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CCBs Contribution in Health Sector to the People of Sindh:
Mirpurkhas & Hyderabad
Dr. Mustaghiz-ur-Rehman, Vishnu Parmar and
Rizwan Raheem Ahmed
SZABIST - Karachi
Abstract
The main objective of the study was to identify the awareness and effectiveness of CCBs in
health sector in two districts in Sindh, namely, Hyderabad and Mirpurkhas Elected
representatives, Government functionaries, Beneficiaries of CCBs, Body of CCBs, as well as
Common People were obtained thru a questionnaire and personal interviews. Convenience
sampling was used in obtaining the data.
This is exploratory-cum-descriptive research based upon both primary and secondary data.
Descriptive statistics as well as qualitative analysis was utilized to analyze the data. Secondary
data has obtained mainly from the publications of National Reconstruction Bureau, Devolution
Trust for Community Empowerment (DTCE), Newspapers, existing research publications and
internet as well. The primary data has been gathered through the personal interviews from the
respondents based upon semi-structured questionnaires.
The main finding of the study was that the awareness level is high in district Mirpurkhas than
Hyderabad. The major reason was the role of DTCE. District Mirpurkhas is one among the five
selected districts of Sindh selected by DTCE. The awareness level has increased among the
people of Mirpurkhas through a mass awareness campaign by DTCE and Local District
Government of Mirpurkhas. The effectiveness of CCBs in the health sector is more significant in
Mirpurkhas as compared to Hyderabad. The available health facilities in rural constituencies of
both districts are very poor. The death rate is enough high due to unavailability of dispensaries
and medicines over there. Poor people cannot afford the expensive private clinics and hospitals
in urban areas while the pathetic conditions of government hospitals in main cities do not
provide any relief to them.
Key Words: Citizen Community Boards (CCBs), Contribution in Health Sector, and
Community Empowerment
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1. Introduction
The present global changes are affecting everyone. The new scientific technologies and social
theories have changed the human life in a big way. Researches in Management Sciences, social
sciences and economics have opened several new dimensions in social livings. The past forty
years have seen a significant improvement in quality of life especially among developing
countries: life expectancy has increased by 50%. Infant and child death rates have been cut by
half, the percentage of children starting school has risen from less than half to more than three
quarters, despite doubling of population and the percentage of rural families with access of safe
water has risen from less than 10% to almost 60%, and the per capita income has doubled in the
last 25 years [1]. Besides these human victories, the existing problems of developing countries
are alarming the prosperity of the future. The essentials of life are much beyond from several
people in the developing world. Poverty is a big challenge today, in 2000; an estimated 113
million children worldwide between the ages of 6 and 11 did not attend the school. More than a
billion people still struggle to survive on less than a dollar a day. Child mortality rates in
developing countries are still ten times higher than in the developed countries. Seven million
people still die every year from easily preventable diseases, incomes in the countries with the
riches 20 per cent of world population grew nearly three times faster than in those countries with
the poorest 20 per cent [2] Families around the world are under sustained and tremendous stress.
Economic and political transformations in many parts of the globe, disease, war, poverty, famine
and other such forces are taxing them, often beyond their ability to cope. Such pressures are
clearly not confined to the developing world as seen by the pressures generated in families by
unemployment, drugs, crime, and AIDS [3]
All the development practitioners, government officials and international donors that local
authorities play an increasingly proactive role in participatory development agree it. The “World
Bank Report (2003)[4] strongly supports devolution for ‘making service delivery work for the
poor’. The outgrowth of decentralization literature has emphasized Local Government as a way
and vehicle for good governance and participatory development [5].
After independence, Government of Pakistan has stipulated three local government ordinances.
The concept of devolution of powers to the grass roots was promulgated by the Local
Government Ordinance 2001, which contemplated community participation mechanisms through
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multi-stage elections to multi-tiered local bodies. The new administrative reforms lead to the
creation of three levels of local government: unions, tehsils and districts, a chain of new offices
created mainly to facilitate “transparency” to and “participation” of the general public.
