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Black Sash: Improving local health services with community-based monitoring

The Black Sash Trust

“Good quality data is key to illustrating the impact of citizen problems to government.” — Lynette Maart, The Black Sash


government facilities monitored for drug availability and health services


citizens reporting on the state of their local health services

Start date
June 2015
End date
December 2015
Period: 6 months


In South Africa, the public perception of the government is tarnished by corruption, inequality in service delivery and accusations of patronage, with nearly 70% of people in a recent Rhodes University survey expressing a lack of trust in political parties.

Despite an active civil society movement, opportunities for ordinary citizens to engage with government and make their voices heard are limited, and voter turn at national elections is declining, especially among South Africa's youth.


Veteran civil rights organisation Black Sash believes that measuring a government's success through the experiences of ordinary people, rather than numbers on a spread-sheet is an important step towards better governance.

By putting citizen's priorities for government front and centre, the organisation is aiming to shift how, and to whom, government service providers are accountable, re-framing the government-citizen relationship.

Working in partnership with the South African government, the project team is bringing citizen feedback into the government’s system for monitoring of its health service provision.

Through an open-source web-based feedback tool (Keystone’s Feedback Commons) the project collects data that is being used to produce government performance reports, providing real-time comparative information across districts, regions and provinces for use by the government and the general public.

The team hope that the partnership provides a new model for working with the government, putting feedback from citizens who use public services at the heart of government planning and implementation.


Black Sash is a human rights organisation advocating for social justice in South Africa. The team focuses on women’s and children’s issues, delivering information, education and training, and conducting community monitoring and advocacy projects.


  • Do your homework - and don't be afraid to change: Black Sash adapted their original questionnaire based on government suggestions to make sure they didn't just gather data, but could make sure the data was useful, and used.
  • Information that you understand is not always information your audience will understand: the team presented their findings to citizen groups, showing how health service users rated the service they got. Initially, Black Sash used percentages - because that was how they usually represented data. But, they found that this simply did not resonate with the citizen groups. Investing in better, more visual representations helped citizen groups engage more citizen groups with what was happening.
  • Choose your tech partner not just for their tech expertise, but also for their thematic knowledge: Black Sash replaced one tech partner because they could not understand what the organisation really wanted, and the tech support required to achieve it. Their new partner understood not only what information was important for Black Sash, but also how to get it, and how to represent it. 

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