CBO MONITORING FORMAT Sewalanka CBO code:

Format completed by:

PART 1: CONTACT INFORMATION Date completed:

1.1 Name of CBO:

1.2 GN: 1.3 DS: 1.4 District:
1.5 Name of contact person:
1.6 Address:
1.7 Phone: 1.8 Email:

PART 2: LOCAL CONTEXT

2.1 Are there other active CBOs in the GN Division? □ Yes □ No 2.2 If yes, give details below:
a. Name of CBO b. Type of CBO c. Sewalanka involvement
□ None □ Coordinate □ Fully active

□ None □ Coordinate □ Fully active

□ None □ Coordinate □ Fully active

□ None □ Coordinate □ Fully active

2.3 Is there a village committee that coordinates CBO activities? □ Yes □ No

2.4 Does this CBO participate in the village committee? □ Yes □ No

2.5 What are the 3 main sources of income for people living in the community?
a. b. c.
2.6 Has the community been affected by war / natural disaster? □ Yes □ No 2.7 If yes, give details:
a. Disaster b. Year(s) c. Impact on community (Check all that apply)
□ Lost lives □ Displaced □ Lost assets □ Livelihoods affected

□ Lost lives □ Displaced □ Lost assets □ Livelihoods affected

□ Lost lives □ Displaced □ Lost assets □ Livelihoods affected

□ Lost lives □ Displaced □ Lost assets □ Livelihoods affected

PART 3: EXTERNAL SUPPORT

3.1 How was the CBO formed?
□ Self-organized by community □ Formed by Government □ Formed by Sewalanka □ Other:
3.2 If it is a Government CBO, what department?
3.3 What year was it formed? 3.4 What year did Sewalanka involve?
3.5 Has the CBO received resources under donor-funded projects? □ Yes □ No 3.6 If yes, give details:
a. Money, goods or assets received b. Year(s) c. Donor d. Implemented by:

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3.7 List all Sewalanka social mobilizers that have worked with the CBO (Start with current mobilizer)
a. Name of social mobilizer b. Time period with CBO c. Reason stopped working with CBO

3.8 In the past year, what activities has Sewalanka organized for the CBO? (PRA, training, etc.)
List CBO-organized activities in Part 4, Question 4.13
# of participants
a. Activity b. Date(s) e. Notes
c. male d. female

PART 4: PLANNING AND IMPLEMENTATION CAPACITY

4.1 Does the CBO have a written objective? □ Yes □ No 4.2 If yes, what is it?

4.3 Has the CBO assessed and prioritized challenges and opportunities? □ Yes □ No
4.4 Has the CBO prepared an action plan with targets? □ Yes □ No
4.5 Is the action plan reviewed and updated at every meeting? □ Yes □ No
4.6 In the past 1 year, the CBO has reached:
□ All of its targets □ 50% of its targets □ 25% of its targets □ None of its targets
4.7 In the past year, has the CBO coordinated any events? □ Yes □ No
4.8 In the past year, has the CBO developed or maintained infrastructure? □ Yes □ No
4.9 In the past year, has the CBO offered any services or started any programs? □ Yes □ No
4.10 In the past year, has the CBO coordinated collective purchasing? □ Yes □ No
4.11 In the past year, has the CBO coordinated collective marketing? □ Yes □ No
4.12 In the past year, has the CBO coordinated a community enterprise? □ Yes □ No
4.13 If there was a yes to Question 4.7-12, give details:

a. Activity b. Date(s) # of participants e. Notes

c. Male d. Female

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a. Activity b. Date(s) # of participants e. Notes
c. Male d. Female

PART 5: FINANCIAL MANAGEMENT CAPACITY

5.1 What financial systems is the CBO managing? □ No funds (Go to Part 6) □ Member fees only
□ Savings scheme □ Revolving loan fund □ External loans □ Community enterprise
5.2 CBO member fees are Rs. _________ per: □ Week □ Month □ Quarter □ Year
5.3 Does the CBO have a bank account? □ Yes □ No 5.4 If yes, give details below:
a. Name of bank b. Type of account c. Year started d. Current balance
□ Savings □ Current
□ Savings □ Current
□ Savings □ Current
5.5 Is the CBO maintaining the following financial records?
a. Type of record b. Year started c. Up-to-date
Receipts and vouchers □ Yes □ No □ Yes □ No
Cash book / General ledger □ Yes □ No □ Yes □ No
Petty cash book □ Yes □ No □ Yes □ No
Member fee ledger □ Yes □ No □ Yes □ No
Savings ledger □ Yes □ No □ Yes □ No
Members pass books □ Yes □ No □ Yes □ No
Loan ledger □ Yes □ No □ Yes □ No
Stock book □ Yes □ No □ Yes □ No
Shares ledger □ Yes □ No □ Yes □ No
5.6 Where are financial records kept?
5.7 Is the CBO preparing monthly reports: □ Cash flow □ Income statement □ Account reconciliation
5.8 Are financial reports presented at general meetings and posted publicly? □ Yes □ No
5.9 What was the date of the last audited financial report?
5.10 Is the audited financial report presented at the AGM and posted publicly? □ Yes □ No
5.11 Does the CBO have any additional assets? □ Yes □ No 5.12 If yes, describe below:
a. Asset b. Value c. Date acquired d. Source
□ Purchased □ Member donation □ Grant

□ Purchased □ Member donation □ Grant

□ Purchased □ Member donation □ Grant

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If the CBO does not have a revolving loan fund, go to Part 6.
5.13 What year did the CBO start providing loans?

5.14 Monthly interest rate: 5.15 Monthly interest rate for “instant” loans:
5.16 What do members use the loans for? (List the 3 most common uses)
a. b. c.
5.17 Loan portfolio outstanding: 5.18 Loan portfolio in arrears:

5.19 CBO Portfolio at Risk (PAR):

5.20 Total # of loans disbursed: 5.21 Total value of loans disbursed:

5.22 Number of female borrowers: 5.23 Number of male borrowers:

5.24 Has the CBO ever borrowed from: □ Sewa Finance □ Bank □ Other MFI 5.25 If yes, give details
b. Loan c. Interest d. Repayment Number of payments
a. Lending institution
size rate period e. # On-time f. # Delayed

PART 6: ORGANIZATIONAL MANAGEMENT CAPACITY

6.1 Has the CBO prepared a constitution or bylaws? □ Yes □ No
6.2 Is the CBO registered with the government? □ Yes □ No 6.3 If yes, give details below:
Registration number Date of registration Registered under

6.4 # of registered male members: 6.5 # of registered female members:

6.6 # of active male members: 6.7 # of active female members:
6.8 Does the CBO have a small group system? □ Yes □ No 6.9 If yes, give details below:

a. Name of small group # of members d. Meeting frequency e. Notes

b. Male c. Female
□ Weekly □ Monthly □ Rarely
□ Weekly □ Monthly □ Rarely
□ Weekly □ Monthly □ Rarely
□ Weekly □ Monthly □ Rarely
□ Weekly □ Monthly □ Rarely
□ Weekly □ Monthly □ Rarely
□ Weekly □ Monthly □ Rarely
□ Weekly □ Monthly □ Rarely
□ Weekly □ Monthly □ Rarely
□ Weekly □ Monthly □ Rarely
□ Weekly □ Monthly □ Rarely

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6.10 Does the CBO have a management Committee? □ Yes □ No
6.11 # of male CBO Committee members: 6.12 # of female CBO Committee members:
6.13 Give the dates of the past 3 CBO Committee meetings:
a. b. c.
6.14 Give the dates of the past 3 officer elections:
a. b. c.
6.15 Give details on the last 3 general meetings:

a. Date of meeting b. Venue # of participants e. Notes

c. Male d. Female

6.16 In the past year, has the CBO formed any sub-committees? □ Yes □ No
a. Role of sub-committee # of members d. Meeting frequency e. Notes
b. Male c. Female
□ Weekly □ Monthly □ Rarely
□ Weekly □ Monthly □ Rarely
□ Weekly □ Monthly □ Rarely
6.17 Is the CBO maintaining the following organizational record systems and supplies?
a. Type of record b. Year started c. Up-to-date
Member registry □ Yes □ No □ Yes □ No
Small group details □ Yes □ No □ Yes □ No
Rubber stamp / seal □ Yes □ No □ Yes □ No
Letterhead □ Yes □ No □ Yes □ No
Record book with minutes / attendance □ Yes □ No □ Yes □ No
Inventory □ Yes □ No □ Yes □ No
Filing system for letters, planning documents, etc. □ Yes □ No □ Yes □ No
6.18 Where are organizational supplies and records kept?
6.19 Does the CBO maintain any paid staff? □ Yes □ No 6.20 If yes, give details below:
a. Name b. Role c. Date hired d. Allowance

PART 7: LEADERSHIP, PARTICIPATION AND GROUP DYNAMICS

Use the next page to:
7.1 Describe the strengths and weaknesses of CBO leadership
7.2 Describe community participation in the CBO
7.3 Describe the dynamics of small groups, the CBO Committee, sub-committees and general meetings
7.4 Describe any conflicts within the community or the CBO. Describe how conflict is addressed.

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Part 7 continued

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PART 8: LINKAGES

8.1 In the past year, what GN-level service providers/stakeholders has the CBO interacted with?
a. Title / institution b. Benefit c. Strength of link
□ Weak □ Medium □ Strong
□ Weak □ Medium □ Strong
□ Weak □ Medium □ Strong
□ Weak □ Medium □ Strong
8.2 In the past year, what DS-level service providers/stakeholders has the CBO interacted with?
a. Title / institution b. Benefit c. Strength of link
□ Weak □ Medium □ Strong
□ Weak □ Medium □ Strong
□ Weak □ Medium □ Strong
8.3 In the past year, what District-level service providers/stakeholders has the CBO interacted with?
a. Title / institution b. Benefit c. Strength of link
□ Weak □ Medium □ Strong
□ Weak □ Medium □ Strong
□ Weak □ Medium □ Strong
8.4 In the past year, what Regional-level service providers/stakeholders has the CBO interacted with?
What National-level service providers/stakeholders has the CBO interacted with?
a. Title / institution b. Benefit c. Strength of link
□ Weak □ Medium □ Strong
□ Weak □ Medium □ Strong
□ Weak □ Medium □ Strong
8.5 Is the CBO aware of Sewa Finance services? □ Yes □ No
8.6 Is the CBO aware of SEDCO services? □ Yes □ No

SUMMARY OF CBO CAPACITY

Based on the data provided in this format and Sewalanka indicators, what is the level of the CBO?

Planning and implantation □ Level 1 □ Level 2 □ Level 3 □ Level 4 □ Level 5

Financial management □ Level 1 □ Level 2 □ Level 3 □ Level 4 □ Level 5

Organizational management □ Level 1 □ Level 2 □ Level 3 □ Level 4 □ Level 5

Leadership, participation, group dynamics □ Level 1 □ Level 2 □ Level 3 □ Level 4 □ Level 5

External linkages □ Level 1 □ Level 2 □ Level 3 □ Level 4 □ Level 5

TOTAL CBO LEVEL: (Sum of 5 levels above divided by 5):

Signature of CBO Chairman: Date: