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PRO-Health or Promoting Rights Organizing for Health is a health organizing initiative of the Government Watch (G-Watch) and Accountability Research Center (ARC) in partnership with several civil society groups and local governments. PRO-Health aims to strengthen transparency, participation and accountability in public health governance by building coalitions and alliances among citizens, groups and communities around health rights issues, and by facilitating learning and problem-solving among accountability frontliners and rights defenders to come up with pro-people and bottom-up solutions to systemic barriers and hurdles to reproductive, maternal, newborn and adolescent health services.
PRO-Health specifically engages three health programs/ policies of the government for the first year: (1) Reproductive Health and Responsible Parenthood, (2) First 1000 Days; and (3) Mental Health for youth and students. The main target of monitoring will be facilities, services and medicines in barangay health units, relevant procurement activities and performance of public health professionals.
The initiative is part of an ongoing cross-country initiative of ARC to learn with, from and for frontline rights and accountability defenders. In the face of both ongoing shrinking of civic space and the pandemic, questions of how to bolster staying power for frontline organizers become even more urgent, particularly in identifying and developing innovative solutions to age-old and structural challenges and problems made complicated by climate change, digital age and other changes in context.
On the first year of PRO-Health, baselining research was conducted by the G-Watch Center team as the sites and partners started organizing and laying the groundwork for PRO-Health monitoring. Eight briefing-orientation seminars were conducted, capacitating a total of 292 volunteer-monitors. Monitoring and data processing and consolidation are done, while sharing sessions that convene select volunteer-monitors to discuss their experience and dialogue with duty-bearers in a problem-solving session are also done in almost all the sites. In the meantime, the G-Watch Center Team has completed setting up a documentation, tracking and learning (DTL) process for PRO-Health, producing out of it one review of evidence and two baseline reports: on organizational capacity and local health situation of the sites and partners.
To continue consolidating the PRO-Health network at the national level through shared learning, analysis and agenda on the monitoring results, PRO-Health learning exchanges shall be held, convening volunteer-monitors, accountability frontliners and G-Watch core members from PRO-Health sites and partners. The first one was held last November 24-26 convening local coordinators from sites with most progress in implementing their monitoring plans.
On April 26-28 in Cebu City, about 40 leaders of G-Watch mostly from the six (6) G-Watch local sites involved in PRO-Health will be convened to learn about and plan on advocacy and engagement. Specifically, the aim of the workshop are the following:
The learning exchange will also center on learning about and devising ways to track advocacy and engagement. Effective advocacy and engagement generates effective response from government as it strengthens networks, organizations and leaders. Joy Aceron’s recent blog captures the silver lining of how the challenges faced by PRO-Health in engaging with government during monitoring became an opportunity to further organize, build allies and empower G-Watchers:
"With efforts to overcome the risks and challenges posed by constraining civic space, enabling citizens to do monitoring and come up with solutions becomes a painstaking process of empowerment…In PRO-Health, the conduct of monitoring in restricted civic space has turned into an organizing and coalition-building process. In a less favorable political context, the recruitment and training of monitors and the practice of monitoring can be seen as civic learning. The broadening of monitoring networks has become key to building collective countervailing power. Monitoring exercises are driven by a know-your-rights and claim-your-rights approach, and by a collective intent to improve governance. This is very different from the conventional focus of third party monitoring on data gathering as an end in itself."
The same dual goals of organizing and generating government response must be sustained as PRO-Health furthers its advocacy and engagement activities.
Meanwhile, the latest paper of Jonathan Fox, et.al. disentangles ‘government response’ to facilitate understanding on varied government’s response and action towards citizen voice and demands, wherein differentiating would be crucial in determining whether accountability delivers enduring changes.
“Government responses to civil society voice and action can fall into three overlapping categories: responses, responsiveness, and accountable responsiveness. Officials may commit to changes—that’s a response. Yet governments may or may not deliver on those promises. In contrast, when governments meet those commitments and recognize the legitimacy and relevance of social actor input into the policy process—that’s responsiveness. The more consistent and inclusionary government actors are in terms of meeting their own commitments to citizens, the more responsive they are. Government agencies that go further, with officials who actually explain and justify their actions (or inaction), can be described as engaging in a third kind of response: accountable responsiveness.
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Governments can respond to voice yet still abuse their power in the ways they distribute material concessions. In this category of ‘responses,’ there is the risk of repeating similar problems in the future because there are no changes in policy or practice to avoid them. In these ‘discretionary response’ scenarios, what may look like a policy win in the short term could be easily withdrawn at the government’s discretion in the future.
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Responsive governance is widely treated as evidence of accountability. That seems intuitive; the ideas certainly overlap.
Yet the key distinction between accountable and responsive governance is that “responsiveness is at the discretion of those in power, rather than an institutional obligation.”15
Yet some kinds of responsiveness do involve accountability. The idea of accountable responsiveness suggests that powerholders respond to citizen voice with explanations, and possibly consequences—as with functioning grievance redress mechanisms.
In brief, accountable responsiveness is a subset of responsive governance…
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Accountable governance includes both public-facing answerability and upwards reporting to higher level or checks-and-balances oversight. Accountable governance is understood here as involving both some kind of process or forum for answerability, where duty-bearers must explain or justify their actions—possibly including some kind of tangible consequences, such as rewards or sanctions. Yet sanctions and rewards for public sector officials mainly come from within the government itself, from above, and may not be public-facing…
To sum up, government responses to voice can be substantive and meaningful without
necessarily adding up to accountable responsiveness.
In contrast, accountable responsiveness would also involve processes of public-facing institutional answerability, such as power-sharing or effective grievance redress…”
To explore tracking government response, G-Watch is devising a Response Tracker and a Commitment Tracker that will be further developed and discussed during the learning exchange.
Finally, there is the challenge of popularizing the documentation of advocacy and engagement progress. G-Watch is also currently exploring whether and how digital means can be used to enable more G-Watchers to tell stories and track progress. In the 2nd learning exchange, each site will be launching their audio-visual presentations (AVP) on local PRO-Health on the following themes:
The best AVP will be given an award during the Solidary Night that the site can use to further their advocacy and engagement activities, including further use of digitalized knowledge outputs.
As a side session, G-Watch invited the Department of Health (DoH) in Cebu to brief on the following on April 26 as a way to further inform the discussions on the PRO-Health reform agenda that will be firmed up in the learning exchange: