Impact of social accountability monitoring on health facility performance: Evidence from Tanzania

Francetić, Igor; Fink, Günther; Tediosi, Fabrizio

doi:10.1002/hec.4219

Cited by 8 publications

(5 citation statements)

References 56 publications

(66 reference statements)

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“…Previous studies have shown mixed results regarding the implementation of similar approaches and improved health outcomes ( 33 – 36 ) . Additionally, given the limited adherence to community action plan activities that address structural challenges at the facility level, there may be limits in the extent to which this approach can be used to address broader health system improvements outside provider behavior and community engagement, particularly in low-resource settings ( 37 , 38 ). Finally, this study finds evidence that the implemented program fostered a sense of accountability from the community towards the facility and providers, yet evidence of increased accountability from the providers to the community is more limited.…”

Section: Perceived Effects Of the Community Engagement Approach On Fp...mentioning

confidence: 99%

A qualitative exploration of how a community engagement approach influences community and health worker perceptions related to family planning service delivery in Togo

Dougherty,

Kassegne,

Nagbe

et al. 2024

Front. Reprod. Health

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BackgroundThere is a growing body of evidence that asserts community engagement approaches can improve the quality of reproductive health services. Family planning (FP) programs in Togo are implementing such approaches, which aim to mobilize both health workers and communities to improve FP service quality and FP uptake. However, there is not enough known about the enabling factors and challenges associated with implementation, or the extent to which the programs improve outcomes leading to contraceptive uptake.MethodsWe qualitatively explored how a community engagement approach influenced health worker and community perceptions related to FP service delivery in and around the city of Lomé, Togo, within the context of the broader integration of social and behavior change and service delivery. We conducted 18 in-depth interviews with health workers and 9 focus group discussions with community members.ResultsWe found the approach, which included community dialogues, site walkthrough visits and the development of community action plans, worked synergistically together to support collaborative action between communities and health workers to increase mutual understanding of their collective needs related to FP services. Community members cited improved reception at the health facilities by health workers and indicated that the site walkthrough visits created a greater sense of empathy towards the providers and the challenges faced in their work environment. Health workers acknowledged a greater understanding of barriers at the community level following community dialogues, particularly among community members that are not routinely encountered at the health facility for reproductive health services such as men and youth. We found limited implementation of health facility improvements included in community action plans because they were dependent on commitment from community leadership and the need to mobilize additional support or financial resources.ConclusionCommunity engagement approaches are a promising mechanism to support collaboration and enhance mutual understanding between health workers and communities to achieve improved FP service quality. Future programs should consider incorporating additional mechanisms to monitor community action plans and provide support to address structural challenges at the facility level particularly those that require financial resources.

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Section: Perceived Effects Of the Community Engagement Approach On Fp...mentioning

confidence: 99%

A qualitative exploration of how a community engagement approach influences community and health worker perceptions related to family planning service delivery in Togo

Dougherty,

Kassegne,

Nagbe

et al. 2024

Front. Reprod. Health

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“…Although social accountability approaches have a long history in the public domain, the integration of social accountability innovations in the health sector is a relatively new phenomenon that has been linked to a wide array of positive outcomes at the health systems level ( 5 ) and is considered as an advanced form of participation ( 6 ). Nowadays more than ever, social accountability is known as one of the effective levers in health system governance ( 7 ) which by involving citizens in the monitoring of the policy process and health services delivery, improves health system performance.…”

Section: Introductionmentioning

confidence: 99%

Social Accountability in Health System Governance: A Scoping Review

Nejatian,

Arab,

Takian

et al. 2024

ijph

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Background: 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. Methods: 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). Results: 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. Conclusion: 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.

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“…Explorative studies from different contexts have suggested that training11 18 19 is a way forward to empower HFGCs, but they have also highlighted the importance of paying attention to the socioeconomic and cultural contexts in which they operate, including power relationships between healthcare providers and the HFGCs, and political capabilities and how HFGCs perceive their role 8 19 20. There is, however, a scarcity of participatory (action) research on how to better strengthen and implement social accountability mechanisms, such as the HFGCs, and their relationships with healthcare providers and the community they serve 16 18 22…”

Section: Introductionmentioning

confidence: 99%

Role of health facility governing committees in strengthening social accountability to improve the health system in Tanzania: protocol for a participatory action research study

et al. 2023

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IntroductionSocial accountability is important for improving the delivery of health services and empowering citizens. The government of Tanzania has transferred authority to plan, budget and manage financial resources to the lower health facilities since 2017. Health facility governing committees (HFGCs) therefore play a pivotal role in ensuring social accountability. While HFGCs serve as bridges between health facilities and their communities, efforts need to be made to reinforce their capacity. This project therefore aims to understand whether, how and under what conditions informed and competent HFGCs improve social accountability.Methods and analysisThis study adopts a participatory approach to realist evaluation, engaging members of the HFGCs, health managers and providers and community leaders to: (1) map the challenges and opportunities of the current reform, (2) develop an initial programme theory that proposes a plan to strengthen the role of the HFGCs, (3) test the programme theory by developing a plan of action, (4) refine the programme theory through multiple cycles of participatory learning and (5) propose a set of recommendations to guide processes to strengthen social accountability in the Tanzanian health system. This project is part of an ongoing strong collaboration between the University of Dar es Saalam (Tanzania), and Umeå University (Sweden), providing opportunities for action learning and close interactions between researchers, decision-makers and practitioners.Ethics and disseminationEthical approval to conduct the study was obtained from the National Ethical Review Committee in Tanzania— National Institute for Medical Research (NIMR/HQ/R.8a/Vol.IX/3928). Permissions to conduct the study in the health facilities were given by the President’s Office Regional Administration and Local Government and relevant regional and district authorities. The results will be published in open-access, peer-reviewed journals and presented at scientific conferences.

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Impact of social accountability monitoring on health facility performance: Evidence from Tanzania

Cited by 8 publications

References 56 publications

A qualitative exploration of how a community engagement approach influences community and health worker perceptions related to family planning service delivery in Togo

A qualitative exploration of how a community engagement approach influences community and health worker perceptions related to family planning service delivery in Togo

Social Accountability in Health System Governance: A Scoping Review

Role of health facility governing committees in strengthening social accountability to improve the health system in Tanzania: protocol for a participatory action research study

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