Social Accountability Mechanisms Research Articles

Power, data and social accountability: defining a community-led monitoring model for strengthened health service delivery.

Despite international commitment to achieving the end of HIV as a public health threat, progress is off-track and existing gaps have been exacerbated by COVID-19's collision with existing pandemics. Born out of models of political accountability and historical healthcare advocacy led by people living with HIV, community-led monitoring (CLM) of health service delivery holds potential as a social accountability model to increase the accessibility and quality of health systems. However, the effectiveness of the CLM model in strengthening accountability and improving service delivery relies on its alignment with evidence-based principles for social accountability mechanisms. We propose a set of unifying principles for CLM to support the impact on the quality and availability of health services. Building on the social accountability literature, core CLM implementation principles are defined. CLM programmes include a community-led and independent data collection effort, in which the data tools and methodology are designed by service users and communities most vulnerable to, and most impacted by, service quality. Data are collected routinely, with an emphasis on prioritizing and protecting respondents, and are then be used to conduct routine and community-led advocacy, with the aim of increasing duty-bearer accountability to service users. CLM efforts should represent a broad and collective community response, led independently by impacted communities, incorporating both data collection and advocacy, and should be understood as a long-term approach to building meaningful engagement in systems-wide improvements rather than discrete interventions. The CLM model is an important social accountability mechanism for improving the responsiveness of critical health services and systems to communities. By establishing a collective understanding of CLM principles, this model paves the way for improved proliferation of CLM with fidelity of implementation approaches to core principles, rigorous examinations of CLM implementation approaches, impact assessments and evaluations of CLM's influence on service quality improvement.

How effective are social accountability mechanisms in Bangladesh’s rural local governments?

How effective are social accountability mechanisms in Bangladesh’s rural local governments?

AKUNTABILITAS PENGELOLAAN WAKAF PADA BAITUL MAAL HIDAYATULLAH PROVINSI BENGKULU

Accountability is important for a waqf management institution. There arevarious ways an institution can demonstrate accountability. This study aims to describethe practice of the accountability of waqf management at Baitul Maal HidayatullahBengkulu. This type of research is a qualitative research with descriptive qualitativeresearch type. This study focuses on 5 accountability mechanisms, namely reportingand disclosure, performance appraisal and evaluation, participation, self-regulation andsocial auditing.The results show that in reporting and disclosure, the financial statements ofwaqf use PSAK 109 and are consolidated with the central Baitul Maal Hidayatullah,data recording of waqf assets in the form of immovable assets is submitted to thedepartment of waqf assets and reports are submitted through various media. In theperformance appraisal and evaluation accountability mechanism, Baitul MaalHidayatullah carries out an evaluation once a month and uses Key PerformanceIndicators as performance appraisal indicators. In the participatory accountabilitymechanism, Baitul Maal Hidayatullah management publishes program plans throughvarious media, involves observers in the implementation of the waqf program, involvesall administrators in institutional decision making. In the self-regulation accountabilitymechanism, the Baitul Maal Hidayatullah administrators provide rewards andpunishments to improve the performance of the management and consult with theRegional Leadership Council and the central Baitul Maal Hidayatullah in resolving waqfproblems. In the social audit accountability mechanism, the management of Baitul MaalHidayatullah provides special media for community aspirations, plays a role in helpingsocial problems and is already responsible for the waqf mandated by the supervisor.

Beyond a facility: A cross-sectional survey on WASH service levels and informal social accountability in childcare centres in Nairobi's informal settlements

Abstract Access to clean water, sanitation, and hygiene (WASH) services is crucial for a healthy start in life. Social accountability has a potential for enhancing WASH services in childcare centres. However, there are inadequate studies to understand how informal social accountability mechanisms contributes to WASH service provision. To address this gap, we conducted a cross-sectional survey in Korogocho and Viwandani informal settlements in Nairobi, Kenya, to explore the relationship between different levels of WASH services (ranging from basic to limited or nonexistent) and indicators of informal social accountability, including rewards, sanctions, voice, and responsiveness. We employed multinomial regression analysis, utilizing a robust error variance estimator to account for potential biases. Our findings revealed disparities in WASH service provision between the two studied areas, with childcare centres in Korogocho exhibiting higher access to basic WASH services compared to those in Viwandani. Our analysis also highlighted a significant association between informal social accountability mechanisms and the provision of WASH services. Notably, the sanction mechanism exhibited a correlation with all WASH services, suggesting its pivotal role in shaping service delivery outcomes. In light of these findings, it is imperative to prioritize efforts aimed at reinforcing social accountability mechanisms in WASH service delivery frameworks.

Decoding Frontex's fragmented accountability mosaic and introducing systemic accountability ‐ System Reset

AbstractIn response to widespread human rights violations involving the European Border and Coast Guard Agency (Frontex), multiple accountability mechanisms were activated, leading to the resignation of the agency's executive director. Does this mean the current framework can ensure Frontex's overall accountability? Playing with IT metaphors, this article scrutinises Frontex's accountability framework as a whole. It explores a holistic understanding of accountability, which includes judicial and non‐judicial (administrative, democratic, social) accountability mechanisms that can together safeguard the Rule of Law. The article highlights the fragmented and ineffective current accountability framework. It challenges traditional accountability notions and suggests a ‘system reset’, introducing the concept of systemic accountability. Systemic accountability addresses systemic issues underlying consistent rights violations through focused structural solutions. As an accountability model, it can be applied further than Frontex operations to the complex realities of shared administration at external borders, where multiple actors and obscured accountabilities lead to systemic violations.

Social Accountability in Health System Governance: A Scoping Review.

Social accountability is an important element in health system governance, which is necessary for health system reform and reaching Universal Health Coverage. Understanding the social accountability mechanism and tools will help policymakers to design policies according to the context. We aimed to explore the extent of the application of social accountability in health system governance, its results, challenges, and tools. We conducted a scoping review study, using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for scoping review. An inclusive search in bibliographic databases and search engines was done to identify peer review articles and grey literatures, published in English in the range of 2010 to 2021. Search terms were (social accountability), (public accountability), AND (health system). Thirty-one records met inclusion criteria from 286 potentially relevant sources, which included 25 peer-review articles and 6 grey literatures. Maternal and child health was the main health subject for social accountability interventions. We identified some social accountability tools to apply at the health facility and community levels. Social accountability has some benefits for the health system and for the community and some challenges to the implementation of social accountability were listed. Social accountability improves health system performance. It contains different tools and strategies applied at different levels of the health system. Successful social accountability initiatives that are strategic, multi-interventional, and context-specific can produce good results in health services and social domains.

Advocating Strong Base Plan for Creating World-Class Universities in Chinese Higher Education System: Problems and Strategies

Abstract Strong Base Plan is committed to exploring multiple admission mechanisms for creating world-class universities, promoting the common resonance of basic education and higher education, and bringing comprehensive quality into the evaluation system is a breakthrough. As an important recruitment institution under the Strong Base plan, the competency of colleges and universities is the key factor affecting the enrollment effect. Due to the unclear employment of basic subjects, students cannot change their major after entering the program, and the long training cycle and other practical factors, the countermeasures and suggestions should include to further strengthen the supervision of all dimensions and improve the social accountability mechanism, strengthen overall planning and coordination to provide guarantee for students’ export and implement follow-up evaluation to promote continuous improvement.

Persecuted Minorities and Defensive Cooperation: Contributions to Public Goods by Hindus and Muslims in Delhi

How does intergroup inequality, specifically minority experiences of persecution, affect contributions to local public goods? Based on an original survey experiment and qualitative research in slums in Delhi, we examine how Hindus and Muslims respond to social norms around promoting cooperation on community sanitation. Mainstream theories of development predict greater willingness to contribute to public goods in more homogeneous areas. In contrast to the “diversity-deficit hypothesis,” however, we find that social accountability mechanisms are more effective among Muslims, a group that routinely faces discrimination and violence in India. We propose that this reflects “defensive cooperation,” or a set of coping strategies developed by minorities to navigate a hostile sociopolitical environment. Our findings point to a new mechanism that helps to enforce prosocial norms and, hence, public goods provision in multiethnic contexts.

