The facility audit is a tool to improve the overall quality and utilization of public service facilities and infrastructures. It ensures accountability of duty bearer towards the citizen, which in turn helps in improving public services. The facility audit enables informed citizen’s participation, empowers the citizens, and enables them to monitor the services as through this process citizens get to know about the public services intended for them. This helps in improving the facilities and assets required for quality service delivery.
What is a Facility Audit?
A facility audit is a comprehensive review of facilities provided by the government, private sector as well as NGOs. It is a standard method for establishing baseline information to understand the status of the existing facilities, which includes staffing, buildings, materials, equipment, and other hardware required for smooth operations of the facilities to provide services to the people. Secondly, it helps to measure the monetary value of an aging asset relative to the cost of replacing that asset and thus projecting future maintenance costs and procurement. The audit includes conducting surveys, observations, and inspections. The findings are always shared with the service providers to improve the standard and quality of the facilities.
For instance, Welthungerhilfe along with its partners implemented this social accountability tool in Jharkhand, India where it was used for assessing two government services:
a) Facilities in elementary education and
b) Facilities used for the Integrated Child Development Services (ICDS), including health centres.
The facility audit was conducted in 4 districts covering 120 childcare centres and 21 health sub-centers. It resulted in the improvement of services. For example, in Dumka district when the report of the facility audit conducted for health centres under ICDS was shared with the district and block administration, it resulted in the government procuring new equipment for monitoring children’s growth in all the health centres of a block. A key lesson learned while conducting this audit was to involve the institutions of local government in this process, namely the elected members of the Gram Panchayat.
How to conduct a Facility Audit?
Step 1: Preparatory phase
Mapping of the service delivery points.
Get buy-in from higher officials for the audit (if possible).
Identify the facilities to be audited and prepare a list of the infrastructure, equipment, materials, staffing and services to be audited. This will be based on government documents which usually list all facilities.
Develop audit checklists for observing or inspecting facilities and services.
Develop guiding questions for the focus group discussion.
Select the team from the community that would conduct the audit.
Train the audit team and orient the service providers on the facility audit process.
Field test the tool and improve the checklists.
Facility audit checklist used in childcare centers in Jharkhand (Page 1)
Facility audit checklist used in childcare centers in Jharkhand – page 2
Step 2: Conduct Facility Audit
Taking service providers on board is very important to conduct a facility audit. The objective of the process should be clearly communicated at the beginning of the audit process so that they understand their roles and cooperate. The service provider is expected to provide the relevant registers, files, documents, and equipment for inspection. A written permission from higher authorities usually helps.
Observe and inspect the facilities i.e., physical verification of the infrastructure, availability of staff, materials, equipment etc. and cross-check with the registers available in the offices.
Interview the service provider.
Collect information from the citizens through focus group discussions on their experiences of the facilities and services provided.
Analyse data and prepare a facility audit report. It is good to summarize key findings and develop recommendations for further advocacy work.
Step 3: Public Hearing and Advocacy
Share the report of the facility audit at a public hearing with the service providers, whose services were audited, and the community members. Ensure that senior officials from concerned government departments are present as they are the ones who can take decisions based on the facility audit report to improve services and facilities.
This paves the way for new demands and the correction of the existing infrastructures and services.
Step 4: Scaling the facility audits
The facility audit tool can be easily developed and replicated jointly with service providers to improve facilities for any public services. However, for replication, it will require a trained team that can facilitate the process with the service providers. This requires skills to analyse the information generated from the facility audit processes.
This tool can be integrated with the regular activities of the service providers for a sustainable process. Based on the experience of using this tool, it requires a team of 2 and an average cost between INR 200-300 (€3-4) per the assessment of a service centre at the village level.
What are the Advantages of Facility Audit?
It creates a database of the status of existing facilities including staffing, infrastructure, and equipment amongst others to advocate with the service providers.
It enables service providers to improve services.
It makes citizens aware of the services they are entitled to.
It initiates relationships between the community and service providers.
It brings attention to the weaknesses in the existing infrastructure or services.
The process is cost-effective.
It can be easily scaled to a larger number of facilities.
It can be used for evidence-based advocacy to improve services.
What are the Challenges?
Some checklists are too specific or too broad, hindering a higher-level review of the facility and its capacity.
Cumbersome or lengthy templates require additional training or preparation time prior to the audit.
If the enumerators are not well oriented about the services, then the actual reality won’t be revealed.
Sometimes service providers do not support the process as they fear that they would be blamed for the poor services being provided to the public.
Case Study
Good Governance Project in Jharkhand, India
Major findings from facility audit of primary health centres and key recommendations
A facility audit was conducted covering 120 childcare centers and 21 sub health centers to study the facilities available for quality service delivery. The facility audit was conducted with due permission from higher authority. The areas were selected in accordance with the backward district list, remoteness, vulnerability, and low access to services, population categories. In the childcare centers (anganwadi centers) availability of staff, physical equipment and infrastructures, resource materials, essential medicines, registers, hygiene of children, and child care services (for 0 to 6 month, 7 months to 3 year, 3 to 6 year, adolescent girls, pregnant women, recently delivered women) were assessed. Whereas from the health facilities (Health Sub Centers (HSC), Primary Health Centers (PHC) and Community Health Centers (CHC)) availability of staff, physical infrastructures, supplies, transport facilities, services from HSC, PHC and CHC as per Indian Public Health Standard norms were studied. The study used various checklists to assess the availability of services from the facilities. Indian Public Health Standards were referred for preparing checklist for health facilities. The checklists were simplified to the extent that it could be used by a layperson to assess availability of mandated services in these centers.
Out of 120 Anganwadi centers visited, it was observed that:
Near about half of the Anganwadi centers do not have their own building and are operating temporarily from semi-permanent buildings
Drinking water is available only in 10 centers
Child growth monitoring charts are available only in the 22 centers
Only 31 centers are using soaps for hand washing
Immunization services are very poor in quality
Lack of regular supplies of medicines
Absence of Vitamin A supplements
Absence or lack of front-line workers
ANMs are attending cases and available at the health center So people come to the center to access services.
The findings were well captured in form of a report and shared with all the stakeholders. This helped in addressing supply issues at the district and state level. The report was disseminated with service providers as well as service receivers at the state level. This resulted in the government issuing orders for timely and regular supply of services. Staff was also recruited.
References:
Department of Finance, Government of Jharkhand (2014): Jharkhand Economic Survey 2013-14.
Integrated Child Development Services (ICDS) Scheme, Ministry of Women and Child Development, Government of India: http://wcd.nic.in/icds/icdsteam.aspx
Ministry of Health and Family Welfare, Government of India: Navjaat Shishu Suraksha Karyakram, Basic newborn care and resuscitation program, Facilitators Guide.
Ministry of Health and Family Welfare, Government of India (2014): 7th Common Review Mission, Jharkhand.
National Rural Health Mission Ministry of Health and Family Welfare, Government of India (2013): Guidelines for the control of Iron Deficiency Anaemia- National Iron + initiative, towards infinite potential in an Anaemia free India.
National Health Mission, Ministry of Health and Family Welfare, Government of India (2012): Indian Public Health Standards
Planning Commission Government of India (2011): Evaluation Study on Integrated Child Development Scheme (ICDS) Volume I, by Program Evaluation Organization.
About the Author:
Sasmita Jena has professional experience of more than 19 years in the social science sector. She is currently associated with Welthungerhilfe, based in Jharkhand, India. She has worked on partnership management, human rights issues, and governance. She is passionate about human rights, especially in the context of food and nutrition security for the most vulnerable communities.