Abstract:
:Social accountability is increasingly invoked as a way of improving health services. This article presents a theory-driven qualitative study of the context, mechanisms and outcomes of a social accountability program, Citizen Voice and Action (CVA), implemented by World Vision (WV) in Zambia. Primary data were collected between November 2013 and January 2014. It included in-depth interviews and focus group discussions with program stakeholders. Secondary data were used iteratively-to inform the process for primary data collection, to guide primary data analysis and to contextualize findings from the primary data. CVA positively impacted the state, society, state-society relations and development coordination at the local level. Specifically, sustained improvements in some aspects of health system responsiveness, empowered citizens, the improved provision of public goods (health services) and increased consensus on development issues appeared to flow from CVA. The central challenge described by interviewees and FGD participants was the inability of CVA to address problems that required central level input. The mechanisms that generated these outcomes included productive state-society communication, enhanced trust, and state-society co-production of priorities and the provision of services. These mechanisms were activated in the context of existing structures for state-society interaction, willing political leaders, buy-in by traditional leaders, and WV's strong reputation and access to resources. Prospective observational research in multiple contexts would shed more light on the context, mechanisms and outcomes of CVA programs. In addition to findings that are intuitive and well supported in the literature we identified new areas that are promising areas for future research. These include (1) the context of organizational reputation by the organization(s) spearheading social accountability efforts; (2) the potential relationship between social accountability efforts and making ambitious national programs operational at the frontlines of the health system and (3) the feasibility of scale up for certain types of local level responsiveness.
journal_name
Health Policy Planjournal_title
Health policy and planningauthors
Schaaf M,Topp SM,Ngulube Mdoi
10.1093/heapol/czx024subject
Has Abstractpub_date
2017-07-01 00:00:00pages
847-859issue
6eissn
0268-1080issn
1460-2237pii
3091419journal_volume
32pub_type
杂志文章abstract::Existing accountability efforts in Nigeria primarily serve as retrospective policing. To enable accountability to guide change prospectively and preemptively, we drew from a literature review to develop a framework that highlights mutually reinforcing dimensions of accountability in health systems along three counterb...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/czw057
更新日期:2016-11-01 00:00:00
abstract::Providing quality emergency obstetric care (EmOC) reduces the risk of maternal and newborn mortality and morbidity. There is evidence that over 50% of maternal health programmes that result in improving access to EmOC and reduce maternal mortality have an EmOC training component. The objective was to review the eviden...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/czz028
更新日期:2019-05-01 00:00:00
abstract::The 1993 World Development Report is proving to be an influential document for the development of the health sector policies in developing countries. One important aspect of the Report concerns its proposals for Disability Adjusted Life Years as a measure of health change and hence effectiveness of interventions. This...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/11.2.179
更新日期:1996-06-01 00:00:00
abstract:INTRODUCTION:Coverage of insecticide-treated nets (ITNs) in sub-Saharan Africa is still low despite their proven efficacy, effectiveness and cost-effectiveness. Delivery systems for ITNs have been hotly debated, but there has been no structured approach to assessing their relative effectiveness. This paper aims to: pro...
journal_title:Health policy and planning
pub_type: 杂志文章,评审
doi:10.1093/heapol/czm021
更新日期:2007-09-01 00:00:00
abstract::There is increasing interest in the prospects for managed market reforms in developing countries, stimulated by current reforms and policy debates in developed countries, and by perceptions of widespread public sector inefficiency in many countries. This review examines the prospects for such reforms in a developing c...
