Development of Citizen’s Charter to Improve the Service Provision at a Regional Health Services Directorate in Sri Lanka

Introduction: Citizen’s charter is a means to improve service delivery processes and foster greater customer satisfaction. Unacceptable delays in providing services by the Office of Regional Director of Health Services, Kurunegala (RDHSK) and subsequent re-visits had created customer dissatisfaction. A citizen’s charter was developed to improve the service provision at RDHSK.

Methods: Ten services being provided to nursing officers by the Establishment Branch (EB) of RDHSKwere prioritized for incorporating in the charter. The services were mapped and redesigned, and deficiencies were dealt with developing and implementing the charter, its sub-components and supplementary interventions. The charter and sub-components were designed and implemented as per the Public Administration circular issued in 2008, adopting the participatory approach. To enhance the effectiveness of charter, several supplementary interventions were designed. A focal point, a steering committee, and monitoring, review and appraisal mechanisms were established. Documents that need access by nursing officers were kept at their workplaces in addition to RDHSK and its website. New developments were effectively communicated to the staff of RDHSK through training and to service recipients through multiple routes.

Results: The new developments included the citizen’s charter, its sub-components and supplementary interventions.  Sub-components include summary charter and feedback and response system with complaint and feedback formats, feedback box and feedback and response register. The supplementary interventions comprise document submission checklists, compilations of formats to be filled for receiving services with a relevant checklist on the top, guidelines for nursing officers and their work institutions on new developments, and a booklet on work steps for MAs providing services at EB.

Conclusion: The participatory approach, stakeholder involvement throughout, wider publicity of charter among service recipients and service providers, effective feedback and response system, and mechanisms for monitoring, evaluation, review and appraisal of the charter are useful means to successfully develop, implement and sustain charters.