Abstract
BackgroundThe majority of documented social accountability initiatives to date have been ‘tactical’ in nature, employing single-tool, mostly community-based approaches. This article provides lessons from a ‘strategic’, multi-tool, multi-level social accountability project: UNICEF’s ‘Social Accountability for Every Woman Every Child’ intervention in Malawi.MethodsThe project targeted the national, district and community levels. Three Civil Society Organisations (CSOs) were engaged to carry out interventions using various tools to generate evidence and political advocacy at one or more levels. This article focuses on one of the social accountability methods – the bwalo forum (a meeting based on a traditional Malawian method of dialogue). A detailed political economy analysis was conducted by one of the co-authors using qualitative methods including interviews and group discussions. The authors conducted in-country consultations and analysed secondary data provided by the CSOs.ResultsThe political economy analysis highlighted several ways in which CSO partners should modify their work plans to be more compatible with the project context. This included shifting the advocacy and support focus, as well as significantly expanding the bwalo forums. Bwalos were found to be an important platform for allowing citizens to engage with duty bearers at the community and district levels, and enabled a number of reproductive, maternal, newborn, child and adolescent health issues to be resolved at those levels. The project also enabled learning around participant responses as intermediate project outcomes.ConclusionsThe project utilised various tools to gather data, elevate community voices, and facilitate engagement between citizen and state actors at the community, district and national levels. This provided the scaffolding for numerous issues to be resolved at the community or district levels, or referred to the national level. Bwalo forums were found to be highly effective as a space for inter-level engagement between citizens and state; however, as they were not embedded in existing local structures, their potential for sustainability and scalability was tenuous. A key strength of the project was the political economy analysis, which provided direction for partners to shape their interventions according to local and national realities and be sensitive to the barriers and drivers to positive action.
Highlights
The majority of documented social accountability initiatives to date have been ‘tactical’ in nature, employing single-tool, mostly community-based approaches
Political economy analysis and responses of project participants The political economy analysis resulted in five key findings: 1) Malawi has, on paper, a conducive legal framework for social accountability; 2) Reproductive health policies and other guidelines emphasise accountability and citizen participation; 3) RMNCAH-related national strategies identify social accountability as an important element; 4) There has been an incomplete decentralisation process, with local government systems and structures not fully developed to ensure meaningful citizen participation or oversight of service delivery, and 5) Existing social accountability initiatives are mainly driven by Civil Society Organisation (CSO) focusing on community-level mobilisation, with many of them operating independently, duplicating efforts, and with minimal engagement with decision-making structures and actors above health facility level
The political economy analysis highlighted several ways in which the CSO partners working on the Social Accountability for ToR Terms of Reference (Health) project should modify their work plans and theory of change to be more compatible with the specific context identified through the analysis
Summary
The majority of documented social accountability initiatives to date have been ‘tactical’ in nature, employing single-tool, mostly community-based approaches. The three intended project outcomes for UNICEF Malawi were: 1) Enhanced platforms and spaces for engagement in social accountability created and deployed at the national, district and community levels; 2) Effective use of interlocutors, including media, in support of active participation and influence of policy and advocacy goals; and, 3) Evidence and recommendations generated by mapping and analysis of data and information coming from communities. These three outcomes were intended to contribute to the broader goal of improving RMNCAH results for women and children by strengthening national mechanisms for greater accountability. An initial literature review identified a lack of documentation of the process of improving health outcomes and of social accountability processes our focus for this work was on process rather than outcome
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