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Evidence of Social Accountability_Caroline Poirrier_5.7.14
1. Building evidence and
supporting effective social
accountability
Results for Development Institute
Washington, D.C.
May 6th, 2014
Name of presenter(s)
2. Agenda
2 | R4D.org
1. R4D’s Social Accountability Experience
2. Transparency for Development (T4D)
3. Social Accountability Atlas & Center
4. Context & R4D’s Social Accountability Work
4 | R4D.org
Since 2006, R4D has been providing direct support to civil society
organizations carrying out SAc projects
Financial and technical support; peer learning
PETS; absenteeism studies; CRC; CSC
Take-aways:
1. More evidence is needed about when and how SAc has
an impact
2. Evidence and experience need to be shared & leveraged
for better SAc
Evaluation work & Social Accountability Atlas
5. R4D’s Evaluation and Evidence Work:
Transparency for Development (T4D)
5 | R4D.org
6. 6 | R4D.org
• Practical information about effective
design features for different contexts
• Smarter, more effective SAc
CSOs
• Evidence about SAc’s impact on health
outcomes
• SAc for strengthened health delivery
Health sector
experts and
policymakers
• SAc interventions with high potential for
impact
• Investing in better and smarter SAc
Donors
• Help shape the agenda for the next
generation of research around SAc
• More actionable evidence
Academics
T4D Goal:
To generate actionable evidence on whether and how a well-
designed social accountability intervention can improve health
outcomes.
7. T4D basics
7 | R4D.org
• Partner: Harvard Kennedy School
• Funding from Hewlett Foundation, Gates
Foundation, DfID
• 5 year project, 2014-8
• Focus countries: Tanzania and Indonesia
• Community scorecard “plus” (CSC-plus)
• Health Focus: Maternal & Newborn Health
• Two phases; mixed methods
8. T4D : Methods and Research Questions
8 | R4D.org
RCTs:
What is the effect of the intervention on the quality of health service
delivery?
What is the effect of the intervention on individual health outcomes?
Case Study/ Qualitative Research:
What are the mechanisms through which these occur?
What is the role of context in shaping these effects?
How do interventions affect citizen’s perceptions of empowerment &
efficacy?
How can the design of the intervention be improved?
Cost-Effectiveness Analysis Research Questions:
How do SAc interventions compare to alternatives in terms of cost-
effectiveness?
9. T4D intervention – “CSC plus”
9 | R4D.org
Intervention
Builds upon existing literature and experience
Co-designed with local partners
Information
Gathering
about outcomes
and problems in
maternal and
newborn health
Community
Meeting
to (1) review
information and (2)
decide on
community action
Social Action
based on
discussions,
community will
decide social action
to take to improve
health
10. T4D intervention – “CSC plus”
10 | R4D.org
Information
Gathering
about
outcomes and
problems in
maternal and
newborn
health
1. Collect data on potential health and
service delivery problems
• information on community health status
and health outcomes
• issues with facilities - resource and
staffing levels, absentee rates, client
satisfaction, or comparative
2. Generate a simple scorecard
• Analyze data
• Summarize key findings
11. 11 | R4D.org
Example of a “levers” scorecard
Indicator Local statistics
First antenatal visit
in first trimester
Quality of Antenatal
care
Giving birth in a
health facility
Seeing health
worker within 2
days of birth
11
12. 12 | R4D.org12
Example of a “levers and barriers” scorecard - giving
birth in a facility
13. T4D intervention – “CSC plus”
13 | R4D.org
Community
Meeting
to (1) review
information
and (2)
decide on
community
action
CSO Facilitators
• Present information to communities
• Facilitate discussion by communities and
possible actions to take to overcome the
problems
• Each community will make a decision about
what “social” action they want to take
14. T4D intervention – “CSC plus”
14 | R4D.org
Community
Meeting
to (1) review
information
and (2)
decide on
community
action
Communities
The intervention incorporates a flexible
social action or “accountability”
component, selected by community
• Carry out (independently) the Social Action
they choose based on context
• monitoring problems at the facility level,
• interface meetings with midwives to
improve service,
• going to sub-district health officers;
• public hearings;
• petitioning of policymakers; etc.
16. Social Accountability Atlas
– Goal & approaches
16 | R4D.org
Goal: To improve the quality and impact of SAc
interventions
By creating a dynamic & user-friendly
online platform that will
• provide accessible, credible information on actual SAc
interventions facilitate knowledge sharing and collaboration
between and among CSOs, funders, researchers and
policymakers
17. Social Accountability Atlas and Center basics
17 | R4D.org
• Pilot in South East Asia
• Pilot funded by USAID
• Timeline: soft launch Summer 2014
Phase II is dependent on phase IIf Phase I reveals positive impacts on health service delivery and individual health outcomes,Can the intervention be scaled and generalized beyond the two countries investigated in Phase I?
Ex.
Ex.
Disseminate user friendly resources to improve design, monitoring, and results reporting