer legal team composed of se- mayor. ReAcción made the most of this situation and exploit- nior-year law students from the National University of the ed the opposition and rivalry between the simple majority in East. It seeks to engage the university’s law school in promot- the Junta Municipal and the mayor of Ciudad del Este. There- ing access to information through strategic litigation.47 fore, of the 12 elected members of the Junta Municipal, nine voted in favor of the 2017 declaration about reAcción and its Have the tools and strategies just described changed minds activities, two abstained, and one was absent. and solved problems? The combination of legal strategies and information dissemination has begun to shift elites’ incen- Success at the municipal level is also on view in the demands tives to respond to reAcción’s pressure. For example, when from other municipalities to engage the group. In June 2016, 47. A formal cooperation agreement between reAcción and the National University of the East’s law school is now in place. Among other things, the agree- ment allows law students to undertake internships at reAcción and receive academic credit. 44 CITIZENS AS DRIVERS OF CHANGE Table 3.3: Application of human rights, reAcción Right Application of right Association Creating a grassroots youth group that evolved into a formally registered nongovernmental organization Assembly Conducting public meetings and workshops for citizens and municipalities, monitoring, hosting WhatsApp and Facebook groups, and increasing public awareness about how FONACIDE works and its entitlements Expression Publishing monitoring reports on FONACIDE, data visualization, blogging, Tweeting, and hosting Facebook and WhatsApp groups Information Requesting information about FONACIDE from state officials at the national and subnational levels, utilizing government data portals, and interviewing high school principals Participation in Providing government officials with monitoring results, policy recommendations, and accountability tools to improve FONACIDE governance administration and prevent corruption; raising awareness and educating government officials about FONACIDE at the national and subnational levels; and combining extrainstitutional collective action with institutional action, such as submitting formal, legal complaints about corruption uncovered by monitoring. the municipality of Presidente Franco invited the youth ReAcción has demonstrably increased the transparency of group to conduct monitoring workshops for all high schools FONACIDE through its mapping and visualizations of the ad- in its city. ministrative process, cross-data research and visualizations, and monitoring of selected schools. It has then strategically Conclusion used the results and tools to further two related objectives. The first is to educate state elites, civil society, the media, and Summary of outcomes beneficiaries about FONACIDE—its policies, administration, annual distribution process, weaknesses, irregularities— In early 2016, reAcción was featured on the World Bank’s through social media outreach, participation in the OGP Spanish website. An article on youth action against corrup- process, one-on-one interactions both in person and through tion states, “Seis años después, [reAcción] ha convertido en Twitter, and public events and workshops with students and una de las principales organizaciones promotoras de partic- state elites. The second is to improve administration of the ipación ciudadana, transparencia y buena gobernanza del fund in order to reduce corruption, enhance the provision of país” (Six years later, [reAcción] has become one of the main education to needy schools and marginalized students, and organizations promoting citizen participation, transparency ultimately increase social inclusion. and good governance of the country)—World Bank (2017a). In November 2016, reAcción was featured in the regional Meanwhile, reAcción has encountered numerous difficulties open data overview by the UN’s Economic Commission for as it has tried to broaden its impact and scale up its activities. Latin America and the Caribbean (Nasser and Rosales 2016). Adequate funding has been an ongoing problem. The youth Overall, in the four years since reAcción began to focus on group depends on volunteers, as well as a pool of meager FONACIDE, it has made progress in achieving its stated goals resources from the sale of T-shirts and stickers, from dona- of improving the fund’s transparency and administration tions, and from limited grants from external actors. The lack and fostering citizen empowerment and participation in the of regular finances has created uncertainty, hampered medi- process. In the short term, reAcción is empowering students um-term planning, and limited the scope of its activities. For and school authorities (the beneficiaries of FONACIDE al- example, Riveros García wanted to engage tiny municipal- locations and infrastructure projects) to track, monitor, and ities, schools, and students in rural areas, which are largely record corruption and mismanagement down the adminis- marginalized and among those most in need of FONACIDE trative pipeline to the Ciudad del Este municipality and in- disbursements, but lack of funds has made this engagement dividual target schools selected for monitoring. This tracking impossible. In June 2016, reAcción did, however, achieve a includes which schools received disbursements, which cate- breakthrough. A proposal submitted to the National Endow- gories were covered (classrooms, toilets, furniture, and other ment for Democracy that same year was selected, and in 2017 school spaces), their rankings on the Ministry of Education’s the group will receive $25,000 to further develop and expand priority list, amounts slated for beneficiary schools, compa- ParaguaYOite.48 Nevertheless, because of resource constraints nies contracted for school improvements, amounts received it has had to drop the development of two new tools that by these companies, and inspection of target school and could empower municipalities and schools to launch their FONACIDE-funded improvements. own monitoring initiatives and collect data. 48. National Endowment for Democracy, http://www.ned.org/region/latin-america-and-caribbean/paraguay-2016/. CASE STUDIES 45 With limited funding, the organization has stressed the im- Shifting incentives, reshaping preferences, and increasing portance of adaptability and continued learning for success. contestability For example, when funding to expand into other marginal- ized communities was not forthcoming, the organization ReAcción has altered power asymmetries in the policy are- decided to expand its reach and impact through tech tools na by activating the three levers for change described in the (including an app under development), workshops, YouTube World Development Report 2017 (World Bank 2017b): information videos, and FONACIDE monitoring guidelines Altering elites’ incentives. ReAcción is gradually affecting elites’ that would be of use to students and groups in other parts incentives in the policy arena by documenting and exposing of the country. When an early project to strengthen anticor- (through reports, workshops, elite engagement, social media, ruption education in student councils failed, reAcción used and media exposure) mismanagement, transparency, and the experience to build ties with high schools and expand the corruption related to the fund. After several years of citizen pool of youth leaders who would later become members of re- engagement that have yielded outcomes and affected pow- Acción and catalysts for the ParaguaYOite project. The youth er asymmetries in the FONACIDE policy arena, the young subsequently returned to these schools for awareness-raising, people are in a stronger position to change elites’ incentives volunteer recruitment, and monitoring. by increasing the costs (including legal sanctions) of certain actions (corruption and mismanagement) and increasing the Recognizing the importance of continued learning, reAcción costs of particular kinds of inaction (failure to improve ad- has engaged with external actors to gain knowledge and skills. ministration and the transparency, quality, and availability of Riveros García participated in Transparency International’s information).49 ReAcción is raising policy recommendations 2013 School on Integrity and the International Center on with elites, including the minister of education, and through Nonviolent Conflict’s 2016 Summer Institute at the Fletcher the OGP process. It has been building a coalition for change School at Tufts University in Boston. In 2015 USAID’s De- through relationships with some state and nonstate elite ac- mocracy and Governance program supported ParaguaYOite tors such as journalists, university administrators and profes- by funding two workshops and sending experts in open data sors, and lawyers. to train its team of university students. Reshaping preferences and beliefs. The youth organization is Rights begetting rights slowly trying to reshape preferences and beliefs about FON- ACIDE transparency, administration, and disbursements for Citizen engagement, as expressed through reAcción, involves school infrastructure projects and beneficiary entitlements. the active application of several fundamental human rights. As noted, in February 2017 it succeeded in convincing the As outlined in chapter 1 of this report, citizen engagement Ciudad del Este Junta Municipal to declare ParaguaYOite a derives from specific human rights—freedoms of associa- project “of interest” to the city. This bestows on the citizen tion, assembly, expression, and information and the right to engagement initiative a degree of official legitimacy and cred- participate in government. These rights most explicitly and ibility that it hopes will reduce the power of hostile local edu- formally relate to people’s opportunities to be knowledgeable cation officials, including principals and teachers. It is also at- about public problems, voice their concerns (even if contrary tempting to have a wider effect on beliefs by directly engaging to established power interests), and organize to tackle these students about FONACIDE entitlements through workshops, problems nonviolently. Table 3.3 illustrates some of the ways events, and social media, and, more broadly, by engaging the in which reAcción has exercised these rights. citizens of Ciudad del Este and Paraguay at large through me- dia coverage and social media efforts. Through this case study, it is possible to see how the realiza- tion of one right can also facilitate the advancement of other Enhancing contestability. The youth-led organization has in- rights. According to Riveros García, prior to passage of the creased contestability by overcoming collective action chal- 2015 Access to Information law, reAcción found it extreme- lenges to effectively bring young peoples’ voices, demands, ly difficult to get the information needed about FONAC- and policy recommendations regarding FONACIDE into the IDE to track the administration of funds and infrastructure policy arena for education and development. Over the last projects from the Ministry of Education down to individual three years, it has built coalitions for change by cooperatively high schools. After the law came into effect, the situation im- engaging with more and more elite actors, such as the media, proved. Thus realization of the right to information enhanced legal profession, and those in higher education. It has expand- the ability of the students to monitor FONACIDE and in- ed the boundaries of the policy arena over time by focusing crease its transparency, with the ultimate goal of improving elite, media, and public attention on FONACIDE’s problem- their rights to education and development. atic transparency and administration, disregard for the prior- 49. These entry points of change are not discussed here in absolute terms. Rather, they reflect an ongoing process to secure the benefits of FONACIDE for its rightful beneficiaries (prioritized schools and their students on the basis of need). 46 CITIZENS AS DRIVERS OF CHANGE ity lists, corruption, and lack of beneficiary knowledge about Figure 3.7: Serbia’s governance score rankings, 2000 and 2015 the process and entitlements. And it has done all this with a team whose average age is 21. 70 Serbia: Reducing corruption and 60 50 improving publicly funded public Percentile rank 40 health care services through citizen 30 agency 20 10 Serbia faces challenges in the equitable delivery of high-qual- 0 ity health services because of the country’s entrenched cor- Control of Government Political stability Regulatory Rule of law Voice and ruption and low levels of transparency. Although Serbia has corruption effectiveness quality accountability broadly improved its governance environment and political 2000 2015 stability over the last 20 years, pockets of corruption contin- ue to plague the delivery of public services, including health Source: World Bank, Worldwide Governance Indicators. care. Moreover, challenges persist in terms of public access Note: Scores are cross-country rankings for 2000 and 2015. Values correspond to global percentile to information about doctors and hospital’s performance. The rank. Zero is the lowest rank and 100 the highest rank. Serbia has seen improvement in all six governance categories covered by the World Bank’s Worldwide Governance Indicators. obfuscation of this information makes it more difficult for pa- tients to make optimal decisions about their care. and preferences to increase transparency and begin to reduce levels of corruption. Its five citizen engagement projects from The mission 2009 to 2015 began with a 1,000-signature drive in support Serbia on the Move (SoM) is a social organization that from of the overall initiative and volunteer recruitment, followed 2009 to 2015 coordinated action among citizens on the issues by engagement with elite stakeholders both directly and indi- of publicly funded health care service corruption and quali- rectly through media outreach and communications. Togeth- ty. It brought to the policy arena new demands and interests, er with policy measures undertaken by the Government and specifically policy recommendations based on collective in- the Ministry of Health (MoH), these initiatives contributed formation and feedback generated by the over 35,000 citizens to increased transparency and accountability in the publicly who took part in collective action, participated as volunteers financed health sector through citizen-generated data about in the NGO, or both. medical personnel and health facilities; support for ethical doctors; professional continuing education on anticorrup- Through these actions, and through strategic engagement tion, transparency, and accountability courses for physicians with subnational and national policy makers as well as hos- and nurses; citizen monitoring of hospital boards; and public pitals and doctors themselves, SoM helped to shift incentives access to doctors’ licensing records. Figure 3.8: Serbia’s relative levels of corruption and societal engagement a. Public sector corruption b. Engaged society 1 5 .8 4 .6 3 Index value Index value .4 2 .2 1 0 0 6 8 10 12 6 8 10 12 Log GDP per capita Log GDP per capita Serbia Serbia Sources: Public sector corruption and engaged society scores: V-Dem (Varieties of Democracy) Version 5.2; GDP per capita: World Bank, World Development Indicators (database). CASE STUDIES 47 Figure 3.9: Outcomes in Serbia’s health sector, 2014–15 a. Life expectancy at birth (years) b. Infant mortality rate (per 1,000 live births) 90 100 Infant mortality rate (per 1,000 live births) 80 Life expectancy at birth (years) 50 70 60 0 50 6 8 10 12 6 8 10 12 Log GDP per capita Log GDP per capita Serbia Serbia Sources: Life expectancy and infant mortality: World Bank, World Development Indicators (database). Note: Data for panel a are for 2014; data for panel b are for 2015. Background context and challenges reporting that had favored Milošević, and they successfully pressured the Federal Electoral Committee to announce the Serbia’s politics and economic development are shaped by the corrected results, leading to the resignation of Milošević. Cit- country’s past as a part of the former Yugoslavia. After the izen engagement and breakdown of the Soviet Union in 1991, Serbia experienced mobilization were thus “We knew the size and war and the violent redrawing of its borders with neighboring instrumental in push- difficulties of dealing with states, as well as the authoritarian rule of President Slobodan ing for transparency and integrity and instituting this issue [corruption in Milošević. Today, the legacy of political instability remains a primary obstacle to inclusive economic development. Serbia’s a democratic system of public health care]. We overall political and governance risk ratings are considered governance (York, and knew that we cannot make Zimmerman 2002). “substantial” (World Bank 2015a, 43). a change by having one Across several metrics of governance used by the World More recently, the Eu- campaign, by only raising Bank’s Worldwide Governance Indicators, Serbia’s relative ropean Union (EU) awareness and by being and absolute performance has improved greatly since the turn accession process has provided incentives and a short-term initiative, a of the century (figure 3.7). However, problems remain with corruption in the public sector (figure 3.8). Although a solid guidance for political spark; we knew that the fight legislative framework for anticorruption in the public sector and governance reforms. will be long and there will To become a member is in place, its implementation is lagging. be a lot of pushback. of the EU, Serbia has to Despite governance challenges, Serbian society has robust ex- comply with the Copen- Ana Babović, co-founder, Serbia on the Move perience with successfully mobilizing its citizens and building hagen criteria, which the movements of groups from across civil society that waged include “the stability of institutions guaranteeing democracy, the pro-democracy and antiwar campaigns in the 