1
Citizen Report Card Study Hyderabad & Matiari
2
TRANSPARENCY INTERNATIONAL PAKISTAN
The Sustainable Goal 16 ‘Make Cities inclusive, safe, resilient and sustainable’ is a big challenge for the Government. For attaining this goal, public services, provided by the local government, need to be improved rapidly. Though the Government increases outlays each year, the public services in both the urban and rural areas do not seem to be moving in the right direction. The local governments need to be given more resources and authority to make a difference. The citizens have to be included in the decision making process so that they have a feeling of ownership. TI Pakistan undertook this research to report the strengths and weaknesses in the provision of public services including education, health, police and local government of the Hyderabad and Matiari Districts in Sindh. The objective of the study is to provide Sindh Government with an external review of the services offered to the general public with recommendations to address the gaps to provide relief to the citizens of the province. This research will also be disseminated amongst the civil society organizations, academia, media, public and other stakeholders. It is hoped that the Sindh Government will follow up on the recommendations provided in this report to improve performance of the service delivery at the district level. This research has been made possible due to a grant from Transparency International Secretariat. Saad Rashid Executive Director Transparency International Pakistan
© 2018 www.transparency.org.pk
http://www.transparency.org.pk/
2
TRANSPARENCY INTERNATIONAL PAKISTAN
Ashfaque Ahmed & Saad Rashid
[email protected]@gmail.com
Transparency International Pakistan would like to thank Youth Development Forum (YDF) for collaboration in the study.
Every effort has been made to verify the accuracy of the information contained in this report. All information was believed to be correct as of December 2018 as per sources quoted in this report. Nevertheless, Transparency International Pakistan cannot guarantee the accuracy and completeness of the contents beyond the sources verified for the purpose of the study. Nor can Transparency International Pakistan accept responsibility for the consequences of its uses for other purposes or in other contexts. Contributions to this report by authors external to Transparency International Pakistan do not necessarily reflect the views of Transparency International Pakistan.
3
TRANSPARENCY INTERNATIONAL PAKISTAN
http://www.transparency.org.pk/
4
TRANSPARENCY INTERNATIONAL PAKISTAN
Table of Contents
1. Introduction ................................................................................................................................ 8
Police ........................................................................................................................................ 9
Health ........................................................................................................................................ 9
Education ................................................................................................................................ 10
Local Government .................................................................................................................. 11
1.2 Study Objectives .................................................................................................................. 12
1.3 Duration ............................................................................................................................... 12
1.4 Scope ................................................................................................................................... 12
2. Research Methods .................................................................................................................... 13
2.1 Research Design .................................................................................................................. 13
2.2 Sample Technique and Size ................................................................................................. 14
2.3 Instrument of Data Collection ............................................................................................. 14
3. Analysis and Results ................................................................................................................. 15
4. Recommendations ..................................................................................................................... 27
5. References and Bibliography .................................................................................................... 28
5
TRANSPARENCY INTERNATIONAL PAKISTAN
List of Acronyms
BHU Basic Health Unit
CD Civil Dispensary
CH Civil Hospital
CRC Citizen Report Card
DHO District Health Officers
DHQ District Headquarter hospitals
EPI Expanded Program on Immunization
FP&PHC Family Planning and Primary Health Care
HFs Health Facilities
LC Leprosy Centre
LG Local Government
LGB Local Government Board
LGC Local Government Commission
LGO Local Government Ordinance
MCH Mother and Child Health Care Centre
MS Medical Superintendent
PPHI People’s Primary Healthcare Initiative
PPP Public Private Partnership
RHC Rural Health Center
SHC Secondary Health Center
SRSO Sindh Rural Support Organization
TBC Tuberculosis Centre
THQ Tehsil Headquarter hospitals
TI-P Transparency International Pakistan
VHP Vertical Health Programs
WHO World Health Organization
6
TRANSPARENCY INTERNATIONAL PAKISTAN
List of Tables
Table 3. 1 Gender .......................................................................................................................... 15
Table 3. 2 Districts ........................................................................................................................ 15
Table 3. 3 Individual Attention ..................................................................................................... 15
Table 3. 4 Availability of Furniture ............................................................................................... 16
Table 3. 5 Cleanliness in Schools .................................................................................................. 16
Table 3. 6 Availability of drinking Water ..................................................................................... 16
Table 3. 7 Availability of clean toilets .......................................................................................... 17
Table 3. 8 Condition of School Building ....................................................................................... 17
Table 3. 9 Satisfaction with housekeeping .................................................................................... 17
Table 3.10 Availability of Medicines ............................................................................................ 18
Table 3. 11 Satisfaction with health facilities................................................................................ 18
Table 3. 12 Availability of doctors/staff during duty hours .......................................................... 18
Table 3. 13 Priority of the government in Health Sector ............................................................... 19
Table 3. 14 Foremost issues for Local Govt. to resolve. ............................................................... 19
Table 3. 15 Situation after LG election ......................................................................................... 20
Table 3. 16 Ways to improve LG system ...................................................................................... 20
Table 3. 17 Use of power delegated to LG rep. ............................................................................ 21
Table 3. 18 Effective use of allocated funds ................................................................................. 21
