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Your Phone Won’t Ring Just Because You Gave Out Your Number

Why Citizens May Not Be Too Keen To Give Feedback

 

Part of Twaweza’s motivation of joining Feedback Labs comes from Isiolo, a cosmopolitan (if a bit unruly) town in north-central Kenya. In contrast to its frenzied town center, Isiolo’s district hospital is calm and orderly, with wide breezy corridors that connect different departments and spacious patient waiting areas. And at every service point the hospital has large, freshly painted walls which spell out the rights and entitlements due to every patient.

These are not abstract or convoluted – in clear language the signs lay out specific, concrete standards: the types of services on offer, the expected waiting time, the fees for different procedures (and which should be free of charge), the prices of medical supplies. The signs also provide a telephone number to report complaints or concerns. The system appears professional, thoughtful, and organized.hospital feedback sign (335x350)

But there is one problem. Over the two hours we spent at the hospital one afternoon in May 2013, we spoke with about twenty patients. None of them appeared to find the signs helpful, even though the official rules of service were often not followed; for example, free drugs are often not available and have to be purchased from a nearby pharmacy. Despite their bright colors and large size (several over 8 x 10 feet), some patients appeared not to have even noticed the signs. Of those that did, none reported ever using their information or calling the telephone numbers listed. When asked why not, people told us it would be a waste of time – no one will even pick up the phone, much less do something about the reported problem.

So we called the number – and within two rings got through to an administrator. She listened with care and patience. She came across as knowledgeable, interested, and ready to take down the details of our concerns so that corrective action could be taken. At the end of the call she thanked us and asked us to call again anytime.

We were stumped. Here was a mechanism that seemed to be well-organized and responsive. And yet people simply did not believe that using the feedback opportunities would be of any use.

 

A Deeper Problem

The example of the Isiolo hospital is hardly an isolated one. Daraja, an initiative that encouraged citizens to SMS non-functional water points in Njombe, Tanzania, had a very low uptake: out of 829 messages received in the extended pilot phase, only 183 met the criteria to be forwarded to the District Water Engineer, and just 38 came from the piloted area. Clearly, the core idea failed to take hold, and the project was discontinued. Additionally, the gorgeous Huduma citizen site in Kenya has low response rates and 0% success rate in problems resolved, despite an inspiring list of backers.

The interesting thing about these examples is that in fact, in all three cases, mechanisms were set up to address problems, and serious professionals were at the ready to help. But their phones just didn’t ring. Why not?

It wasn’t technological bugs. It worked well and was easy to use. It wasn’t the cost. The mechanisms were low cost or free of charge. It wasn’t lack of publicity. These projects had generally good communication efforts. And it wasn’t irrelevance. Plenty of data shows that people care about basic services in health, water, and education.

Here’s our bet: people don’t respond because they just don’t believe their voices will count. In East Africa where Twaweza works, years of unresponsive and predatory systems have cared little about citizen voice, so much so that even when there is a “real” opportunity for feedback, people simply do not believe it’s worth their while. When for 10, 15, 20 years one’s core experience of public service delivery has been one of disinterest or even fear, simply setting up attractive new mechanisms, however well-intentioned and sophisticated, won’t cut it.

Learning Through Experience

As we consider making best use of Feedback Labs, the temptation might be to work really hard to get a brilliant technological design from the outset, and to make evermore earnest presentations about the potential of the platform to get citizen views and have them influence policy and fix problems. But those presentations tend to be to others like ourselves, and tend towards the grander notions of social change.

The answer may lie in the other direction: rather than designing perfect citizen feedback architectures and publicizing them widely to get people to use it, it may be more productive to go for a limited number of well-thought experiments in which we work out pathways of change in relation to very specific, contextualized issues, and develop clear hypotheses about what motivates and triggers people (and systems) to act differently. The key here is that learning must take space in a short time span (in the order of months, not years), and information gained must be used continuously to adapt, improve. We are committed to learning, through an iterative process, which feedback mechanisms and tools are most effective and under what circumstances, what are the role of incentives, how to build the citizen’s confidence to interact with the systems, and, in turn, how to make governments responsive to citizen voices.

 

Brokering Trust in Feedback

In essence, we are talking about building trust and confidence of citizens in public agencies. But credibility is easy to lose and very hard to regain. We need to simultaneously work with both the demand and supply side of the equation, nudging the service providers and systems into demonstrating responsiveness, as much as encouraging citizens to engage with the mechanisms (after all, few things could be more counter-productive than motivating citizens to speak out when there is no one to listen). In such circumstances the skills to be able to broker trust between mistrustful and unequal parties may be far more essential than the mechanics of the platform.

Fundamentally, we believe citizens have a right to express opinions about public service provision, and governments have a responsibility to listen, respond and act. Figuring out how both public service reforms and citizen groups can cultivate a culture of intelligent listening and continuous learning, with huge doses of improvisation and curiosity, may be worth more than the best laid plans.

By Varja Lipovsek, Learning, Monitoring and Evaluation Manager, Twaweza
and Rakesh Rajani, Head, Twaweza
www.twaweza.org

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3 Responses so far.

  1. Awesome blog. I enjoyed reading your articles. This is truly a great read for me. I have bookmarked it and I am looking forward to reading new articles. Keep up the good work.

  2. Patricia Dorsher says:

    Olena,

    That’s very interesting to hear you had a similar experience in Ukraine, and the reports on your site about innovations in how to get feedback may be applicable in other situations as well. I hope you continue to share your experiences with us!

    Have other experienced a similar hesitancy to participate with their organizations or governments in the world? What has been useful in overcoming reluctance among citizens?

  3. Olena Ursu says:

    Dear colleagues,

    thanks for sharing your stories and thoughts about the efficiency of feedback mechanisms between the citizens and providers of the public services. We had pretty much the same feelings while researching on the existing practices of public monitoring of the administrative service provision here in Ukraine.

    http://europeandcis.undp.org/blog/2013/06/12/what-if-citizens-dont-want-to-monitor-administrative-services/#comment-928751210

    I found your advice and further plans really useful for our undertaking. We’ll definitely explore more on Feedback Labs.

    Regards, Olena

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