1990s. These the rule of law, human rights and respect for and protection movements culminated in the resignation of Milošević. Pro- of minorities.”50 In line with this requirement, Serbia has be- tests began in response to the government’s war politics, hate come a signatory to a number of international and regional speech, and conscription of regular citizens into the armed treaties promoting human rights and good governance. In forces. For over a decade, the opposition grew in strength 2008 the newly elected government made corruption a pri- and also began to focus on domestic politics. In 1998 a youth ority issue, developed a National Anticorruption Strategy and group founded the Otpor! social movement for democracy, Action Plan, and established entities such as the Anticorrup- which was instrumental in mobilizing citizens in response to tion Agency to support and monitor the implementation of the 2000 elections. They challenged the false election result its commitments. Public sector anticorruption and ethics leg- 50. EUR-Lex, http://eur-lex.europa.eu/summary/glossary/accession_criteria_copenhague.html. 48 CITIZENS AS DRIVERS OF CHANGE SPOTLIGHT 3: Current challenges in the health care system in Serbia Serbia’s key health outcomes are good for its income level: life expectancy at birth is 75 and the maternal mortality ratio (MMR) is 17 per 100,000 live births (2015). The under-5 mortality rate (U5MR) declined from 28 per 1,000 live births in 1990 to 7 per 1,000 live births in 2015 and the infant mortality rate from 24 to 6 per 1,000 live births in the same period. However, poor and marginalized groups—such as the Roma—have worse health and nutrition outcomes (World Bank 2015c). As the population of Serbia has aged, the burden of noncommunicable diseases (NCDs) has grown. Since 1990, the Serbian population has decreased by an average of about –0.2 percent annually. The percentage of the population age 65 and over went up from 10 in 1990 to 14 percent in 2012, and it is projected to reach 25 percent by 2050. Because of its aging population, the disease burden in Serbia is now weighted toward NCDs and external causes such as injuries. The top three causes of premature death in 2010 were heart disease (19.9 percent), stroke (18.8 percent), and cancers (about 18 percent), which implies that coverage and quality of prevention, promotion, and first-line screening and treatment at the primary care levels are key (World Bank 2015b). The health care system in Serbia is based on universal health coverage. About 94 percent of the population has health insurance, but lower-income groups tend to have higher unmet medical needs and lower insurance coverage (HPI 2014; World Bank 2015c). Besides the need to expand the access to care for marginalized groups, other major challenges in Serbian publicly funded health care are improving the quality of care and health outcomes and enhancing the efficiency of health spending. Health care quality. Use of hospital care went up between 2006 and 2013. In a recent survey, 7.8 percent of respondents age 15 and over (compared with 6.5 percent in 2006) said they had been treated in a hospital in the 12 months preceding the survey. This increase cannot be explained just by the aging of the population. Other factors are also responsible, including unnecessary hospital admissions, shortcomings in primary care, excessive use of acute care beds for long-term care, and inadequate use of day surgery. Wait lists for elective procedures are frequent and significantly longer than in member countries of the Organisation for Economic Co-operation and Development (OECD). They contribute to the high prevalence of bribery, particularly in the hospital sector (World Bank 2015b). Inefficient government expenditure on health. In Serbia, total public health spending increased from 5.2 percent of GDP in 2000 to 6.4 percent in 2013, higher than the average for upper-middle-income countries (3.9 percent) and slightly higher than the European Union average (6.3 percent). In the West- ern Balkans, only Bosnia and Herzegovina spends more on health. In 2009–13, Serbia’s per capita government health spending was three times higher at US$715 per capita per year than the average for countries with similar GDPs, US$298 per capita per year. Despite Serbia’s considerably higher spending, its health outcomes are similar and sometimes lower than those of other Central European countries, which suggests that inefficiency in the use of public funds combined with corruption is a primary concern for national authorities. For example, there are only five hospital beds for every 1,000 Serbians—lower than the Europe and Central Asia average (World Bank 2015a, 2015b). Source: Data on life expectancy and infant mortality: World Bank, World Development Indicators (database), http://databank.worldbank.org/data/reports.aspx?source=world-development-indicators. islation is also in place, but its implementation is considered journalists report facing political pressure, resulting in an in- uneven (World Bank 2015a). crease in self-censorship and a decline in investigative jour- nalism.52 Serbia joined the Open Government Partnership in 2012. Its OGP action plans have been aligned with other efforts to im- Governance improvements have helped improve service de- prove the efficiency of public administration and strengthen livery, but Serbia continues to face challenges in eliminating integrity in order to reach EU standards. The second action corruption in basic services, particularly health care. Serbia plan (2016–18) seeks to improve the consultation processes has significantly increased its spending on health care over with civil society and increase the involvement of citizens in the last decade, by almost 4 percent of its gross domestic these reform processes. Ongoing efforts also include improv- product (GDP), and now outperforms other countries at its ing access to information and the availability of open data, as income level in life expectancy and infant mortality (panels a well as increasing the transparency of public procurement.51 and b, figure 3.9). And yet health care is lagging in quality as well as access for marginalized groups.53 For example, in 2006 Although its progress on these issues has been good, Serbia’s for Roma living in urban slums the estimated infant mortality score on press freedom has declined. Freedom of speech and rate and probability of death before age 5 were three times the freedom of the press are protected under Serbian law, but national average. 51. Open Government Partnership, http://www.opengovpartnership.org/country/serbia/action-plan. 52. Freedom House, https://freedomhouse.org/report/freedom-press/2016/serbia. 53. World Bank, http://data.worldbank.org/indicator/SH.XPD.TOTL.ZS?locations=RS&view=chart; http://pubdocs.worldbank.org/en/111121446462343202/ Serbia-CPF-eng-web.pdf, p. 13. CASE STUDIES 49 The health sector is one of the sectors perceived by citizens Collective action to enhance contestability as the most corrupt, as, for example, in a 2010 survey by the United Nations Development Programme (UNDP) and the Serbia on the Move (Srbija u Pokretu) was officially launched 2006 Transparency International Global Corruption Barom- as a registered association in July 2009 by a small group of eter.54 The surveys also ranked corruption as the factor most young professionals in their 20s. They had a vision of empow- likely exacerbating existing inequalities in access to and qual- ering citizens to hold those in charge of public resources ac- ity of care and thus in multiple ways undermining develop- countable. SoM was co-led by Ana Babović, who at the time ment efforts as well as the fulfillment of human rights. Indeed, served as adviser for European integration to Serbia’s deputy corruption plagues the health system, making a transition to- prime minister, Bozidar Djelic.56 The organization operates ward improved treatment and prevention of noncommuni- under three guiding principles: cable diseases more challenging. Serbia now faces challenges related to noncommunicable diseases that are similar to those 1. Citizen support.  SoM requires written support from of other upper-middle and high-income countries (GBD 1,000 citizens before implementing any overall initiative. 2015 Mortality and Causes of Death Collaborators 2016), and As described here, this requirement was applied to the yet there is a culture of not seeking out preventive care (Hjelm focus on corruption in the publicly funded health sector, et al. 1999).  which spanned five projects over six years. 2. Community organizing.  The realization of SoM projects Such corruption and irregularities in public health care and activities depends on the direct involvement of cit- have resulted in discrimination and inequality. Because they izens. are unable to meet bribe demands, poor people experience discrimination in health care while those with greater eco- 3. Transparency. All of the organization’s resources and ex- nomic means receive preferential attention and treatment. penditures are available publicly on its website. Even though checks and balances are in place on the books SoM began by focusing on combatting corruption in health to control corruption and punish wrongdoers, enforcement care because of the widespread complaints about the prob- has been lax. For example, the Serbian Medical Chamber fre- lem. Grievances ranged from demands for bribe, to public quently does not revoke the professional licenses of doctors doctors setting up private clinics and channeling patients to found guilty of corruption in criminal cases even though this them, to receiving monetary and other valuable perks from is stipulated in the country’s legal system. One reason given pharmaceutical companies. Because of citizens’ perceptions is that the Medical Chamber has not been informed of the of graft among health care professionals, SoM found that verdicts. As well, there is a perception among citizens that ju- many public doctors themselves were aggrieved, feeling un- dicial processes are slow and sentences relatively lenient. derappreciated while working long hours for relatively low salaries. In addition, corruption in the health sector was par- Because citizens seeking health care often face demands for ticularly salient and personal because access to health care bribes, the power of doctors is asymmetrical relative to that is deemed fundamental to society, and citizens directly con- of patients. Proving corruption and bringing perpetrators tribute to the National Health Insurance Fund through their to justice are a daunting process. Victims or whistleblowers earnings. Thus health care is considered both a right and an must go to the police, which is not necessarily an appealing entitlement that people themselves ultimately fund. After re- prospect because the police are second to doctors in terms of searching the problem, SoM concluded that, although several reported bribe payments.55 SoM reports that police then plan laws and bylaws regulated health care, supported integrity, a sting operation with the victim to catch the medical practi- and punished graft, in reality checks and balances as well as tioner in a criminal act of corruption. But such an operation judicial functions were not working optimally. has requirements: the citizen or family member must have enough time before the medical intervention to take action, SoM sought to reduce corruption in the health sector by and the medical practitioner must make a direct bribe de- strengthening prevention mechanisms, transparency, and mand (as opposed to an indirect or third-party demand). Be- accountability through citizen engagement. To accomplish cause of the difficulty in challenging these entrenched power this goal, the young professionals identified four mutual- asymmetries, under-the-table bribes in exchange for medical ly reinforcing short-term objectives. First, raise awareness services have become an entrenched norm in Serbian society. among citizens about how to fight corruption in publicly 54. Transparency International, Global Corruption Barometer, 2006, https://www.transparency.org/whatwedo/publication/gcb_2006; UNODC (2011). 55. The 2010 UNDP survey reported the following results: “In most cases the bribe was given to doctors (57%), then to police officers (26%) and to state administration employees (13%). The trend of corruption incidence in these sectors is increasing. Corruption in other sectors is rarely reported.” http://www. undp.org/content/dam/serbia/Publications%20and%20reports/UNDP_SRB_Serbia_Corruption_Benchmarking_Survey.pdf, p. 8. 56. Babović left her position in 2012 to become Serbia on the Move’s executive director. Until assuming this official position, she worked on a voluntary basis. She was selected to be a Ford Foundation Mason Student Fellow in 2016 and is currently a research fellow at Harvard’s Ash Center for Democratic Gover- nance and Innovation, while also maintaining her active involvement in Serbia on the Move. 50 CITIZENS AS DRIVERS OF CHANGE Box 3.7: Serbia on the Move’s project structure Predrag Stojičić, a medical doctor, was exposed to the community organizing resources developed by Marshall Ganz, a senior lecturer in public policy at the Ash Center for Democratic Governance and Innovation at Harvard’s Kennedy School of Government, before he co-founded Serbia on the Move in 2009. He and his co-founder, Ana Babović, further studied Ganz’s approach through online resources and discovered they were already practicing much of his model. After Ganz launched a distance learning course in 2010, Stojičić convinced SoM’s core leadership to take it, and they adapted what they learned to the Ser- bian context (see figure B3.6.1). In the snowflake model, citizen mobilization is integrated into project organization rather than treated as a stand-alone objective. At the center is the core leadership team, initially the founding young professionals of SoM. At the next level are the project leadership teams. Each member at the core of a project team is in charge of leading the people (volunteers) working on one functional part of the project. Common functional teams include education and training (including leadership development), community organizing, logistics and public actions, public relations, and evaluation. The community organizing team is responsible for recruiting team leaders, who in turn are tasked with recruiting10 volunteers on the ground. In this framework, interdependent leadership teams are composed of individuals who bring complementary strengths to bear on solving the problem. Collaboration is essential to create “power to” based on the interests of all parties. Each SoM project has its own leadership team. Figure B3.7.1: Citizen engagement project structure of Serbia on the Move Source: Ana Babović, Serbia on the Move. Using analytical resources developed by Ganz, SoM conducts a strategic analysis of each citizen engagement project incorporating the following compo- nents: 1. People. Who are my people? 2. Problem. What is their problem and what change do they need? 3. Map of actors. Who are the relevant actors at the local, state and national levels in terms of their interests and resources, including citizen engage- ment constituency, opposition, allies, supporters, competitors, collaborators, and others (such as media, judiciary, general public). 4. Power: Based on the map of actors, who holds the resources (decision-making authority, funds, time, skills) that our constituency needs to achieve its goal(s). 5. Theory of change. What is our hypothesis about how our constituency can use its resources to create the power needed to achieve the stated change, beginning with a specific campaign goal that is clear and measurable and involves a specific outcome that can focus citizens’ efforts, leverage our constituency’s resources, build capacity, and motivate participation? funded health care in contrast to conventional public aware- adoption and implementation of these new transparency and ness efforts that simply aim to identify corruption. Second, accountability mechanisms. formulate new transparency and accountability mechanisms to reduce graft in health care. Third, build a coalition of stake- These goals were accomplished by relying on a project struc- holders (citizens, civil society, state institutions, public health ture that is built on citizen engagement and organized around practitioners) interested in reducing corruption in this sector. the concept of interdependent leadership and a snowflake or- Fourth, build the capacity of citizens to actively push for the ganizational structure (box 3.7). Like WDR 2017, Marshall CASE STUDIES 51 Ganz’s community organizing model rests on power anal- improvements. The group also sought to overcome nega- ysis (Ganz 2013). It presumes that an imbalance of power tive views about NGOs through community and university can exist between those with decision-making roles (elites) events, personal narrative videos, and public training, which and those (citizens) affected by their decisions (policies) in served as well to recruit members and volunteers. SoM en- negative or socially unjust ways. Community organizing can gaged citizens and recruited volunteers through contact with thus be understood as a form of citizen engagement involving local patient organizations; local civil society organizations; highly strategic collective action, whereby grassroots power is university outreach (lectures and workshops, including at built and wielded in the policy arena (contestability) to affect schools of law, medicine, pharmacy, and political science); outcomes. “To create change, you need power. If you don’t “anticorruption coffee” meetings; creative, often humorous have power, use the resources you have. People are a source of street actions (“teaser events”); free training and workshops; power,” says Babović. and social media.57 Citizens are the source of SoM’s power, and, as a volun- As noted, to launch an overall initiative SoM, together with its teer-based organization, its key challenge is overcoming volunteers, must first gather at least 1,000 signatures of sup- collective action challenges to ensure commitment from vol- port from citizens. Each signature represents a one-on-one unteers to the organization’s initiatives. SoM was founded conversation with a citizen about the subject of the project through voluntary efforts. None of the seven members of the and why it is important. Citizens are asked about their view of original strategic team has ever been paid. Citizens are the the problem and proposed actions and whether they want to drivers of the organization’s activities as volunteers in proj- show support through their signature. For example, in 2009, ects, as supporters of projects, as a key constituency whose prior to implementation of the first citizen engagement ini- problems are addressed by the citizen engagement initiatives, tiative, “I am not on the take, I work for the salary,” 5,000 and ultimately as resources and sources of power. Each grass- people made the following affirmation: “With this signature roots project is carried out by dozens of volunteers organized I want to express my support of doctors who publicly declare around the snowflake structure. Babović recognized the po- themselves as uncorrupted and who commit to promote zero tential power of citizen engagement and highlighted the lim- tolerance of corruption in their work or health care facility.” its of the existing theories of change in Serbia, which focused This action has multiple functions: it is an information-gath- on raising awareness and then “asking those in power to do ering tool to get input from citizens and gauge the proposed something to solve our problems,” based on the belief that project’s appeal; it helps to prime a base of citizens for poten- “power is something that others have and we don’t.” By con- tial mobilization if the project is launched; and it is one way trast, SoM focused on harnessing citizen power itself to con- in which SoM recruits volunteers, ranging from post–high test in the policy arena. school young people to university students, professionals, and unemployed youth. The latter group is an acute socioeco- Public apathy, fear, cynicism, and lack of trust of NGOs have nomic challenge for the country.58 been key obstacles for the organization. Early on, when the group reached out to NGOs and discussed their mobilization To ensure volunteer commitment, SoM cultivates collective strategy, the reaction was often laughter. “They would say this responsibility and collective ownership. The first point of is impossible unless we have money to pay them [citizen-vol- SoM’s manifesto (appendix B) is “We are free to express and unteers] and even in that case it’s quite unlikely it would hap- organize ourselves, and we do not wait for others to solve our pen,” says Babović. problems.” For citizens, this point involves responsibility not only for tackling corruption in public health care, but also for SoM thus sought to change citizens’ beliefs and preferences addressing their own roles in the problem. “There is no law, about collective action, power, and prospects for change. This policy, measure and action plan that can make a change if citi- was achieved in part through personal interactions, notably zens do not behave in a corresponding way,” explains Babović. the 1,000-signature requirement to launch an overall initia- Collective ownership, a central element of Ganz’s community tive, an inclusive process that fostered a sense of commu- organizing framework, is embedded in SoM’s organizational nity and countered feelings of isolation. “To get them to go structure, manifesto, and operating principles (including the out in the field, they need to understand they’re not alone,” requirement for 1,000 citizen signatures of support). explains Babović. SoM also attempted to create collective responsibility by emphasizing that it was not created to pro- SoM deliberately takes measures to cultivate a sense of collec- vide services or other benefits for citizens and communities, tive identity. Volunteers are given badges and T-shirts to wear, but rather to work together to address problems and achieve which serve as symbols to help them recognize each other 57. https://www.youtube.com/watch?v=mYys-B_mvCg. 58. Youth unemployment remains a pernicious problem in Serbia. It reached a high of 54.2 percent in July 2014, and as of July 2016 it stood at 36.1 percent. http://www.tradingeconomics.com/serbia/youth-unemployment-rate. 52 CITIZENS AS DRIVERS OF CHANGE on the street. Preparations include sharing stories of “us” posed of volunteers largely drawn from previous projects. and their linkages to the objectives of the citizen engagement This structure enhanced citizen cooperation and coordina- project and greater hope to change Serbia. The organization tion in the policy arena and reinforced a sense of collective strategically creates and crafts a narrative to build collective identity. identity and a sense of agency among citizens. As mentioned earlier, through some of its projects it also has cultivated a Initiatives to change elites’ incentives and collective identity among ethical medical practitioners. A preferences visible example is the “honorary” badge doctors wore after taking a public integrity pledge. In its health care initiative, SoM reduced barriers for entry in the public health and anticorruption, transparency, and ac- From its initial organic roots, SoM has expanded and become countability policy arenas, first through citizen-driven collec- more formally structured. International actors, including the tive action, which cumulatively affected power asymmetries. European Commission, UNDP, and USAID, have provided As this form of contestability gained traction, SoM proactive- SoM with financial support. For example, when SoM received ly sought to align with other actors (state and nonstate) to its first grant from USAID for the “I’m not on the take, I work pressure other elites through stakeholder consultations and for the salary” project, the young founders hired a project coalition building. As well, it contributed to fostering a new manager and two part-time program assistants. As SoM’s ac- collective identity among other elites—specifically, honest tivities and experience grew, it created in 2013 a new structure professional doctors and nurses through social affirmation to improve citizen coordination and cooperation. It consisted and professional development courses accredited by the Ser- of a national committee and five regional committees com- bian Medical Chamber. Finally, it helped stimulate public de- Table 3.4: Altering elites’ incentives on the ground: Five SoM projects Outcomes (by altering costs of action, inaction, or Project Actions opposition) “I am not on the take, I Collection of 10,000 citizen signatures through direct, one-on-one Prior to collection of the signatures, the Ministry of Heath work for the salary” and interactions demanding Citizens Charter. was unresponsive to SoM’s engagement efforts. Afterward, it Anticorruption Citizens called SoM for a meeting. Charter “What’s your doctor Collected 12,640 evaluations of 5,000 doctors and made them Public disclosures to increase the transparency and account- like?” available through the SoM website. ability of unprofessional doctors and recognize professional doctors, thereby altering the incentives for negative and positive behavior. Voice for Health Citizens reported corruption and irregularities using the SMS (text Ministry of Health invited SoM to cooperate on policy recom- messaging) tool. mendations based on information generated by citizens; this reflected a change in incentives for putting policy measures in place that address corruption in medical facilities. Hospitals without Cooperated with patients’ rights groups to conduct 62 public work- Increased transparency and accountability in hospitals by Corruption shops on patients’ rights, thereby educating 852 citizens about the empowering patients with information and user-friendly mechanisms available to counter corruption in hospitals. mechanisms to increase the costs of corrupt actions. Cooperated with elites to prominently post anticorruption policies and reporting mechanisms in the country’s five major hospitals. Right to Know Conducted a comparative policy analysis of different models of The Serbian Medical Chamber agreed to publish and patients’ rights to information concerning physicians, and held maintain a list of all licensed public and private doctors in the stakeholder consultations through engagement with the Serbian country on its website. Medical Chamber. 200 volunteers in five cities recruited and trained to raise public awareness and encourage citizens to access a list of all licensed public and private doctors in the country on the Serbian Medical Chamber’s website. Convened public workshops on patients’ rights attended by 700 citizens. CASE STUDIES 53 liberation through the Hospitals without Cor- Photo 3.1: Honorary badge: “I am not on the take, I work for the salary” ruption project, whereby representatives of patient organizations or communities gained access to the five main hospital boards in the country. SoM sought wide engagement with elites in the policy arena. The individuals and institu- tions varied according to the particular citizen engagement project. From 2009 to 2015 for its health care initiative, SoM engaged with ƒƒ Government policy makers at the na- tional and subnational levels, including the Ministry of Health, Anticorruption Agency, Commissioner for Information of Public Importance and Personal Data Protection, Ministry of Justice, Ombuds- man, Parliament’s Committee on Health, National Health Insurance Fund, Nation- Source: Courtesy of Serbia on the Move al Police, Belgrade City Health Secretari- at, and local governments tackle problems at all levels (on the ground, subnational, and ƒƒ Hospital and health care facility administrations and eth- national) simultaneously because of the overlay of multiple ical boards state institutions, professional medical bodies, and confusing ƒƒ National and subnational professional medical associ- lines of authority and decision making. Rather, a vertically ations, including the Serbian Health Council, Serbian integrated approach could unfold over time through multi- Medical Society, Serbian Medical Chamber, and Region- ple, consecutive citizen engagement initiatives that would al Medical Chambers of Novi Sad, Nis, Kragujevac, and build on each other. SoM thus developed citizen engagement Belgrade projects that would wield grassroots power, thereby affecting power asymmetries and elites’ incentives. Table 3.4 summa- ƒƒ Doctors and nurses, including both perpetrators of rizes the five citizen engagement projects that SoM carried health care corruption and irregularities as well as honest out from 2009 to 2015 and that are described in more detail professional providers of medical services. in this section. Each effort began with volunteer recruitment, Based on Ganz’s community organizing model, SoM identi- followed by engagement with elite stakeholders, both directly fied and mapped the relevant actors at the local, state, and and through media outreach and communications. national levels in terms of their interests and resources, in- Project: “I am not on the take, I work for the salary” (2009– cluding the citizen engagement constituency, opposition, al- 10) and Anticorruption Citizens Charter (2010–12) lies, supporters, competitors, collaborators, and others (such as the media, judiciary, and general public). SoM then over- The objectives of these linked initiatives were to promote the laid the map of actors with a power distribution of who holds values of integrity and an ethical code of conduct among phy- the resources (decision-making authority, funds, time, skills) sicians. During the “I am not on the take” initiative, 5,000 citi- needed to achieve the organization’s goals. Finally, using this zens signed a declaration in support of ethical physicians, and map and the power distribution, SoM developed hypotheses 300 trained volunteers directly interacted with 1,000 doctors about how to effect change, beginning with a specific cam- in Belgrade and later more practitioners in five major cities. paign goal that is clear and measurable and involves a specific The doctors were encouraged to sign an anticorruption code outcome that can focus citizens’ efforts, leverage its constitu- of conduct. In the end, almost 1,000 physicians in Belgrade ency’s resources, build capacity, and motivate participation. (70 percent of the total) and 50–70 percent of their counter- parts in other cities took the integrity pledge; wore a “badge In mapping the actors in the public health care policy arena, of honor” stating, “I am not on the take, I work for the salary”; SoM identified a variety of elite stakeholders and institutions and agreed to have their names publicly listed on SoM’s web- that play a role in adopting and implementing policies and site (photo 3.1). developed strategies for effectively building coalitions and se- lectively pressuring certain groups. It eventually understood At the same time, SoM called for the adoption of an Anti- that it was not possible, necessary, or strategically wise to corruption Citizens Charter to be displayed prominently in 54 CITIZENS AS DRIVERS OF CHANGE primary health care facilities, first in the capital and then securely report instances of corruption to the Public Prose- throughout Serbia. In 2010 volunteers collected 10,000 sig- cutor’s Office through the platform (McDonough 2012). To natures from citizens in support of the charter, which SoM mobilize citizens to rate their doctors and report corruption, submitted to the City of Belgrade Health Secretariat because SoM recruited and trained 30 team leaders, who in turn creat- it controls primary health care facilities under its jurisdiction ed teams of 10 volunteers operating in seven cities across the and can send the request to the Ministry of Health. The objec- country. They used cartoons and personal narrative videos, tive was to devise an anticorruption mechanism that would social media, university presentations, teaser (street) actions, be useful to honest health care professionals and citizens a launch event with 200 people and journalists, and a contest while creating deterrents for corrupt practices. for the best short story and aphorism about Serbia’s health care system. Voting on the 100 submissions was held through Through publicity and the power of numbers, SoM changed the social media.60 physicians’ and hospitals’ incentives to embrace integrity and corruption and also gained access to policy makers at the sub- To launch the website, SoM engaged with national regulators national and national levels. Prior to collecting the 10,000 sig- to gain support and ensure compliance with the law. At the natures demanding an Anticorruption Citizens Charter, the time, the law on transparency of public information and per- young professionals had tried to engage with officials at the sonal data protection was quite new. Nevertheless, the group Belgrade Health Secretariat but without success. By contrast, secured a green light from the Commissioner for Informa- after this exercise of collective action the secretariat called tion of Public Importance and Personal Data Protection for SoM for a meeting at which it agreed to ask the Ministry of the website. It also was in contact with the Public Prosecutor’s Health to write the charter. UNDP supported the ministry Office to set up the digital conduit for citizens to report cor- in this endeavor. However, the process was slow, prompting ruption. SoM’s leadership team to draft its own version. Members solicited input from experts within the country and abroad, The website was launched on November 17, 2012. Within 10 including from Harvard, and convened a public stakeholder days, it had logged 30,000 visitors and 12,650 citizen evalu- roundtable in October 2012, which received significant press ations of 5,000 doctors—essentially 22 percent of all public coverage. Through contacts, SoM also passed its draft charter health physicians in the country. The results greatly exceeded to the ministry. The final version of the charter was similar SoM’s expectations. Only 5 percent of the practitioners eval- to that prepared by SoM. To SoM’s disappointment, however, uated by the public received the lowest score (1) and 55 per- there was no implementation because the Ministry of Health cent received the highest score. In addition, only 8 percent never posted the charter in health care facilities. of respondents reported that they had been asked for bribes. For SoM, the data indicated that most doctors actually were Project: “What’s your doctor like?” (2012) competent and not corrupt in contrast to general perceptions. Serbia on the Move’s next project centered on citizen evalua- The group quickly suffered a setback, however. Following a tions of doctors. The objectives were to increase transparency complaint from the Serbian Medical Chamber, the Commis- and accountability in public health care by exposing bad doc- sioner for Information of Public Importance and Personal tors and acknowledging good ones; gathering actionable data Data Protection reinterpreted the law and ordered the or- on corruption that could be used for policy recommenda- tions; and channeling citizens’ reports of graft to government ganization to remove the names of all physicians from the authorities for investigation. SoM sought to change incentives site, thereby blocking public access to the information. In by increasing the costs of corruption through public disclo- response, SoM assembled a small team of volunteer lawyers sure and investigations and to reshape preferences and beliefs to mount a legal challenge, but it was unsuccessful. The Com- by acknowledging integrity and creating a sense of collective missioner’s decision backfired, however. It stoked public out- identity among honest doctors. rage, which SoM tapped to win greater support for its efforts. Through social media, SoM published the government’s con- SoM created a website with multiple functions for citizen tradictory official opinions on the legality of the “What’s your engagement in the digital realm, including rating individual doctor like?” website. It quickly organized on-the-ground and physicians by asking three simple questions: “Did your doc- digital actions with volunteers, from a silent protest to a “Call tor listen to you?” “Do you trust your doctor?” “Would you the Commissioner” day; collected the signatures of 3,000 cit- recommend your doctor to family and friends?” People could izens for delivery to the Ministry of Health on International also answer yes/no questions about bribe demands and refer- Anticorruption Day (December 9); and made media appear- rals to private health care facilities.59 Finally, patients could ances (including on popular national talk shows).61 Neverthe- 59. http://www.kakavjedoktor.org/. 60. https://www.youtube.com/watch?v=yBU8t40D2bs; https://www.youtube.com/watch?v=mYys-B_mvCg. 61. The following links are to coverage of and social media reactions to the Commissioner for Information of Public Importance and Personal Data Protec- CASE STUDIES 55 less, in the short term SoM experienced a setback that forced In the first year of the initiative, SoM received 995 SMS re- a strategic and operational reassessment.62 ports from citizens, providing a “very good picture of the whole system with all its anomalies and problems as well as Project: Voice for Health (2013) healthy parts,” said Babović. The SMS data and investigations were compiled into monthly, quarterly, and annual reports on With its next initiative, SoM developed an integrated ap- the public health care system, along with recommendations proach to improving the health care system, combining cit- to the Ministry of Health on how to address the problems izen engagement, cooperative engagement with elites, in- and improve the services that received the most complaints. vestigative journalism, and coalition building. The initiative The ministry’s track record was modest, which SoM disclosed had three objectives: to increase transparency over how the publicly. Even so, there were some notable gains in the poli- publicly funded health care services were functioning, to pro- cy arena. The ministry agreed and implemented SoM’s rec- mote ethical standards among practitioners, and to develop ommendation to display posters about the SMS service in all evidence-based policy for the Ministry of Health. To carry public health care facilities in the country. These posters were out its objective, SoM launched a new SMS (text messaging) designed and printed by SoM. tool for citizens to report corruption and irregularities in the publicly funded health system, including among medical per- The initiative helped to reveal lesser-known forms of corrup- sonnel and facilities.63 In addition, the organization created tion and gain the Ministry of Health’s cooperation in com- a new volunteer-staffed center to help citizens who wanted batting them. For example, the initiative shed light on the to go beyond the SMS tool to directly contact the relevant practice of paying bribes to be hired as technical and medical official authorities. staff in hospitals. In response, the ministry adopted SoM’s recommendation that new, detailed hiring procedures and Coalitions with media and other civil society organizations qualification requirements be followed by all facilities. In ad- helped empower SoM to change the incentives of policy mak- dition, SoM pointed out the illicit practice of paying to move ers at the Ministry of Health. SoM formed a team of young up the waiting list for medical procedures. The ministry then journalists to investigate the corruption reports generated by adopted SoM’s proposal that doctors provide in writing the citizens. These stories were published through blogs and oth- waiting time to reach the top of the list. If the time is not met, er social media outlets. In addition, it brought a number of patients can choose to go to a private provider and receive anticorruption, health care, and patients’ rights organizations reimbursement by the state for the cost. into a new coalition, which began to meet regularly.64 In tan- dem, SoM created a new structure to organize citizens, con- In addition, 10 investigative stories were published, although sisting of a national committee and five regional committees there were challenges in convincing the judicial system to prosecute wrongdoers. The volunteer center helped one per- composed of volunteers largely drawn from previous projects. son receive protected whistleblower status, and the legal team Meanwhile, the organization reached two milestones in terms submitted over 60 cases on behalf of citizens to the Public of its engagement and collaboration with national policy Prosecutor’s Office. Because of fear of reprisals, all requested makers. First, it secured the cooperation of the Anticorrup- anonymity, but the judicial body refused to investigate with- tion Agency. Second, once citizens began using the SMS tool, out disclosure of identities. As of March 2017, this shortcom- the Ministry of Health invited SoM to cooperate with it. It ing and other concerns about the judicial system were being was agreed that SoM would publicize its findings, policy rec- discussed by SoM, some civil society groups, and a major ommendations to the ministry, and independent assessments donor. of subsequent implementation, and that the ministry would Project: Hospitals without Corruption (2014) publicly announce its measures and accomplishments. These outcomes revealed how SoM’s citizen engagement over the In 2014, five years after its founding, SoM devised a new, years cumulatively changed elites’ incentives and gained SoM multifaceted project to deepen and expand its integrated a seat at the bargaining table. approach to increasing transparency based on civil society tion’s reinterpretation of the Information of Public Importance and Personal Data Protection law that forced SoM to shut down the online citizen evaluations of doctors: http://www.b92.net/info/vesti/index.php?yyyy=2010&mm=07&dd=18&nav_id=446300; https://uperiprstom.wordpress.com/2013/11/14/kakav-je-doktor-iza-kulisa/; http://www.rts.rs/page/stories/sr/story/125/drustvo/1640004/prijava-korupcije-u-zdravstvu-sms-om.html. 62. https://www.youtube.com/watch?v=tJ1oh2m1ng4. 63. The SMS service captured the following data: WHO (name and title), WHEN (date and time), WHERE (city, health care facility, department), and WHAT (corrupt or irregular activity). See UNDP (2013). 64. Among the coalition members were Law Scanner (health care); BIRN (Balkan Investigative Research Network—transparency, corruption); BIRODI (Bu- reau for Research—corruption, transparency, research); CRTA (Center for Transparency and Accountability—corruption, transparency, activism); and Blue Circle (patients’ rights). 56 CITIZENS AS DRIVERS OF CHANGE Photo 3.2: SoM’s anticorruption tool poster in hospital, Hospitals without Corruption project Source: Courtesy of Serbia on the Move. coalition building and cultivating constructive relationships The third initiative was the placement of a representative of with policy makers. SoM’s core leadership team began by se- a local patient organization or a community member as an curing one-on-one meetings with key stakeholders, followed observer on five targeted hospital boards around the coun- by roundtables with representatives of stakeholder groups try (USAID 2016). Observers were chosen for the five boards to develop measures to reduce the perception of and actual from applicants—local chapters of the Voice for Health asked corruption in health care facilities. “We wanted everyone’s patients’ groups to submit candidate applications. After the buy-in,” says Babović. “If we came to them with everything, project ended, three of the facilities continued the practice. In they would not cooperate, so we wanted to create it [mea- addition, at each of these hospitals SoM displayed a poster on sures] with them.” The stakeholders included the Ministry of the SMS anticorruption tool, intended to serve as a resource Health, Anticorruption Agency, Serbian Medical Chamber, for citizens and a deterrent for medical practitioners (see pho- Serbian Medical Society, Serbian Health Council, and various to 3.2). patient organizations. To evaluate the impact of the anticorruption information Three initiatives emerged from these deliberations. The first drive and the presence of citizen observers on the boards, was an educational program for physicians and nurses on an- SoM volunteers conducted two surveys of patients (random- ticorruption. SoM cooperated with the Serbian Health Coun- ly selected) at the five targeted hospitals. The surveys yielded cil and the Anticorruption Agency to develop and conduct mixed results (table 3.5). The first survey compared patient accredited workshops for doctors and nurses that are part perceptions about corruption in the targeted hospitals before of what is called Continuing Medical Education and is im- the onset of the project. The second survey was conducted portant for maintaining professional credentials. The content six months later, after all measures had been implemented. focused on integrity, a code of conduct, and how to protect A total of 102 people were interviewed, proportionately se- oneself from corruption. The course was taken by 452 doctors lected according to the average number of patients in each and nurses (or 2 percent of all doctors in the country), and medical center. Although bribery was not the norm overall, they received credit under the Continuing Medical Education either before or after the project, its occurrence was relative- program (USAID 2016). In evaluations, 91.6 percent said the ly unaffected. However, doctors’ direct demands for bribes course met their expectations, and 76.8 percent would recom- dropped significantly. In addition, the targeted hospitals saw mend it to their colleagues. a large increase in knowledge about patient mechanisms to In the second initiative, through the Voice for Health chap- fight hospital corruption. However, the hospitals also saw ters, volunteer teams worked with patient organizations to a shift from overt forms of corruption (that is, explicit and conduct citizen workshops. Core topics included recognizing implicit demands for bribes by doctors) toward more hidden corruption or the potential for it, discerning the difference corruption (third-party “gift” requests). Finally, the finding between corruption and malpractice, using anticorruption that patients increased their unsolicited offers of gifts point- mechanisms and steps to report corruption, and understand- ed to the need and challenge to overcome entrenched norms, ing how patients can feed corruption—for example, through which SoM has also endeavored to affect. Overall, the results offering bribes or “gifts.” Around the country, 852 people par- revealed the adaptability of corruption and the reality that ticipated in 62 citizen workshops. progress is incremental. CASE STUDIES 57 Table 3.5: Selected questions and results from patient perception surveys, Hospitals without Corruption project Patients surveyed in Patients surveyed in targeted hospitals before targeted hospitals after Selected questions from survey project (average rating) project (average rating) In your opinion, how widespread is corruption in the health care system? (1=lowest 3.25 2.8 rating of corruption; 5=highest rating) Has anyone during your treatment (stay) in the hospital asked you/requested money for a 13% 12% “present” in order to provide the treatment? (yes/no) ¾¾ If you answered yes, has anyone during your treatment (stay) in the hospital directly 14% 0% asked you/requested a “present” in order to provide the treatment? (yes/no) ¾¾ If you answered yes, has anyone during your treatment (stay) in the hospital indirect- 25% 16% ly asked you/requested a “present” in order to provide the treatment? (yes/no) ¾¾ If you answered yes, has a third party [nurses, other staff) during your treatment 20% 23% (stay) in the hospital indirectly asked you/requested a “present” for the doctor in order to provide the treatment? (yes/no) During your treatment (stay), did you offer the doctor an unsolicited “present”? (yes/no) 41% 61% Are you informed (do you have the knowledge) about the mechanisms to report the 11% 38% corruption in health care? (yes/no) Source: Data and translation provided by Predrag Stojičić, co-founder, Serbia on the Move. Project: Right to Know (2015) creasing the costs of particular nefarious actions and helped to reshape preferences by creating an alternate positive collec- After six years, Serbia on the Move decided to tackle another tive identity about the medical profession. link in the publicly funded health care transparency-account- ability-quality ecosystem: the right to information about phy- SoM told the Serbian Medical Chamber about the project at sician licenses, malpractice, and corruption charges. Serbia the outset. It conducted a comparative policy analysis of dif- ranks toward the bottom of all European countries in terms of ferent models of patients’ rights to information on physicians, the accessibility of information about patients and hospitals and it held stakeholder consultations through engagement (USAID 2016). The Serbian Medical Chamber is responsible with the Serbian Medical Chamber and three roundtables for maintaining records and taking disciplinary measures (USAID 2015). Participants in the consultations included against physicians in both public and private practice.65 The representatives from the National Health Insurance Fund, overall objective of the project was to institute public access Commissioner for Information of Public Importance and to this information, thereby increasing transparency and ac- Personal Data Protection, various health councils, patients’ countability in the health care system and strengthening pa- rights organizations, and interested civil society organiza- tients’ rights to information about their doctors’ professional tions, as well as the Serbian Medical Chamber. Even before backgrounds and records. SoM began building capacity for citizen action, the chamber agreed to publish and maintain a list of all licensed public and Through this initiative, SoM hoped to change doctors’ incen- private doctors in the country on its website.66 As a result of tives by making information public. SoM’s core leadership this constructive and positive outcome, there was no need to team saw this policy as a preventive measure. According to organize street actions to pressure the chamber. Instead, SoM Babović, “If this information is public, it will make everyone recruited and trained two hundred volunteers in five cities to [physicians] think twice before they commit a corrupt act raise public awareness and encourage citizens to access this because they can lose not only a license, but a job and fur- vital information about doctors on the chamber’s website. thermore their integrity.” On the other hand, SoM once again The NGO’s volunteers also convened public workshops on wanted to support honest professional physicians. Transpar- patients’ rights. ency on medical licensing allows patients to check the status of their doctors and also see that only a small minority are The Serbian Medical Chamber’s acquiescence demonstrated wrongdoers. This initiative changed doctors’ incentives by in- how SoM had shifted incentives: the threat of street actions 65. The Serbian Medical Chamber regulation is for “Specifying the Conditions for Issuance, Renewal or Revocation of Licenses.” 66. http://www.lks.org.rs/clanovi-lks/cid182-672/zbirka-podataka-evidencija-lekara-sa-vazecom-licencom-januar-2017. 