SEND Foundation Ghana uses open source software and portable computers to gather data on policy implementation from people living in rural communities.
Since 2002, the SEND Foundation has been monitoring Ghana’s poverty reduction strategy, and researching whether the country’s poor have been benefitting from the government’s policies. The NGO works mostly with farming communities in the north of the country to improve food security, through increasing access to market prices, credit facilities, warehousing and agricultural inputs. The organisation also supports community-based organisations to give rural communities more influence on agricultural and other relevant policies.
Health care is one such issue. SEND Ghana and its partner organisations, known as focus NGOs, have been assessing the national health insurance scheme (NHIS) to determine its availability in rural communities.
The Ghanaian government introduced the NHIS in 2003 to deliver quality health care ‘within five years’ to everyone in the country, regardless of income. Together with the focus NGOs, SEND Ghana developed questionnaires to find out how many people could access medical services through the scheme, and assessed the quality of the care given. The organisation then used the data to provide feedback to government ministries, and to advocate for changes to the policy to ensure it reached more people in rural communities.
Citizen monitoring committees gathered the data, initially on paper forms. The process of entering that data into a central database was time-consuming and prone to mistakes as it was sometimes difficult to interpret handwritten notes. SEND Ghana needed a more efficient system that could deliver results quickly. Faster analysis of the data meant that the organisation could provide ministries with more reliable and up-to-date information.
The project team investigated several existing data collection methods, but found that none met their specific requirements. They decided to work with a local software developer to produce their own open source computer program that suited their exact needs, but which could also be easily adapted to collect data on any subject, not just on health care issues.
The new software, called Open Source Monitoring and Evaluation Tool (OSMT), is loaded onto small portable computers, also known as netbooks, which committee members can easily carry on visits to rural communities. Questionnaires are downloaded from their nearest local office and can be adapted to include multiple choice questions or longer typewritten comments. They can also be adapted to suit particular situations; the committee members enter the data as they interview people at home, for example, or in the clinics. When they get back to their district office, or arrive at a town covered by a cell phone network, they can upload the data using a GSM modem built into the netbook.
One problem the organisation experienced with other data collection software was that, at the time, many did not allow for offline work and the subsequent online upload. Offline working was an important feature of OSMT since not all of the rural areas in the 21 districts covered in the initial pilot project are covered by cell phone networks.
While it is difficult to say whether their work has directly led to any change in policy, Martine Koopman, Ghana country manager at the International Institute for Communication and Development, which provided technology training to the project, explains that SEND Ghana has developed a good reputation among government departments. Their status, she says, and that of the focus NGOs, is likely to improve through the enhanced data gathering techniques.
‘One of the first results that came out of their research on the NHIS,’ says Koopman, ‘was that more people are indeed entering the scheme, but that the number of doctors in rural areas has not increased. They showed that those doctors now have a much greater workload, which has an influence on the quality of care provided. It is not a problem that can be solved overnight, it takes a long time to train more doctors, but at least there is now concrete evidence to help the ministries adapt their policies.’
The government also benefits from the organisation’s data as it can present the results to funding agencies and investors when looking for financial support. But, says Koopman, the project will also have an impact on local policy development. ‘The data is currently uploaded to a central database at SEND Ghana’s main office, but they are now working to make sure the district offices can get the information related to their specific area. This would give the focus NGOs the information they need to influence local government strategies.’
SEND Ghana make their reports available online for anyone to download and read. ‘NGOs can provide accurate and independent data that people can trust,’ adds Koopman. ‘Gathering information directly from those who use the services, and then making it public, encourages discussion, and gives people the chance to influence decision making.’
Martine Koopman is country manager for Ghana at the International Institute for Communication and Development , and Mumuni Mohammed is project manager for SEND Ghana .