Social accountability methods (citizen and civil society-led efforts to hold politicians, government officials, service providers and other duty-bearers to account) have great potential to improve family planning programs and services, including responsiveness of providers, patient-centered quality of care, availability of resources, service access, coverage, and satisfaction. A new infographic helps explain how social accountability works and the relevance for family planning programs.
Building on a synthesis of existing evidence, the project conducted a retrospective study of the Healthy Action Project in Uganda, with detailed results to be published in the next issue of the African Journal of Reproductive Health, and a prospective study comparing two reproductive health projects in Uganda. The project is also collaborating with WHO to examine how social accountability in the context of FP programs influences contraceptive uptake and use, and hosted a learning exchange with the Accountability Research Center at American University, International Planned Parenthood Federation, and the Reproductive Health Supplies Coalition, on “Transparency and Accountability Strategies and Reproductive Health Delivery Systems” (meeting report forthcoming).There are gaps, though, in understanding how social accountability interventions effect change and, importantly, how they can be applied in different contexts. The Evidence Project brings an implementation science lens to the question “How, and in what ways, can social accountability methods improve the delivery and quality of RH and family planning services?” Implementation science studies are concerned not just with outcomes but also with how those outcomes were reached, and are structured to account for and be responsive to real world contexts. This approach can help focus on “how people actually experience the operation of complex systems.”
The Evidence Project’s initial studies and collaborations with practitioners form the basis for the project’s recent activities, and are helping the Evidence Project team better map the pathways through which social accountability can improve family planning programs. As Vicky Boydell reflected at the learning exchange, “By outlining the assumed pathway through which change takes hold (both technical and political), measures and outcomes can be linked to the theory of change, and data on the assumed change processes better captured.” By fleshing out the theories of change that underpin social accountability interventions and more concretely defining the processes and changes that occur, the Evidence Project is helping to explore how social accountability can be used to expand access to and choice of quality, voluntary family planning programs and services.