1.1 Background of the Study
Decentralization refers to the structuring or reorganization of authority so that there is a system
of co-responsibility between institutions of governance at the central, regional and local levels
according to the principle of subsidiarity (i.e. the local authorities will have the authority and
responsibility to address all problems that are, in their determination, with their ability of solve),
thus increasing the overall quality and effectiveness of the system of governance, while
increasing the authority and capacities of sub-national levels [6].
Devolution is the transfer of resources and power to lower level authorities, which are largely or
wholly independent of higher levels of government [7]. The present devolution plan in Pakistan
is a result of global trend. Several developing countries of Latin America, Europe or East Asia
have introduced this plan [8]. It serves the basic need of political stability-decentralization by
delegating the political powers from federal to local elected politicians. Political scientists
suggest that this is an outcome of the declining credibility of the centralized state.
Decentralization is expected to achieve higher economic efficiency, better accountability large
resource mobilization, and lower cost of service provisions and higher satisfaction of local
preferences. This devolving plan improves the match between the mix of services produced by
the public sector and the preferences of the local population. It transfers the fiscal resources from
richer to poorer areas and leads to an increase in the quantity and quality of expenditures in these
areas [9].
1.2 Problem Statement
For the last six years, the newly established local government system is in operation, which
provides the services to the community at the doorstep through power devolution from top to
bottom. It is now right time to evaluate the performance of CCB’s (one of the community’s
participation constitution in local development) in health sector in two districts of Sindh:
Hyderabad and Mirpurkhas.
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1.3 Focus of the Research
This study is focused on the performance of CCB’s in health sector in two districts of Sindh
province: Hyderabad and Mirpurkhas. This research paper has evaluated the awareness of CCBs
among people, effectiveness of CCB's, participation of local people, and functioning areas of
CCBs in health sector.
2. Previous Research
2.1 Historical Perspective of Local Government
Local governments have existed in the Indian subcontinent for many centuries, with the first
municipal corporation set-up in Madras in 1688 by the East India Company. In 1842, the
Conservancy Act, which leads to the formation of sanitary committees for garbage disposal,
became the first formal measure of municipal organization, which applied to the Bengal
Presidency. In Karachi, the Board of Conservancy was established in 1846, while in Lahore and
Rawalpindi; the Municipal Act was passed in 1867. Subsequent important events were Lord
Ripon's Resolution on local self-government in 1882, which allowed for the provision of some
elected members in municipal committees and proposed the establishment of rural local
governments. The 1907 Decentralization Commission recommended the appointment of non-
official Chairmen of municipal committees, a recommendation which was endorsed and
extended further by the 1925 Simon Commission set up to assess the performance of local self-
government. The 1935 Government of India Act allowed provincial autonomy and permitted
provinces to frame legislation on local government systems [10].
In 1947 the areas that constituted Pakistan had few developed systems of local government and
they were confined mainly to Punjab. The period 1958 to 1969 saw the development of an
extensive elected system of local government by the first military government of Pakistan. The
military government gave rise to the Basic Democracies System providing for a new local
government system across the country through which members were elected. Under the Basic
Democracies Ordinance of 1959 Town committees were expected to perform 37 functions
ranging from measures for promotion of social welfare and health to the maintenance of
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infrastructural facilities. Urban areas consisted of union committees that had six to ten elected
members. The Chairman of the union committee was elected as an ex-officio member of the
municipal committee. Union committees were deprived of fiscal powers of any sort. While all
the Chairmen of union committees were members of the municipal committee, Commissioners
appointed by the provincial government or the Chairman of the municipal committee itself. In
rural areas, the first tier of government was the Union Council that consisted of a group of
villages. Like urban areas, each Council elected a Chairman from amongst its members who
served as the executive head of the committee. Like town committees, Union Councils also had
37 functions assigned to them. The Chairmen of the Union Councils in an area constituted
collectively a higher Council, the Tehsil Council, which did not perform any executive functions.
Its main function was to coordinate the activities of Union Councils and Union Committees in its
jurisdiction.
The Basic Democracies system closed with the fall Ayub Khan’s regime. The first Martial Law
Government was the pioneer in devising an extensive system of local government it was the
second Martial Law Regime of General Zia that implemented elected local governments. These
were revived in 1979 under the provincial local government ordinances, which, with
amendments, was in operation till 14th August 2001 in Pakistan. Under this ordinance, there
were four levels of municipal government in the urban areas: town committees, municipal
committees, municipal corporations and metropolitan corporations. Members of the council elect
the senior officers of these councils and the controlling authority was the elected house. There
was a three-tier system of local government in operation in Pakistan in the rural areas, where
Union Councils, Tehsil or Taluka Councils and District Councils were supposed to exist [11].
2.2 The New Local Government System 2001
The present government of Pakistan, sensing the obvious shortcomings of local government
system under Ordinance of 1979 and putting the country on the road of democracy came up with
a new local government plan. The plan integrates the rural with the urban local governments on
one hand and bureaucracy with the local government on the other. In this system district
administration and police are answerable to the elected Chief Executive of the district. Citizen
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monitoring of the affairs of governance through elected representatives, the civil society's
involvement with development activities and system of effective check & balances.
Local governments are formed on three levels District, Tehsil & Union Council level. They are
based on five fundamentals devolution of political power, decentralization of administrative
authority, decentralization of management functions, and diffusion of power authority nexus and
distribution of resources at different levels. Elections were held in August 2001 under the new
local government Ordinance. Elected Local governments have been successfully setup at all tiers
and devolution of administrative, bureaucratic and financial resources one at the final stages. The
Local Governments have successfully completed their tenure and new elections of Local
Governments were held in year 2005. A major paradigm in shift has taken place after devolution
plan 2001. Powers have been decentralized at grass roots level, which enhanced efficiency and
effectiveness.
Today 96 District Councils have vertical linkage with 342 Tehsil/Towns Councils and 6,022
Union Councils. At every tier of the LG women have been guaranteed at least 33%
representation. Peasants and minorities have 5% reserved seats [12]. This new system, which may
be best, described through the following 5Ds Local Government System 2001
1. Devolution of Political Power
2. Distribution of Resources to the districts
3. Diffusion of the Power Authority Nexus
4. Decentralization of Management Functions
5. Decentralization of Administrative Authority
The essence of this system is that the local governments are accountable to citizens for all their
decisions. It enables the proactive elements of society to participate in community work and
development related activities. It has also removed rural-urban divide.
2.3 Citizen Community Board (CCBs)
The word CCB stands for Citizen Community Board. Under LGO 2001, twenty-five or more
persons can join together to form a community organization called CCB. After a CCB is
registered, it is eligible to execute various development projects with the approval of respective
councils. There is no restriction on the number of CCBs, which might be registered in union
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council local area. The CCBs can be registered only with the office of EDO (CD) at the District
level. The office of the CCB shall be established in the Union at the address mentioned in the
Registration Certificate issued by the office of EDO (CD). The registered CCBs can work at any
level i.e. District/Tehsil/Union within the District in which CCBs is registered. An NGO can be
registered as a CCB by fulfilling the registration formalities as stipulated in the law. NGO has to
add the word of CCB with its name and the name/number of Union Council in which its office is
located e.g., XYZ NGO can be named as ‘XYZ CCB (Name/number of Union Council)'. There
is no provision of membership fee for a CCB. However, donations/contributions required for
particular CCBs activity are allowed. The priorities for CCBs projects are to be set by the local
governments on the basis of the number of projects submitted by the CCBs/ communities.
