Aid in Action

Citizen Charter Reaches Rural Health Clinics

"Service with a smile" in North Sumatra

Medan | Monday, June 15, 2009

“Siap?” (“Are you ready?”), asked Drs. H. Amri Tambunan, Bupati (district head) of Deli Serdang district, North Sumatra, at a workshop on improving public services on March 3, 2009.

“Siap!” (“Ready!”), replied the gathering of over 50 stakeholders, including five sector department heads and other officials from local government and civil society organization representatives.

These officials were signaling their commitment to a stronger client focus in the delivery of public services in Deli Serdang. The department heads for investment, education, industry and trade, population and labor later signed an MOU with the bupati at the workshop committing to citizen-focused service improvements.
The commitment to a spirit of customer focus was spearheaded by the Deli Serdang director of health, Dr. Masdulhag Siregar, who has piloted a program to develop a citizen charter for health service delivery.

USAID’s Local Governance Support Program (LGSP) worked with the director and a multi-stakeholder group of citizens and health department staff to develop the charter using a framework developed by LGSP called Service Improvement Action Planning, or SIAP—an acronym which captures the bupati’s call for his officials to be ready.

The program was piloted at five health centers in Deli Serdang, including Tanjung Morawa. The essence of the citizen charter is captured on a billboard posted in the center’s waiting area. Its motto is “Excellence in service—and service with a smile.” The billboard informs the hours that the center is open, the delivery time for each service, and how to navigate through the center. The charter also lists the rights and responsibilities of staff and patients. In a nearby feedback box, patients can drop a red, yellow or green slip of paper to signal their level of satisfaction with the services.

At the workshop, Dr. Siregar reported that access to health care is not a problem in Deli Serdang. What has been lacking is a management approach that stresses quality of service; a commitment to customer service. Service with a smile means treating patients with dignity and respect. This is particularly important in the area of health care, where citizen surveys have found that failure of government health personnel to respect the privacy and sensitivity of patients has led citizens to avoid going to government health centers. It is therefore imperative that the head of service set the bar for excellence in service performance.

“What is needed is a commitment from all stakeholders to implement quality services,” says Dr. Siregar.