How effectively are social accountability mechanisms being applied in mental health services within the newly federalized health system of Nepal? A multi-stakeholder qualitative study

BackgroundThe burden of mental health problems and inequalities in healthcare has emerged as critical issues, in Nepal. Strengthened citizen-driven social accountability (SA) is an effective strategy for building equitable health systems and providing quality healthcare services to all, yet SA in mental health is an under-researched area in Nepal.ObjectiveThis study explores changes in mental health service delivery in the re-configured federal health system and discusses the functioning and effectiveness of SA in the federalized context of Nepal.MethodThis case study research used a qualitative approach to data collection. We conducted Key Informant Interviews (KIIs), and Focus Group Discussions (FGDs) with local stakeholders including people with experience of mental health problems. The audio-recorded interviews and discussions were transcribed and analyzed using a thematic content method.ResultsA total of 49 participants were recruited, and 17 participated in interviews and 32 participated in six focus group discussions. From the data, eight themes emerged: Policy challenges in mental health, Governance and service delivery, Tokenism in the application of social accountability processes, Weak role of key actors in promoting accountability, Complaints and response, Discriminatory health and welfare system, Public attitudes and commitment towards mental health, and No differences experienced by the change to a federal system. It was found that existing health policies in Nepal inadequately cover mental health issues and needs. The prevailing laws and policies related to mental health were poorly implemented. There is a lack of clarity at different levels of government about the roles and responsibilities in the delivery of mental health services. Poor intra- and inter-governmental coordination, and delays in law-making processes negatively impacted on mental health service delivery. SA mechanisms such as social audits and public hearings exist within government health systems, however, application of these in mental health services was found poor. Rights-holders with mental health problems had not experienced any change in the provision of healthcare services for them even after the federalization.ConclusionMental health is insufficiently addressed by the health policies in Nepal, and SA mechanisms appeared to be rarely institutionalized to promote good governance and provide effective healthcare services to vulnerable populations. The provision of more equitable services and honest implementation of SA tools may foster greater accountability and thereby better service delivery for people with mental health problems.

Understanding Social Accountability at Rural Local Governance in Bangladesh and the Way Forward: In the Case of Union Parishad

In the 21st Century social accountability has become one of the preconditions to create a more transparent and representative government and aid public institutions in meeting the expectations of the population through empowering citizens which is necessary for effective and sustainable development. Social accountability of the elected representatives at the rural level may help the government increase service quality, empower rural citizens, and promote good governance. At present Bangladesh, mostly known as the “Development Surprise”, has leaped towards lower middle-income country status from a poor developing one within four decades of its decisive victory. In this stage of growth and development, the persistence of social accountability at the rural local government would ensure the attainment of sustainable development through ensuring demand-based service delivery. Against this backdrop, this paper intends to explore the present status of social accountability mechanisms at the Union Parishad which is the lowest tier of rural local governance in Bangladesh. Based on the analysis, several recommendations for the way forward have been summarized. Secondary data analysis and empirical knowledge have been exerted which would refer to a clear view of the current status of social accountability at the grass root level. The first section mentions the importance of social accountability at the union level based on theoretical analysis. Existing mechanisms to ensure social accountability at Union Parishad have been delineated in the second section. The third section develops a compact understanding of the current status of social accountability at the Union Parishad level. The fourth section will share a discussion of the findings, recommendations, and conclusion. This study finds that the lack of interest among Union Parishad Functionaries, avoidance by citizens, irregularities in committee formation, irregular meetings, lack of resources, clientelism and Govt. supervision, etc. have made the social accountability mechanisms at the rural local government ineffective and fruitless. The political willingness of the Government, GO-NGO collaboration, allocation of resources to rural local government, awareness raising among citizens, educating citizens politically, and ensuring proper training for the officials in the Union Parishad can play an important role to revive social accountability through deliberative forums and committees in the rural local government.

Advisory councils as an instrument of social accountability at the local level?

The article aimed to examine to what extent the social (advisory) councils operating in Poland can be considered a social accountability mechanism. The author refers to the theoretical assumptions of social accountability, which constitutes one of the forms of accountability of public authorities. Additionally, the paper presents the peculiarities of social councils, which are well-known, highly institutionalized, and formalized collegial bodies operating worldwide for many years. The article presents the results of qualitative research (semi-structured interviews) among members of three types of social councils, i.e., youth councils, senior citizens’ councils, and councils for people with disabilities. The analysis included 46 interviews with their members conducted in selected cities with county (districts) rights in Poland.

Co-creation and self-evaluation: An accountability mechanism process in water, sanitation and hygiene services delivery in childcare centres in Nairobi's informal settlements.

Accountability strategies are expected to enhance access to water, sanitation and hygiene (WASH) service delivery in low-and middle-income countries (LMIC). Conventional formal social accountability mechanisms (SAMs) for WASH service delivery have been inadequate to meet the needs of residents in informal settlements in LMICs. This has prompted growing interest in alternative informal SAMs (iSAMs) in Nairobi's informal settlements. To date, iSAMs have shown a limited effect, often due to implementation failures and poor contextual fit. In childcare centers in Nairobi's informal settlements, co-creation of the iSAMs process, where parents, childcare managers, researchers and other WASH stakeholders, contribute to the design and implementation of iSAMs, is an approach with the potential to meet urgent WASH needs. However, to our knowledge, no study has documented (1) co-creating iSAMs processes for WASH service delivery in childcare centers and (2) self-evaluation of the co-creation process in the informal settlements. We used a qualitative approach where we collected data through workshops and focus group discussions to document and inform (a) co-creation processes of SAMs for WASH service delivery in childcare centers and (b) self-evaluation of the co-creation process. We used a framework approach for data analysis informed by Coleman's framework. Study participants co-created an iSAM process that entailed: definition; action and sharing information; judging and assessing; and learning and adapting iSAMs. The four steps were considered to increase the capability to meet WASH needs in childcare centers. We also documented a self-evaluation appraisal of the iSAM process. Study participants described that the co-creation process could improve understanding, inclusion, ownership and performance in WASH service delivery. Negative appraisals described included financial, structural, social and time constraints. We conclude that the co-creation process could address contextual barriers which are often overlooked, as it allows understanding of issues through the 'eyes' of people who experience service delivery issues. Further, we conclude that sustainable and equitable WASH service delivery in childcare centers in informal settlements needs research that goes beyond raising awareness to fully engage and co-create to ensure that novel solutions are developed at an appropriate scale to meet specific needs. We recommend that actors should incorporate co-creation in identification of feasible structures for WASH service delivery in childcare centers and other contexts.

MEWUJUDKAN TATA KELOLA PEMERINTAHAN DESA YANG BAIK MELALUI PENERAPAN AKUNTABILITAS SOSIAL

The Village Law mandates village administration to realize good village governance. One indicator of the achievement of good village governance is the accountability of village government and the fulfillment of the rights of villagers. Accountability in practice has two mechanisms, namely vertical accountability and horizontal accountability. However, the two mechanisms are considered incapable of realizing good village governance because there are still loopholes for corrupt behavior in government. So there must be another mechanism, namely social accountability mechanisms. This study uses the method of a literature review. Data collection was carried out by extracting library sources that were relevant to the topic of study. Through the application of the principle of social accountability, village residents will be directly involved in supervising the administration of the village government and will hold them accountable for the policies and services that have been carried out by the village government. So that the application of social accountability can be a catalyst or tool in realizing good village governance.Keywords: Social Accountability; Good governance; Village Administration

A whole-of-community approach to promote cardiovascular health: Healthy Communities in Moldova

Abstract A low-income country, Moldova is facing a rapidly growing burden of non-communicable diseases with a cardiovascular disease mortality rate of 202.2 per 100'000. Scarce resources require urgent preventative actions and involvement of communities and patients in the definition and design of locally relevant health promoting activities. Our intervention is a holistic, whole-of-community approach to foster local leadership in health promotion for the prevention of cardiovascular risks. The Healthy Life project to reduce the burden of non communicable diseases, funded by the Swiss Agency for Development and Cooperation (SDC), operates since 2016 in rural communities of Moldova. We present a 5-step model towards initiating Healthy Communities in Moldova based on 5 complementary steps: 1. Raising awareness on cardiovascular risk factors through community education seminars tailored to audience needs 2. Building multisectoral community coalitions for health between local elected leaders and community representatives around local health data and locally defined health priorities 3. Fostering community leadership in defining local health solutions through health asset mapping exercises 4. Community-led small projects based on identified needs and assets to improve local cardiovascular health 5. Empowering chronic patients for healthy behavior change through community-based self-management workshops The Healthy Communities intervention was rolled out to 40 communities in 20 districts, reaching 1332 direct beneficiaries. Important learning emerged from social accountability mechanisms embedded in community coalitions which ensure regular, health-focused dialogue on community health. Using local assets to health problem solving is changing the perspective on the resourcefulness of community actors in health. Progress towards sustainability is achieved by local public authorities and community making a matching contribution to start-up funding to small projects. Key messages • Our Healthy Communities model proposes a strength-based vision of health promotion which empowers community coalitions to self-organize for the prevention of cardiovascular risk factors. • We promote bottom-up approaches that strengthen local health governance and community leadership into defining and addressing local health priorities.

Human rights-based accountability for sexual and reproductive health and rights in humanitarian settings: Findings from a pilot study in northern Uganda.

Ensuring accountability for the realization of sexual and reproductive health and rights is a human rights obligation and central tenet of strategies to improve health systems and outcomes in humanitarian settings. This pilot study explored the feasibility and acceptability of deploying human rights strategies, specifically through a participatory community-led complaints mechanism, to hold humanitarian health systems to account for the sexual and reproductive health and rights of refugee and host community women and girls in northern Uganda. Over a fifteen-month period we conducted a multi-methods exploratory study with refugee and host community rights-holders and duty-bearers using longitudinal in-depth interviews, focus groups, and secondary data document review. Deductive and inductive coding techniques were used to analyze data iteratively for content and themes. 107 sexual and reproductive health and rights related complaints and feedback were collected through the community complaints mechanism. Complaints concerned experiences of disrespect and abuse by health care workers; lack of adolescent access to sexual and reproductive health services and information; sexual and gender-based violence; and lack of access to acceptable and quality health goods and services. Participants reported an increased understanding and claiming of human rights through the intervention, acceptability of rights-based accountability strategies among humanitarian health system actors, and improved access to remedies when sexual and reproductive health rights are not respected. Findings demonstrate integrating rights-based social accountability mechanisms at the level of humanitarian response as a promising approach for strengthening and holding humanitarian health systems accountable for the sexual and reproductive health and rights of women and girls affected by humanitarian situations.

Informal social accountability mechanisms for water sanitation and hygiene (WASH) in childcare centres in Nairobi City County's informal settlements

Social accountability for water, sanitation and hygiene (WASH) services is a critical component to realising child rights to WASH services by the urban poor, more so in childcare centres. Despite the existence of discrete social accountability mechanisms (SAMs) in informal settlements, informal SAMs rarely form part of strategic approaches to addressing social accountability challenges in access to WASH services in childcare centres. The main objective of the study was to explore informal social accountability mechanisms for WASH in childcare centres in Korogocho and Viwandani informal settlements in Nairobi City County, Kenya. This qualitative study was an ethnography, where we administered governance diaries to 24 participants (parents and childcare managers) for 4 months. Data generated were analysed using a framework analysis derived from a principal-stewardship framework. Parents and centre managers, who are key actors for WASH services in childcare centres in informal settlements, relied on using informal SAMs. We identified three SAMs; (i) discretionary behaviours (rewards and sanctions, interpretation of rules and guidelines and peer mentorship); (ii) norms and values; and (iii) facilitative behaviours. The SAMs were interrelated and operated in synergy for access to WASH service by children in childcare centres. The SAMs for WASH used by parents and childcare owners in childcare centres encountered the following challenges; unrealistic expectations, negligence, conflicting expectations, conflicting agenda and administrative cultures, and tensions over performance standards and monitoring. Identified strategies for strengthening the SAMs included consistency in adhering to rules and guidelines for WASH service provision, and collaboration with strong WASH actors. Data from this study suggest it is valuable to examine and understand SAMs as this then offers clear pathways to mitigate problems and enact change in the WASH service delivery for improved global agenda of SDG 4 and SDG 6. Further, there is potential for joint advocacy for improved WASH services throughout the informal settlement. While SAMs are often conceptualised as a formal process or an intervention, this study shows that existing daily informal SAMs play an important role in promoting or maintaining WASH service delivery. Therefore, WASH stakeholders need to revisit, co-develop and evaluate informal SAMs for WASH service delivery.

Trust and citizen participation in community-based monitoring system: An experimental evidence from Bangladesh

We utilize the unique setting of a public procurement project in Bangladesh to understand the relationship between trust and citizen engagement in social accountability mechanisms. In this model of civic engagement, in each project site, a citizen-monitoring group is formed to oversee the quality of implementation and report any irregularities to the authorities. We investigate whether the level of trust in the community affects the performance of their citizen-monitoring group and/or the interactions resulting from the participation in the monitoring task affects the level of trust of the monitoring group members. We measure trust using both a simplified trust game and a survey. Our finding is inconclusive to the question of whether the trust level in the community affects the performance of the citizen-monitoring group. While we find no such indication from the trust games, the data on generalized trust from the survey show a positive effect of trust on monitoring group activity. We find stronger support for the hypothesis that participation in the monitoring group affects the level of trust. According to our findings, the effect has been negative in this case. An additional aspect of our study is carrying out a simplified design that allows us to collect behavioral data effectively from a population that lacks general and technological literacy and to implement the experiment remotely under extraordinary circumstances, such as the COVID-19 pandemic.

Negotiating Access to Health Care for All through Social and Political Accountability: A Qualitative Study in Rural Nigeria

Social accountability is an important strategy towards ensuring that political leaders and actors implement the right policies in the interest of the entire society. In 2007, a community-based health insurance programme was implemented in selected rural communities in Kwara State, Nigeria, through collaboration between the Dutch Health Insurance Fund, PharmAccess Foundation, the Kwara State Government, and Hygeia Nigeria Limited to provide access to basic healthcare for the people. After operating for 9 years, the programme stopped in 2016. This paper describes how social and political accountability shaped the introduction, functioning, and stoppage of the CBHI programme. The study adopted a qualitative approach for data collection, particularly in-depth (n = 22) and key informant interviews (n = 32). Findings indicate that the community-based health insurance programme was proposed by the foreign agency and that the state government was instrumental in the stoppage of the programme. Also, the change in government (via voting against a political bloc that had been in power since 2003) in Kwara State during the 2019 general elections was among the accountability measures employed by the citizenry in reaction to the stoppage of the Community-Based Health Insurance programme. The implication of this is that the current government, expectedly, will not only draw up a more robust healthcare policy for implementation but will also ensure that the people are carried along through adequate social and political accountability mechanisms.

Untangling blame and responsibility for service delivery and local governance performance: testing a grounded social accountability approach in Tanzania

ABSTRACT We examine the gap between theory and practice in social accountability mechanisms to improve local governance performance in Tanzania. We do so through drawing on an ethnographic investigation tracing lines of blame and responsibility for service delivery, from individual citizens up to the central state incorporating a total of 340 interviews and 12 focussed group discussions. We have two keys findings: Firstly, that there is a wide divergence between formal lines of accountability and where actors direct blame for performance failure in practice. Secondly, building a collective understanding of this divergence provides an effective starting point for intervention to improve performance. Our conclusion is that dominant assumptions on social accountability interventions require significant revision in light of our findings.

Social accountability approaches employed by civil society organisations to address maternal mortality and morbidity in Uganda

ABSTRACT Despite ground breaking technological innovations, maternal mortality and morbidity (MMM) remains pervasive, especially in the least developed world. This article maintains that one way of empowering women to demand for an improvement in maternal health is through prioritising social accountability. It is forwarded that the implementation of social accountability mechanisms, substantially contributes to the reduction of preventable MMM in Uganda. Social accountability is a vibrant and dynamic process through which communities as well as civil society use various means to make public officials and other service providers more effective in the execution of their duties and obligations. Social accountability emphasises going beyond capacity building, which is often the focus of most community engagement strategies, to deliberately involving communities in tracking government programmes and adopting remedial mechanisms. The application of these processes helps to address gaps in the health system that lead to maternal deaths as well as morbidities. Using a documentary review approach, the paper identifies social accountability strategies that have been used by Civil Society Organisations (CSOs) in Uganda. This is aimed at highlighting how social accountability can be implemented to tackle maternal mortality and morbidity and ultimately improve sexual and reproductive health and rights.