2.4 (DTCE) as a Capacity Building Organization for CCBs
The Devolution Trust for Community Empowerment (DTCE) is a “not-for-profit” non-
governmental organization registered with Securities and Exchange Commission of Government
of Pakistan, under Section 42 of the Companies Ordinance 1984. Its aim is to build a support
system by mobilizing all segments of the society through networking and public/private
partnerships to empower local communities and ensure their participation in the development
process by facilitating the formation of Citizen Community Boards (CCBs) and building their
capacity to identify and implement development projects as envisaged in Local Government
Ordinance 2001 [14]
3. Research Methodology
3.1 Type of Research
This is exploratory-cum-descriptive research based upon both primary and secondary data.
Secondary data have obtained mainly from the publications of National Reconstruction Bureau,
Devolution Trust for Community Empowerment (DTCE), Newspapers, existing research
publications and Internet as well. The primary data has been gathered through the personal
interviews from the respondents based upon semi-structured questionnaires (see annexure-II)
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3.2 Target Population
This research has conducted in Hyderabad and Mirpurkhas districts. Both are thickly populated
districts of Sindh Province and covered up large area. The total population of this research is
very large. There is 730 registered CCBs are in Mirpurkhas and 47 are in Hyderabad, but the
funds that have been disbursed are as follows: 38 in Mirpurkhas and 5 in Hyderabad. Using the
convenience sampling method from those functioning CCBs to whom funds have been disbursed
has collected data. Further the target population is divided into five stakeholders: government
functionaries; elected members of local government; beneficiaries of CCBs; body of CCBs; and
common people. The detail is as under:
3.3 Methods of Sampling
Due to the diversified nature of target population, convenience and stratified sampling methods
are used for this research paper. By random sampling the probability of unaware respondents
would have been increased as majority of respondent in district Hyderabad were unaware about
CCBs and were reluctant to respond, so they were contacted through personal references.
Therefore convenience sampling method was adopted. Further there were five main stakeholders
of target population so they were first grouped through stratified sampling and than data obtained
through convenience sampling. The groups of target population for this study are as under:
1. Government functionaries
2. Elected members of local government
3. Beneficiaries of CCBs
4. Body of CCBs, and
5. Common People
The samples size for the subject study was 121. The breakdown of the sample size is as under:
Table 1 Sample Size of the Study
No. Stakeholders Target Pop. Hyd MPK Total
01 ER 20 05 07 12
02 BEN CCBs 1000 8 17 25
03 B. CCBs 100 2 18 20
04 GF 22 04 10 14
05 CP 1000 20 30 50
Total 1167 41 80 121
Source: Author’s research
One CCB consist on at least 25 members so one member selected from one CCB
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3.4 Method of Data Collection
The Primary Data has been collected through personal interviews and questionnaire (enclosed in
annexure) from the selected samples. While secondary data has obtained from the Websites and
printed literature of Devolution Trust for Community Empowerment (DTCE) and National
Reconstruction Bureau (NRB), Newspapers, and past empirical studies.
4. Data Analysis
Seven general and health related questions are answered in this study. These questions are
designed on likert scale from 5 to 1 (5 means strongly agree, 4 means agree, 3 means do not
know, 2 means disagree, and 1 means strongly disagree). This is an exploratory research so
through descriptive statistics the Mean, Median and Mode have calculated from mega state
excel. The base data (enclosed in annexure) has developed on five main questions according to
the response of selected samples. Question wise data analysis and interpretation is as under:
4.1 Awareness of CCBs in Both Districts
Awareness of CCBs among all stakeholders’ means that the people are familiar with the term
CCBs, they know how CCBs work? How to register the CCBs? What are the functional areas of
CCBs? What is the procedure to formulate a CCB? The relevant question is as under:
Q: Local people aware to participate and form CCBs for development projects in their
constituencies? (5 4 3 2 1)
Table 7
Awareness of CCBs Among Common People
Mirpurkhas Hyderabad Both
3.99 2.23 3.42 Source: This Study
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GRAPH 1
People awareness & Participation in CCBs Projects
3.99
2.23
3.42
-
0.50
1.00
1.50
2.00
2.50
3.00
3.50
4.00
4.50
1
Mirpurkhas Hyderabad Both Districts
Above table and graph show that there is high awareness about CCBs in Mirpurkhas district than
Hyderabad. In Mirpurkhas, 63 respondents out of 82 were agreed or strongly agree (on likert
scale 5 to 1) that people are aware about CCBs. While in Hyderabad only 9 respondents out of
39 were agree that people are aware in their surrounding about CCBs even the literate people
were not well aware about CCBs in Hyderabad. This major difference is due to the intervention
of DTCE. Mirpurkhas is one among the five districts of Sindh province the rest are: Badin,
Thatta, TandoAllahyar, and district Khairpur.
4.2 System Improvement
In this study the system Improvement means that the existing system regarding disseminating of
information about CCBs among common people, registration process of CCBs, funds
disbursement procedure, proper guidance by government functionaries, and elected members of
local government, to increase the peoples’ participation in social development projects of their
constituencies. The related question was formulated as under:
Q The existing system of peoples’ participation in social development projects by CCBs
need to be further improved (5 4 3 2 1)
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Table 8
System Improvement in Both Districts
Mirpurkhas Hyderabad Both
4.32 4.26 4.30 Source: This Study
GRAPH 2
System Improvement in CCBs in all the districts
4.32
4.26
4.30
4.22
4.24
4.26
4.28
4.30
4.32
4.34
1
Mirpurkhas Hyderabad Both Districts
All the five category of respondents unanimously agreed that the system of CCBs needs to be
improved. The author observed some good facilities in Mirpurkhas district for the registration of
CCBs, proper guidance and support by the government functionaries, and elected members of
local government, published literature is available in related offices. Local government has
started the campaign of awareness through lectures, seminars, and Khuli Kuchairees. As a result
the registration process has speed up and people specially women are registering their CCBs
rapidly. Until the last day of compiling the report there was 730 CCBs are registered and
approximately 50% are of them are of women. But this rapid change occurred after intervention
of DTCE. This is the main difference between the both districts. CCBs but still there are
bottlenecks of documentation, long wait for funds disbursement
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4.3 Health Facilities in Mirpurkhas and Hyderabad
Available Health Facilities means availability of govt. hospitals, dispensaries, medicines, and
doctors for the masses, where people can get relief from health complications. The question
relevant, the mean of respondents and graphical presentations of the same are as under:
Q There are sufficient health facilities are available in Hyderabad and Mirpurkhas (5 4 3 2 1)
Table 09
Health Facilities in Hyd. & MPK.
Mirpurkhas Hyderabad Both
Mean 1.77 1.96 1.91 Source: This Study
GRAPH 3
Health Facilities in Hyd & MPK
Comparatively Hyderabad has better health facilities than Mirpurkhas mainly due to the 2nd
biggest city of the province and 8th
of the country.
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4.4 Effectiveness of CCBs in Mirpurkhas
CCBs are very effective in health sector in district Mirpurkhas. All the respondents particularly
Government functionaries and Bodies of CCBs are very optimistic in this sector. People have
submitted several proposals to improve the health facilities. Here, the proper guidance by the
Government functionaries, elected members of local government and people’s personal interest
has highly motivated the people to participate in health projects. The women are also taking high
interest in health sector particularly, in the various types of vaccination programs like Hepatitis,
B, C, and labor room facilities for pregnant women. The following relevant question, table, and
graph shows the calculated mean of the respondents in district Mirpurkhas:
Q CCBs are playing effective role in health sector in your constituency
(5 4 3 2 1)
Table 10
Effectiveness of CCBs in Mirpurkhas
ER BEN CCB B. CCB GF CP
Mean 3.29 3.35 4.5 4.3 3.37
Source: This Study
GRAPH 4
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4.5 Effectiveness of CCBs in Hyderabad
In Hyderabad, the author did not find the working CCBs in health sector like other sectors. The
poor awareness among people is the main hurdle. Due to the same the peoples’ participation is
very poor. Government functionaries show their high interest to work in health sectors, while
common people also show their interest to work but they are not familiar with the procedure. The
following table and graph shows the calculated mean of the respondents.