Table 3. 19 Ease in registering FIR ............................................................................................... 22
Table 3. 20 Satisfaction with police behavior ............................................................................... 22
Table 3. 21 How to improve police department ............................................................................ 22
Table 3. 22 Citizens feel secure in presence of police ................................................................... 23
Table 3. 23 Can a common man make a difference ...................................................................... 23
Table 3. 24 Most corrupt department ............................................................................................ 24
Table 3. 25 Departments where respondents paid bribe ................................................................ 25
Table 3. 26 Reasons of not reporting corruption ........................................................................... 26
7
TRANSPARENCY INTERNATIONAL PAKISTAN
List of Figures
Figure 1. 1 Data gathering in Matiari .............................................................................................. 8
Figure 1. 2 A ward of Government Hospital in Sindh ................................................................... 10
Figure 1. 3 CRC Survey, Hyderabad ............................................................................................. 12
Figure 3. 1 Gender ......................................................................................................................... 15
Figure 3. 2 Districts ....................................................................................................................... 15
Figure 3. 3 Individual Attention .................................................................................................... 15
Figure 3. 4 Availability of Furniture ............................................................................................. 16
Figure 3. 5 Cleanliness in schools ................................................................................................. 16
Figure 3. 6 Availability of drinking Water .................................................................................... 16
Figure 3. 7 Availability of Clean Toilets ....................................................................................... 17
Figure 3. 8 Condition of School Building ..................................................................................... 17
Figure 3. 9 Satisfaction with housekeeping ................................................................................... 17
Figure 3. 10 Availability of Medicines .......................................................................................... 18
Figure 3. 11 Satisfaction with Health facility ................................................................................ 18
Figure 3. 12 Availability of doctors/staff during huty hours ......................................................... 18
Figure 3. 13 Priority of the government in Health Sector ............................................................. 19
Figure 3. 14 Foremost issues for Local Govt. to resolve ............................................................... 19
Figure 3. 15 Situation after LG election ........................................................................................ 20
Figure 3. 16 Ways to improve LG system ..................................................................................... 20
Figure 3. 17 Use of power delegated to LG rep. ........................................................................... 21
Figure 3. 18 Effective use of allocated funds ................................................................................ 21
Figure 3. 19 Ease in registering FIR .............................................................................................. 22
Figure 3. 20 Satisfaction with police behavior .............................................................................. 22
Figure 3. 21 How to improve police department ........................................................................... 23
Figure 3. 22 Citizens feel secure in presence of police ................................................................. 23
Figure 3. 23 Can a common man make a difference ..................................................................... 23
Figure 3. 24 Most corrupt departments ......................................................................................... 24
Figure 3. 25 Departments where respondents paid bribe .............................................................. 25
Figure 3. 26 Reasons of not reporting corruption .......................................................................... 26
file:///D:/Ashfaque%20data/2018/4%20Oct%20to%20Dec/CRC/Hyderabad/CRC%20Hyderabad.docx%23_Toc2179945file:///D:/Ashfaque%20data/2018/4%20Oct%20to%20Dec/CRC/Hyderabad/CRC%20Hyderabad.docx%23_Toc2179946file:///D:/Ashfaque%20data/2018/4%20Oct%20to%20Dec/CRC/Hyderabad/CRC%20Hyderabad.docx%23_Toc2179947file:///D:/Ashfaque%20data/2018/4%20Oct%20to%20Dec/CRC/Hyderabad/CRC%20Hyderabad.docx%23_Toc2179945file:///D:/Ashfaque%20data/2018/4%20Oct%20to%20Dec/CRC/Hyderabad/CRC%20Hyderabad.docx%23_Toc2179946file:///D:/Ashfaque%20data/2018/4%20Oct%20to%20Dec/CRC/Hyderabad/CRC%20Hyderabad.docx%23_Toc2179947file:///D:/Ashfaque%20data/2018/4%20Oct%20to%20Dec/CRC/Hyderabad/CRC%20Hyderabad.docx%23_Toc2179948file:///D:/Ashfaque%20data/2018/4%20Oct%20to%20Dec/CRC/Hyderabad/CRC%20Hyderabad.docx%23_Toc2179949file:///D:/Ashfaque%20data/2018/4%20Oct%20to%20Dec/CRC/Hyderabad/CRC%20Hyderabad.docx%23_Toc2179950file:///D:/Ashfaque%20data/2018/4%20Oct%20to%20Dec/CRC/Hyderabad/CRC%20Hyderabad.docx%23_Toc2179951file:///D:/Ashfaque%20data/2018/4%20Oct%20to%20Dec/CRC/Hyderabad/CRC%20Hyderabad.docx%23_Toc2179952file:///D:/Ashfaque%20data/2018/4%20Oct%20to%20Dec/CRC/Hyderabad/CRC%20Hyderabad.docx%23_Toc2179953file:///D:/Ashfaque%20data/2018/4%20Oct%20to%20Dec/CRC/Hyderabad/CRC%20Hyderabad.docx%23_Toc2179954file:///D:/Ashfaque%20data/2018/4%20Oct%20to%20Dec/CRC/Hyderabad/CRC%20Hyderabad.docx%23_Toc2179955file:///D:/Ashfaque%20data/2018/4%20Oct%20to%20Dec/CRC/Hyderabad/CRC%20Hyderabad.docx%23_Toc2179956file:///D:/Ashfaque%20data/2018/4%20Oct%20to%20Dec/CRC/Hyderabad/CRC%20Hyderabad.docx%23_Toc2179957file:///D:/Ashfaque%20data/2018/4%20Oct%20to%20Dec/CRC/Hyderabad/CRC%20Hyderabad.docx%23_Toc2179958file:///D:/Ashfaque%20data/2018/4%20Oct%20to%20Dec/CRC/Hyderabad/CRC%20Hyderabad.docx%23_Toc2179959file:///D:/Ashfaque%20data/2018/4%20Oct%20to%20Dec/CRC/Hyderabad/CRC%20Hyderabad.docx%23_Toc2179960file:///D:/Ashfaque%20data/2018/4%20Oct%20to%20Dec/CRC/Hyderabad/CRC%20Hyderabad.docx%23_Toc2179961file:///D:/Ashfaque%20data/2018/4%20Oct%20to%20Dec/CRC/Hyderabad/CRC%20Hyderabad.docx%23_Toc2179962file:///D:/Ashfaque%20data/2018/4%20Oct%20to%20Dec/CRC/Hyderabad/CRC%20Hyderabad.docx%23_Toc2179963file:///D:/Ashfaque%20data/2018/4%20Oct%20to%20Dec/CRC/Hyderabad/CRC%20Hyderabad.docx%23_Toc2179964file:///D:/Ashfaque%20data/2018/4%20Oct%20to%20Dec/CRC/Hyderabad/CRC%20Hyderabad.docx%23_Toc2179965file:///D:/Ashfaque%20data/2018/4%20Oct%20to%20Dec/CRC/Hyderabad/CRC%20Hyderabad.docx%23_Toc2179966file:///D:/Ashfaque%20data/2018/4%20Oct%20to%20Dec/CRC/Hyderabad/CRC%20Hyderabad.docx%23_Toc2179967
8
TRANSPARENCY INTERNATIONAL PAKISTAN
Figure 1. 1 Data gathering in Matiari
1. Introduction
Social Accountability plays an important role in the development of essential
structural reforms for accountability and good governance in the country. Through
this process, a productive engagement between citizens and government is
established, which helps to evaluate the performance of public officials, politicians,
and service providers as these are the entities that use public resources.1 As a result
of this accountability process, the public service delivery is improved and public
money is spent in a more transparent manner benefiting citizens at large.
