2018 Guidance Note: Community Feedback Mechanism (CFM)

A key component of the 3MDG Fund’s approach to Health for All is to implement “ Community Feedback Mechanisms (CFMs) within a rights based approach.” This is
underpinned by four principles: Accountability, Equity, Inclusion and Conflict Sensitivity. Community feedback mechanisms allow people to share their views, empowering
them to achieve or control their health outcomes. They support health service providers to be responsive and deliver quality health services.
In the National Health Plan Monitoring & Evaluation framework and Annual Operational Plan, CFMs should be established to systematically capture community voices at
township level in 2018. This means it is critical for existing CFMs implemented by 3MDG Implementing Partners (IPs) to support and be linked with township mechanisms and
structures. This note provides a technical guideline to IPs to implement an effective CFM system at field level and township level. Recommendations are based on the case
study called “How effective are CFRMs in improving access to better health for all” from June 2016.

Three minimum requirements for all 3MDG IPs in 2018 project implementation:

Item Concrete Action Indicator

1 Capacity building and technical support to improve understanding of CFM  Output 5.1 Number of staff from MoHS, IPs, local NGOs and CBOs at
central, regional and township level receiving AEI&CS related trainings
 Staff of IPs (including field staff and volunteers) and local partners are trained on conducted by IP and 3MDG resource persons (disaggregated by sex and
“Social Accountability and CFM.” 3MDG will provide a refresher training (ToT) and technical age)
support to senior field staff of IPs and local partners. Field staff will further train to their
volunteers. Data source: IP six-monthly training attendance tracking sheet
 Responsibilities must be “mainstreamed” for all staff (including volunteers) to listen to
voices and engage the project community.
 This training should be integrated into regular technical training to staff and volunteers.

2 Focus on voice and engagement through grass root service delivery level project activities Output 5.6 Number of events/meetings conducted during the reporting
period that includes participation and engagement between health care
 IPs should use existing opportunities for engagement (at no additional cost) as well as providers and target communities
apply at least one context-appropriate method with a flexible approach (e.g. outreach
sessions, community meetings or quarterly rural health center meetings, etc.). Data source: IP meeting records, reports, supervision/monitoring checklist
 These should stimulate two-way discussions where service providers listen to the voices
of project community and exchange information between them.
 The “project community feedback” section should be included in the monitoring checklist of IPs
and progress should be reported regularly.

3 Information sharing, co-ordination and maximizing collaborative working relationship Output 5.2.3 Number and percentage of feedback that were addressed by
the IP in the reporting period based on the IP’s procedure
 IPs should strengthen systems to share relevant project information, and manage and
provide oversight of the community feedback loop. Data source: IP records and six-monthly reports
 Issues raised by the project communities through CFM must be analyzed, addressed and
responded in timely manner and informed to and coordinate with service providers to
identify solutions.
Case study link: http://www.3mdg.org/sites/3mdg.org/files/publication_docs/community_feedback_and_response_mechanisms_case_study.pdf
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 2018 Guidance Note: Gender and Social Inclusion Awareness and Sensitivity

The purpose of the guidance note is to be used as key support document for 2018 grant negotiation process with 3MDG IPs to ensure proposed activities are gender sensitive
and inclusive of women, girls and other traditionally disadvantaged groups such as elderly, ethnic and religious minorities, the disabled and other vulnerable or at-risk
population including people from conflict affected areas. Essentially, this guidance was developed based on 3MDG’s DOA, AEI Strategic Framework, Gender Approach and log
frame output 5 and also in line with current IPs’ implementation activities. The recently developed National Health Plan also includes equity and inclusiveness in guiding
principles and this guidance document is also in line with National Strategic Plan for Advancement of Women (NSPAW) 2013-2022 - “Women and Health” key priority area
of Myanmar Government.

Three minimum requirements for all 3MDG IPs in 2018 project implementation:

Item Concrete Action Indicator

1. Capacity building and technical support to improve understanding on Gender and Social  Output 5.1 Number of staff from MOHS, IPs, local NGOs
Inclusion concepts and CBOs at central, regional and township level receiving
IP staff (including field staff and volunteers) and local partners must be trained on Gender and AEI&CS related trainings conducted by IP and 3MDG
Social Inclusion. The training will be provided by the 3MDG contracted technical service provider resource persons (disaggregated by sex and age)
to selected senior IP staff. It will include a refresher training (ToT) and technical support. This
must be cascaded via trained senior IP staff to field staff, volunteers and local partner CSO/CBOs. Data source: IP six-monthly training attendance tracking
sheet
2. Promote equitable participation and access to health services of women and other  Output 5.4 Proportion of women representatives
disadvantaged groups attending the annual Comprehensive Township Health
 IPs must work to ensure project services increase the participation of women and other Plan (CTHP) review workshop
disadvantaged groups. This is essential at all levels of project planning and service delivery  Output 5.5 Proportion of women representatives on (i)
activities. (E.g. (i) include in consultation, working groups, coordination meetings and (ii) township health committee (ii) village tract health
strengthen mobile health teams and peer outreach sessions and harm reduction services for committees/ village health committees.
female IDUs via DIC, etc.…)  Number of women who are involved in Peer-based/self-
 Women representatives must be included in CTHP reviews, peer/self-help groups and help group-formed activities or community based
community volunteer groups in project areas, THC/VTHC/VHC meetings and quarterly RHC volunteer activities in project areas.
meetings, etc. Progress must be monitored.
 Strengthen VHC/peer self-help groups, community volunteer groups to increase women Data source: IP workshop records & reports, supervision
participation. (E.g. (i) review and revise TORs of VHCs and other working groups to increase checklist
women’s representation and leadership, (ii) create learning opportunities and build capacity
for women to increase leadership skills and health knowledge, etc.…)
 IP must ensure that programme messages on appropriate care for ATM and MNCH address
all genders and work to increase male involvement, thereby challenging the stereotype that
only women are responsible for the care of family/children.
3. Include measureable gender indicators appropriate to the interventions in monitoring Data source: IP six monthly reports
framework
IPs must collect, analyse and report data disaggregated by sex and age and case studies/success
stories.

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 2018 Guidance Note: Conflict Sensitivity

The 3MDG Fund is committed to ensuring that support to the provision of health services in areas previously or currently affected by conflict is based on a thorough
understanding of the different social, political and institutional situations in these areas. The Fund ensures that interventions operate in a manner that:

 Adhere to international best practices related to ‘do no harm’ practices and the development of a set of principles for 3MDG engagement in conflict affected areas;
 Tailor program interventions to ensure appropriateness to the operating environments in conflict affected areas;
 Maximize the peace-building opportunities of its interventions by bringing people together around health.

The Fund’s strategy to operate in conflict affected areas is based on a conflict analysis approached from a national, regional and local perspective, keeping in mind grievances
and aspirations of communities that are at the root of the conflict and its resolution. The principle of ‘Do No Harm’ forms the basis of the 3MDG’s strategy to operate in
conflict affected areas. In the last year of the Fund, however, the Fund will carefully expand beyond ‘do no harm’ to maximize opportunities where the Fund and its partners
can contribute to peace-building and cooperation across conflict lines.

3 Minimum Requirements in 2018 for all 3MDG IPs operating in conflict affected areas:

1. Capacity building of key stakeholders to improve understanding on CS where feasible.

2. Conflict Analysis: prepare/update a conflict analysis that includes stakeholder analysis, conflict factors and conflict dynamics. Once prepared, update on a regular basis e.g.
2-3 monthly.
3. Building on 1 & 2, explore opportunities to further increase coverage and quality of health service, or to facilitate dialogue amongst key stakeholders

CS consideration in project management cycle 1:

 Improve understanding of the concept and context: Understanding the context, including social determinants/norms of health is a key to successful planning and
implementation. It also affects how different gender/population groups – men and women, the most vulnerable, marginalised people for example, disabled, economic migrants
and diverse ethnic groups - can be engaged in discussions about health service delivery. The analysis should include good understanding of the local conflict parties, conflict
factors and dynamics, whilst keeping progress in the peace process in view.
 Context-appropriate and flexible approach: Based upon good understanding of the situation, develop context-appropriate and flexible approaches, to respond to opportunities
and constraints (which in conflict affected areas are often referred to as ‘the positive’ and ‘the negative’)
 Promote coordination and information sharing: All key stakeholders should be properly consulted and engaged prior to and throughout the design and delivery of any
interventions. This includes representatives from relevant government agencies, armed opposition groups (especially health departments where these exist), other health
providers and civil society organisations.
 Inclusion / non-discrimination: Intervention programmes should place emphasis on inclusion and non-discrimination, so that services are provided equitably to all population
groups, regardless of ethnicity, language, religion, gender and age. In conflict affected areas, it is important to ensure a balance between populations / areas under government
control, and those under ethnic armed group control.
 Work with local structures/organisations: Work with local structures/organisations to create spaces for constructive engagement and use local facilitators to listen to
community voices and stimulate two-way discussions. Build networks and coalitions to amplify people’s voices and address social barriers for improving access to health care. In
conflict affected areas, civil society organisations are often better placed to understand local conflict dynamics and have better access to conflict areas.

* 3MDG with technical expert team will provide technical assistance throughout the process.

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All the considerations listed here are fully aligned to 3MDG CS principles. For more details, please refer to 3MDG strategy to operate in conflict affected areas.
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