58 CITIZENS AS DRIVERS OF CHANGE Table 3.6: Application of human rights, Serbia on the Move Right Application of right Association Creating a grassroots group that formally registered as an NGO; creating volunteer-based national and subnational SoM committees Assembly Conducting public meetings, workshops for citizens and medical professionals, recruitment activities, digital monitoring, and evaluations of medical professionals Expression Publishing citizen-generated medical assessments, reports, and surveys about corruption, irregularities, and health care services; publish- ing policy recommendations and assessments of the adoption and implementation of policies by the Ministry of Health; providing citizens with the information needed to report corruption and irregularities in public hospitals Information Providing access to information about the licenses of medical practitioners and citizen-generated information about medical practitioners and health care facilities; educating patients about their rights and citizens about their rights to health care Participation in Providing citizen-generated monitoring and evaluation results and policy recommendations to government officials and nonstate profes- governance sional medical bodies in order to reduce corruption and increase transparency and accountability in the public health care sector and to improve the provision of publicly funded health care services raised the anticipated cost of inaction high enough to change SoM’s successes demonstrate the importance of adaptability the Medical Chamber’s incentives to publish the list. As a re- and incrementalism. When tackling entrenched, systemic sult, the relationship between SoM and the Medical Chamber problems with obscure, complicated lines of authority and had come full circle: in 2010 the chamber successfully blocked accountability, a single citizen engagement initiative cannot the SoM’s “What’s your doctor like?” online evaluations by remake an entire sector. Rather, such efforts can be likened pressuring the Commissioner for Information of Public Im- to building blocks where outcomes or achievements are often portance and Personal Data Protection, but over the years the partial, progress is incremental, and setbacks are likely. For relationship grew more constructive and the balance of power Serbia on the Move, “each project is a step in making change more equalized. The Medical Chamber went from restricting in the field of corruption in health care,” observes Babović. access to citizen-generated information (evaluations) about doctors to providing previously undisclosed information In Serbia, international actors were visible players in the pub- about them (medical licenses). “Such successful cooperation lic health care policy arena, and they directly interacted with between Serbia on the Move and the Serbian Medical Cham- Serbia on the Move, helping to create broader coalitions to ber and the Commissioner for Information of Public Impor- effect change. They exerted influence on state actors through tance and Personal Data Protection is an illustration of not policy recommendations, funding, and technical assistance, only good cooperation but also a successful public advocacy essentially participating as a stakeholder in the publicly fund- process initiated by civil society,” says Marijana Trifunović ed health care and transparency-anticorruption-accountabil- Stefanović, team leader of the government accountability ity policy arenas. Finally, in some cases they fostered spaces component of USAID’s Judicial Reform and Accountability for public deliberation, thereby helping to enhance contest- Project (USAID 2015). ability for civil society groups and influence power asymme- tries in these overlapping policy arenas. For example, UNDP Conclusion pressed state elites for the adoption of anticorruption mea- sures and institutions and cooperation with civil society. Summary of outcomes Babović reports that it funded Anticorruption Agency proj- ects to initiate dialogue with civil society. SoM was included Over several years, Serbia on the Move’s citizen engagement in some of these efforts. initiatives have increased transparency and accountability in the public health sector through citizen-generated data about Rights begetting rights medical personnel and health facilities; support for ethical doctors; professional for-credit anticorruption, transparency, Serbia on the Move does not identify as a human rights or- and accountability courses for physicians and nurses; citizen ganization, but its public manifesto does incorporate human monitoring of hospital boards; and public access to doctors’ rights and the related principles of equality and diversity. licensing records. Meanwhile, over the years SoM has ex- Meanwhile, its citizen engagement projects are anchored in panded to other issues in society such as reforming the elec- human rights related to citizen participation, governance, and toral system, increasing the accountability of politicians, ma- inclusive development. “Although campaigns were not invit- ternity benefits, and a free education program for leadership ing people to fight for their basic rights,” explains Babović, and community organizing. “those were implicitly integrated in the cause, and denial of CASE STUDIES 59 those was understood by people as breaching their basic hu- reached out to it, called for cooperation, or even met its de- man rights.” For example, during SoM’s “What’s your doctor mands in anticipation of the collective action. like?” project, the Commissioner for Information of Public Importance and Personal Data Protection faced public out- Changing incentives. Serbia on the Move changed elites’ in- rage after reversing a legal interpretation and thereby forc- centives through several initiatives: it used citizen-generated ing SoM to stop releasing citizens’ evaluations of doctors. For reports to submit criminal corruption cases; it cooperated SoM, this anger suggested that many citizens understood that with the Ministry of Health to present policy recommenda- the government was blocking a website that allowed patients tions based on citizens’ reports of corruption and irregulari- to express their experiences and opinions about care in health ties; and it compelled the Serbian Medical Chamber to main- facilities—that is, it was essentially blocking their freedom tain an online roster of all licensed doctors in the country. of expression and right to information. Table 3.6 illustrates SoM shifted de facto power by publicly exposing corruption some of the ways in which Serbia on the Move exercised these among individual doctors and health care facilities and co- rights. operating with the Ministry of Health to display posters for the SMS corruption reporting tool in all public health centers. Corruption and irregularities in the public health care sec- tor directly deprived people their right to this public service, This case study illustrates how citizen engagement can change which is essential for development and even life. Thus Serbia elites’ incentives through positive reinforcement; SoM used on the Move’s overarching objectives to deter corruption, in- carrots and not just sticks. In the Voice for Health initiative, crease transparency, and enhance accountability in the public SoM fostered a win-win situation with the Ministry of Health health care sector embody the principle of universality that by acknowledging the institution’s progress in adopting poli- all citizens share the right to health care and inclusive devel- cy recommendations based on citizen-generated information opment. “In Serbia health care is universal and everybody has and experiences. (The institution faced negative costs, how- a right to it,” says Babović. In this sense, SoM used human ever, when SoM reported policy inaction.) Furthermore, citi- rights language as an intangible motivator to create a sense zen-generated information about ethical professional doctors of collective responsibility, helping to overcome collective ac- and positive experiences in hospitals can increase the positive tion challenges. benefits of particular policies and actions aimed at integrity and quality health care services. “We wanted to have contact Likewise, SoM used protected human rights, particularly the with the ‘good guys’; we needed to uplift the good doctors,” right to information, to help push for greater transparency recalls Babović. and accountability in the public health care sector. It demand- ed and succeeded in gaining public access to official infor- Reshaping preferences and beliefs. SoM contributed to re- mation—for example, about conditions in state hospitals and shaping the preferences and beliefs of actors in the policy a registry of the physicians holding medical licenses, there- arena. Specifically, it contributed to developing a cadre of by allowing public scrutiny, oversight, and collective action. like-minded medical practitioners and a sense of collective It also expanded the boundaries of the right to information identity through the “I am not on the take, I work for the sal- beyond that held by elites to encompass evidence and data ary” project and the accredited integrity workshops for doc- generated by citizens for both the public and elites. SoM’s ef- tors and nurses conducted in cooperation with the Serbian forts to educate and empower citizens, educate patients about Medical Chamber. As a doctor from Vršac General Hospital their particular rights, educate medical practitioners about observed, “As many doctors and health care institutions as transparency and integrity, and build a coalition of state possible should be involved in this. A rare chance to hear the and nonstate stakeholders is another illustration of how cit- details of this important topic” (USAID 2016). However, this izen engagement involves exercising the basic human rights case study also demonstrates the difficulty in reshaping pref- of assembly, association, and access to information in order erences and beliefs in the short term when norms of corrupt to gain rights—in this case, equal access to quality publicly behavior are deeply entrenched. In the face of entrenched be- funded health care and ultimately to inclusive development. liefs, SoM used the media and training to more gradually shift preferences throughout society. Shifting incentives, reshaping preferences, and increasing contestability Enhancing contestability. SoM focused on harnessing citi- zen power through collective action to contest in the policy Serbia on the Move’s successive citizen engagement initiatives arena. SoM sees community organizing as a form of citizen have built power through collective action. The NGO has engagement that involves highly strategic collective action, been particularly adept at applying pressure on elites through whereby grassroots power is built and wielded in the policy the power of numbers, such as the massive one-to-one sig- arena (contestability) to affect outcomes. SoM enhanced de nature drives, often in combination with street actions. They facto contestability through the power of numbers, such as have elevated thousands of citizen voices in the policy arena. the massive one-to-one signature drives, often in combina- Elites who previously ignored the NGO have subsequently tion with street actions. In doing so, it elevated thousands of 60 CITIZENS AS DRIVERS OF CHANGE citizen voices in the policy arena. Elites who previously ig- commitment, SoM deemed it essential to cultivate collective nored SoW reached out to it, called for cooperation, or even responsibility and collective ownership. Collective ownership met its demands in anticipation of the collective action. is embedded in SoM’s organizational structure, manifesto, and operating principles (including obtaining the signatures Citizens are the source of SoM’s power, and, as a volun- of 1,000 citizens that are required to launch an initiative). teer-based organization, its key challenge is therefore over- SoM also deliberately took measures to cultivate a sense of coming collective action challenges to ensure that volunteers collective identity, strategically creating and crafting a narra- remain committed to the organization’s initiatives. It has done tive toward that end and a sense of agency among citizens. so by focusing on intangible motivators. To ensure volunteer CHAPTER 4: From analysis to action: FROM ANALYSIS TO ACTION 63 CHAPTER 4 From analysis to action T he research conducted for this report was designed to explore patterns rather than test hypotheses. It focus- es on citizen engagement and collective action across three has been a missing element in development policies and prac- tice by elaborating how citizens in the policy arena are capa- ble of shifting power asymmetries. In doing so, it provides a case studies with differing trajectories, societal and cultural path for development actors seeking to integrate power anal- norms, and socioeconomic indicators. And yet, despite these ysis into citizen engagement. variable contexts, a number of commonalities emerged. This final chapter summarizes the key findings in this report about In all three case studies, the underlying functional challeng- citizen engagement and how to mainstream these findings es that spur citizen action are driven by power asymmetries: into international development practice. exclusion, capture, and clientelism. In Afghanistan, the high levels of corruption that undermine the access to and qual- Key messages and takeaways ity of education are aggravated by the exclusion of citizens and communities from addressing education-related prob- Now that these three cases have been analyzed through the lems in their communities; teacher quality is undermined lens of the World Development Report 2017: Governance and by clientelism and patronage. In Paraguay, because of local the Law (WDR 2017b) framework and a human rights–based clientelism and capture, funds are sometimes targeted to po- approach, this chapter begins by asking how well these two litically favored schools rather than the marginalized ones, approaches worked and whether they resonated in the case as intended. Furthermore, the intended recipients are often studies. In both approaches, the framing helped dig into the excluded from the National Public Investment and Develop- underlying dynamics that explain processes and outcomes ment Fund (FONACIDE) process and unaware they should in the selected cases. The WDR 2017 approach forced con- be receiving funds. In Serbia, the effective exclusion of pa- sideration of the power asymmetries that undermine the tients from using institutional means of controlling health functional effectiveness required for service delivery, and it care corruption and punishing wrongdoers results in doctors pointed to ways in which citizens act collectively and engage possessing asymmetrical power relative to patients. Because strategically with elites and international actors to rebalance of the difficulty in challenging these entrenched power asym- power and shape elites’ incentives and preferences. The hu- metries, under-the-table bribes in exchange for medical ser- man rights–based approach helped demonstrate mechanisms vices have become an entrenched norm in Serbian society. through which citizen groups ensure voluntary commitment In each case study, citizens effected change by increasing to their causes, as well as complementary strategic angles contestability through extrainstitutional means—citizen col- whereby citizen groups use the availability of certain rights to lective action itself ameliorated power asymmetries and gave help fight for and obtain additional rights. citizens a seat at the table through the power of numbers. A And what contribution are the case studies making to the useful typology from the social movement field distinguishes WDR 2017 analysis? They are helping to extend that analy- between institutional and extrainstitutional pressure (Schock sis in two major directions by delving deeper into (1) how 2005; West 2013). Within the WDR 2017 framework, there organic social organizations motivate volunteerism and com- are four mechanisms through which citizens can engage to mitment to a cause to overcome the plethora of obstacles to produce change. The mechanisms of voting and political or- collective action, and (2) the strategies that social organiza- ganization involve institutional power. Social organization tions use when engaging with elites. Both of these areas are largely harnesses extrainstitutional power, whereas public identified as important elements of the WDR 2017 discussion deliberation can tap both. Extrainstitutional pressure is espe- of change processes, but neither is fleshed out in that report cially needed in the policy arena when elite-led institutional because of space constraints. policies are unsupportive of rules and policies for transpar- ency, accountability, and development outcomes. In such WDR 2017 resonance: Power matters settings, policies and rules can hinder reform and change, or they can be weak, inconsistent, nonexistent, and captured Power is at the heart of citizen engagement initiatives involv- by corrupt interests (Beyerle 2014). Social organization, such ing collective action. The WDR 2017 framework adds what as the community-based monitoring organized by Integrity 64 CITIZENS AS DRIVERS OF CHANGE Watch Afghanistan (IWA), reAcción’s student monitoring, development through the ill effects of corruption, the insuffi- and the grassroots campaigns run by Serbia on the Move cient and low-quality provision of vital public services, mar- (SoM), used extrainstitutional pressure to shift power asym- ginalization, poverty, and poor governance. Such experiences metries and enable citizens to take a seat at the bargaining are the basis of shared grievances, concerns, or problems in table. Co-founder Ana Babović encapsulates the process: “We citizen engagement initiatives. Notions about claiming rights got power from engaging with citizens. Those elites would informed these civic initiatives: the right to education (IWA, never sit with us if we didn’t get power from citizens.” Only reAcción), health care (SoM), and information (all case stud- after SoM organized silent protests and a petition drive, de- ies). This dynamic is captured in IWA’s innovative Communi- livering 3,000 signatures to authorities within five days, did ty-Based Monitoring toolkit (Gupta, Jahangeer, and Zupancic the Ministry of Health ask it to cooperate on a text messaging 2015): service enabling citizens to securely report corruption. SoM’s request for such cooperation had previously been blocked by [Volunteers] should raise awareness about commu- authorities. nity rights and responsibilities and raise awareness about corruption and its negative consequences Human rights and citizen engagement and encourage [citizens] to fight against corrup- tion. . . . Explain the legal basis for the right to mon- Citizen-driven engagement initiatives are in effect a way of itor for every Afghan citizen. Pass out brochures actively exercising human rights to improve development. on the Right to Monitor and other human rights, Such initiatives tap into grievances and problems experienced based on the Afghan constitution and international in daily life, frame such concerns through context-specific conventions. Emphasize the moral duty to exercise discourse, and underscore and empower voice and collective the right to monitor. action in order to enhance outcomes such as transparency, accountability, and vital public services. Second, human rights were used to gain other rights. Exercis- ing rights related to citizen voice and action (often articulated All three case studies are examples of the active exercise of through monitoring and evaluating elites and services) was human rights for instrumental purposes rather than (or in also prominent. The nongovernmental organizations (NGOs) addition to) their moral and intrinsic worth. Citizen engage- catalyzing citizen engagement educated citizens about such ment adds a missing dimension to understanding the inter- rights—from the general public (Serbia) to youth (Paraguay), dependent and mutually reinforcing relationship between communities and educators (Afghanistan), and patients (Ser- development and human rights, articulated in the 2007 “DAC bia). The introduction of right to information laws in Para- Action-Oriented Policy Paper on Human Rights and Devel- guay and Serbia helped citizen groups access the information opment” issued by the Organisation for Economic Co-op- they needed to expose and combat corruption. eration and Development (OECD 2007) and the landmark World Bank/OECD report Integrating Human Rights into Extending the WDR 2017 