Citizen report card is a tool
of social accountability
for the provision of public
service delivery to the
masses. 2 It can be used to
solicit user feedback on
service provider
performance. In developing
countries, the delivery of
public services is often
inefficient and inadequate
due to corrupt practices,
poor management, and lack
of transparency and
accountability. During the
CRC process, quantitative
feedback of the services
provided to the users, is
taken scientifically. This
feedback is analyzed
statistically and presented
with recommendations and
suggestions to improve the
public service quality.
This CRC study has been conducted in Hyderabad and Matiari, two districts of the
Sindh Province. Police, Education, Local Government and Health are the four basic
services which have been evaluated in this study. A brief overview of these services in
the province is described below.
1 http://www.ansa-eap.net/about-us/who-we-are/the-four-pillars-of-social-accountability/
2 https://www.sdpi.org/media/media_details179-press-2011.html
9
TRANSPARENCY INTERNATIONAL PAKISTAN
Police
Modern police may be described as an organized body of personnel assigned to preserve
law, order, prevent and detect crime.3 They need to work in close coordination with
citizens. As an institution, it requires constant reforms and up gradation, inevitable for
better performance. Traditionally in the Sindh Province, reforms were a result of mutual
understanding between ruling classes and police top officials. The public was given the
least importance. In May 2018, the then Chief Justice of the Supreme Court of Pakistan,
constituted a Police Reform Committee (PRC). Prior to this, there were some 21 reports
on police reforms, whose recommendations were barely implemented.4 In January 2019,
the Law and Justice Commission of Pakistan launched the PRC report in which the need
to redress public complaints against police was given the highest priority. This was
necessary if meaningful reforms in the criminal justice system were to be achieved.5 The
recommendation to give public complaints a priority becomes more important in the
backdrop of the perception that the majority of Pakistanis believe that police as the most
corrupt department.6 The citizens’ perception about the police needs to be changed for
citizens to interact and assist the police for crime prevention/control and maintaining
social order. Due to the lack of trust in the police this interaction becomes difficult.
Among many methods of citizens’ involvement in this reform process, one is a
systematic feedback on the services through citizen report card. Therefore, in this CRC,
we asked citizens questions about police services as well as the amount of difficulties
citizens face in registering a FIR, behavior of police with citizens, and citizens feedback
on how to improve police force. The respondents replied these questions based on their
past experience with police.
Health
Education and health conditions are the main parameters against which the status of
human capital of any economy is gauged. Numerous studies validate the significant
positive relationship between health indicators and economic growth.7 Better health
indicators, especially in childhood, such as good nutrition for infants and toddler and less
exposure to infectious disease may improve their productivity in future and develop a
strong foundation for sustainable economic growth.8 But if we consider the health
situation in the country, Pakistan ranked 149th
towards its progress to achieve United
3 https://www.thebalancecareers.com/the-history-of-modern-policing-974587
4 https://www.dawn.com/news/1410471
5 https://tribune.com.pk/story/1887648/1-law-justice-commission-set-launch-police-reforms-report-today/
6 6 http://gallup.com.pk/2013-2016-majority-urban-pakistanis-view-police-as-the-most-corrupt-authority-
judges-and-magistrates-are-perceived-to-be-the-least-corrupt-world-justice-project-and-gallup-pakistan/ 7 Currie, J. (2009). Healthy, Wealthy, and Wise: Socioeconomic Status, Poor Health in Childhood, and Human Capital
Development. Journal of economic literature, 47(1), 87-122. 8 Schultz, T. P. (2010). Health Human Capital and Economic Development. Journal of African Economies, 19(3), 12-
80.
10
TRANSPARENCY INTERNATIONAL PAKISTAN
Figure 1. 2 A ward of Government Hospital in Sindh
Nations’ health-related Sustainable Development Goals (SDGs)9 and scored just 38 out
of 100.
One can question the
government’s huge budget
spending on health which is yet
to deliver benefits properly. The
most common challenges being
faced in the health care system
in Pakistan are: shortage of
hospitals, doctors and
specialists in remote areas, poor
management, inadequate
resources, scarcity of drugs,
untrained staff, unavailability of
female staff, absenteeism, and
private practice of many
doctors.10 In Sindh province, majority of Tehsil Headquarters hospitals are in urban areas.
People in distant villages, due to lack of transportation/ambulances, have avail the
services of BHUs and RHCs which provide only basic treatment. In these primary health
centers, people often complain about the poor quality of facilities and shortage of staff,
doctors, diagnostic equipment and laboratories.11 The government of Sindh is supposed to
consider citizens’ feedback about the services they are providing in these government run
hospitals, but with the absence of any well-defined mechanism or complaint management
system it is difficult. In this CRC, we included some basic questions about health services
with a provision that it will assist the policy makers to improve health services.
Education
According to the Constitution of Pakistan, the government is responsible to provide free
and compulsory education to all children between the age of 5 and 16 years. Before the
18th
amendment in 2010, education was a federal issue, but it has now been transferred
to the provinces.12 It is now the responsibility of the provincial government to focus on
education and fulfill the constitutional obligation towards its citizens13.
