Evidence of Social Accountability_Caroline Poirrier_5.7.14


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  • 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?
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  • Disseminate user friendly resources to improve design, monitoring, and results reporting
  • Evidence of Social Accountability_Caroline Poirrier_5.7.14

    1. 1. Building evidence and supporting effective social accountability Results for Development Institute Washington, D.C. May 6th, 2014 Name of presenter(s)
    2. 2. Agenda 2 | R4D.org 1. R4D’s Social Accountability Experience 2. Transparency for Development (T4D) 3. Social Accountability Atlas & Center
    3. 3. R4D’s Social Accountability Experience 3 | R4D.org
    4. 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. 5. R4D’s Evaluation and Evidence Work: Transparency for Development (T4D) 5 | R4D.org
    6. 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. 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. 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. 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. 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. 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. 12 | R4D.org12 Example of a “levers and barriers” scorecard - giving birth in a facility
    13. 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. 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.
    15. 15. R4D’s: Social Accountability Atlas & Center 15 | R4D.org
    16. 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. 17. Social Accountability Atlas and Center basics 17 | R4D.org • Pilot in South East Asia • Pilot funded by USAID • Timeline: soft launch Summer 2014
    18. 18. Thank you! 18 | R4D.org