framework: Spurring Development: Donor Approaches, Experiences, and Challeng- collective action es (World Bank and OECD 2013).67 These publications em- phasize the conceptual, moral, intrinsic, and practical imper- The World Development Report 2017 highlights the impor- atives for integrating human rights into development, as well tance of citizen engagement through social organization in as the policies, approaches, and experiences of donor agen- which citizen groups must overcome challenges to collective cies. Complementing this body of work, the case studies illus- action, but the WDR does not delve into how citizens actually trate how citizens, through grassroots initiatives, can exercise overcome these barriers. The three case studies described in human rights through voice and action to gain human rights chapter 3 explore this question in much greater depth. related to accountability and development objectives. In other words, citizen engagement can involve the active exercise of All of these cases of organic citizen engagement highlight human rights, whereby rights beget other rights. the importance of volunteerism and agency in overcoming collective action problems. Highly structured, induced so- The case studies suggest two main ways in which the active ex- cial accountability interventions in which only elites identify ercise of human rights helped achieve goals. First, the absence the problem, objectives, and desired outcomes, and choose of rights served as a focal point for collective action. Human the modes of engagement with elites and nonelites, are not rights are more than abstract aspirations and moral impera- conducive to volunteerism and initiative. By contrast, in these tives. Their presence or absence can be tangibly experienced case studies citizens voluntarily contribute their time, energy, in daily life. For example, citizens could be denied the right to effort, and other resources. According to Ganz (2013), this 67. The interdependent and mutually reinforcing relationship between human rights and development was recognized at the 1993 Vienna World Conference on Human Rights, the 2000 Millennium Summit, and the 2005 and 2010 World Summits (World Bank and OECD 2013). FROM ANALYSIS TO ACTION 65 commitment of resources is what makes collective action they were captured by prominent nonstate community elites. possible. Citizens choose to participate in part because they Working instead with volunteers helped to nurture sustain- connect to the grievance or problem, share objectives, are ability, and collective ownership increased the legitimacy of able to overcome inhibitions (such as fear and apathy) to act, the communities’ demands. and begin to feel a collective sense of responsibility, owner- ship, and identity—that is, the intangible motivators. In the Paraguay and Serbia case studies, generating a sense of collective identity was essential for fostering unity and volun- Intangible motivators tary commitment. ReAcción’s “ParaguaYOite” initiative was itself designed to foster unity and collective identity through Sustained citizen engagement and collective action depend association of the name (“truly Paraguayan”) with the positive on collective responsibility, collective ownership, and collec- values espoused by reAcción (integrity, citizen participation, tive identity.68 These motivators foster commitment, coopera- honesty, and transparency). The logo reAcción designed was tion, and coordination; help to overcome fear and apathy; and laden with familiar symbols associated with Paraguay, and it build participation. They can function in a variety of formats, was emblazoned on T-shirts that members and student vol- from structured social accountability programs to ongoing unteers wore to activities. In Serbia, SoM found that citizens projects and mobilization efforts. Before moving to the action avoid civic activities in part because they feel isolated and are phase of their citizen engagement efforts, all three organiza- fearful of interacting with fellow citizens. To counter this at- tions highlighted in this study crafted narratives about the omization, SoM created a narrative that strengthened a sense value of citizens improving their lives and how they could go of collective identity, of shared stories of “us” and how “we” about it. This process could be considered a form of framing, (collectively) are the hope to change Serbia. This identity was “a process through which a given situation is defined and ex- reinforced by the badges and T-shirts that helped people rec- perienced” (Oliver, Cadena-Roa, and Strawn 2003). ognize each other and bolstered the sense that they were not alone in wanting to reduce the role of corruption in health As a starting point, successful recruitment strategies depend- care. ed on convincing potential volunteers that all citizens have the duty (and ability) to tackle the problem at hand, thereby cre- Confidence, recognition, and skills—benefits of ating a sense of collective responsibility. The concept of rights participation was linked to collective responsibility through narratives. For example, IWA built a narrative around “our” rights to educa- Citizens can gain direct and indirect benefits from engage- tion and how “we [the community] can play a role.” ReAcción ment initiatives beyond the stated objectives of social ac- built a narrative around peoples’ right to transparency (con- countability interventions. Such benefits can bolster their cerning FONACIDE) and the right to know and the fact that participation, cooperation, and commitment. Even though students could improve the administration of FONACIDE citizen engagement in this research was voluntary in nature, and the allocations for their schools. SoM emphasized that both citizens and elites derived tangible and intangible bene- the problems and injustices citizens faced could not be solved fits such as useful skills, confidence, dignity, and social recog- just by others (elites) and that people themselves were part nition. IWA brings local monitors together for peer-to-peer of bringing forth improvements and changes in governance exchanges, a special event for people who have few oppor- and society. tunities to travel beyond their communities and meet others who share their concerns and commitment to improving the All three social organizations described here stressed that education of their children. Local volunteer monitors and participants should have a role in planning and decision community representatives also gain confidence and social making, helping to create a sense of collective ownership. recognition for their roles in improving their communities Collective ownership is embedded in SoM’s organization- and interacting with elites such as officials and other formal al structure, manifesto, and operating principles (including stakeholders. To increase the status of local monitors, IWA in the requirement for 1,000 citizen signatures of support). In some instances holds officiation ceremonies and hands out Afghanistan, working with volunteers and building collec- certificates. tive ownership based on community engagement helped IWA avoid the problem that previous interventions had faced Skills are an important benefit of participation. For NGO when school management councils became inactive after members, volunteers, journalists, and even state elites, ed- funding and attention from international donors shifted, or ucation and ongoing learning are the keystones of effective 68. Collective responsibility is the personal sense individuals have that, unless they are a part of a joint effort to fight corruption, address accountability, and deal with development problems, things will not change. Collective ownership refers to the personal sense individuals have that “I am needed, and my own efforts will contribute to achieving our shared goals and success.” Collective identity, according to sociologist Lee Smithey, is a shared sense of “we-ness” that comes from shared cognitions, beliefs, and emotions among a group of people seeking positive change (Smithey 2013, 32). Also see Beyerle (2015). 66 CITIZENS AS DRIVERS OF CHANGE citizen engagement initiatives. Education of citizens is often that has sought to balance centralized versus decentralized a first step in recruiting volunteers and preparing for collec- decision making and planning. Such a balance has been ob- tive action (Baez Camargo 2013). IWA, reAcción, and SoM served in other effective grassroots citizen engagement initia- educate volunteers to participate in grassroots projects and tives and social movements (Beyerle 2014). In Paraguay, Da- campaigns. IWA provides local monitors (elected volunteer vid Riveros García founded reAcción when he was only a high community representatives) with systematic training in an- school student, and despite his youth he attempted to shape ticorruption, community mobilization, monitoring, and the the organization around an overarching vision of a “transpar- status of the Afghan education system. ReAcción conducts ent Paraguay.” He in turn cultivated youth leadership in the FONACIDE training for high school and university students. ParaguaYOite and Alliance for Open Government (AIGA) Courses cover the fund’s basics and administrative process, projects. Serbia on the Move was launched and initially driv- main points about the law regulating the fund, how to use en by the vision of Ana Babović, together with Predag Stojičić. government open data portals and the group’s unique visu- They expanded the leadership circle to a committed core and alization tools, and pressure points for influence. They even fostered what can be described as both transformational and conduct role playing to practice interactions with officials. transactional leadership not only among this initial group but In Serbia, SoM has developed specialized training, includ- also among the various project teams that were encouraged to ing leadership development and community organizing for take initiative and make collective decisions based on overall campaign team leaders and organizing basics for campaign objectives and strategies. volunteers. Youth inclusion, voice, and power Beyond training, participation itself develops new skills. Of- ten, people who are relatively marginalized learn firsthand Youth make up approximately one-quarter of the world’s pop- about governance as well as useful skills such as negotiating, ulation, a demographic noted by development actors (Fernan- problem solving, and auditing. Naser Sidiqee, former manag- do 2017). Yet, their voices are often not heard in transparency, er of IWA’s Community-Based Monitoring School (CBM-S) accountability, and governance efforts, just as in the formal program, summarizes how this translates into practice: “The electoral processes (McGee and Greenhalf 2011). McGee program must design a multi-faceted strategy to ensure that and Greenhalf (2011, 32,) find that many initiatives targeting every group finds something to call their own in the program. young people have increased their “voice” but not necessarily For example, community elders are brought face-to-face with their “influence.” However, “young people can acquire a set of higher level officials to express their grievances. People of a expectations about their right to participate and their power younger age are introduced to school managers and commu- to bring about change by doing so.” Other qualitative research nity elders, which earns them respect so that they themselves has found that youth often spur grassroots accountability ini- feel fulfilled.” tiatives, mobilize their peers and other age groups, and take part in collective action (Beyerle 2014; Mills 2013). ReAcción Role of leadership and Serbia on the Move affirm these findings. The reAcción case study demonstrates how even high school students can Leaders help determine collective outcomes by transforming affect power relations in the policy arena through social or- the beliefs and preferences of followers or by solving coordi- ganization and collective action. Serbia on the Move was nation challenges (Ahlquist and Levi 2011). If one uses the launched by youthful professionals, and a key component of distinction provided by Burns (1978) of “transformational” their volunteer base is young people, from university students versus “transactional” leaders, transforming beliefs and pref- to the unemployed. Moreover, young people are “learning by erences corresponds to the transformational role of leaders, doing”—that is, experimenting with how they engage with whereas the ability to solve coordination challenges corre- elites and citizens in order to influence policy and bring forth sponds to their transactional role. Transformational leaders change—a finding from a 2006–11 youth and governance can change preferences or gain a following by shaping pref- program funded the U.K. Department for International De- erences. In doing so, they can indelibly alter the nature of the velopment (DfID) and echoed in this research (McGee and policy arena. Both transformational and transactional leader- Greenhalf 2011, 33). ship can help grassroots efforts to recruit and sustain mem- bership. According to Mansuri and Rao (2013, 32), “Organic Use of technology participation is driven by self-motivated leaders who work tirelessly, with little compensation, often at a high opportu- Information and communications technology (ICT) can help nity cost. They are constantly innovating, networking, and facilitate collective action, though the tools themselves are organizing to get the movement to succeed.” neutral; their efficacy depends on a variety of contextual fac- tors and the parameters of citizen engagement initiatives. In The effectiveness of the social organizations in Paraguay and this research, their efficacy depended on factors that included Serbia has been in large part determined by strong leadership the overall context, the nature of the citizen engagement ini- FROM ANALYSIS TO ACTION 67 tiative, the suitability of the tool for targeted users (in terms through collective action that wielded pressure and disrupt- of their access to technology and their capacity to use it), the ed the corrupt status quo. Thus these approaches helped to information or outcomes generated by the tool, who/what or- change elites’ incentives through both pressure and positive ganization or institution is accessing information gathered by inducements. In addition, these case studies illustrate how the tool, and what is being done with the information. successful strategies can change over the course of engage- ment, necessitating an ability to learn and adapt. ReAcción’s core team applied themselves to learning, adapt- ing, contextualizing, and applying new technologies in vir- Collaboration and positive inducements tually all aspects of their activities. For communication, co- ordination through online groups, and outreach, they used Social organizations are often perceived as antagonistic to GoogleMaps, WhatsAPP, Facebook, Twitter, and YouTube. government and elite interests. In all three case studies, these In 2016 they adopted a new project management tool, JIRA. NGOs showed that citizen engagement can also benefit elites. It comes with its own messaging app, HipChat, which they Because elites in a sector or institution are not monolithic, use to connect chatting with the progress of monitoring. Even those who champion pro-development and anticorruption though no members of the core team had a background in policies or seek to implement them may need the support of computer science, they taught themselves and made use of citizens to overcome obstacles or resistance from other elites. MOOCs (massive open online courses) to learn how to code SoM’s “I am not on the take, I work for the salary” campaign and use visualization tools. They now do all of their own dig- provided such backing for doctors who wanted to say no to ital work, from social media networking to mobile/web app corruption. and website development. This research finds that citizen participation and action can For Serbia on the Move, technology enabled mobilization also activate “power with” in conjunction with state elites. of citizens and physicians in the digital realm. It was used to Collective action can wield “power over” and “power with,” create user-friendly, easily accessible tools that citizens could the latter based on cooperation, common ground, and coali- use to report corruption, irregularities, and substandard qual- tion building (VeneKlasen and Miller 2007). “Power over” is ity in health care facilities. Examples of such tools were the when one group or set of elites can impose its will on others. “What’s your doctor like?” platform, the SMS service, and Serbia on the Move’s collection of 10,000 signatures to achieve transparency mechanisms (the public roster of licensed phy- an Anticorruption Citizens Charter illustrates citizen-gen- sicians). When hundreds or thousands of people used these erated “power over” vis-à-vis elites. “Power with” involves tools, they engaged in collective action that wielded pressure. building collective strength by finding common ground and Through digital collective action, citizens entered the policy shared interests. It entails collaboration and can help build arena and shifted power asymmetries to influence transpar- bridges across different interests and stakeholders—that is, ency, accountability, and health care service delivery. actors in the policy arena (VeneKlasen and Miller 2007, 45). It has the potential to reduce social conflict and promote in- Extending the WDR 2017 framework: Effective clusion and equitable relations, the latter a core human rights engagement strategies principle. An example of such “power with” is SoM’s “I am not on the take, I work for the salary” campaign, which turned a When civil society groups challenge a corrupt, inequitable negative (corruption among doctors) into a positive through status quo and seek to increase contestability in the policy social recognition and support for doctors with integrity. arena, they can end up challenging the benefits and interests of elites, which can preclude constructive engagement, at