Comparing the attendance rates of the four provinces, Sindh, has 67 percent attendance rates
while other provinces attendance is around 80 percent.14 Student’s performance are a
9 https://www.dawn.com/news/1285528
10 https://www.ncbi.nlm.nih.gov/pubmed/28712245 11
https://www.pakistantoday.com.pk/2017/06/07/poor-functioning-at-government-hospitals/ 12
http://www.ipripak.org/education-system-of-pakistan-issues-problems-and-solutions/ 13
https://www.dawn.com/news/570524 14
http://dailytimes.com.pk/sindh/28-May-16/sindh-secures-6th-position-in-education-ranking
11
TRANSPARENCY INTERNATIONAL PAKISTAN
good gauge to know how well the education system is working. The standard of
education in the government schools in Rural Sindh is so poor; it is estimated that in
grade 5, 77 percent students in schools are not able to read Urdu/Sindh sentences and 75
percent are not able to read sentences in English.15 According to the Annual State of
Education Report (ASER), private school students’ are performing better than those
students who are studying in government run schools.16
The condition of basic facilities available in school is also very poor. According to a
report, out of 42,383 schools, 4,910 do not have buildings, 4,810 of which are primary
schools.17
23,235 schools do not have electricity18
, 18,128 do not have drinking water19
,
15,478 schools do not have washrooms20
and 16,359 do not have boundary wall. Lack of
basic facilities is also a reason why there is a low enrollment in these government run
schools. In order to provide and improve basic facilities in schools, citizens’ feedback can
play an important role along with improved transparency and accountability mechanism.
Questions have therefore been included in this CRC to get citizens feedback on education
services.
Local Government
In Pakistan there are three levels of government: local, provincial and federal. The local
government which is the essence of democracy is the first level of government and
primarily responsible for matters close to local communities such as public
health, local roads and footpaths, parks and playing fields, libraries, local environmental
issues, waste disposal, and many community services institutions provide various public
services to citizens. In the presence of a strong local government system, citizens easily
receive basic public services and can improve their standard of living. They can also have
easy access to their local government representatives and hold them accountable.
In Sindh, the LG system which was introduced in 2013 was implemented in 201621
. The
step although delayed but was important towards enhancing the quality of local service
delivery in the province. A strong local government system is needed to redress
grievances of all the citizens. However, the LG system is yet to deliver what it was
established for. According to a study, political, social, administrative and
mismanagement of resources and rampant corruption are the many causes which have
severely paralyzed the governance system at local government level of Pakistan.22
The
15
Annual Status of Education Report, ASER Pakistan 2018, p-199 16
https://www.thenews.com.pk/print/123008-In-a-shambles-is-what-education-is-in-Sindh 17
Table 5.1.2, Pakistan Education Statistics 2016-17 18
Table 5.4.2, Pakistan Education Statistics 2016-17 19
Table 5.5.2, Pakistan Education Statistics 2016-17 20
Table 5.6.2, Pakistan Education Statistics 2016-17 21
Undermining Local Governance, A Review of the Sindh Local Government System, 2013 22 Local Government System in Pakistan: Causes of bad Governance of Local Government System, Journal of Social and Administrative Sciences, vol2, issue 2
12
TRANSPARENCY INTERNATIONAL PAKISTAN
Figure 1. 3 CRC Survey, Hyderabad
allocated funds to each of the districts
are so insufficient that elected
councilors are unable to address
public issues which are of utmost
importance to the citizens.
1.2 Study Objectives
The main objectives of the research
were:
To evaluate police, education,
health and local government
services from the end-user’s
perspective.
To identify gaps in service
delivery processes and appraise
the good practices.
To provide a quantitative
feedback to all the stakeholders,
particularly the Sindh government
about the service quality while
pointing out weak areas for future planning and budgeting.
To provide a basis for future research in the same area.
1.3 Duration
The duration of the study was three months. It started from November 2018, ended in
February, 2019. During this period, all work of research design, data collection, and
analysis was carried out.
1.4 Scope
The data collected during this study was based on the sample taken from district
Hyderabad and Matiari. Due to time and resource constraints, the data was only taken
from this district whereas other districts were excluded from the study. Hence its findings
can only be generalized to these two districts.
13
TRANSPARENCY INTERNATIONAL PAKISTAN
2. Research Methods
2.1 Research Design
A research design can be defined as an objective, systematic plan to gather data that has
application to other situations/ populations.23
It directly addresses the goals and questions
of research24
, gives a structure to the scientific work and provides a basis for its direction
and organization.25
The selection of a particular design depends on research objectives
and the overall conditions under which a particular research is carried out. It involves
decisions about target population, development of a questionnaire, sample size, sampling
technique, data collection method and the selection of analysis technique.
This Citizen Report Card (CRC) study was conducted in two districts Hyderabad and
Mitiari. Studies like Citizen Report Card (CRC) use a survey method in which a
respondent chooses from a set of options against a statement or a question about the
services they receive from government departments. These questions designed carefully
considering their relevance and consistency with the problems or issues relevant for the
citizens. In the questionnnare design it was made sure that the questions should be
consistent with the objectives of the study.
Another issue was defining the survey population and collecting data from it through a
proper sampling technique. According to the objectives of the study, the target population
of this study should be the users of health, education, police and local government
services provided by the provincial government. Users of these services are easily
available in public places like; markets or parks etc; however, defining the purpose of the
study and taking data from them require skilled enumerators with relevant experience.
These enumerators should have a familiarity with local language, culture and geography.
For this reason, a local NGO, Youth Development Forum (YDF), was contacted which
had the past experience of conducting such surveys and had access at the grassroot level
in the district necessary for data collection. They were also in contact with local
authorities.
Before the study, the enumerators were given a briefing about the purpose of study,
questions of the survey and respondents’ eligibility. The respondents for this study were
the user of the public services. In the selected tehsils, the data was collected from places
like markets and parks where people from nearby areas gathered in large numbers,
making it easy to collect the data that represent the entire population. A total of 400
responses were gathered from the entire district. The local NGO provided basic
information about the district and key problems faced by its inhabitants to access public 23
Introduction to Nursing Research: Incorporating Evidence Based Practice by Carol Boswell, Sharon Cannon Jones & Bartlett Learning, 2011 24
Participant Observation: A Guide for Fieldworkers by Kathleen Musante (DeWalt), Billie R. DeWalt AltaMira Press, 2010 ⦁ 25
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2808761/
https://books.google.com/books?id=R69bnmpadeIC&source=ttbhttps://books.google.com/books?id=ymJJUkR7s3UC&source=ttb
14
TRANSPARENCY INTERNATIONAL PAKISTAN
services. The first draft of the questionnaire was designed after thorough research of
available literature, newspaper articles, experts’ opinion and previous CRC studies
conducted by TI Pakistan. It was finalized after consultation and discussion with the local
NGO.
The collected data was analyzed on IBM SPSS software. The results were compiled and
presented in a tabular form with a graphical representation for easy understanding.
2.2 Sample Technique and Size
A sample of 400 respondents was taken for the study using non-probability convenience
sampling technique. It was used because of time and financial constraints; however, it
was made sure that the sample should be a good representation of the entire district. This
approach is not new, as majority of survey researchs follow the same sampling technique.
2.3 Instrument of Data Collection
The instrument of data collection for this CRC was a questionnaire which consisted of 24
questions. These questions were divided among four services; health, education, police
and local government in such a way that six questions were asked to evaluate education
service, five questions were asked to evaluate health service, five questions were asked to
evaluate local government, and four questions were asked to evaluate police service. In
addition to this, four questions were asked to get a general feedback of citizens about
corruption perception. The questionnaire also included questions about respondent’s
demographic and personal information. The questions were participant friendly, simple
and carefully designed matching the objectives of the study and the analysis plan.
15
TRANSPARENCY INTERNATIONAL PAKISTAN
Yes 67%
No 17%
To some extent
16%
Male 89%
Female 11%
Figure 3. 1 Gender
Matiari 46%
Hyderabad 54%
3. Analysis and Results
The data of this study was collected from 400 respondents, 183 from Matiari and 217
from Hyderabad. 89 percent of the total respondents were male while 11 percent were
female. No gender was particularly targeted; however, the reason that male respondents
are more in number is because of cultural issues and also they are more familiar with the
services in question, and available in large number in public places where the survey was
conducted.
Table 3. 1 Gender
Table 3. 2 Districts
3.1 Analysis of Questions
Q.1 Do the teachers give individual attention to the students?
According to the results most of the respondents, 67 percent, responded Yes that the
teacher gave individual attention to students, while 17 percent responded No and 16
percent responded that teachers pay individual attention on students up to some extent.
Table 3. 3 Individual Attention
Frequency Percent
Yes 269 67
No 68 17
To some extent 63 16
Total 400 100
Frequency Percent
Male 358 89
Female 42 11
Total 400 100
Frequency Percent
Matiari 183 46
Hyderabad 217 54
Total 400 100
Figure 3. 3 Individual Attention
Figure 3. 2 Districts
16
TRANSPARENCY INTERNATIONAL PAKISTAN
Yes 70%
No 30%
Yes 52%
No 22%
To some extent 26%
Yes 57%
No 43%
Figure 3. 4 Availability of Furniture
Figure 3. 6 Availability of drinking Water
Q.2 Is required furniture available in schools?
According to the results, 70 percent responded that the required furniture is available
while 30 percent responded it is not available.
Table 3. 4 Availability of Furniture
Frequency Percent
Yes 281 70
No 119 30
Total 400 100
Q.3 Is cleanliness satisfactory in the schools?
According to this CRC results, 52 percent respondents were satisfied with the cleanliness
in the schools, while 22 percent were not. The other 26 percent responded that they were
satisfied ‘to some extent’.
Table 3. 5 Cleanliness in Schools
Frequency Percent
Yes 209 52
No 86 22
To some extent 105 26
Total 400 100
Q.4 Is drinking water available in schools?
Drinking water is a basic necessity. Safe drinking water prevents many stomach diseases.
When asked whether drinking water is available in school, 57 percent responded ‘Yes’
and 43 percent responded ‘No’.
Table 3. 6 Availability of drinking Water
Q.5 Are toilets cleaned regularly in schools?
Clean toilets are basic necessity and should be available in all public schools. Students
particularly females suffer badly if they are not available. When we asked this question,
40 percent responded that the toilets are not clean, while 35 percent responded ‘Yes’. The
other 25 percent were satisfied with cleanliness ‘to some extent’.
Frequency Percent
Yes 228 57
No 172 43
Total 400 100
Figure 3. 5 Cleanliness in schools
17
TRANSPARENCY INTERNATIONAL PAKISTAN
Yes 35%
No 40%
To some extent 25%
Yes 61%
No 15%
To some extent 24%
Yes 32%
No 28%
To some extent 40%
Figure 3. 7 Availability of clean toilets
Figure 3. 8 Condition of School Building
Figure 3. 9 Satisfaction with housekeeping
Table 3. 7 Availability of clean toilets
Q.6 Is the school building in good condition?
According to the result of this CRC, 61 percent responded that the school building were
in good condition; however, 15 percent responded ‘No’ while 24 percent responded they
were satisfied with the condition of school building 'to some extent’.
Table 3. 8 Condition of School Building
Q. 7 Are you satisfied with the house-keeping in the health facilities?
In response to this question, 32 percent responded ‘Yes’ and 28 percent responded ‘No’
while 40 percent responded ‘To some extent’.
Table 3. 9 Satisfaction with housekeeping
Q.8 Are medicines easily available in the hospital?
Inadequate access to essential medicines is a common issue in developing
countries. According to this CRC, 27.5 percent responded ‘Yes’ however 35 percent
responded ‘No’. The other 37 percent are satisfied with the availability of medicines up
to some extent.
Frequency Percent
Yes 140 35
No 160 40
To some extent 100 25
Total 400 100
Frequency Percent
Yes 243 61
No 59 15
To some extent 98 24
Total 400 100
Frequency Percent
Yes 129 32
No 110 28
To some extent 161 40
Total 400 100
18
TRANSPARENCY INTERNATIONAL PAKISTAN
Yes 27%
No 35%
To some extent 38%
Yes 25%
No 37%
To some extent 38%
Yes 47%
No 21%
To some extent 32%
Figure 3. 10 Availability of Medicines
Figure 3. 11 Satisfaction with health facilities
Table 3.10 Availability of Medicines
Frequency Percent
Yes 110 27
No 140 35
To some extent 150 38
Total 400 100.0
Q.9 Are you satisfied with the facilities available in hospitals?
In response to this question, 37 percent respondents were not satisfied about the facilities
available in the hospital, while 38 percent were satisfied to some extent. The other 25
percent respondents were satisfied with the available facilities.
Table 3. 11 Satisfaction with health facilities
Q.10 Are doctors and other staff available during duty hours?
47 percent responded that the doctors and other staff were available during duty hours;
however, 21 percent responded to this question with No. 32 percent responded that up to
some extent doctors and other staff are available in their duty hours.
Table 3. 12 Availability of doctors/staff during Duty Hours
Q.11 What should be the priority of the government in health sector?
The respondents were provided with five options. Among them, 38 percent of the
respondent said that government should curb corruption in hospitals, 26 percent said that
free checkup with latest technology, 17 percent said availability of doctors, 15 percent
said availability of medicines and 4 percent said cleanliness should be their top priority.
Frequency Percent
Yes 102 25
No 146 37
To some extent 152 38
Total 400 100
Frequency Percent
Yes 190 47.5
No 82 20.5
To some extent 128 32.0
Total 400 100
Figure 3. 12 Availability of doctors/staff during Duty Hours
19
TRANSPARENCY INTERNATIONAL PAKISTAN
Drinking water 43%
Sewage 24%
Maintenance of roads
19%
Cleanliness 14%
0 20 40 60 80 100 120 140 160
Corruption in Hospitals
Free checkup with latest technology
Availability of Doctors
Availability of Medicines
Cleaniliness
Figure 3. 14 Foremost issues for Local Govt.to resolve
Table 3. 13 Priority of the government in Health
Q.12 What problem should the local government address foremost?
The respondents were given four basic problems which are usually dealt by the local
government. These options were derived through a systematic process of research
explained in the previous chapters. 43 percent responded drinking water should be
addressed first by the local government. 24.8 and 20.8 percent responded sewage system
and maintenance of roads should be the local government priority. The results show that
providing safe water for drinking is the main problem people of the district are facing.
They also desired that the local government improved the sewage system and road
maintenance.
Table 3. 14 Foremost issues for Local Govt.to resolve
Frequency Percent
Corruption in Hospitals 151 38
Free checkup with latest technology 104 26
Availability of Doctors 68 17
Availability of Medicines 61 15
Cleanliness 16 4
Total 400 100
Frequency Percent
Drinking water 173 43
Sewage 94 24
Maintenance of roads 76 19
Cleanliness 57 14
Total 400 100
Figure 3. 13 Priority of the government in Health
20
TRANSPARENCY INTERNATIONAL PAKISTAN
Yes 20%
No 41%
To some extent 39%
Figure 3. 15 Situation after LG election
Figure 3. 16 Ways to improve LG system
Q.13 Has the administrative situation improved after the Local Government
election?
This question was asked about the improvement in the administrative situation in the
district after the LG elections. In response, 41 percent responded that there was No
improvement while only 7 percent responded ‘Yes’, there was an improvement. The
result shows that majority of the respondents are not satisfied with the administration of
local government.
Table 3. 15 Situation after LG election
Frequency Percent
Yes 81 20
No 164 41
To some extent 155 39
Total 400 100
Q.14 In your opinion how can the local government system be improved?
To improve the service delivery of LG, citizens play an important role by providing their
feedback about the services received and also suggest ways to improve them further. In
this study, we have provided them with four strategies which can possibly improve the
LG system. Among them, 35 percent responded that by inserting a minimum level of
education for the members the LG system can be improved. 29 percent responded in
favor of having a better accountability mechanism while 26 percent said that by
increasing the powers of LG members. 10 percent were of the view that by increasing the
funds given to LG members, the system of LG can be improved.
Table 3. 16 Ways to improve LG system
0 50 100 150
By inserting a minimum level of…
Better accountability
To increase the authority
dissemination of more funds
Frequency Percent
By inserting a minimum level of education 141 35
Better accountability 116 29
To increase the authority 103 26
Dissemination of more funds 40 10
Total 400 100
35%
29%
26%
10%
21
TRANSPARENCY INTERNATIONAL PAKISTAN
Yes 24%
No 33%
To some extent 43%
Figure 3. 17 Use of power delegated to LG rep.
Yes 22%
No 34%
To some extent 44%
Figure 3. 18 Effective use of Allocated funds
Q.15 Do the local government representatives making the best use of the powers
delegated to them?
There has been a constant debate on the powers given to the local government. The
Mayor Karachi has attributed the LG government toothless. In his opinion that is the
reason for people not getting good services through their elected representatives.26
However, the respondents were asked whether the powers given to the elected LG
representatives were being utilized effectively. In response to this question, majority of
the respondents, 43 percent said ‘To some Extent’, while 33 percent responded ‘No’. 24
percent responded that they are effectively using the powers delegated to them.
Table 3. 17 Use of power delegated to LG rep.
Frequency Percent
Yes 98 24
No 131 33
To some extent 171 43
Total 400 100.0
Q.16 Do you think LG representatives make effective use of the allocated funds?
In response to this question, only 22 percent responded ‘Yes’, while 34 percent
responded No. The other 44 percent according to this survey were of the opinion that
funds allocated to LG representatives are not being utilized effectively. The other 39
percent of the respondents said the funds are being used effectively to a certain extent.
Table 3. 18 Effective use of Allocated funds
Q.17 Is it easy to register an FIR with the Police?
First Information Reports (FIR) are registered to report a crime. The process of
registering FIR should be simple to encourage citizens to give the first information report
to the concerned police station. However, it is also reported that the registering process
has its flaws which effects prosecution and investigation27
. Non-registration of FIR is an
offense and can be a ground for disciplinary action against the concerned police officer.
26
https://pakobserver.net/lb-representatives-not-given-power-by-sindh-govt-waseem/ 27
https://tribune.com.pk/story/974777/fir-registration-process-replete-with-flaws-cops-say/
Frequency Percent
Yes 87 22
No 135 34
To some extent 178 44
Total 400 100
22
TRANSPARENCY INTERNATIONAL PAKISTAN
Yes 55%
No 45%
Figure 3. 19 Ease in registering FIR
In this CRC, we asked respondents whether FIRs can be easily registered easily. In
response to this question, 55 percent responded that it was easy to register a FIRs while
the other 45 percent responded No.
Table 3. 19 Ease in registering FIR
Frequency Percent
Yes 221 55
No 179 45
Total 400 100
Q.18 Are you satisfied with the behavior of police with common people?
In response to this question, 36 percent respondents that they are satisfied with the
behavior of police with citizens, while 33 percent responded No. The other 31 percent
respondents were satisfied to some extent.
Table 3. 20 Satisfaction with police behavior
Frequency Percent
Yes 146 36
No 130 33
To some extent 124 31
Total 400 100
Q.19 In your opinion how can police department be improved?
Citizens can suggest various steps which can improve the performance of police
department. The respondents were given six options as shown in Table 3.21. According
to their replies, induction on merit is the most popular option opted by 33 percent of the
respondents, while political interference and police reforms were the second and the third
highest chosen options.
Table 3. 21 How to improve police department
Frequency Percent
Induction on merit 133 33
End political interference 96 24
Police reforms 87 22
Independent & Autonomous Police 39 10
Need better training 34 8
Need more facilities 11 3
Total 400 100
Yes 36%
No 33%
To some extent 31%
Figure 3. 20 Satisfaction with police behavior
23
TRANSPARENCY INTERNATIONAL PAKISTAN
Yes 36%
No 24%
To some extent 40%
Figure 3. 22 Citizens feel secure in presence of police
Q.20 Do the citizens feel secure in presence of police?
It is the responsibility of police to maintain law and order which results in the safety and
security of its citizens. The citizens were asked if they felt secure in the presence of
police. In response to this question, 36 percent respondents said that they felt secure, and
24 percent said ‘No’. While 40 percent responded that they feel secure ‘to some extent’.
Table 3. 22 Citizens feel secure in presence of police
The next four questions were added to get citizens feedback on corruption and corrupt
practices.
Q.21 Do you agree that a common man can make a difference in the fight against
corruption?
This question was added to know how a respondent perceives his capacity in the fight
against corruption. In its response, 46 percent said ‘No’ that a common man can’t make a
difference while 32 percent responded ‘Yes’. The other 22 percent responded ‘to some
Extent’.
Table 3. 23 Can a common man make a difference in the fight against corruption
Frequency Percent
Yes 128 32
No 183 46
To some extent 89 22
Total 400 100
Frequency Percent
Yes 144 36
No 95 24
To some extent 161 40
Total 400 100
Yes 32%
No 46%
To some extent 22%
Figure 3. 23 Can a common man make a difference in the fight against corruption
Figure 3. 21 How to improve police department
0 20 40 60 80 100 120 140
Induction on merit
End political interference
Police reforms
Independent & Autonomous Police
Need better training
Need more facilities
Frequency
3%
8%
10%
22%
24%
33%
24
TRANSPARENCY INTERNATIONAL PAKISTAN
Q.22 Based on your previous experience, which public department is most corrupt?
According to our results, Police department is perceived to be the most corrupt while
Education is the least corrupt department. The second most corrupt department is
Revenue department, while Local Government is at third number. The rest of the details
is shown in table 3.24.
Table 3. 24 Most corrupt departments
Frequency Percent
Police 113 28
Revenue Department 97 24
Local Government 86 22
Health department 41 10
Judiciary 32 8
Education Department 31 8
Total 400 100
Figure 3. 24 Most corrupt departments
Q.23 In which department were you compelled to give a bribe in getting public
services?
The respondents were given six different options. The options included Police, Revenue,
Local Govt., Education, Health and Judiciary department. The result is shown in the
following table.
The department where most of the people had to pay bribe is Police which is mentioned
by 21 percent of the respondents, 20 percent mentioned Local Government Department,
and 19 percent mentioned Revenue Department. The findings suggest that the Education
department is the least corrupt. The findings are consistent with the responses of previous
question.
0 20 40 60 80 100 120
Police
Revenue Department
Local Government
Health department
Judiciary
Education Department
Frequency
8%
8%
10%
22%
24%
28%
25
TRANSPARENCY INTERNATIONAL PAKISTAN
Table 3. 25 Departments where respondents paid bribe
Frequency Percent
Police 85 21
Local Government 82 20
Revenue Department 77 19
Health Department 59 15
Judiciary 55 14
Education Department 42 11
Total 400 100
Figure 3. 25 Departments where respondents paid bribe
Q.24 According to some people, corruption is not reported. Based on your
experience what is the most common reason?
According to this survey, the most common reason for not reporting corruption is that
citizens think that the complaint receivers are themselves involved in corruption. The
next 31 percent respondents think that there is no use of reporting corruption. 15 percent
respondents do not know whom to report corruption, and 12 percent respondents do not
know where to report corruption.
0 10 20 30 40 50 60 70 80 90
Police
Local Government
Revenue Department
Health Department
Judicary
Education Department
26
TRANSPARENCY INTERNATIONAL PAKISTAN
Table 3. 26 Reasons of not reporting corruption
Frequency Percent
The complaint receivers are themselves involved in corruption 171 43
There is no benefit to report 86 22
People don't know to whom to report the complaint 46 11
People don't know where to report 40 10
Don't have time to report the corruption complain 33 8
This is public money not government, so it our duty to report 24 6
Total 400 100
Figure 3. 26 Reasons for not reporting corruption
43%
22%
11% 10% 8%
6%
The complaintreceivers are
themselves involvedin corruption
There is no benefit toreport
People don't know towhom to report the
complaint
People don't knowwhere to report
Don't have time toreport the corruption
complain
This is public moneynot government, so it
our duty to report
27
TRANSPARENCY INTERNATIONAL PAKISTAN
4. Recommendations
Education
1. According to this study, 30 percent respondents said that adequate furniture is not available
in schools. The government should ensure its availability. The school administration should
be responsible and accountable for these assets.
