Accountability Mechanisms to Improve Family Planning and Reproductive Health Programs

Social accountability refers to the efforts of citizens and civil society to scrutinize and hold duty bearers (politicians, government officials, and service providers) to account for providing promised services, actions most often at the sub-national or community level. In the family planning/reproductive health field, this concept builds on a rich history of community involvement and civil society participation.

The Evidence Project is undertaking a variety of activities that aim to contribute to a deeper knowledge of whether and how the implementation of accountability mechanisms in family planning and reproductive health programs improves clients’ access to and quality of services.

The Evidence Project convened an expert consultation on July 16-18, 2014. In preparation for the meeting, the project prepared a working paper that synthesized the existing literature on social accountability across development sectors, including the family planning and reproductive health sector.

At the meeting, participants discussed the applicability of findings on social accountability in other sectors to social accountability for improving family planning and reproductive health programming, examined promising social accountability interventions and measurement strategies to assess effectiveness, and proposed research priorities on social accountability in family planning and reproductive health programming. Participants included experts on social accountability from diverse fields (e.g., governance, maternal health) as well as family planning experts, researchers, implementers, and activists. The meeting report highlights the key points from the presentations and the rich discussions that followed. To build the evidence base, participants argued strongly for better documentation of existing accountability programs.

The Evidence Project is building on the findings and insights from the meeting by conducting a qualitative case study of a social accountability intervention that improved clients’ access and use of family planning services. The focus of the case study is the Health Action Project in Uganda, which worked with civil society to build citizen capacity to formulate policy priorities, monitor policy implementation, and hold decision-makers accountable for implementing policies.  The case study aims to understand how the project applied social accountability mechanisms to family planning and reproductive health programming and how they achieved improvements in access and uptake of services.  Our analysis will fill critical evidence gaps in identifying “good practices” in family planning/reproductive health social accountability.  It also will identify variables for a prospective intervention study we will conduct, the findings from which will facilitate improved program design and scale up of family planning/reproductive health social accountability interventions.