Social accountability: What are the lessons for improving family planning and reproductive health programs?

Boydell, Victoria; Keesbury, Jill

doi:10.31899/rh10.1005

Cited by 27 publications

(36 citation statements)

References 31 publications

(45 reference statements)

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“…There are currently very few accessible systems for accountability and redress. 9 , 55 It will remain very difficult to ensure accountability if problematic issues such as disrespectful and abusive treatment, including coercion, are not adequately described and measured and there is no agreement on how to identify, measure, monitor, and respond when issues arise. If these issues are not recognized and addressed promptly in programs, women’s well-being as well as the reputation of family planning methods and programs are at risk.…”

Section: Discussionmentioning

confidence: 99%

Measuring and monitoring quality of care in family planning: are we ignoring negative experiences?

Harris

Reichenbach

Hardee

2016

OAJC

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Despite decades of emphasis on quality of care, qualitative research continues to describe incidents of poor quality client–provider interactions in family planning provision. Using an emerging framework on disrespect and abuse (D and A) in maternal health services, we reviewed the global published literature for quantitative tools that could be used to measure the prevalence of negative client experiences in family planning programs. The search returned over 7,000 articles, but only 12 quantitative tools included measures related to four types of D and A (non-confidential care, non-dignified care, non-consented care, or discrimination). We mapped individual measurement items to D and A constructs from the maternal health field to identify measurement gaps for family planning. We found significant gaps; current tools are not adequate for determining the prevalence or impact of negative client experiences in family planning programs. Programs need to invest in tools that describe all aspects of client experiences, including negative experiences, to increase accountability and maximize the impact of current investments in family planning programs.

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Section: Discussionmentioning

confidence: 99%

Measuring and monitoring quality of care in family planning: are we ignoring negative experiences?

Harris

Reichenbach

Hardee

2016

OAJC

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“…Strong cohesion of community and social network have also helped to improve healthcare delivery and utilisation of health services in similar settings [ 12 , 13 ]. Social accountability approaches such as citizen report cards, village health committees and community score cards (CSC) have helped in increasing accountability in health facility monitoring [ 14 ]. The CSC, a social audit tool that brings together service users and providers of a particular service to assess, plan, monitor and evaluate services, in particular has worked successfully in improving healthcare utilisation in rural settings in other developing countries such as Afghanistan, Democratic Republic of Congo and Malawi [ 15 – 17 ].…”

Section: Introductionmentioning

confidence: 99%

Do community scorecards improve utilisation of health services in community clinics: experience from a rural area of Bangladesh

Hanifi¹,

Hossain²,

Chowdhury

et al. 2020

Int J Equity Health

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Background The government of Bangladesh initiated community clinics (CC) to extend the reach of public health services and these facilities were planned to be run through community participation. However, utilisation of CC services is still very low. Evidence indicates community score card is an effective tool to increase utilisation of services from health facility through regular interface meeting between service providers and beneficiary. We investigated whether community scorecards (CSC) improve utilisation of health services provided by CCs in rural area of Bangladesh. Methods This study was conducted from December 2017 to November 2018. Three intervention and three control CCs were selected from Chakaria, a rural sub-district of Bangladesh. CSC was introduced with the Community Groups and Community Support Groups in intervention CCs between January to October 2018. Data were collected through observation of CCs during operational hours, key informant interviews, focus group discussions, and from DHIS2. Utilisation of CC services was compared between intervention and control areas, pre and post CSC intervention. Results Post CSC intervention, community awareness about CC services, utilisation of clinic operational hours, and accountability of healthcare providers have increased in the intervention CCs. Utilisation of primary healthcare services including family planning services, antenatal care, postnatal care and basic health services have significantly improved in intervention CCs. Conclusion CSC is an effective tool to increase the service utilization provided by CCs by ensuring community awareness and participation, and service providers’ accountability. Policy makers and concerned authorities may take necessary steps to integrate community scorecard in the health system by incorporating it in CCs.

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“…The study is implementing community and health provider driven social accountability interventions where service users and providers in each study country assess the quality of local FP/C services and jointly identify ways to improve the delivery and quality of such services. The CaPSAI intervention builds on community scorecard (CSC), citizen voice and action and citizen hearing methodologies that have been implemented and evaluated by other organizations 13,35,36 . Eight common steps were distilled (Table 2) and the essential principles of these steps were identified for adaptation to local contexts, emphasizing conceptual fidelity over standardization 37,38 .…”

Section: Study Design and Methods 1 The Interventionmentioning

confidence: 99%

Rationale and design of a complex intervention measuring the impact and processes of social accountability applied to contraceptive programming: CaPSAI Project

et al. 2020

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Background: There are numerous barriers leading to a high unmet need for family planning and contraceptives (FP/C). These include limited knowledge and information, poor access to quality services, structural inefficiencies in service provision and inadequately trained and supervised health professionals. Recently, social accountability programs have shown promising results in addressing barriers to accessing sexual and reproductive health services. As a highly complex participatory process with multiple and interrelated components, steps and actors, studying social accountability poses methodological challenges. The Community and Provider driven Social Accountability Intervention (CaPSAI) Project study protocol was developed to measure the impact of a social accountability process on contraceptive uptake and use and to understand the mechanisms and contextual factors that influence and generate these effects (with emphasis on health services actors and community members). Methods: CaPSAI Project is implementing a social accountability intervention where service users and providers assess the quality of local FP/C services and jointly identify ways to improve the delivery and quality of such services. In the project, a quasi-experimental study utilizing an interrupted time series design with a control group is conducted in eight intervention and eight control facilities in each study country, which are Ghana and Tanzania. A cross-sectional survey of service users and health care providers is used to measure social accountability outcomes, and a cohort of women who are new users of FP/C is followed up after the completion of the intervention to measure contraceptive use and continuation. The process evaluation utilizes a range of methods and data sources to enable a fuller description of how the findings were produced. Conclusion: This complex study design could provide researchers and implementers with the means to better measure and understand the mechanisms and contextual factors that influence social accountability processes in reproductive health, adding important findings to the evidence base.

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Social accountability: What are the lessons for improving family planning and reproductive health programs?

Cited by 27 publications

References 31 publications

Measuring and monitoring quality of care in family planning: are we ignoring negative experiences?

Measuring and monitoring quality of care in family planning: are we ignoring negative experiences?

Do community scorecards improve utilisation of health services in community clinics: experience from a rural area of Bangladesh

Rationale and design of a complex intervention measuring the impact and processes of social accountability applied to contraceptive programming: CaPSAI Project

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