least Citizens can serve as the government’s eyes and ears in iden- at the outset. A solely confrontational relationship with the tifying corruption, poor-quality public services, and mis- elite actors who ultimately are in charge of policy formulation management, as was evident in all three case studies. The and implementation can be counterproductive. In the case quality information had legitimacy precisely because it came studies described here, social organizations had three gener- from the grassroots. Citizen-led initiatives can be a source al responses and strategies to productively engage with elite of informed policy recommendations that are practical, us- actors, combining pressure with positive inducements rath- er-friendly, resonant with the public, and based on data from er than focusing solely on exposing corrupt behavior. First, grassroots monitoring and evaluation. As well, they can drive these social organizations used positive inducements and col- governance innovation. ReAcción’s two-tier mapping and laborative relationships to change the incentives of the elite data visualizations of FONACIDE were the first of their kind actors targeted for engagement. Second, when certain elite in Paraguay, and they are now being used by government of- groups resisted cooperation, these social organizations built ficials and the media. coalitions with other actors and institutions and selectively Training for elites can be a part of changing norms and prac- engaged with other sets of elite actors to increase pressure. tices and improving the provision of public services. For Third, these social organizations shifted power asymmetries example, Serbia on the Move launched a unique course for 68 CITIZENS AS DRIVERS OF CHANGE doctors and nurses. In cooperation with the Serbian Health in the FONACIDE sovereign wealth fund and its weak ad- Council, a professional body for medical personnel, the ministrative system. course was included among its professional training curric- ula whereby members earned education credits. ReAcción’s All three case studies exhibited elements of a vertically in- training programs are now so well known and regarded that tegrated approach to accountability. IWA’s expansion of the in 2016 some municipalities asked for them in order to access Community-Based Monitoring School program is careful FONACIDE. In 2015 the youth group began to train jour- and considered because of Afghanistan’s situational fragili- nalists to utilize the government’s open data portal in order ty and violence. It also uses locally generated findings from to create infographics about the fund. During the course of school monitoring in policy advocacy at the provincial and the CBM-S program, IWA began developing joint capaci- national levels. In its Voice for Health project, SoM strategi- ty-building workshops for stakeholders. cally planned at the outset to use citizen-generated informa- tion to formulate policy recommendations for the Ministry of Selective engagement and coalition building Health. It also built a volunteer-based mobilization structure across the country. And reAcción uses social media to broad- Effective elite engagement is strategic; it serves a purpose and en horizontal coverage. It combines local collective action in is not an end unto itself. Citizen engagement initiatives can Ciudad del Este through student monitoring with action at map institutions and relationships to identify allies, oppo- the national level such as participation in the Open Govern- nents, and targets. To counter or prevent efforts by elites to ment Partnership (OGP), media coverage, and interface with delegitimize their efforts, organizers in all three case studies the relevant national institutions and elites. laid extensive groundwork before mobilizing citizens. This groundwork involved building the capacity of the citizen on Ongoing learning, flexibility, and adaptation the street for leadership and civic engagement and cultivating alliances (coalitions in the WDR 2017 framework) with elite Citizen engagement can benefit from reflection and internal state and nonstate actors and institutions, which over time assessment because the relationship between citizens and came to perceive them as stakeholders. For example, IWA elites shifts over time, and the incentives of actors are not has developed what it calls a “holistic approach to enhancing static. For example, the relationship between SoM and the stakeholder involvement.”69 It conducts the most intense en- Serbian Medical Chamber came full circle. In 2010 the cham- gagement with elites at the outset, first securing cooperation ber successfully blocked the online evaluations produced by from the relevant government departments, including at the SoM’s “What’s your doctor like?” effort. By 2015 the relation- national level. This strategy enables IWA to reach out to local ship had grown more constructive as the balance of power authorities and gain their support. equalized through collective action. Likewise, the Serbian Medical Chamber went from restricting access to citizens’ Even within a given sector, including education and health evaluations of doctors to publicly providing information care, elites are not monolithic, and it was possible for the about their medical licenses. three organizations to identify allies, shift positions, and cul- tivate relationships through persistence, engagement, and Recognizing the importance of education and ongoing learn- collective action. All three sets of organizers made deliber- ing to effective citizen engagement initiatives, the three orga- ate efforts to map and navigate institutions and elite actors, nizations described here have continually assessed the skills often at particular points in the trajectory of the citizen en- needed for their organization and citizen engagement efforts. gagement projects. For example, the policy and governance For example, IWA called on the expertise and experiences of landscape in war-torn Afghanistan is particularly confusing the international NGO Integrity Action, including its peer- because of the complex layers of national, subnational, and to-peer network; core team members of reAcción taught local levels of institutions and authorities and the weak rule themselves programming so they could map FONACIDE of law. IWA initially secured a memorandum of understand- and compete in national transparency and accountability ing with the Ministry of Education—a seal of approval that hackathons; and SoM studied community organizing with gives it credibility to engage with other elites throughout the Marshall Ganz at Harvard University. education system at different stages of the community-based monitoring initiatives. Through its Focal Points (local staff), Finally but not least, the three organizations learned from IWA traverses these channels to identify elite interlocutors at their setbacks, successes, and changing circumstances. IWA the relevant national, provincial, and local levels, all the way launched the CBM-S program relying on provincial moni- to oversight of individual schools. In Paraguay, elites in mul- toring boards for education. This approach was based on the tiple institutions and levels are a core target constituency for success of this forum in its community-based monitoring of reAcción because of the involvement of multiple state actors reconstruction and development projects. However, once the 69. Naser Sidiqee, former program manager, CBM-B, Integrity Watch Afghanistan. FROM ANALYSIS TO ACTION 69 school program was under way, it discovered that there were ƒƒ Create spaces to convene and deliberate. International ac- already many other board-like entities in the education sec- tors have an important role to play in financing social tor. So, rather than sticking to a set formula, it adapted to the organizations, but they may be particularly effective at situation and replaced its boards with ad hoc meetings with creating spaces for social groups to convene, both togeth- the relevant education officials and stakeholders based on the er and with elite actors. issues to be addressed. ReAcción has incorporated self-as- ƒƒ Focus on process, not “best practice.” Rather than replicate sessments into its planning, resulting in a significant reorga- a technique, method, tool, or social accountability inter- nization and formalization of its status as a registered NGO. vention, international actors should support assistance And at the end of each of its campaigns, Serbia on the Move that scales up processes. builds in time to step back, reflect, learn from its experience, and then resume planning the next steps. ƒƒ Support flexible arrangements and incremental outcomes. International actors can best support citizen engagement To achieve flexibility, the NGOs in the three case studies en- by increasing project horizons or supporting consecutive couraged a degree of autonomy among members and vol- initiatives that build on one another. unteers in terms of decision making, prioritizing, planning, problem solving, and carrying out activities, from monitoring Support citizen engagement in all contexts to engaging with elites (online and offline) and to mobiliza- tion and mass actions (online and offline). Context is the baseline situation out of which projects and initiatives develop over time. Context does matter insofar Short-term “failures” can provide medium- and long-term as citizen engagement involves dynamic processes that re- lessons and even valuable experience that can subsequently quire constant adaptation and changes in strategy and tac- be used. ReAcción missed some of its indicators and commit- tics (Grandvoinnet, Aslam, and Raha 2015; Guerzovich and ments during its second year, but that was a turning point be- Rozenzweig 2014; Wajli 2016). As such, context shapes the cause it realized it had to shift from being a “weekend NGO” parameters, strategies, and activities of citizen engagement to being a stable organization that recruited more members initiatives. And yet, by shifting power asymmetries citizen from among the student contacts it had made. Serbia on the engagement also affects context. Taking context into account Move suffered what at the time was a devastating setback is part of a strategic (rather than tactical) approach to citizen when the government forced it to shut down its “What’s your engagement that could be supported by international actors. doctor like?” digital assessment tool. However, this closure backfired on the government, and the group gained public In all of these case studies, organic citizen engagement ini- attention and support. It salvaged part of the platform and tiatives emerged in spite of less than ideal settings. The three launched a new SMS campaign for reporting corruption in countries share a recent history of grim starting points and cooperation with the Ministry of Health and the Anticorrup- collective trauma. They have endured authoritarian rule, re- tion Commission. plete with brutal repression of dissent, human rights abuse, and, in Afghanistan and Serbia, violent conflict. They pres- Lessons for international actors ently face entrenched corruption and social insecurity re- sulting from this legacy. Overall, IWA, reAcción, and SoM The messages about citizen engagement emerging from these reported similar starting points for their citizen mobiliza- three case studies have important implications for interna- tion—principally, minimal engagement with elites, general tional development organizations. The research implies that apathy, cynicism, lack of awareness of entitlements and rights, international actors should consider taking the following deficiencies in the rule of law, and a lack of transparency and steps: information, especially about policies and responsibilities re- lated to public welfare and services. ƒƒ Support citizen engagement in all contexts. Even in frag- ile contexts and highly corrupt environments social or- This study adds to the growing body of research challenging ganizations can be effective. Indeed, especially in these the conventional notion that effective citizen engagement and environments grassroots movements may be essential to collective action require predefined “favorable” conditions to gaining legitimacy and partnering with the state. Inter- take root (Beyerle 2014). Leaders and organizers in the case national support may be the most effective in the most studies faced uphill battles, but they were able to surmount “difficult” contexts. these situational challenges and obstacles (structural deter- minants)—a finding observed in other qualitative examina- ƒƒ Build on organic structures and bottom-up solutions. tions of bottom-up collective action against corruption and Organic, bottom-up participation can help enhance nonviolent struggles for democracy, self-determination, land participation and is also more effective at generating rights, minority rights, and gender equality (Ackerman and context-specific, home-grown solutions than induced DuVall 2001; Ackerman and Kruegler 1994; Beyerle 2014; participation, which is often seen as illegitimate. Beyerle and Olteanu 2016; Chenoweth and Stephan 2011; 70 CITIZENS AS DRIVERS OF CHANGE Dudouet 2015; Schock 2005, 2015; Sharp 2005). Moreover, The traditional notions of how organized civil society func- they recognized and cultivated among citizens and commu- tions within development circles are increasingly outdated nities a sense of hope, agency, and collective responsibility, as when it comes to citizen engagement and collective action. well as awareness of rights and rules. They also directly pro- In the social movement field, there is growing interest in un- vided coaching and training to build the confidence, skills, derstanding the variety of social movement organizations and capacities needed for activities such as monitoring, policy (SMOs), their organizational processes, and the balance be- mapping, mobilizing, and negotiating with officials. tween formalization and autonomy in SMOs (Caniglia and Carmin 2005).70 The entities involved in the three case stud- The research described here reveals as well that citizen par- ies—Integrity Watch Afghanistan, reAcción, and Serbia on the ticipation and social accountability can positively influence Move—defy conventional classifications. On the one hand, all development outcomes in fragile contexts. Citizens in frag- three are now formal, registered NGOs. On the other hand, ile countries, whether emerging from conflict or in danger they have a strong grassroots base that gives them legitimacy, of falling into conflict, typically display lower levels of trust resources (volunteers, in-kind donations, and support), and in the government (World Bank 2011). Rebuilding trust is numbers (people power). Just as important, they combine cit- central to rebuilding peace. When the state appears unable to izen engagement with informed policy formulation and con- provide these, citizens are less likely to trust the elites. Engag- structive elite engagement. Development actors thus are now ing citizens and civil society to pursue social accountability able to look beyond conventional NGOs for engagement and in fragile contexts is valuable because community-based or- possible cooperation—a lesson also noted in the recent liter- ganizations often play an important role where the state falls ature in the transparency, accountability, peacebuilding, and short (Grandvoinnet, Aslam, and Raha 2015). Such engage- nonviolent action realms (Halloran and Flores 2015; Joyce ment could also reduce the risk of violent action and support and Walker 2015; Stephan, Lakhani, and Naviwala 2015). the sustainability of peacebuilding efforts. Even in contexts in which a country is divided or levels of institutional legitimacy Create spaces to convene and deliberate are low, community-based organizations have the potential to strengthen a sense of citizenship (Gaventa and Barrett 2010). International actors can increase contestability in the poli- The case study of Integrity Watch Afghanistan demonstrates cy arena by providing alternative sites for contestation and the unique and fruitful role that a civil society organization deliberation. In the case studies reviewed here, social orga- engaged in social accountability efforts can play in a context nizations benefited from financial support from external ac- marked by profound divisions and high levels of fragility. tors, but they also benefited considerably from international interventions to create spaces for deliberation. For example, Build on organic structures and bottom-up in late 2015 reAcción learned that FONACIDE transparency solutions was among the government’s 2014–16 OGP commitments, and it was accepted into Mesa Conjunta, the group com- For international actors, a key lesson is that citizen engage- posed of civil society organizations that was monitoring the ment “projects” can incorporate the strategic analysis and government’s OGP action plan commitments, along with dynamic elements of bottom-up campaigns. International ac- representatives of public institutions responsible for fulfilling tors can extend support to hybrid NGOs and informal groups those commitments. Through this forum, supported by the beyond the traditional, often technocratic organizations that Democracy and Governance program within the U.S. Agency are removed from the grassroots and operating largely in cap- for International Development (USAID), reAcción presented ital cities. Civil society groups can lose credibility in the eyes its monitoring system and findings and contributed input on of citizens when they appear to be following a foreign agenda FONACIDE education commitments to the new 2016–18 ac- and getting paid handsomely for their efforts, including cit- tion plan. ReAcción also benefited from participating in two izen engagement. Volition and agency are central factors in hackathons run by the Ministry of Education with support sustaining citizen commitment, participation, and collective from USAID. action. Highly structured, induced social accountability in- terventions in which elites identify the problem, objectives, SoM invited USAID to participate as a stakeholder in the pol- and desired outcomes and choose the modes of engagement icy roundtables and public panels it convened in 2014 and with elites and nonelites are not conducive to volunteerism 2015. The United Nations Development Programme (UNDP) and initiative. However, it is possible to integrate elements of also played a conduit role. It had financially supported anti- volition and provide space for agency in citizen engagement corruption health care efforts in both the Ministry of Health projects. and Serbia on the Move. In 2015 the Ministry of Health 70. Although there is no definitive definition, a social movement organization is a nonstate entity that is part of a social movement and can perform multiple functions for the movement such as identity, leadership, strategizing, and planning. However, the movement is not bounded by the SMO, nor are SMOs essen- tial for social movements to flourish (see Beyerle 2014, 293). FROM ANALYSIS TO ACTION 71 approached SoM through UNDP to propose cooperation social movements and civic campaigns, and it is often part of after SoM launched its SMS tool for citizens to report cor- an overall strategy of movement planners over time (Popovic, ruption and irregularities, which was supported by a grant Milivojevic, and Djinovic 2006). Increasingly, scholars and from UNDP. UNDP also pressed state elites for adoption of practitioners in the fields of transparency, participation, and anticorruption measures and institutions and for coopera- accountability and development are recognizing that “there is tion with civil society. Babović reports that it provided the no single route to citizen empowerment or to evoke respon- Anticorruption Agency with funding for projects to initiate siveness of public officials (Baez Camargo 2013, 13). a dialogue with civil society. SoM was included in some of these efforts. Looking at citizen engagement initiatives in isolation rather than holistically may obscure the longer-term power shifts Focus on process, not ”best practice” and outcomes. For example, had this research homed in on one SoM campaign, one year of time in reAcción’s trajecto- The conventional view in development is that a technique, ry, or one CBM-S initiative in Afghanistan, the conclusions method, tool, or social accountability intervention should would be different. Ganz provides a useful definition of a be widely replicated. The underlying assumption is that what campaign that applies to citizen participation: “A campaign is “works” in one context can work in another. The WDR 2017 a streamed set of activities leading to achieving a goal that will framework points to the conceptual weakness of this assump- bring us one step closer to the change we want to see in the tion because power asymmetries vary and each policy arena world.”71 Thus it is the cumulative impact of initiatives over has its own interplay of drivers of policy effectiveness, levers time that can lead to general improvements in governance for change, and drivers of change. and development. The emerging more nuanced notions about scaling up for ac- It often takes time to build power in the policy arena. Within countability and development call for scaling up approaches its first three years of operation, Serbia on the Move launched and processes rather than interventions and solutions. The the “I am not on the take, I work for the salary” campaign implication for international actors seeking to support cit- and expanded it to five cities. With the support of citizens izen engagement is that the question is not “What works?” through a petition of 10,000 signatures, SoM increased the but “What are the dynamics and pathways towards change?” contestability for an Anticorruption Citizens Charter for (Fox 2016, 32). Rather than scaling up induced interventions or solutions, Wajli (2016) proposes scaling up the approaches health care. It engaged with health care elites, organized a and processes through which solutions are developed. This stakeholder roundtable, and drafted the charter. Ultimately, form of scale-up is evident in IWA’s community-based school the Ministry of Health, with financing from UNDP, decided monitoring program. From 2014 to 2016, 180 communities/ to create its own charter. Nevertheless, the final content was schools participated voluntarily, and plans are to expand to similar to that prepared by SoM. In terms of the WDR 2017 270 in 2017. IWA has developed a clear framework with con- framework, over time SoM played the rules game. It built textually driven interactions and tools, but it reports that each power to increase contestability, change incentives to pursue initiative has its own unique characteristics, and it is the com- anticorruption goals in health care, and reshape elite prefer- munities that drive solutions to the problems identified by the ences concerning graft in this sector. local monitors. In operating over the medium term, social organizations Support flexible arrangements and incremental must themselves be flexible, and international support should reflect this need. The research revealed both the science and outcomes the art of grassroots collective action (Chenoweth 2015). On Through incremental outcomes, citizen engagement initia- the one hand, the organizing groups carried out systematic tives can contribute to social and developmental change, but activities (the “science”) such as analysis of their context and the process is nonlinear and builds over time. Internation- problem, planning, education (from awareness to skills build- al actors can best support citizen engagement by expanding ing), and strategic deliberations about challenges, strengths, project horizons or supporting consecutive initiatives that policies, elite actors, and citizen mobilization. On the other build on one another. hand, the “art” of collective action involved flexibility, cre- ativity, and inspiration. The organizers adapted to changing The three case studies reveal that social change is discon- circumstances or new opportunities, and they encouraged tinuous in the medium term (Fox 2016, 32). Outcomes are grassroots empowerment, autonomy, and problem solving incremental, building modestly with interim objectives and on the part of volunteers and members. ReAcción and Ser- “small victories.” This pattern can be noted across a variety of bia on the Move deliberately encouraged their colleagues and 71. Global Partnership for Social Accountability (GPSA), http://www.thegpsa.org/sa/about/what-we-do; Stephan, Lakhani, and Naviwala (2015). 72 CITIZENS AS DRIVERS OF CHANGE volunteers to come up with imaginative, fun, and sometimes tonomous councils, access to food was a tangible and positive humorous ways in which to move forward. outcome even if the majority of councils were captured by elites. Similarly, IWA’s CBM-S project does not have a perfect In keeping with this flexibility, international actors should track record. Communities are not able to solve every prob- be more judicious in defining success and failure. Fox (2016) lem identified by local volunteer monitors, as indicated by the cites as an example Mexico’s community food councils, which overall fix rate of 37 percent. But the fact that they are able to were launched in the early 1980s when the country was un- collectively spur some improvements in schools is significant, der authoritarian rule. About a third of these accountability particularly given the severity of common problems such as bodies managed to maintain their autonomy from the bu- insufficient, absent, “ghost,” or ill-prepared teachers, and a reaucracy, ruling party, and local elites. For the thousands of lack of classrooms, building infrastructure, drinking water, marginalized citizens in remote villages served by these au- toilets, and equipment. APPENDIXES 74 CITIZENS AS DRIVERS OF CHANGE APPENDIX A Integrity watch Afghanistan’s CBM-S framework The framework within which Integrity Watch Afghanistan vey. They administer a standardized questionnaire developed (IWA) conducts its Community-Based Monitoring School by IWA to citizens. The questionnaire provides information (CBM-S) program has eight stages. about the existing situation at the grassroots and captures citizens’ views. Because it involves direct, “door-to-door” in- Preparation. IWA secures a memorandum of understanding teractions, it also serves as a community outreach and mobi- from the Ministry of Education that enables it to contact and lization tool for the civic initiative. The data generated can be undertake coordination with the relevant officials within the used as well as a source of bottom-up social pressure on elites ministry. The next step involves coordination with the public because it reflects collective concerns and the observations of education sector at the provincial level. After securing letters communities. from these elites, IWA presents them to district and local school officials. Monitoring. The monitoring program focuses on problems at two levels: (1) school administration and operations and (2) Recruitment. IWA’s Focal Points (district-level staff working state education institutions. The first includes matters such as with communities and engaging with subnational and local cleanliness, attendance of teachers and support staff, teach- elites) approach communities by speaking with respected er use of lesson plans, and school infrastructure. The second members (such as elders and mullahs), the local school man- relates to the Ministry of Education and education depart- agement, and citizens in informal gatherings. If a community ments, including allocations of school resources and funding is interested in participating in the CBM-S program, IWA’s and official decision making (Sidiqee 2016). Local monitors Focal Points contact the local community development coun- visit the targeted schools twice a week, filling out week- cils, which elect a local monitor. The monitors are not paid for ly monitoring, which are then given to IWA’s Focal Points, their time and receive only a modest monthly stipend (1,000 who enter the information in a database. IWA summarizes in Afghanis) to cover transportation and communication ex- monthly feedback sheets the problems and issues identified penses during monitoring. during monitoring, and local monitors use this information Training. Local monitors undergo training in preparation for in following up with the school administration and apprising their activities. At the outset, they have limited capacities for the community through the school management shura (SMS) mobilization and self-organization, monitoring (from bud- meetings and monthly community meetings in which local gets to school operations and infrastructure), and interaction monitors also share achievements and, if necessary, request with elites, including officials at the subnational and local lev- support from the respective communities. els. Training thus includes an introduction to anticorruption, Engagement. Community-based monitoring involves engage- transparency, integrity, and accountability; an overview of ment not only with elites but also with citizens, and it as- corruption and governance challenges in Afghanistan’s ed- sumes a variety of structured and unstructured forms. IWA’s ucation sector; and familiarization with the skills and tools needed to monitor education services and carry out surveys. strategy has been to build trust and use existing entities as IWA is also experimenting with joint capacity-building work- much as possible. Local monitors attend and participate in shops for stakeholders to enhance coordination, cooperation, monthly school management shura meetings, where they up- and commitment between citizens and elites. In Herat prov- date members of the community and local school officials on ince, it brought together 30 local monitors, 30 school prin- their findings and seek cooperation to address the problems. cipals, and officials from the Directorate of Education and At the outset of the monitoring initiative, they ask the SMSs Department of Education in Injil district and Herat city. Fi- to prepare a meeting schedule for the year. The schedule pro- nally, at the district level it organizes monthly meetings for vides the shuras with a structure, and it can be considered a local monitors. These were instituted to enable peer-to-peer lever to reactivate them (many existed solely on paper or went exchange and learning, support network building, and foster dormant after donor money dried up), push them to meet unity across communities. regularly, and pressure members to address problems. IWA also facilitates monthly coordination meetings for the com- Baseline survey. One of the first activities of local monitors munity at large. These gatherings help to build accountability is to canvass community members through a baseline sur- and legitimacy into the citizen engagement initiative because APPENDIX A 75 the local monitors report back to their fellow citizens. They opment councils, or district–level and provincial education are intended to harness grassroots support and encourage bodies. They may receive input from fellow monitors in other collective action to address problems identified by the local communities through the monthly monitor gatherings. As monitors. During the third quarter of 2016, for example, 16 important, they often turn to their fellow citizens to collec- coordination meetings were held with communities in Par- tively take action. The responses are frequently highly creative wan province. and resourceful. Problem solving. When local monitors detect problems in the Endline survey. Every year during a CBM-S initiative as well targeted schools, responses vary by community. The moni- as when it comes to a close IWA’s Focal Points carry out an tors, often together with respected figures, may seek solutions endline survey in order to take stock and assess the program’s through the school management shuras, community devel- outcomes. 76 CITIZENS AS DRIVERS OF CHANGE APPENDIX B Serbia on the move’s manifesto (English translation) The mission of Serbia on the Move (Srbija u Pokretu) is to build a strong and responsible civil society through motivating individuals to take an active part in creating changes that will improve their lives. MANIFESTO During the past five years, Serbia on the Move has conducted projects in the areas of fighting against corruption in health care, environmental protection, accessibility, and the labor rights of women, and we have educated citizens in modes of community organizing. In our work, we stick to three basic principles: (1) citizens’ support, (2) social activism, and (3) transparency. Serbia on the Move brings together people who are not satisfied with simply talking about problems and criticizing others, but who wish to be active and work on solving those problems. WE WISH FOR SERBIA TO BE A COUNTRY WHERE: 1. We are free to express and organize ourselves, and we do not wait for others to solve our problems. 2. Modern education and science are available to us, and we continuously work on our personal development. 3. We make progress in accordance with how much we are worth and how much we work 4. We know the rules, and the same law applies to all. 5. Government is a service of citizens, not a restraining force. 6. Health is a right of everyone, not a privilege of individuals. 7. We respect the lives and safety of all. 8. We accept diversity and we are solidary. 9. We live in a society of equal opportunities and accessibility for all. 10. We look after nature and we do not pollute it. 11. We use the media critically and the internet is available to all of us. 12. 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World Development Report 2017: Governance World Bank. 1994. “The World Bank and Participation.” and the Law. Washington, DC: World Bank. Working Paper 13726, World Bank, Washington, World Bank and OECD (Organisation for Economic Co-op- DC. eration and Development). 2013. Integrating Hu- ______. 2001. World Development Report 2000/2001: Attack- man Rights into Development, Donor Approaches, ing Poverty. New York: Oxford University Press. Experiences, and Challenges. 2d ed. Washington, ______. 2003. World Development Report 2004: Making Ser- DC: World Bank and OECD. Since 2014, the World Bank Group (WBG) has formally mainstreamed citizen engagement in its strategy to end extreme poverty and share prosperity, building on 25 years of emerging practice and research. In the early 2000s, the WBG issued guidance on multistakeholder engagement to strengthen accountability relationships through citizen participation and ensure that the benefits of development projects reached the poor. Most recently, the development community has acknowledged that development outcomes improve when citizens participate in development, leading to the WBG mandate to mainstream citizen engagement across sectors and countries. The research described in this report, made possible through the Nordic Trust Fund (NTF), a multidonor knowledge and learning program on human rights for WB staff, aims to deepen understanding of citizen engagement in the development arena through in- depth study of three grassroots initiatives in which empowered citizens played a central role. The research complements existing approaches by explicitly adopting a human rights perspective as well as focusing on organic citizen-led initiatives rather than WBG- or client-initiated projects. In analyzing these cases, this report applies the framework of the World Development Report 2017: Governance and the Law (WDR 2017) to understand how citizens effectively disrupted the persistent power asymmetries that undermined development outcomes. This report analyzes citizen engagement to reduce corruption in service delivery in three diverse settings: in Afghanistan, improving education outcomes through community-based monitoring of schools; in Paraguay, monitoring sovereign wealth fund resources allocated to education to improve the infrastructure of marginalized schools; and in Serbia, promoting transparency and the integrity of physicians to reduce corruption in the health sector. The World Bank 1818 H St NW (202) 473-1000 www.worldbank.org