Using Feedback to Improve Accountability in Global Environmental Health and Engineering

Abstract

Engineered environmental health interventions and services in low-income and resource-limited settingssuch as water supply and treatment, sanitation, and cleaner household energy serviceshave had a less than expected record of sustainability and have sometimes not delivered on their potential to improve health. These interventions require both effectively functioning technologies as well as supporting financial, political, and human resource systems, and may depend on user behaviors as well as professionalized service delivery to reduce harmful exposures. In this perspective, we propose that the application of smarter, more actionable monitoring and decision support systems and aligned financial incentives can enhance accountability between donors, implementers, service providers, governments, and the people who are the intended beneficiaries of development programming. Made possible in part by new measurement techniques, including emerging sensor technologies, rapid impact evaluation, citizen science, and performance-based contracting, such systems have the potential to propel the development of solutions that can work over the long-term, allowing the benefits of environmental health improvements to be sustained in settings where they are most critical by improving trust and mutual accountability among stakeholders.

Necessary conditions for sustainable water and sanitation service delivery in schools: A systematic review

“…Thomas and Brown (2021) emphasize the need to align financial, political, and social incentives to increase the likelihood that the information generated will be acted upon. Their work illustrates how timely and actionable monitoring and decision support mechanisms can be designed for different types of stakeholders, including recipient communities, program implementers and service providers, researchers, and donors [ 42 ]. Similar efforts in other contexts would yield a better understanding of key service delivery design elements, such as (1) priority information needs of key actors, (2) effective information distribution channels, and (3) strategies to link information flows with accountability mechanisms.…”

Improving the Reliability of Water Service Delivery in Rural Kenya through Professionalized Maintenance: A System Dynamics Perspective

“…26 advanced monitoring to improve environmental interventions. 27 Aligning with the aforementioned contemporary pluralist approaches to sustainability studies, system dynamics modeling was selected for this research because it is an actionoriented approach that explores the interconnected factors and feedback loops that comprise the system, enables shared agency through collaborative production and emergent understanding of counterintuitive system behavior, and can inform and optimize the intentional design of effective interventions.…”

“…Thomas and Brown (2021) note the particular importance of feedback through developed partnerships and…”

Systems Thinking for Effective Interventions in Global Environmental Health

“…Complexity-aware monitoring approaches are more likely to include data collection that is appropriate for complex systems, thereby leading to an increased awareness of the complexity in those systems (a reinforcing feedback loop). Some principles for complexity-aware monitoring include setting appropriate boundaries, matching the pace of change in a system, and being flexible enough to capture unexpected changes and emergent behaviors. , Additionally, to improve accountability with stakeholders, monitoring data should be relevant to causal theories of change and reported in a timely manner . In short, monitoring should not be performed just for the sake of tracking progress, but rather as a tool for gaining a more holistic understanding of the structural aspects of a given system.…”

“…58,59 Additionally, to improve accountability with stakeholders, monitoring data should be relevant to causal theories of change and reported in a timely manner. 60 In short, monitoring should not be performed just for the sake of tracking progress, but rather as a tool for gaining a more holistic understanding of the structural aspects of a given system. To this end, monitoring and evaluation approaches often benefit from the use of mixed quantitative and qualitative methods.…”