Governance and Service Delivery: Practical Applications of Social Accountability Across Sectors

Abstract

This volume began as a means of reflecting on RTI's collective experience with social accountability, learning from past projects to improve our current and future development efforts. As the case studies developed, it became clear that they were of a quality and depth that should be shared more broadly, resulting in this book. We are grateful to F. Henry Healey, Alyson Lipsky, and Felicity Young, as well as Taylor Williamson, for their excellent work writing or reviewing the chapters of this book. In addition, a large number of RTI colleagues helped the chapter authors with insights, documents, and feedback related to each of the projects profiled; they are individually recognized for each case in the pages that follow. We would like to recognize support from RTI's Internal Research and Development funds to develop the cases and overview analysis, as well as prepare the manuscript for publication. In particular, Aaron Williams, Paul Weisenfeld, Luis Crouch, and Karen Posner championed support for this research. Finally, we would like to thank the RTI Press team, led by Karen Lauterbach. The peer review process, managed by Gary Bland, sharpened the writing and analysis. We are also grateful to the editors and designersincluding Erin Newton, Joanne Studders, Anne Gering, Sonja Douglas, and Alisa Clifford-for the care with which they treated our manuscript.

“We come as friends”: approaches to social accountability by health committees in Northern Malawi

“…According to a classification of social accountability purposes by Wetterberg, Brinkerhoff, & Hertz (2016), the purpose of HFC’s social accountability role can be understood as “co-production focused”. This purpose moves away from compliance-focused or confrontational actions to interrogate and sanction health worker behaviour [36]. It also deviates from the retrospective character of many accountability approaches; HFCs combine multiple service delivery functions and build relations with health workers through other activities than only monitoring and feedback on poor performance.…”

“…This would be more effective than strengthening the accountability interface role of HFCs as a stand-alone project. The strengthening of social accountability relations requires long-term repeated and extended interactions between citizens, health workers and provider organisations [36].…”

The Value of Integrating Governance and Sector Programs: Evidence from Senegal

“…GoLD collaborated with Neema in four regions (Figure 1) using an integrated approach to improve the capacity of local governments to provide priority services by strengthening skills and processes for planning, budgeting, community involvement, and resource mobilization (Figure 2). In line with the recognized need for a multilevel approach to improving service delivery, [21][22][23] GoLD supports Municipal Councils and their technical working groups, such as Health Technical Commissions (HTC * ), charged with defining and monitoring…”

“…Social accountability efforts to improve service delivery often fail due to lack of response from higher level decisionmakers. 23,29 For example, a series of seminal studies have focused on the effects of community monitoring on service delivery in Uganda. 21,30,31 The most recent research, analyzing effects of years-long support to community advocates, shows that such efforts in Uganda led to notable changes in accountability relations.…”

Governance and Sector Outcomes: Making the Connections

“…This practice decouples interventions from context, treating them as "widgets" expected to achieve similar results across distinctive operating environments. 18,19 A qualitative research stream has also yielded insights through case studies and meta-analyses of published research. 20 These studies have captured contextual factors and their influence on governance and/or sectoral interventions, underscoring the well-recognized challenge of generalizing findings to other settings.…”