Issue
The health and nutrition accountability sector in South Asia is a rich and vibrant field, with a great deal to offer in terms of innovation and best practice – but it still performs relatively poorly on health and nutrition indicators.
A range of accountability initiatives have been implemented in the health and nutrition sector, including techno-managerial, transparency oriented, participatory and collective or social accountability initiatives, but there is little work yet that is taking both a comparative and theoretical perspective to ground existing and future initiatives on accountability, and accountability in health in particular.
Learning
In March 2016, in partnership with the Community of Practitioners on Accountability and Social Action in Health (COPASAH), the project convened an online expert discussion which brought together 49 practitioners involved in improving health and nutrition services in South Asia. They shared their experiences on community participation and engagement, negotiating with the state, private sector accountability, and how to define and measure impact.
The learning they shared included the following:
- A ‘culture of questioning’ is crucial to mobilising communities around social accountability in healthcare.
- The effectiveness of social accountability tools – online or offline – depends on the way they are used. Part of their value is that they create an environment where people can sit together and start talking about healthcare issues.
- Clear, attainable goals are essential to ensure community participation.
- When locally-collected data are used to push for better service delivery at ‘higher’ levels of government, the voice of community members becomes more legitimate.
- Lack of regulation in the private sector means there is no effective framework for accountability in service delivery.
- It is essential to put politics and power at the centre of the accountability discourse, to make sense of the changes we seek to create.
Download the report here and view a presentation of the findings here.