Table 11
Effectiveness of CCBs in Hyderabad
ER BEN CCB B. CCB GF CP
Mean 2.4 3.12 2 4.25 3.8
Source: This Study
GRAPH 5
4.6 Effectiveness of CCBs in Both Districts
The effectiveness of CCBs in health sector is high in district Mirpurkhas than Hyderabad. There
is hope that this high peoples’ participation in health sector in Mirpurkhas will bring some relief
to the poor people. The comparison of both districts is presented below in Table 5 and graph 5:
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Table 12
Effectiveness of CCBs in Both Districts
ER BEN CCB B. CCB GF CP
MPK 3.29 3.35 4.5 4.3 3.37
HYD 2.4 3.12 2 4.25 3.8
Source: This Study
GRAPH 06
4.7 Working Areas of CCBs in Health Sector in Mirpurkhas
In Mirpurkhas districts people are enthusiastically participating in various health projects like
New and extension of existing dispensaries, mass vaccination program of Polio, Hepatitis B-C,
Vaccinations of Snake and Dog biting. Various proposals have submitted for X-Ray machines,
and ultra-sound centers. Schools are participating in vaccination program in their constituencies
in Mirpurkhas. The relevant research question, calculated mean, and graphical presentation are
given below:
Q. CCBs are effectively working in the following areas of health sector in your
constituencies
(a) Opening and expanding dispensaries (5 4 3 2 1)
(b) Vaccination program (5 4 3 2 1)
(c) Labor room facilities to pregnant women (5 4 3 2 1)
(d) X-ray machines (5 4 3 2 1)
(e) Ultra Sound machines (5 4 3 2 1)
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Table 13
Working Areas of CCBs in Mirpurkhas
DIS VAC LBR RM X-Ray ULT SND
Mean 4.35 4.43 4.20 2.26 3.85 Source: This Study
GRAPH 7
Working Areas of CCBs in MPK
4.8 Working Areas of in District Hyderabad
In Hyderabad district people are interested to work in the various sectors of health but the author
did not find any CCB active in health sector. The relevant question, calculated mean and
graphical presentation of the same is as under:
Q. CCBs are effectively working in the following areas of health sector in your
constituencies
(f) Opening and expanding dispensaries (5 4 3 2 1)
(g) Vaccination program (5 4 3 2 1)
(h) Labor room facilities to pregnant women (5 4 3 2 1)
(i) X-ray machines (5 4 3 2 1)
(j) Ultra Sound machines (5 4 3 2 1)
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Table 14
Working Areas of CCBs in Hyderabad
DIS VAC LBR RM X-Ray ULT SND
Mean 4.44 4.15 3.82 2.31 3.33 Source: This Study
GRAPH 8
Working Areas of CCBs in Hyderabad
4.9 Working Areas of CCBs in Both Districts
Respondents in both districts almost highlighted the same working areas of CCBs. In Hyderabad
people verbally show their interest but in of Mirpurkhas people are participating in various health
projects. The relevant questions, the mean and the graphical presentations of the same is as
under:
Q. CCBs are effectively working in the following areas of health sector in both districts.
(k) Opening and expanding dispensaries (5 4 3 2 1)
(l) Vaccination program (5 4 3 2 1)
(m) Labor room facilities to pregnant women (5 4 3 2 1)
(n) X-ray machines (5 4 3 2 1)
(o) Ultra Sound machines (5 4 3 2 1)
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Table 15
Working Areas of CCBs in Both Districts
DIS VAC LBR RM X-Ray ULT SND
Mean 4.38 4.27 4.07 2.27 3.69 Source: This Study
GRAPH 9
Working Areas of CCBs in Both Districts
5. Conclusion and Recommendations
This paper was an attempt to access the role of CCBs in health sector in two districts of Province
Sindh: Mirpurkhas and Hyderabad. CCBs provide a platform to common people to enhance
participation in social development projects in their own constituencies. The present government
has transferred the powers at the grass root level by introducing the Local Government system in
2002 by LGO (2002). The main objective behind the new system was to increase the peoples’
participation in social development projects. The conclusion of this research paper is as under:
1. The system is ideal and people are interested to work in social development projects but
people are not well aware with this system
2. The Most important areas where CCBs can be more effective are Health, Education,
Infrastructure, and Entrepreneurship.
