Accountability and Service Delivery

Article
Challenges to Social
Accountability and Service
Delivery in Pakistan
Muhammad Hamza Abbas1
Vaqar Ahmed2
Abstract
This article highlights the major challenges to social accountability in Pakistan.
Based on a perception survey of 800 household-level respondents from four
provinces of Pakistan besides relevant focus group discussions and key inform-
ant interviews, the findings of the study reveal that the respondents have an
understanding of which of the basic services they are entitled to and which
are not being facilitated by public sector service providers. Owing to the trust
deficit between communities and state administration, there is a dire need for
establishing and reforming informal and formal grievance redressal mechanisms.
On the other hand, with over half of Pakistan’s population not having any formal
education, communities need to be trained in social accountability tools through
which they may access their rights and entitlements. Civil society organisations
(CSOs), working in Pakistan for over the last two decades, urgently need to intro-
duce innovative methods for community mobilisation. These CSOs are also facing
severe internal and external security threats which are impacting the effective-
ness of community-level accountability exercises. While we take stock of such
challenges, there is renewed hope that government and donor community will
support local-level CSOs to mitigate threats to social accountability interventions.
Keywords
Social accountability, communities, service delivery, CSOs and Pakistan
Social Change
46(4) 560–582
© 2016 CSD
SAGE Publications
sagepub.in/home.nav
DOI: 10.1177/0049085716666601
http://sch.sagepub.com
1
International Center for Research on Women (ICRW), Washington, DC.
2
Sustainable Development Policy Institute, Pakistan.
Corresponding author:
Muhammad Hamza Abbas, International Center for Research on Women (ICRW), 1120, 20th Street
NW, Suite 500 North, Washington, DC.
E-mail: hamzaabbas87@gmail.com

Abbas and Ahmed 561
Introduction and Background
Social accountability relates to community-based initiatives intended to improve
transparency and access to information by holding the state and its agents account-
able (Gaventa & McGee, 2010). Malena et al. (2004) explain this concept in the
context of demand for good governance; it is referred to as strengthening the
voice and building the capacity of citizens to demand greater accountability and
responsiveness from public authorities and service providers. Social accountabil-
ity is also closely linked with the concept of citizen-led accountability. A study by
the World Bank (2005) defines social accountability as a demand-side effort of
good governance and explains how communities can best interact with local
governments, service providers and the actors of the state for demanding better
service delivery in, for example, education and health (Agarwal et al., 2009).
The effectiveness of social accountability tools is highly dependent on the way
in which they are initiated and exercised. The National Institute of Administrative
Research (n.d.) in its study relates the effectiveness and success of social account-
ability mechanisms with institutionalisation: indirectly, social accountability
mechanisms try to improve the efficiency and performance of government officials
and politicians.
Social accountability is the new buzzword for development partners around
the world in order to understand the state’s and society’s synergy that can be
helpful for a better provision of public services (King, 2014). In the long term,
the major advantages of social accountability are that it has the potential to reduce
poverty, enhance service delivery, create people-centric policies and lead to the
empowerment of citizens thus strengthening democratic processes (Institute of
Development Studies, 2006). Social accountability is also closely related to the
general concept of voice and accountability.
The concept of voice, given by Brown et al. (2008), explains that this is
actually the capacity of citizens to express their views, demanding their basic
rights and complaining to those who are responsible and in control. Voice is more
effective if it is done by lobbying, protest and through proper complaint mecha-
nisms. Accountability, generically speaking, is the relationship between the state
(national and local levels) and its people (Foresti et al., 2007). Voice and account-
ability are closely interrelated but it does not mean they are the same, organised
voices lead to accountability and vice versa.
The Affiliated Network for Social Accountability (ANSA) (2012) provides
a compact framework for social accountability (see Appendix). The four pillars
of social accountability are organised and capable public groups, responsible
government, access to information and lastly, sensitivity to culture and context.
In order to achieve smooth and well-functioning demand-side mechanisms and
functions civic engagement is of highest importance. Different social account-
ability tools used all around the world, include citizens charters, a check list
of entitlements, participatory budgeting, budget tracking, Right to Information
(RTI), awareness of relevant laws, civic education, community score card (CRC),
citizens report card, participatory planning and community-led procurements
(Khadka & Bhattarai, 2012).

