Social Accountability in Health System Governance: A Scoping Review
,
Abstract
Background: Social accountability is an important element in health system governance, which is necessary for health system reform and reaching Universal Health Coverage. Understanding the social accountability mechanism and tools will help policymakers to design policies according to the context. We aimed to explore the extent of the application of social accountability in health system governance, its results, challenges, and tools.
Methods: We conducted a scoping review study, using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for scoping review. An inclusive search in bibliographic databases and search engines was done to identify peer review articles and grey literatures, published in English in the range of 2010 to 2021. Search terms were (social accountability), (public accountability), AND (health system).
Results: Thirty-one records met inclusion criteria from 286 potentially relevant sources, which included 25 peer-review articles and 6 grey literatures. Maternal and child health was the main health subject for social accountability interventions. We identified some social accountability tools to apply at the health facility and community levels. Social accountability has some benefits for the health system and for the community and some challenges to the implementation of social accountability were listed.
Conclusion: Social accountability improves health system performance. It contains different tools and strategies applied at different levels of the health system. Successful social accountability initiatives that are strategic, multi-interventional, and context-specific can produce good results in health services and social domains.
1. Merriam-webster Online dictionary (2022). Governance. Available from: https://www.merriam-webster.com/dictionary/governance
2. Addink Henk (2019). Good Governance: Concept and Context. Oxford University Press, UK, pp:157-165.
3. Jones, GW (1992). The search for local accounta-bility. Strengthening local government in the 1990s. Longman, London, pp: 49-78.
4. Malena C, Forster R, Singh J (2004). Social accountability: An introduction to the concept and emerging practice. The World Bank, Washington, p: 1.
5. Francetic I, Fink G, Tediosi F (2021). Im-pact of social accountability monitoring on health facility performance: Evi-dence from Tanzania. Health Econ, 30(4): 766-785.
6. Lodenstein E, Mafuta E, Kpatchavi AC, et al (2017). Social accountability in prima-ry health care in West and Central Afri-ca: exploring the role of health facility committees. BMC Health Serv Res, 17(1): 403.
7. Esther Suter, Sara Mallinson (2015). Ac-countability for coordinated/integrated health services delivery. WHO Regional Office for Europe, Copenhagen, p:1. Available from: https://iris.who.int/bitstream/handle/10665/367061/WHO-EURO-2015-6511-46277-66941-eng.pdf?sequence=1
8. World Bank (1993). World Development Report, Investing in Health. Oxford University Press, New York. Available from: https://openknowledge.worldbank.org/handle/10986/5976
9. Argaw MD, Desta BF, Mamo E, et al (2021). Implementing a social accountability approach for maternal, neonatal, and child health service performances in Ethiopia: a pre-post study Design. Glob Health Sci Pract, 9(1): 123-135.
10. Gurung G, Derrett S, Hill PC, Gauld R (2020). The role of social audit as a so-cial accountability mechanism for strengthening governance and service delivery in the primary health care set-ting of Nepal: a qualitative study. Crit Public Health, 30(5): 612-623.
11. Chan M (2016). Making fair choices on the path to universal health coverage. Health Syst Reform, 2(1): 5-7.
12. Kantamaturapoj K, Kulthanmanusorn A, Witthayapipopsakul W, et al (2020). Leg-islating for public accountability in uni-versal health coverage, Thailand. Bull World Health Organ, 98(2): 117-125.
13. Vian T (2020). Anti-corruption, transparen-cy and accountability in health: con-cepts, frameworks, and approaches. Glob Health Action, 13(sup1): 1694744.
14. Schaaf Marta Lee Britt. Social Accountabil-ity and Legal Empowerment for Quality Maternal Health Care. (PhD thesis) Co-lombia University, USA: 2018.
15. Danhoundo G, Nasiri K, Wiktorowicz ME (2018). Improving social accountability processes in the health sector in sub-Saharan Africa: a systematic review. BMC Public Health, 18: 497.
16. Brinkerhoff DW, Jacobstein D, Kanthor J, Rajan D, Shepard K (2017). Accountability, health governance, and health systems: uncover-ing the linkages. USAID, Washington DC, pp:35-42
17. Boydell V, McMullen H, Cordero J, Steyn P, Kiare J (2019). Studying social accounta-bility in the context of health system strengthening: innovations and consid-erations for future work. Health Res Policy Sys, 17: 34.
18. Bennett S, Ekirapa-Kiracho E, Mahmood SS, et al (2020). Strengthening social ac-countability in ways that build inclusion, institutionalization and scale: reflections on FHS experience. Int J Equity Health, 19(1): 220.
19. Brummel L (2021). Social accountability be-tween consensus and confrontation: de-veloping a theoretical framework for societal accountability relationships of public sector organizations. Administra-tion & Society, 53(7): 1046-1077.
20. Charlese Boelen, Jeffery E Heck (1995). De-fining and measuring social accountability in medical schools. World Health Organiza-tion, Geneva, p: 3.
21. Rajendra ABS (2021). Social Accountability of Research Publications in Journals. Journal of Orofacial Sciences, 13(1): 1.
22. Cambridge Business English Dictionary (2022). Social accountability Definition. Available from: https://dictionary.cambridge.org/dictionary/english/social-responsibility?q=social+responsibility
23. Peters MD, Godfrey CM, Khalil H, et al (2015). Guidance for conducting system-atic scoping reviews. Int J Evid Based Healthc, 13(3): 141-146.
24. Grant MJ, Booth A (2009). A typology of reviews: an analysis of 14 review types and associated methodologies. Health In-fo Libr J, 26(2): 91-108.
25. Colquhoun HL, Levac D, O'Brien KK, et al (2014). Scoping reviews: time for clarity in definition, methods, and reporting. J Clin Epidemiol, 67(12): 1291-1294.
26. Tricco AC, Lillie E, Zarin W, et al (2018). PRISMA extension for scoping reviews (PRISMA-ScR): checklist and explana-tion. Ann Intern Med, 169(7): 467-473.
27. Banke-Thomas A, Ayomoh FI, Abejirinde IOO, et al (2021). Cost of utilising ma-ternal health services in low-and mid-dle-income countries: a systematic re-view. Int J Health Policy Manag, 10(9): 564-577.
28. McGinn E, Lipsky A (2015). Social Ac-countability: A primer for civil society organizations working in family plan-ning and reproductive health. Health policy project. U.S. Agency for Interna-tional Development, Futures Group, Health Policy Project. Washington, DC. p:18-20. Available from: https://www.healthpolicyproject.com/pubs/449_PSocialAccountabilityReportFINALEC.pdf
29. Hamal M, de Cock Buning T, De Brouwere V, et al (2018). How does social account-ability contribute to better maternal health outcomes? A qualitative study on perceived changes with government and civil society actors in Gujarat, India. BMC Health Serv Res, 18: 653.
30. Naher N, Balabanova D, Hutchinson E, et al (2020). Do social accountability ap-proaches work? A review of the litera-ture from selected low-and middle-income countries in the WHO South-East Asia region. Health Policy Plan, 35(Supplement_1): i76-i96.
31. Topp SM, Sharma A, Chileshe C, et al (2018). The health system accountability impact of prison health committees in Zambia. Int J Equity Health, 17(1): 74.
32. Mecwan S, Sheth M, Khanna R (2021). En-hancing social accountability through adolescent and youth leadership: a case study on sexual and reproductive health from Gujarat, India. Gend Dev, 29(1): 151-169.
33. Squires F, Martin Hilber A, Cordero JP, et al (2020). Social accountability for re-productive, maternal, newborn, child and adolescent health: A review of re-views. PLoS One, 15(10): e0238776.
34. Fox JA (2015). Social accountability: what does the evidence really say? World Dev, 72: 346-361.
35. Lodenstein E, Molenaar JM, Ingemann C, et al (2019). “We come as friends”: ap-proaches to social accountability by health committees in Northern Malawi. BMC Health Serv Res, 19: 1-14.
36. Schaaf M, Cant S, Cordero J, Contractor S, Wako E, Marston C (2021). Unpacking power dynamics in research and evalua-tion on social accountability for sexual and reproductive health and rights. Int J Equity Health, 20: 56.
37. Page MJ, McKenzie JE, Bossuyt PM, et al (2021). The PRISMA 2020 statement: an updated guideline for reporting system-atic reviews. Int J Surg, 88: 105906.
38. Blake C, Annorbah-Sarpei NA, Bailey C, et al (2016). Scorecards and social account-ability for improved maternal and new-born health services: a pilot in the Ashanti and Volta regions of Ghana. Int J Gynaecol Obstet, 135(3): 372-379.
39. Wangũi Machira Yvonne (2015). Integrating Social Accountability in Healthcare De-livery: Lessons Drawn from Kenya. World Bank Group, Washington, DC. Available from: https://openknowledge.worldbank.org/handle/10986/21666?locale-attribute=fr
40. Pieterse P (2019). Citizen feedback in a fragile setting: social accountability in-terventions in the primary healthcare sector in Sierra Leone. Disasters, 43 Suppl 2:S132-S150.
41. McMullen H, Boydell V, Cordero JP, et al (2022). Accounting for complexity–Intervention design in the context of studying social accountability for repro-ductive health. Gates Open Research, 5:107.
42. Mafuta EM, Dieleman MA, Hogema LM, et al (2015). Social accountability for ma-ternal health services in Muanda and Bolenge Health Zones, Democratic Re-public of Congo: a situation analysis. BMC Health Serv Res, 15: 514.
43. Feruglio F, Nisbett N (2018). The challeng-es of institutionalizing community-level social accountability mechanisms for health and nutrition: a qualitative study in Odisha, India. BMC Health Serv Res, 18(1): 788.
44. Butler N, Johnson G, Chiweza A, et al (2020). A strategic approach to social ac-countability: Bwalo forums within the reproductive maternal and child health accountability ecosystem in Malawi. BMC Health Serv Res, 20(1): 568.
45. Boydell V, Neema S, Wright K, Hardee K (2018). Closing the gap between people and programs: lessons from implemen-tation of social accountability for family planning and reproductive health in Uganda. Afr J Reprod Health, 22(1): 73-84.
46. Agaba DK (2020). Social accountability ap-proaches employed by civil society or-ganisations to address maternal mortali-ty and morbidity in Uganda. Int J Hum Rights, 25(9): 10.1080/13642987.2020.1845158
47. Lodenstein E, Dieleman M, Gerretsen B, & Broerse JE (2017). Health provider re-sponsiveness to social accountability ini-tiatives in low-and middle-income coun-tries: a realist review. Health Policy Plan, 32(1): 125-140.
48. Gullo S, Galavotti C, Sebert Kuhlmann A, Msiska T, Hastings P, Marti CN (2017). Effects of a social accountability ap-proach, CARE’s Community Score Card, on reproductive health-related outcomes in Malawi: a cluster-randomized con-trolled evaluation. PLoS One, 12(2): e0171316.
49. Kirk T (2017). A strategic approach to so-cial accountability in Pakistan. Institute of Development Studies. Brighton UK. Available from: https://opendocs.ids.ac.uk/opendocs/bit-stream/handle/20.500.12413/13275/Wp497%20Online.pdf?sequence=1&isAllowed=y
50. Eng Netra, Vong Mun, Hort Navy (2015). Social Accountability in Service Deliv-ery in Cambodia. Phnom Penh. Cam-bodia Development Resource Institute, Cambodia. Available from: https://cdri.org.kh/storage/pdf/wp102e_1617792667.pdf
51. Jacobs B, Sam Oeun S, Ir P, et al (2020). Can social accountability improve ac-cess to free public health care for the poor? Analysis of three health equity fund configurations in Cambodia, 2015–17. Health Policy Plan, 35(6): 635-645.
52. Papp SA, Gogoi A, Campbell C (2013). Im-proving maternal health through social accountability: a case study from Orissa, India. Glob Public Health, 8(4): 449-464.
53. Nepal A, Dangol SK, Van der Kwaak A (2020). Improving maternal health ser-vices through social accountability interventions in Nepal: an analytical re-view of existing literature. Public Health Rev, 41(1):31.
54. Mafuta EM, Dieleman MA, Essink L, et al (2017). Participatory approach to design social accountability interventions to improve maternal health services: a case study from the Democratic Republic of the Congo. Glob Health Res Policy, 2: 4.
55. Boydell V, Keesbury J (2014). Improving family planning and reproductive health programs? Population Council, Washington.
2. Addink Henk (2019). Good Governance: Concept and Context. Oxford University Press, UK, pp:157-165.
3. Jones, GW (1992). The search for local accounta-bility. Strengthening local government in the 1990s. Longman, London, pp: 49-78.
4. Malena C, Forster R, Singh J (2004). Social accountability: An introduction to the concept and emerging practice. The World Bank, Washington, p: 1.
5. Francetic I, Fink G, Tediosi F (2021). Im-pact of social accountability monitoring on health facility performance: Evi-dence from Tanzania. Health Econ, 30(4): 766-785.
6. Lodenstein E, Mafuta E, Kpatchavi AC, et al (2017). Social accountability in prima-ry health care in West and Central Afri-ca: exploring the role of health facility committees. BMC Health Serv Res, 17(1): 403.
7. Esther Suter, Sara Mallinson (2015). Ac-countability for coordinated/integrated health services delivery. WHO Regional Office for Europe, Copenhagen, p:1. Available from: https://iris.who.int/bitstream/handle/10665/367061/WHO-EURO-2015-6511-46277-66941-eng.pdf?sequence=1
8. World Bank (1993). World Development Report, Investing in Health. Oxford University Press, New York. Available from: https://openknowledge.worldbank.org/handle/10986/5976
9. Argaw MD, Desta BF, Mamo E, et al (2021). Implementing a social accountability approach for maternal, neonatal, and child health service performances in Ethiopia: a pre-post study Design. Glob Health Sci Pract, 9(1): 123-135.
10. Gurung G, Derrett S, Hill PC, Gauld R (2020). The role of social audit as a so-cial accountability mechanism for strengthening governance and service delivery in the primary health care set-ting of Nepal: a qualitative study. Crit Public Health, 30(5): 612-623.
11. Chan M (2016). Making fair choices on the path to universal health coverage. Health Syst Reform, 2(1): 5-7.
12. Kantamaturapoj K, Kulthanmanusorn A, Witthayapipopsakul W, et al (2020). Leg-islating for public accountability in uni-versal health coverage, Thailand. Bull World Health Organ, 98(2): 117-125.
13. Vian T (2020). Anti-corruption, transparen-cy and accountability in health: con-cepts, frameworks, and approaches. Glob Health Action, 13(sup1): 1694744.
14. Schaaf Marta Lee Britt. Social Accountabil-ity and Legal Empowerment for Quality Maternal Health Care. (PhD thesis) Co-lombia University, USA: 2018.
15. Danhoundo G, Nasiri K, Wiktorowicz ME (2018). Improving social accountability processes in the health sector in sub-Saharan Africa: a systematic review. BMC Public Health, 18: 497.
16. Brinkerhoff DW, Jacobstein D, Kanthor J, Rajan D, Shepard K (2017). Accountability, health governance, and health systems: uncover-ing the linkages. USAID, Washington DC, pp:35-42
17. Boydell V, McMullen H, Cordero J, Steyn P, Kiare J (2019). Studying social accounta-bility in the context of health system strengthening: innovations and consid-erations for future work. Health Res Policy Sys, 17: 34.
18. Bennett S, Ekirapa-Kiracho E, Mahmood SS, et al (2020). Strengthening social ac-countability in ways that build inclusion, institutionalization and scale: reflections on FHS experience. Int J Equity Health, 19(1): 220.
19. Brummel L (2021). Social accountability be-tween consensus and confrontation: de-veloping a theoretical framework for societal accountability relationships of public sector organizations. Administra-tion & Society, 53(7): 1046-1077.
20. Charlese Boelen, Jeffery E Heck (1995). De-fining and measuring social accountability in medical schools. World Health Organiza-tion, Geneva, p: 3.
21. Rajendra ABS (2021). Social Accountability of Research Publications in Journals. Journal of Orofacial Sciences, 13(1): 1.
22. Cambridge Business English Dictionary (2022). Social accountability Definition. Available from: https://dictionary.cambridge.org/dictionary/english/social-responsibility?q=social+responsibility
23. Peters MD, Godfrey CM, Khalil H, et al (2015). Guidance for conducting system-atic scoping reviews. Int J Evid Based Healthc, 13(3): 141-146.
24. Grant MJ, Booth A (2009). A typology of reviews: an analysis of 14 review types and associated methodologies. Health In-fo Libr J, 26(2): 91-108.
25. Colquhoun HL, Levac D, O'Brien KK, et al (2014). Scoping reviews: time for clarity in definition, methods, and reporting. J Clin Epidemiol, 67(12): 1291-1294.
26. Tricco AC, Lillie E, Zarin W, et al (2018). PRISMA extension for scoping reviews (PRISMA-ScR): checklist and explana-tion. Ann Intern Med, 169(7): 467-473.
27. Banke-Thomas A, Ayomoh FI, Abejirinde IOO, et al (2021). Cost of utilising ma-ternal health services in low-and mid-dle-income countries: a systematic re-view. Int J Health Policy Manag, 10(9): 564-577.
28. McGinn E, Lipsky A (2015). Social Ac-countability: A primer for civil society organizations working in family plan-ning and reproductive health. Health policy project. U.S. Agency for Interna-tional Development, Futures Group, Health Policy Project. Washington, DC. p:18-20. Available from: https://www.healthpolicyproject.com/pubs/449_PSocialAccountabilityReportFINALEC.pdf
29. Hamal M, de Cock Buning T, De Brouwere V, et al (2018). How does social account-ability contribute to better maternal health outcomes? A qualitative study on perceived changes with government and civil society actors in Gujarat, India. BMC Health Serv Res, 18: 653.
30. Naher N, Balabanova D, Hutchinson E, et al (2020). Do social accountability ap-proaches work? A review of the litera-ture from selected low-and middle-income countries in the WHO South-East Asia region. Health Policy Plan, 35(Supplement_1): i76-i96.
31. Topp SM, Sharma A, Chileshe C, et al (2018). The health system accountability impact of prison health committees in Zambia. Int J Equity Health, 17(1): 74.
32. Mecwan S, Sheth M, Khanna R (2021). En-hancing social accountability through adolescent and youth leadership: a case study on sexual and reproductive health from Gujarat, India. Gend Dev, 29(1): 151-169.
33. Squires F, Martin Hilber A, Cordero JP, et al (2020). Social accountability for re-productive, maternal, newborn, child and adolescent health: A review of re-views. PLoS One, 15(10): e0238776.
34. Fox JA (2015). Social accountability: what does the evidence really say? World Dev, 72: 346-361.
35. Lodenstein E, Molenaar JM, Ingemann C, et al (2019). “We come as friends”: ap-proaches to social accountability by health committees in Northern Malawi. BMC Health Serv Res, 19: 1-14.
36. Schaaf M, Cant S, Cordero J, Contractor S, Wako E, Marston C (2021). Unpacking power dynamics in research and evalua-tion on social accountability for sexual and reproductive health and rights. Int J Equity Health, 20: 56.
37. Page MJ, McKenzie JE, Bossuyt PM, et al (2021). The PRISMA 2020 statement: an updated guideline for reporting system-atic reviews. Int J Surg, 88: 105906.
38. Blake C, Annorbah-Sarpei NA, Bailey C, et al (2016). Scorecards and social account-ability for improved maternal and new-born health services: a pilot in the Ashanti and Volta regions of Ghana. Int J Gynaecol Obstet, 135(3): 372-379.
39. Wangũi Machira Yvonne (2015). Integrating Social Accountability in Healthcare De-livery: Lessons Drawn from Kenya. World Bank Group, Washington, DC. Available from: https://openknowledge.worldbank.org/handle/10986/21666?locale-attribute=fr
40. Pieterse P (2019). Citizen feedback in a fragile setting: social accountability in-terventions in the primary healthcare sector in Sierra Leone. Disasters, 43 Suppl 2:S132-S150.
41. McMullen H, Boydell V, Cordero JP, et al (2022). Accounting for complexity–Intervention design in the context of studying social accountability for repro-ductive health. Gates Open Research, 5:107.
42. Mafuta EM, Dieleman MA, Hogema LM, et al (2015). Social accountability for ma-ternal health services in Muanda and Bolenge Health Zones, Democratic Re-public of Congo: a situation analysis. BMC Health Serv Res, 15: 514.
43. Feruglio F, Nisbett N (2018). The challeng-es of institutionalizing community-level social accountability mechanisms for health and nutrition: a qualitative study in Odisha, India. BMC Health Serv Res, 18(1): 788.
44. Butler N, Johnson G, Chiweza A, et al (2020). A strategic approach to social ac-countability: Bwalo forums within the reproductive maternal and child health accountability ecosystem in Malawi. BMC Health Serv Res, 20(1): 568.
45. Boydell V, Neema S, Wright K, Hardee K (2018). Closing the gap between people and programs: lessons from implemen-tation of social accountability for family planning and reproductive health in Uganda. Afr J Reprod Health, 22(1): 73-84.
46. Agaba DK (2020). Social accountability ap-proaches employed by civil society or-ganisations to address maternal mortali-ty and morbidity in Uganda. Int J Hum Rights, 25(9): 10.1080/13642987.2020.1845158
47. Lodenstein E, Dieleman M, Gerretsen B, & Broerse JE (2017). Health provider re-sponsiveness to social accountability ini-tiatives in low-and middle-income coun-tries: a realist review. Health Policy Plan, 32(1): 125-140.
48. Gullo S, Galavotti C, Sebert Kuhlmann A, Msiska T, Hastings P, Marti CN (2017). Effects of a social accountability ap-proach, CARE’s Community Score Card, on reproductive health-related outcomes in Malawi: a cluster-randomized con-trolled evaluation. PLoS One, 12(2): e0171316.
49. Kirk T (2017). A strategic approach to so-cial accountability in Pakistan. Institute of Development Studies. Brighton UK. Available from: https://opendocs.ids.ac.uk/opendocs/bit-stream/handle/20.500.12413/13275/Wp497%20Online.pdf?sequence=1&isAllowed=y
50. Eng Netra, Vong Mun, Hort Navy (2015). Social Accountability in Service Deliv-ery in Cambodia. Phnom Penh. Cam-bodia Development Resource Institute, Cambodia. Available from: https://cdri.org.kh/storage/pdf/wp102e_1617792667.pdf
51. Jacobs B, Sam Oeun S, Ir P, et al (2020). Can social accountability improve ac-cess to free public health care for the poor? Analysis of three health equity fund configurations in Cambodia, 2015–17. Health Policy Plan, 35(6): 635-645.
52. Papp SA, Gogoi A, Campbell C (2013). Im-proving maternal health through social accountability: a case study from Orissa, India. Glob Public Health, 8(4): 449-464.
53. Nepal A, Dangol SK, Van der Kwaak A (2020). Improving maternal health ser-vices through social accountability interventions in Nepal: an analytical re-view of existing literature. Public Health Rev, 41(1):31.
54. Mafuta EM, Dieleman MA, Essink L, et al (2017). Participatory approach to design social accountability interventions to improve maternal health services: a case study from the Democratic Republic of the Congo. Glob Health Res Policy, 2: 4.
55. Boydell V, Keesbury J (2014). Improving family planning and reproductive health programs? Population Council, Washington.
| Files | ||
| Issue | Vol 53 No 1 (2024) | |
| Section | Review Article(s) | |
| DOI | https://doi.org/10.18502/ijph.v53i1.14681 | |
| Keywords | ||
| Good governance Health policy Health system Social accountability | ||
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How to Cite
1.
Nejatian A, Arab M, Takian A, Shtarian K. Social Accountability in Health System Governance: A Scoping Review. Iran J Public Health. 2023;53(1):35-47.