journal_title:Health policy and planning
pub_type: 杂志文章,评审
doi:10.1093/heapol/9.3.237
更新日期:1994-09-01 00:00:00
abstract::The burden of diarrhoeal disease remains high in the developing world. Community-based safe drinking water programmes are being promoted as cost-effective interventions that will help reduce this illness burden. However, the effectiveness of these programmes remains under-investigated. The primary argument of this pap...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/czn017
更新日期:2008-11-01 00:00:00
abstract::Ensuring financial access to health services is a critical challenge for poor countries if they are to reach the health Millennium Development Goals (MDGs). This article examines the case of Rwanda, a country which has championed innovative health care financing policies. Between 2000 and 2007, Rwanda has improved fin...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/czr070
更新日期:2011-11-01 00:00:00
abstract::Mental disorders account for a significant and growing proportion of the global burden of disease and yet remain a low priority for public financing in health systems globally. In many low-income countries, formal mental health services are paid for directly by patients out-of-pocket and in middle-income countries und...
journal_title:Health policy and planning
pub_type: 杂志文章,评审
doi:10.1093/heapol/czl004
更新日期:2006-05-01 00:00:00
abstract::Scarce evidence exists on the features, determinants and implications of physicians' dual practice, especially in resource-poor settings. This study considered dual practice patterns in three African cities and the respective markets for physician services, with the objective of understanding the influence of local de...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/czt071
更新日期:2014-09-01 00:00:00
abstract::A decade after the first International Conference on Safe Motherhood, maternal mortality remains very high in most West African countries, even in capital cities. The detection of high risk pregnancies, known as the risk approach, during antenatal consultations has been the basis of most maternal and child health prog...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/15.1.11
更新日期:2000-03-01 00:00:00
abstract::Many countries have expanded insurance programmes in an effort to achieve universal health coverage (UHC). We assess a complementary path toward financial risk protection: increased access to technologies that improve health and reduce the risk of large health expenditures. Malawi has provided free HIV treatment since...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/czaa023
更新日期:2020-07-01 00:00:00
abstract::During the last 20 years Lao People's Democratic Republic has successfully developed and adopted some 30 health policies, strategies, decrees and laws in the field of health. Still, the implementation process remains arduous. This article aims at discussing challenges of health policy development and effective impleme...
journal_title:Health policy and planning
pub_type: 杂志文章,评审
doi:10.1093/heapol/czu017
更新日期:2015-05-01 00:00:00
abstract::Unlike any other disease so far, the 'exceptional' nature of HIV/AIDS has prompted debate about the necessity, but also the challenges, of regulating practitioner-patient communication around HIV testing. In India, the National AIDS Control Organization (NACO) has adopted the guidelines of the World Health Organizatio...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/czl021
更新日期:2006-09-01 00:00:00
abstract::This article presents research findings into the effectiveness of an innovative equity fund approach to improving access to public sector health services for the poor in Kirivong Operational Health District in Cambodia. The operational health district is the lowest organizational level in the Cambodian health system, ...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/czj001
更新日期:2006-01-01 00:00:00
abstract::Generic prescribing and generic substitution are mechanisms for reducing the cost of drugs. The purpose of this study was to assess the extent to which generic prescribing by private medical practitioners and generic substitution by private pharmacists is practised in South Africa and to estimate the potential savings...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/11.2.198
更新日期:1996-06-01 00:00:00
abstract::This study compares the quality of services provided by public and private hospitals in Bangladesh. The premise of the paper was that the quality of hospital services would be contingent on the incentive structure under which these institutions operate. Since private hospitals are not subsidized and depend on income f...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/15.1.95
更新日期:2000-03-01 00:00:00
abstract::Reducing maternal mortality and providing universal access to reproductive health in resource poor settings has been severely constrained by a shortage of health workers required to deliver interventions. The aim of this article is to determine evidence to optimize health worker roles through task shifting/sharing to ...
journal_title:Health policy and planning
pub_type: 杂志文章,评审
doi:10.1093/heapol/czt026
更新日期:2014-05-01 00:00:00
abstract::The 'Community Action for Preventing HIV/AIDS Project' was implemented in four provinces in Cambodia (2001-04) to support a comprehensive set of HIV prevention efforts. Implementation was strictly monitored in terms of inputs, outputs and outcomes. We examine changes in these variables during the project period to ass...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/czn014
更新日期:2008-07-01 00:00:00
abstract::This paper reports an empirical investigation into the pattern of private health insurance coverage in South Africa before and after deregulation of the health insurance industry. More specifically, we sought to measure trends in risk-pooling over the period 1985-95, and to assess the impact of risk pooling on the cos...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/15.4.378
更新日期:2000-12-01 00:00:00
abstract::We assessed the technical content of sugar, salt and trans-fats policies in six countries in relation to the World Health Organization 'Best Buys' guidelines for the prevention and control of non-communicable diseases (NCDs). National research teams identified policies and strategies related to promoting healthy diets...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/czz175
更新日期:2020-06-01 00:00:00
abstract::Recent efforts to prevent post-partum haemorrhage (PPH) in low-income countries have focused on providing women with access to oral misoprostol during home birth. The WHO recommends using lay health workers (LHWs) to administer misoprostol in settings where skilled birth attendants are not available. This review synth...
journal_title:Health policy and planning
pub_type: 杂志文章,评审
doi:10.1093/heapol/czv012
更新日期:2016-02-01 00:00:00
abstract::Past efforts to promote family planning in Pakistan have been disappointing, but between 1990-91 and 2000-01 contraceptive use has more than doubled. This rise has coincided with a concerted effort on the part of the Pakistani government to increase access to contraceptive services, particularly in rural areas. The La...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/czi014
更新日期:2005-03-01 00:00:00
abstract::There has been increased interest in and experimentation with demand-side mechanisms such as the use of vouchers that place purchasing power in the hands of targeted consumers to improve the uptake of healthcare services in low-income settings. A key measure of the success of such interventions is the extent to which ...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/czt079
更新日期:2014-07-01 00:00:00
abstract::Most government health facilities in Cambodia perform poorly, due to lack of funds, inadequate management and inefficient use of resources, but mostly due to poor motivation of staff. This paper describes contracting as a possible tool for Ministries of Health to improve health service delivery more rapidly than the m...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/18.1.74
更新日期:2003-03-01 00:00:00
abstract::This paper investigates the key factors associated with the demand for Urban Resident Basic Medical Insurance (URBMI), which was established in 2007 and aims to cover all Chinese urban residents. Two waves of longitudinal household survey data are used, and a three-level random-intercept logit model is used for the an...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/czs014
更新日期:2012-12-01 00:00:00
abstract::Policy entrepreneurs are individuals who attempt to influence the policy process and its outcomes through their opportunistic or incremental actions. Their success in the policy-making process has been associated with the convergence of four factors: behavioural traits; institutional factors; network position and poli...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/czv044
更新日期:2015-12-01 00:00:00
abstract::Traditional medicine is commonly assumed to be a crucial health care option for poor households in developing countries. However, little research has been done in Asia to quantify the reliance on traditional medicine and its determinants. This research contributes to filling in this knowledge gap using household surve...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/czv060
更新日期:2016-04-01 00:00:00
abstract::Given the demonstrated efficacy of vitamin A supplements in reducing childhood mortality, health officials now have to decide whether it would be efficient to target the supplements to high risk children. Decisions about targeting are complex because they depend on a number of factors; the degree of clustering of prev...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/12.1.29
更新日期:1997-03-01 00:00:00
abstract::Evidence suggests that a regular and reliable transfer of cash to households with orphaned and vulnerable children has a strong and positive effect on child outcomes. However, conditional cash transfers are considered by some as particularly intrusive and the question on whether or not to apply conditions to cash tran...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/czt060
更新日期:2014-10-01 00:00:00
abstract:BACKGROUND:Several countries in sub-Saharan Africa have recently adopted policies that remove user fees for facility-based delivery services. There is little rigorous evidence of the impact of these policies on utilization of delivery services and no evaluations have examined effects on neonatal mortality rates (NMR). ...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/czu027
更新日期:2015-05-01 00:00:00