2. The schools, along with the areas surrounding it, need to be kept clean. The administration
should have the budget to deploy proper house-keeping staff.
3. Another facility that schools are missing is availability of washrooms and clean drinking
water. 43 percent of the respondents said schools do not have drinking water facility, while
40 percent said toilets are available. These facilities should be available in all schools.
Health
4. Housekeeping of all health facilities need to be improved. Area around hospitals should be
kept clean at all times. Medical waste should be properly disposed of.
5. Important/necessary medicines/vaccines should be available at all health facilities.
6. Biometric devices and CCTV should be installed in all health facilities to address the issue
of punctuality and ghost employees.
7. Corruption in hospitals should be addressed at priority basis. Anti-Corruption mechanism
should be in place in the hospital for accountability and transparency.
8. Government should improve infrastructure, make available necessary equipment and
diagnostic laboratories at the hospitals, so as to improve the services offered to the citizens.
This will help doctors in the treatment of their patients.
Local Government
9. The local government should address three main problems faced by the citizens; providing
safe drinking water, improve sewage system and improving roads.
10. Reforms are needed to improve the administrative situation of Local Government. There is
also a need to keep a balance of power between provincial and local government.
11. To improve the performance of LG representatives, minimum qualifications of the
candidates should be set. They should also be provided training after the elections.
12. Measures should be taken to improve local government accountability system.
Police
13. The police department should facilitate complainants to register FIR. They should also
punish those officers who intentionally hinder the FIR registration process.
14. A proportion of respondents were not satisfied with the behavior of police with citizens. It
requires further investigation to know its reasons. The police should be trained to be
courteous at all times.
15. The police department should be independent and free from any political influence. The
department also needs a transparent hiring and promotion process.
28
TRANSPARENCY INTERNATIONAL PAKISTAN
5. References and Bibliography
1. http://www.ansa-eap.net/about-us/who-we-are/the-four-pillars-of-social-accountability/
2. https://www.sdpi.org/media/media_details179-press-2011.html
3. https://www.thebalancecareers.com/the-history-of-modern-policing-974587
4. https://www.dawn.com/news/1410471
5. https://tribune.com.pk/story/1887648/1-law-justice-commission-set-launch-police-reforms-report-today/
6. http://gallup.com.pk/2013-2016-majority-urban-pakistanis-view-police-as-the-most-corrupt-authority-judges-and-magistrates-are-perceived-to-be-the-least-corrupt-world-justice-project-and-gallup-
pakistan/
7. Currie, J. (2009). Healthy, Wealthy, and Wise: Socioeconomic Status, Poor Health in Childhood, and Human Capital Development. Journal of economic literature, 47(1), 87-122.
8. Schultz, T. P. (2010). Health Human Capital and Economic Development. Journal of African
Economies, 19(3), 12-80.
9. https://www.dawn.com/news/1285528
10. https://www.ncbi.nlm.nih.gov/pubmed/28712245
11. https://www.pakistantoday.com.pk/2017/06/07/poor-functioning-at-government-hospitals/
12. http://www.ipripak.org/education-system-of-pakistan-issues-problems-and-solutions/
13. https://www.dawn.com/news/570524
14. http://dailytimes.com.pk/sindh/28-May-16/sindh-secures-6th-position-in-education-ranking
15. Annual Status of Education Report, ASER Pakistan 2018, p-199
16. https://www.thenews.com.pk/print/123008-In-a-shambles-is-what-education-is-in-Sindh
17. Table 5.1.2, Pakistan Education Statistics 2016-17
18. Table 5.4.2, Pakistan Education Statistics 2016-17
19. Table 5.5.2, Pakistan Education Statistics 2016-17
20. Table 5.6.2, Pakistan Education Statistics 2016-17
21. Undermining Local Governance, A Review of the Sindh Local Government System, 2013
22. Local Government System in Pakistan: Causes of bad Governance of Local Government System,
Journal of Social and Administrative Sciences, vol2, issue 2
23. Introduction to Nursing Research: Incorporating Evidence Based Practice by Carol Boswell, Sharon Cannon Jones & Bartlett Learning, 2011
24. Participant Observation: A Guide for Fieldworkers by Kathleen Musante (DeWalt), Billie R.
DeWalt AltaMira Press, 2010 ⦁
25. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2808761/
26. https://pakobserver.net/lb-representatives-not-given-power-by-sindh-govt-waseem/
27. https://tribune.com.pk/story/974777/fir-registration-process-replete-with-flaws-cops-say/
28. Annual Status of Education Report
29. Budgets and Fiscal Decentralization: A case study of Sindh
30. Community Policing in Pakistan
31. Factor Influencing Police Image in Public, Pakistan Journal of Criminology
32. Health Profile of Sindh, District Wise 2016
33. Pakistan Education Statistics 2016-17
34. Police Organization in Pakistan, HRCP 2010
35. Revisiting Police Reforms in Pakistan: A Critical Analysis
36. Role of Pakistan Police in Counterinsurgency
37. State of Health Sector in Pakistan 2018
38. Structural Organization of Police: Official Record of the Government of Pakistan Based on Cabinet
Division and Secretariat
39. The Definition and Importance of Local Governance
40. Undermining Local Governance: A Review of the Sindh LG System 2013
https://www.sdpi.org/media/media_details179-press-2011.htmlhttps://www.dawn.com/news/570524https://books.google.com/books?id=R69bnmpadeIC&source=ttbhttps://books.google.com/books?id=ymJJUkR7s3UC&source=ttbhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC2808761/
29
TRANSPARENCY INTERNATIONAL PAKISTAN
30
TRANSPARENCY INTERNATIONAL PAKISTAN