Social Accountability Study

Social obligation on ASRH

According to WHO, creating a supportive social environment for ASRH is a social obligation of community and citizen. Community acceptance support for service provision is significant determinant of uptake of services. There is high chance to use AFS services where communities are more aware and exists” supportive social environment “. Therefore wider social mobilsaiton and community awareness interventions are needed. As a comprehensive strategy for improving health services, community engagement should be made integral part of program design (WHO, 2009). Furthermore, WHO highlighted the researches on community participation and mobilsation in Nepal, India and Mozambique have established evidences that community participation

The citizens’ levels of awareness about their entitlements and of their capacity to use information determine the effectiveness of social accountability. Furthermore, the review highlights the ways in which bureaucratic accountability mechanisms often constrain the functioning of external accountability mechanisms. For example, meeting the expectations of relatively powerful managers further up the system may crowd out efforts to respond to citizens and patients. Organizational cultures characterized by supervision and management systems focused on compliance to centrally defined outputs and targets can constrain front line managers and providers from responding to patient and population priorities(Cleary, Molyneux, & Gilson, 2013)

Factors affecting effectiveness of Social Accountability:

Campbell and Gogoi ( 2013) presented a case study of how SA improves maternal health , they observed three “drivers” of success in social accountability – increased demand for services , intermediary group acted as lever for establishing voices of poor marginalized mothers and local leaders and services providers became sensitive to the needs of needy women . They applied simple framework of psychological underpinning of accountability and concept of ‘critical conscientisation’

Murthey and Klugman further suggests to establish strong democracy , media and strong social movement for promotion as pre- requisite for community participation in Sexual and Reproductive health and promote culture of claiming rights .

It was noted by Lodenstein et al ( 2013) that social accountability effectiveness is influenced by contextual situation . In a critical realist synthesis of literature on social accountability, they have presented a hypothesized framework of Social Accountability with configuration of context , mechanism and outcome , summarized that SA is context sensitive and outcomes are triggers by mechanisms through Citizen engagement and collective action (Lodenstein, Dieleman, Gerretsen, & Broerse,