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3. The respondents are not satisfied with the present working procedure and it needs to be
more improved.
4. Peoples’ participation is increasing in health sector in district Mirpurkhas. People are
submitting the proposals for opening and expanding the new and existing dispensaries
respectively. Schools are working for vaccination program in their school through CCBs.
Women CCBs are very active to provide labor room facilities to pregnant women. Some
proposals have been submitted to create the awareness among the poor about the Hepatitis
B & C, and HIV AIDS. Doctors are also taking interest to open their clinics and hospitals
equipped with X-Ray and Ultra sound machines. Snake and dog biting are the prime
concern in many areas some proposals are in process to provide vaccination of the same.
5. The registration process is very high in district Mirpurkhas and till compiling this report
there are 730 CCBs have been registered while in Hyderabad 47 CCBs are registered, this
is very low in the district due to poor awareness among people and the district is not being
selected by the Devolution Trust Community Empowerment (DTCE).
6. The funds disbursement process is very slow. The funds have disbursed only to 38 CCBs
out of 730. Among them 04 are in health sector, 08 in Infrastructure, 18 in Education, 05
in entrepreneurship, 02 are in micro credit and only 01 in Entertainment. Total
Rs1,45,33500 have been disbursed21
. In Hyderabad 5 CCBs have funded and no one in
health sector.
7. The accelerated speed of CCBs registration in health sector reflects the better health
facilities in district Mirpurkhas. The Beneficiaries of 4 CCBs in health sector are very
satisfied. Other people are largely motivated and registering their CCBs in this sector. The
level of awareness about formation of CCBs in health sector and participation level is
better in district Mirpurkhas as compare than Hyderabad.
21
Source: Interviewed by govt. functionaries Mirpurkhas
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5.1 Recommendations
The recommendations are as under
1. The awareness campaign is the need of the hour. The Government must educate the
people about CCBs especially in Hyderabad district. Publication of literature in easy
regional languages, Television and Radio campaign at grass root level is required for
this purpose. It is recommended that the system should be introduced in the
curriculum at school, colleges and university level to attain the maximum
participation of common people. As the system is new so people have several queries,
2. Government further needs to improve the existing system. The complication in
registration process, documentations, and technical requirement are the areas where
people are facing difficulties and avoiding participating in development projects.
People must be well trained to make the budget of CCBs, motivate the other people,
operating the projects, teamwork and hunting the qualified and technically sound
people for their projects.
3. People must be properly educated motivated by government functionaries and elected
local members to work in various areas of health sectors. Government must facilitate
the doctors to work in rural areas.
4. Health, Education, Infrastructure, and Entrepreneurship are the more effective areas
of CCBs. Concerned authorities must motivate the people to form the CCBs in their
desired areas. Technical support must be provided to common people by concerned
authorities by developing the links with established educational and health units in
urban areas. The expertise must be invited to design the projects economically.
5. The powers and responsibilities must be well defined in every tier of government.
Due to overlapping in powers and responsibilities at district, provincial, and federal
level hurdles are creating. Some respondents were highly reluctant and de-motivated
to participate in social development projects.
6. Philanthropists and NGOs must be invited to play their active role in CCBs projects.
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7. This study focuses on the contribution of CCBs in health sector in Mirpurkhas and
Hyderabad. Further CCBs contribution can be evaluated in other sectors like
education, infrastructure, and Entrepreneurship. The study can be further extended to
the other districts of province Sindh. The criteria to select a district by Devolution
Trust for Community Empowerment (DTCE) must be studied. Other districts have
not been selected yet.
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