Introduction: Accountability for Health Equity: Galvanising a Movement for Universal Health Coverage

Abstract

This issue of the IDS Bulletin developed out of a workshop held at IDS, 19-21 July 2017, entitled 'Unpicking Power and Politics for Transformative Change: Towards Accountability for Health Equity'. We consider three thematic strands that emerged from the workshop. First, the nature of accountability politics 'in time' and the cyclical aspects of national and transnational accountability for health equity efforts. Second, the contested politics of 'naming' and measuring accountability, and the intersecting dimensions of marginalisation and exclusion that are missing from current debates. Third, the shifting nature of power in global health and new configurations of health actors, social contracts, and the role of technology in this new era. We conclude with a proposal for long-term approaches to the institutionalisation of accountability processes and the strategic galvanising of a broader range of partners to work towards Universal Health Coverage, as both a metric and a mechanism of achieving greater health equity.

How do we shape and navigate pathways to social accountability scale? Introducing a middle-level Theory of Change

“…Falisse et al 2019;Mills, 2020) as well as e-Pact's (2016) review of DFID programing. The collection of findings provides important clues to: a) conceptualize outcomes of scaling up -focusing on adaptations, rather than binary adoption of wholesale civil society interventions or failure; b) focus on public sector actors' own efforts rather than only looking at those of civil society; and c) question the appropriate length of time, rather than assuming short-term time horizons or the long-durée (Nelson et al 2018). These issues are discussed in greater detail in the remainder of the paper.…”

The Basic Determinants of Malnutrition: Resources, Structures, Ideas and Power

“…Stand-alone local-level initiatives need to be vertically integrated with national-level measures for political redress, and vice-versa. 102,103 Attention needs to be paid to community and national dynamics of politics and power: while high levels of inequality can be seen to inhibit participation, they can also lead to new forms of collective action and resistance. 104 Accountability and participatory approaches focused on child nutrition are not well documented in the global literature, but a few accounts exist.…”

‘I’m Not that Kind of Doctor’

“…How I came to understand the contested truth claims of the project has been necessarily infl uenced by my grounding in particular kinds of literature and debates. In the four years since Project CERCA ended, I have had the opportunity to contribute to research on conceptualisations of gender in global health (for related work, see Hawkes et al 2017) and on accountability relationships as they impact health equity (Nelson et al 2018). This work has given me ample pause to rethink the hierarchies of knowledge that structured the format and functioning of the CERCA health intervention and the ways in which it remained 'gender-blind' with regard to internal power dynamics in spite of being a sexuality-and-reproductivehealth-focused intervention.…”