| 4. In which ways is the initiative creative and innovative?
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The initiative exploits several innovative approaches to reach it's goals. An obvious one is technology, specially in a country that has very high connectivity, including within the most vulnerable population thanks to several digital inclusion plans. At the same time it reaches it's policy objectives while improving transparency, involving social actors and fully embracing Open Government and Open Data. However, the greatest merit of ATuServicio.uy is not in the technological tool, rather in the fact that the government and civil society unite to provide the citizens with the delivery of a new quality service, with very accesible data, at the right time. As a consequence of that, a greater demand for data was created and established a new reference point for the information that every citizen needs to choose their health care services.
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| 5. Who implemented the initiative and what is the size of the population affected by this initiative?
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Beyond being co-created, the initiative is also co-implemented by the Ministry of Public Health and DATA Uruguay. This brings to the table interests of government and its policies as well as civil society and it's demands. It's also worth mentioning that both parties participarte in the national Open Government Initiative and through that dialogue with other civil society organizations has been enabled, framing the initiative in a broader ecosystem of collaboration.
Among the main partners, the distribution of tasks is according to areas of expertise, while the project as a whole and each of it's sections are agreed upon both parties. The Ministry holds responsibility over the collection, digitalization, update, revision and proper formatting of the data, proper usage of technical terms, academic revision of the platform and so on. DATA Uruguay on the other hand is responsible for the software, visualization, user interface, user experience and interpretation/presentation of the data. Overall both parties take consensus based decisions for the platform and it's development, being a true co-creation and co-implementation project.
The affected population is at the very least the 1,5 million people who every year have the possibility to switch health providers in february. However, we believe that the broader objective is not reduced to those switching providers, but to give every Uruguayan better information over their health providers, having greater transparency and accountability.
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| 6. How was the strategy implemented and what resources were mobilized?
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The project started after the ministry shoed interest in a small data journalism experiment done by DATA Uruguay with the previously available data. The link for both organizations was the Open Government Initiative led by the uruguayan eGov agency (AGESIC). After agreeing to work together on the project, the planning stage started, involving the co-creation of a prototype as well as the collection of extra data and it's formatting not only for use within the app but for publication as Open Data. The funding for the first iteration was mixed, coming 50% from the Ministry itself and another 50% by the Latin American Initiative for Open Data (ILDA) and AVINA Foundation through DATA Uruguay. The beta version was launched on february 2, 2015 and shortly after a new government was sworn in. The initiative was not only maintained by the new authorities but the commitment reinforced with a plan spanning to the end of the administration (2020), that includes funding. Work for the 2016 edition started shortly after, focusing on improving the user interface with the feedback collected from the beta. After the new version was launched showing a significant improvement in user reach and experience, the focus shifted to broadening the amount of data available, which is one of the news for the recently launched 2017 edition. The plan is already in place for next year, where the strategy is to broaden the use of the tool beyond february, adding other kinds of data related to user rights in health services.
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| 7. Who were the stakeholders involved in the design of the initiative and in its implementation?
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The Ministry of Health and DATA Uruguay were the two main partners, responsible for co-design and co-implementation. Within the Ministry Elena Clavel played a key role in the fruition of this idea, with critical support from Jorge Scarone and Diego Soria. After the administration change, Soledad Acuña took the role of initiative lead within the Ministry. AGESIC also played a significant role through the Open Government Initiative and facilitating contact. Finally, ILDA and AVINA provided funding that allowed the full development of the beta.
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| 8. What were the most successful outputs and why was the initiative effective?
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Firstly it gave the population as a whole a new level of transparency and accountability for both public and private health which included monitoring of sanitary goals directly related to the SDG'd such as maternal and child mortality, mother-to-child HIV transmission and universal sanitary coverage. This is also directly related to SDG 16 in the creation of efficient, accountable and transparent institutions.
Allowing to compare in detail over 300 different datapoints in an easy, fast and simple manner, it gave -specially those most vulnerable, living father from cities or with less resources- to learn more about the performance of health providers, without the need to move or gather incompatible information from different sources. A clear example of this is the services provided in a specific clinic, which might be much more important for a person living in a remote town, than the overall services that the provider offers, if they imply trips to the capital. Another clear example is the recommendation of the tool among migrants, who face the decision of choosing a health provider without any previous knowledge of the offer.
Beyond that, a much broader discussion on quality was fostered, and for the first time based on data. The app and it's data was used in different instances and places by government (including the Health Minister himself) to present results, by opposition parties to demand changes, by unions to demand even grater transparency, press to analyze diverse aspects of the health system through data journalism and civil society to demand reforms or further data.
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| 9. What were the main obstacles encountered and how were they overcome?
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The main obstacles had to do with the systematization and availability of data, that was distributed among separate areas of the Ministry. After a very tough first year collecting this data from all parties and convincing then of the importance of making it public and transparent, a system was installed, and every party involved in the design process of presenting their data.
Today, each edition of ATuServicio.uy implies representative from diverse areas of the Ministry collaborating and reaching consensus among them as well as with DATA Uruguay. The solution to the problem was in fact strengthening collaboration among areas.
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