Peru: Service Quality

The Participatory Voices Project was implemented in Peru between 2008 and 2011 to introduce community monitoring as a tool to improve the quality of health services. While the project did not focus specifically on the interpersonal relationship between patients and providers, it aimed to: 1) strengthen capacities of civil society networks, 2) identify and connect key actors in the rights-based approach to heath, 3) build partnerships between NGOs, international cooperation agencies, grassroots social organizations, civil society networks, and international actors; and 4) encourage political advocacy and provide technical assistance to an array of actors to improve responsiveness of the health system to marginalized populations.1

The project was planned with flexibility for local adaptation, and there were four general steps for implementation: 1) activity planning by the technical supporting team, 2) public announcement, selection, and capacity building of the members of the monitoring committees, 3) implementation of field activities, and 4) monitoring of commitments and evaluation.  Related to steps 2 and 3, in each province, a group of individuals were identified to carry out the community monitoring activities. Trainings were conducted to teach individuals about some of the following concepts: human rights, health care rights, democracy and citizenship, sexual and reproductive health and rights, and organization and operation of health care services. Implementation differed but generally included visits to facilities for citizen monitoring, meetings for participatory analysis of findings, and discussion with authorities on commitments for improving services.1 Observations of the program found that a number of respectful care practices were encouraged and fostered such as a greater promotion of culturally appropriate practices and increased attention to the right to health by authorities. Additional information on the Participatory Voices Project can be found on the CARE International website.


  1. Frisancho A, Vasquez ML. Citizen monitoring to promote the right to healthcare and accountability [Internet]. Centre for Health and Social Justice. 2015. Available from: