Social Accountability Mechanisms Research Articles

Can people-centered community-oriented interventions improve skilled birth attendance? Evidence from a quasi-experimental study in rural communities of Cambodia, Kenya, and Zambia

BackgroundSkilled attendance at delivery is a key marker for reducing maternal mortality. Effective community engagement strategies complemented by community health worker (CHW) services can improve access to maternal health services in areas with limited health infrastructure or workforce.MethodsA quasi-experimental study with matched comparison groups was conducted in Cambodia, Kenya and Zambia to determine the effect of integrated community investments on skilled birth attendance (SBA). In each country, communities in two districts/sub-districts received a package of community-oriented interventions comprised of timed CHW household health promotion for maternal, newborn and child health complemented by social accountability mechanisms using community scorecards. Two matched comparison districts/sub-districts received ongoing routine interventions. Data from the final evaluation were examined to determine the effect of timed CHW services and community-oriented interventions on SBA.ResultsOver 80% of the 3037 women in Cambodia, 2805 women in Kenya and 1171 women in Zambia reported SBA. Women in intervention sites who received timely CHW health promotion and social accountability mechanisms in Cambodia showed significantly higher odds of SBA (aOR = 7.48; 95% CI: 3.87, 14.5). The findings also indicated that women over the age of 24 in Cambodia, women with primary or secondary education in Cambodia and secondary education in Kenya, women from higher wealth quintiles in Cambodia, and women with four or more antenatal care (ANC) visits in all countries reported significantly higher odds of SBA. Inclusion of family members in pregnancy-related discussions in Kenya (aOR = 2.12; 95% CI: 1.06, 4.26) and Zambia (aOR = 6.78; 95% CI: 1.15, 13.9) and follow up CHW visits after a referral or health facility visit (aOR = 2.44; 95% CI: 1.30, 4.60 in Cambodia; aOR = 2.17; 95% CI 1.25, 3.75 in Kenya; aOR = 1.89; 95% CI: 1.05, 2.02 in Zambia) also showed significantly greater odds of SBA.ConclusionsEnhancing people-centered care through culturally appropriate community-oriented strategies integrating timely CHW health promotion and social accountability mechanisms shows some evidence for improving SBA during delivery. These strategies can accelerate the achievement of the sustainable development goals for maternal child and newborn health.

Organizing dissonance through institutional work: The embedding of social and environmental accountability in an investment field

Advocacy movements play an increasingly prominent role in shaping corporate social responsibility (CSR) management and reporting practices. Prior research mainly studies advocacy movements who form and operate on the periphery of the organizational field(s) they seek to alter. We know comparatively little about how these movements materialize within fields and use established field networks, resources and power structures to transform CSR and CSR reporting norms. This paper examines how an advocacy movement formed and evolved within the Dutch investment field to embed a suite of social and environmental accountability mechanisms therein. We examine the evolution of VBDO, a membership association which promotes and polices corporate accountability among Dutch listed companies and investment institutions. We depict how a movement of diverse actors materialized in and around VBDO to stimulate responsible investment and sophisticated CSR reporting in the investment field. Insights from social movement theory and institutional work are integrated with Stark’s (2009) concept of organizing dissonance to theorise the conditions underpinning the movement’s emergence and influence. We uncover how rankings work - the co-creation, dissemination and policing of CSR benchmarks - and (institutional) work censorship - the strategic self-censoring of institutional work - coalesced to cultivate constructive collaborations among movement actors. We show how this enabled the creation of accountability mechanisms that facilitated VBDO’s transition into an influential and unique boundary organization. Our analysis extends prior research by revealing the role of institutional work in cultivating cooperation between advocacy movements and the targets of their reforms. By illustrating how actors’ opposing value frames co-existed peacefully as VBDO’s accountability mechanisms evolved, we offer a counterpoint to studies suggesting that compromise underpins the organization of dissonance among actors constructing corporate accounts.

Can social accountability mechanisms using community scorecards improve quality of pediatric care in rural Cambodia?

To determine the effect of social accountability strategies on pediatric quality of care. A non-randomized quasi experimental study was conducted in four districts in Cambodia and all operational public health facilities were included. Five patients under 5years and their caretakers were randomly selected in each facility. To determine the effect of maternal and child health interventions integrating citizen voice and action using community scorecards on quality of pediatric care. Patient observations were conducted to determine quality of screening and counseling, followed by exit interviews with caretakers. Results indicated significant differences between intervention and comparison facilities; screening by Integrated Management of Childhood Illness (IMCI) trained providers (100% vs 67%, P<0.019), screening for danger signs; ability to drink/breastfeed (100% vs 86.7%, P<0.041), lethargy (86.7% vs 40%, P<0.004) and convulsions (83.3 vs 46.7%, P<0.023). Screening was significantly higher for patients in the intervention facilities for edema (56.7% vs 6.7%, P<0.000), immunization card (90% vs 40%, P<0.002), child weight (100 vs 86.7, P<0.041) and checking growth chart (96.7% vs 66.7%, P<0.035). The IMCI index, constructed from key performance indicators, was significantly higher for patients in the intervention facilities than comparison facilities (screening index 8.8 vs 7.0, P<0.018, counseling index 2.7 vs 1.5, P<0.001). Predictors of screening quality were child age, screening by IMCI trained provider, wealthier quintiles and intervention facilities. The institution of social accountability mechanisms to engage communities and facility providers showed some improvements in quality of care for common pediatric conditions, but socioeconomic disparities were evident.

Unpacking Corruption Techniques and Countermeasures

This paper discusses mechanisms of corruption in the Philippines and surveys impact evaluation studies of anti-corruption initiatives across the world with a focus on bottom-up or grassroots approaches. Corruption is an age-old issue faced by societies all over the world, but most especially by developing countries that do not yet have the strong institutions that could curb corrupt behavior and tendencies. In the Philippines, corrupt activities take on many forms from vote-buying to bid-rigging. Because of corruption, citizens have difficulty in accessing to quality public goods and services. Literature on corruption has evolved from focusing solely on the relationship between public officials and top bureaucrats/politicians (“horizontal accountability”) and has expanded to the accountability mechanisms between voter and politician (“vertical accountability”) and citizen and public servants (“social accountability”). Grassroots approaches addressing social accountability mechanisms have become increasingly popular in developing countries as these fit well with community-driven politics in these societies and empowers citizens in these countries to push back against erring officials. However, there are issues in the effectiveness of grassroots approaches because of the community’s possible lack of capability in processing and acting on information related to government activities, the lack of power in collective civil action, and its susceptibility to local capture by elites. More than ever, it is crucial for those in developing countries to be more watchful of the different players involved in corruption and how existing anti-corruption initiatives are holding up in the ever-changing political landscape.

The Impact of Social Accountability Mechanisms on Fiscal Management Challenges Facing Goromonzi Rural District Council, Zimbabwe

This paper examines the impact of social accountability mechanisms on the fiscal management challenges facing local government bodies in Zimbabwe. The paper hypothesises that there is a positive relationship between the use of social accountability mechanisms or tools by local authorities and the effectiveness of their fiscal management policies to mobilize more revenue for service delivery. In this study, both quantitative and qualitative methods are adopted in gathering and analysing data from central government officials, Goromonzi Rural District Council employees and members of the public. The results of the study reveal that the local government body faces a number of fiscal management challenges that include a shrinking tax base, non-payment of taxes, resistance to successive budgets; lack of implementation; lack of monitoring and evaluation. Council has implemented participatory budgeting to deal with some of these challenges. While results show a significant improvement in tax collection, some of the challenges have persisted. The paper proposes some recommendations useful to central government, policy makers, civil society organisations, local government officials and the general public. The paper manages to demonstrate that the implementation of social accountability tools can have positive impacts on the fiscal management challenges facing local governments.

Can social accountability improve access to free public health care for the poor? Analysis of three Health Equity Fund configurations in Cambodia, 2015-17.

Within the context of universal health coverage, community participation has been identified as instrumental to facilitate access to health services. Social accountability whereby citizens hold providers and policymakers accountable is one popular approach. This article describes one example, that of Community-Managed Health Equity Funds (CMHEFs), as an approach to community engagement in Cambodia to improve poor people's use of their entitlement to fee-free health care at public health facilities. The objectives of this article are to describe the size of its operations and its ability to enable poor people continued access to health care. Using data collected routinely, we compare the uptake of curative health services by eligible poor people under three configurations of Health Equity Funds (HEFs) during a 24-month period (July 2015-June 2017): Standard HEF that operated without community engagement, Mature CMHEFs established years before the study period and New CMHEFs initiated just before the study period. One year within the study, non-governmental organizations (NGOs) stopped operating the HEF nationwide and only the community-participation aspects of New CMHEF continued receiving technical assistance from an NGO. Using utilization figures for curative services by non-poor people for comparison, following the cessation of HEF management by the NGOs, outpatient consultation figures declined for all three configurations in comparison with the year before but only significantly for Standard HEF. The three HEF configurations experienced a highly statistically significant reduction in monthly inpatient admissions following halting of NGO management of HEFs. This study shows that enhancing access to free health care through social accountability is optimized at health centres through engagement of a wide range of community representatives. Such effect at hospitals was only observed to a limited extent, suggesting the need for more engagement of hospital management authorities in social accountability mechanisms.

The Role of Social Movements in Strengthening Health Systems: The Experience of the National Health Forum in El Salvador (2009-2018).

In 2009, the newly elected FMLN government of El Salvador launched a comprehensive health reform, which gave the National Health Forum (NHF) a key role in developing community participation. This study aims to examine and analyze the content and impact of this social movement during the study period 2009–2018. The context was analyzed through relevant documents, which helped identify key stakeholders. Semi-structured interviews took place at 3 levels of decision making: the political level, the health professionals, and the community. Data were analyzed using a qualitative methodology. Participation is carried by a structure created by the Ministry of Health, the National Health Forum. The NHF developed 3 strategies: (1) leadership building in the communities through the strengthening of social, political, and economic skills, where they developed social accountability mechanisms at all decision-making levels of the health system; (2) the strategy carried by the sectoral working groups, where they responded to prioritized needs identified by the community; and (3) advocacy for human rights-based policies. The NHF, and its role in the strengthening of the National Public Health System, provides strong evidence of community participation strategies and co-governance with the health system within the social determinants of health scope.

Factors Affecting Social Accountability in Service Providing Public Sectors: Exploring Beneficiaries’ Perspectives in Jimma Zone

This study was undertaken to identify the factors affecting social accountability in service providing public sector organizations from beneficiary perspectives in Jimma Zone. Factors hindering social accountability, social accountability mechanisms implemented in public sectors and the role of social accountability were the objectives assessed in this study. Qualitative research approach was employed. Beneficiaries of four public sectors (health, education, agriculture and water) were selected purposively because these are the main focus of the Ethiopian Social Accountability Program (ESAP2). Two administrative towns (Jimma and Agaro) and two woreda/kebele towns (Limu Kosa and Gera districts) were purposively selected for this study. Eight Focus group discussion, sixteen in-depth interviews and four key informant interviews were conducted. The main findings of the study revealed that factors hindering social accountability are the low citizens’ rights awareness and the socio cultural barriers that limit speaking out, absence of access to information guarantees rendering government income and expenditure because beneficiaries lack of their right awareness up to this and service provider’s unwillingness to share information. Community score cards and service providers in face to face meetings are the two commonly implemented social accountability mechanisms respectively. Based on the findings the researchers recommended that long- term institutional reforms to make the public sectors more accountable to citizens, devolutions to local government levels or responsibility and accountability for service provision, community and civil society participation should have to be encouraged by the government.

The role of social audit as a social accountability mechanism for strengthening governance and service delivery in the primary health care setting of Nepal: a qualitative study

ABSTRACT Social audit is a mechanism used to hold frontline health service providers accountable. Using the case of the social audit process in Dang District, Nepal, this study explored the role of social audit in facilitating direct accountability between service providers and community. This relationship was summarised by three elements: information/data collection, dialogue/forum, and sanctions. A total of 39 interviews were held with health facility operation and management committee members, service providers, district level health managers and non-government organisation members. Reviews of records of social audit action plans were undertaken at 10 health facilities. Participants reported that the social audit process was able to facilitate information provision/data collection, and provided opportunities for dialogue between community and service providers, but the provision of sanctions was found to be weak. While social audit had a positive role in increasing transparency, accessibility and quality of services, its effectiveness in addressing perennial governance problems was mixed. Manipulation of the participation process, falsification of information, and lack of authority affected the role of social audit in facilitating accountability. These factors are essential to consider while designing and implementing social audit processes. While giving more power and control to the community to monitor and implement social audit action plans seems appealing, the concept of partnership between community and service providers with joint problem-solving and an emphasis on relational elements of accountability are most likely to build trust and responsiveness. If social audit is used alongside existing traditional accountability mechanisms, it could help to address governance and accountability issues.

Linking Social Rights to Active Citizenship for the Most Vulnerable: the Role of Rights and Accountability in the ‘Making’ and ‘Shaping’ of Social Protection

Social protection has the potential to provide a key interface between states and citizens. We consider how the institutional framing and design of social protection can be adapted from top-down forms of provision to forms that stimulate vulnerable citizens to make rights-based claims and demand accountability for their entitlements. A conceptual framework is developed that illustrates three channels through which citizenship can be engaged through social accountability mechanisms and in the context of social protection provision. Drawing on case studies, we highlight the different contexts in which the design and delivery of social protection can open up spaces for different forms of citizenship engagement and expression. Through opening up institutional spaces where citizens can engage with the state, and each other, we conclude that social protection is uniquely placed to build the economic, social and political capabilities of citizens.

Association of mother's handwashing practices and pediatric diarrhea: evidence from a multi-country study on community oriented interventions.

SummaryIntroductionImproved hand hygiene in contexts with high levels of diarrheal diseases has shown to reduce diarrheal episodes in children under five years. A quasi-experimental multi-country study with matched comparisons was conducted in four rural districts/sub districts in Cambodia, Guatemala, Kenya and Zambia.MethodsCommunity oriented interventions including health promotion for appropriate hand washing was implemented in the intervention sites, through community health workers (CHW) and social accountability mechanisms. Community councils were strengthened/established in all study sites. Using household surveys, information on mother’s handwashing practices and diarrhea incidence of children 2 weeks preceding the study was obtained.Results and ConclusionAccess to safe drinking water was reportedly higher for communities in Guatemala and Zambia (> 80%), than those in Cambodia and Kenya (< 63%), with significantly higher levels in intervention sites for Guatemala and Kenya. Improved sanitation was low (< 10%), for Kenya and Zambia, compared to Cambodia and Guatemala (> 40%); intervention sites reporting significantly higher levels, except for Zambia. Hand washing index; hand washing before food preparation, after defecation, attending to a child after defecation, and before feeding children was significantly higher for intervention sites in Cambodia, Guatemala and Kenya (Cambodia, 2.4 vs 2.2, p < 0.001, Guatemala, 3.0 vs 2.5, p < 0.001, Kenya, 2.6 vs 2.3, p < 0.001). Factors significantly associated with lower odds of diarrhea were; mother’s marital status, higher educational status, one or more handwashing practices, wealthier quintiles, older (> 24 m), and female children. The findings suggest that caretaker handwashing with soap or ash has a protective effect on prevalence of diarrhea in children.

Social accountability in maternal health services in Baglung district, Nepal: a qualitative study

# Background Despite there being many state and non-governmental organisation (NGO) health programs, Nepal still has a high maternal mortality ratio of 258. Previous research has indicated that social accountability mechanisms can improve maternal health. However, the functioning of these mechanisms has not yet been explored in Nepal. Social accountability mechanisms can be identified and analysed through the information, dialogue & negotiation model. # Objective To identify the role of social accountability mechanisms in maternal health and the challenges regarding these mechanisms in Baglung district, Nepal. # Methods Ten semi-structured interviews were held with healthcare officials, healthcare providers, NGO staff and mothers at the community level, and four focus group discussions were held with pregnant women and recent mothers, healthcare providers and Health Facility Operation and Management Committee (HFOMC) members. Data was coded and analysed with ATLAS.ti using the information, dialogue & negotiation model. # Results Mothers' Groups, Female Community Health Volunteers (FCHVs) and the HFOMC function as a two-step social accountability mechanism. The FCHVs act as a bridge between Mothers' Groups at the community level and the HFOMC. The HFOMC holds dialogues and negotiations with the district and central government. There seem to be two main obstructions in the information flow from the central or district levels to the community. They are located between the central government level and/or district level and the HFOMC, and between the HFOMC and the FCHV and Mothers\' Groups. The information from the community to higher levels seems to have an obstruction in the voicing of service-related needs/complaints in the Mothers' Groups and another obstruction of HFOMCs rarely interacting with health sector actors other than the local health facility. # Conclusions The information, dialogue & negotiation model is a sensitive analytical model to understand the functioning and challenges of social accountability in the maternal health care system of Nepal. The community-based accountability chain of HFOMC, FCHVs and Mothers' Groups presents a structure that facilitates the optimisation of maternal health services. Recommendations are given to improve gaps in this accountability chain.

The challenges of institutionalizing community-level social accountability mechanisms for health and nutrition: a qualitative study in Odisha, India

BackgroundIndia has been at the forefront of innovations around social accountability mechanisms in improving the delivery of public services, including health and nutrition. Yet little is known about how such initiatives are faring now that they are incorporated formally into government programmes and implemented at scale. This brings greater impetus to understand their effectiveness. This formative qualitative study focuses on how such mechanisms have sought to strengthen community-level nutrition and health services (the Integrated Child Development Services and the National Rural Health Mission) in the state of Odisha. It fills a gap in the literature on considering how such initiatives are running when institutionalised at scale. The primary research questions were ‘what kinds of community level mechanisms are functioning in randomly selected villages in 3 districts of state of Odisha' and 'how are they perceived to function by their members and frontline workers’.MethodsThe study is based on focus group discussions with pregnant women and mothers of children below the age of 2 (n = 12) and with women’s self-help groups (n = 12); interviews with frontline health workers (n = 24) and with members of community committees (n = 36). Interviews were analysed thematically using a priori coding derived from wider literature on key accountability themes.ResultsFour main types of community-based mechanisms were examined – Mothers committees, Jaanch committees, Village Health and Sanitation Committees and Self-Help Groups. The degree of their effectiveness varied depending on their ability to offer meaningful avenues for participation of their members and empower women for autonomous action. Notably, in most of these mechanisms community participation is very weak, with committees largely controlled by the frontline workers who are supposed to be held to account. However, self-help groups showed real levels of autonomy and collective power. Despite not having an explicit accountability role, these groups were nevertheless effective in advocating for better service delivery and the broader needs of their members to a level not seen in institutional committees.ConclusionsThe study points to the need for community-level mechanisms in India to adequately address issues of participation and empowerment of community members to be successful in contributing to service improvements in health and nutrition.

How does social accountability contribute to better maternal health outcomes? A qualitative study on perceived changes with government and civil society actors in Gujarat, India

BackgroundSocial accountability mechanisms have been highlighted as making a contribution to improving maternal health outcomes and reducing inequities. But there is a lack of evidence on how they contribute to such improvements. This study aims to explore social accountability mechanisms in selected districts of the Indian state of Gujarat in relation to maternal health, the factors they address and how the results of these mechanisms are perceived.MethodsWe conducted qualitative research through in-depth interviews and focus group discussions with actors of civil society and government health system. Data were analyzed using a framework of social determinants of maternal health in terms of structural and intermediary determinants.ResultsThere are social accountability mechanisms in the government and civil society in terms of structure and activities. But those that were perceived to influence maternal health were mainly from civil society, particularly women’s groups, community monitoring and a maternal death review. The social accountability mechanisms influenced structural determinants – governance, policy, health beliefs, women’s status, and intermediary determinants – social capital, maternal healthcare behavior, and availability, accessibility and the quality of the health service delivery system. These further positively influenced the increased use of maternal health services. The social accountability mechanisms, through the process of information, dialogue and negotiation, particularly empowered women to make collective demands of the health system and brought about changed perceptions of women among actors in the system. It ultimately improved relations between women and the health system in terms of trust and collaboration, and generated appropriate responses from the health system to meeting women’s groups’ demands.ConclusionSocial accountability mechanisms in Gujarat were perceived to improve interaction between communities and the health system and contribute to improvements in access to and use of maternal health services. The influence of social accountability appeared to be limited to the local/district level and there was lack of capacity and ownership of the government structures.

Social Accountability in Diaspora Organizations Aiding Syrian Migrants

AbstractThis article presents data from a study of Syrian diaspora organizations providing assistance to conflict‐affected Syrians in Europe, the Middle East, and North America. Using interview data from leaders in four Syrian diaspora non‐profit organizations, this article examines the social mechanisms used to ensure accountability within the challenging environments where the organizations operate. We find that Syrian diaspora organizations benefit from informal social accountability mechanisms that derive from individuals’ social network ties. Personal, social forms of accountability are particularly valuable to these organizations because these mechanisms help circumvent uncertainty and challenges in the operational environment. These findings reflect an important theme in the extant literature on diaspora philanthropy: diaspora members may have an advantage over other actors because of dense personal networks that make them adept at identifying dependable partners and enforcing agreements even in places where banking and legal systems are fragile.

Optimising mHealth helpdesk responsiveness in South Africa: towards automated message triage.

In South Africa, a national-level helpdesk was established in August 2014 as a social accountability mechanism for improving governance, allowing recipients of public sector services to send complaints, compliments and questions directly to a team of National Department of Health (NDoH) staff members via text message. As demand increases, mechanisms to streamline and improve the helpdesk must be explored. This work aims to evaluate the need for and feasibility of automated message triage to improve helpdesk responsiveness to high-priority messages. Drawing from 65 768 messages submitted between October 2016 and July 2017, the quality of helpdesk message handling was evaluated via detailed inspection of (1) a random sample of 481 messages and (2) messages reporting mistreatment of women, as identified using expert-curated keywords. Automated triage was explored by training a naïve Bayes classifier to replicate message labels assigned by NDoH staff. Classifier performance was evaluated on 12 526 messages withheld from the training set. 90 of 481 (18.7%) NDoH responses were scored as suboptimal or incorrect, with median response time of 4.0 hours. 32 reports of facility-based mistreatment and 39 of partner and family violence were identified; NDoH response time and appropriateness for these messages were not superior to the random sample (P>0.05). The naïve Bayes classifier had average accuracy of 85.4%, with ≥98% specificity for infrequently appearing (<50%) labels. These results show that helpdesk handling of mistreatment of women could be improved. Keyword matching and naïve Bayes effectively identified uncommon messages of interest and could support automated triage to improve handling of high-priority messages.

Factors influencing the capacity of women to voice their concerns about maternal health services in the Muanda and Bolenge Health Zones, Democratic Republic of the Congo: a multi-method study

BackgroundThis paper aims to identify factors that influence the capacity of women to voice their concerns regarding maternal health services at the local level.MethodsA secondary analysis was conducted of the data from three studies carried out between 2013 and 2015 in the Democratic Republic of the Congo (DRC) in the context of a WOTRO initiative to improve maternal health services through social accountability mechanisms in the DRC. The data processing and analysis focused on data related to factors that influence the capacity of women to voice their concerns and on the characteristics of women that influence their ability to identify, and address specific problems. Data from 21 interviews and 12 focus group discussions (n = 92) were analysed using an inductive content analysis, and those from one household survey (n = 517) were summarized.ResultsThe women living in the rural setting were mostly farmers/fisher-women (39.7%) or worked at odd jobs (20.3%). They had not completed secondary school (94.6%). Around one-fifth was younger than 20 years old (21.9%). The majority of women could describe the health service they received but were not able to describe what they should receive as care. They had insufficient knowledge of the health services before their first visit. They were not able to explain the mandate of the health providers. The information they received concerned the types of healthcare they could receive but not the real content of those services, nor their rights and entitlements. They were unaware of their entitlements and rights. They believed that they were laypersons and therefore unable to judge health providers, but when provided with some tools such as a checklist, they reported some abusive and disrespectful treatments. However, community members asserted that the reported actions were not reprehensible acts but actions to encourage a woman and to make her understand the risk of delivery.ConclusionsFactors influencing the capacity of women to voice their concerns in DRC rural settings are mainly associated with insufficient knowledge and socio-cultural context. These findings suggest that initiatives to implement social accountability have to address community capacity-building, health providers’ responsiveness and the socio-cultural norms issues.

The Trap of Neo-patrimonialism: Social Accountability and Good Governance in Cambodia

In this article, we analyse the social accountability (SA) mechanisms that have recently been established in Cambodia. These initiatives take place in a socio-political context marked by pervasive neo-patrimonial structures. Our focus is on the “strategies” implemented by state actors, CSOs and ordinary citizens (mediated by neo-patrimonial structures) – strategies that demonstrate a “neo-patrimonial trap” into which SA initiatives have fallen, whereby official institutions and accountability lines have been undermined. These “strategies” are: to focus SA activities on local level authorities who have no means or power to introduce changes in governance or to improve public services, and to allow SA practices to emerge only to the extent that they do not threaten actual authoritarian distribution of power, norms and practices of clientelistic exchange, and the benefits obtained through patron-client relations. As a result, citizens have not been empowered to demand accountability but, paradoxically, have been encouraged to take over some government responsibilities. This, in turn, strengthens the networks of clientelism and patronage. These insights indicate the weak potential of externally-imposed SA mechanisms in an authoritarian and neo-patrimonial setting in which the government is only partly committed to achieving accountability. The findings are based on a two-year study conducted using a combination of qualitative sociological methods and an ethnographic approach.

Instituciones formales de la gobernanza metropolitana en Colombia: un análisis de elección racional

En este artículo se indaga por las condiciones necesarias para la cooperación de municipios colindantes en la integración de áreas metropolitanas en Colombia a partir de una revisión, bajo el marco analítico del institucionalismo de elección racional, de las principales teorías sobre el gobierno metropolitano y la normativa vigente relacionada con la jurisdicción metropolitana en el país. Se concluye que la conformación de un área metropolitana en Colombia obedece a la existencia de beneficios extraordinarios para los municipios participantes, y que el fortalecimiento de la gobernanza metropolitana depende, bien del mantenimiento de dichos beneficios o bien de un fortalecimiento de los mecanismos de veeduría que modifiquen los incentivos a los hacedores de políticas.

Public Hearing as Social Accountability Mechanism Towards Customer Satisfaction

Public Hearing as Social Accountability Mechanism Towards Customer Satisfaction