562 Social Change 46(4)
The concept of social accountability is new to Pakistan and is being introduced
by leading international development partners and some local non-governmental
institutions to improve the state of public service delivery in the country.
The emergence of an independent media in the country has also played the role
of catalyst in demanding rights from the state. Recently, these pressure groups
in the country have forced the government to pass the Right to Information
(RTI) Act, which allows communities and individuals access to information and
transparent mechanisms at the national, provincial and district level.
The state has also realised the importance of social accountability mecha-
nisms in the country: multiple accountability structures have been initiated by the
government in Pakistan to institutionalise accountability mechanisms, internally
and externally. The Government of Pakistan, in fact, passed a formal notification
in 1994 for forming school management committees (SMCs) and parent–teachers
associations in all its—provinces, and also earlier for the formation of health man-
agement committees with the idea to ensure better participation of communities in
decision-making processes (Khan, 2001; Khan, Kazmi & Latif, 1999).
Objectives
The objectives of this study are:
• To highlight challenges faced by CSOs and the government in implement-
ing social accountability mechanisms in Pakistan.
• To inquire about the state of service delivery in the social sectors of Punjab
and Khyber Pakhtunkwa. These sectors include education, health, water
and sanitation.
• To identify the course correction required in the social accountability mech-
anisms currently in practice.
Our starting point is to identify gaps in existing literature and outline how our
study adds to the existing body of knowledge. The third section provides detailed
methodology of the study followed by the results from survey exercises and key
informant interview (KIIs). In a separate section, we also provide results from our
focus group discussions (FGDs). We conclude with specific recommendations to
CSOs on how best to design and implement social accountability interventions in
social sectors. The appendix also contains few of the important initiatives by
CSOs related to social accountability.
Gaps in the Literature
It is now encouraging to see a growing local literature on social accountability in
Pakistan and South Asia. Bhidal (2011) has applied social accountability tools
such as citizens’report cards for service delivery of education. The findings depict
a dismal position of service delivery in the education sector and SMCs have failed
to deliver. There is a dire need to redefine the work and processes of SMCs or

Abbas and Ahmed 563
some alternative approach for performance monitoring. Other recommendations
include participatory budgeting and an improved quality of education.
A baseline study for AAWAZ voice—and accountability programme in
Khyber Pakhtunkhwa and Punjab provinces of Pakistan evaluates the percep-
tion of women and community members on service delivery in the education,
health, water and sanitation. A key recommendation that needs to be put in place
is the participatory approach which includes the clients of services in the decision-
making processes which deal with local-level resource allocation, quality of
services and timely access (Ahmed, 2015; SDPI, 2012).
CPDI (2013) has used RTI legislation as their entry point for promoting greater
transparency and accountability in public sector financial management. The chal-
lenges to social accountability in Pakistan mentioned in Bhidal (2013) include
the state’s resistance to service delivery reforms, overlapping layers of account-
ability, vested interests in important social sectors like education and health,
implementation flaws in RTI legislation, decentralisation of fiscal powers to the
provincial governments and absence of enabling environment for social mobilisa-
tion owing to security issues (Suleri et al., 2013).
There is also some literature available on the challenges specific to the service
delivery in education (Watson & Khan, 2005), health (Ahmed & Ahmed, 2014)
accountability failures at local levels (Mohmand & Cheema, 2007) and the impor-
tance of decentralisation for effective service delivery processes (Ahmad, 2005).
Although the studies mentioned above provide details on social accountabil-
ity interventions in various sectors, we still lack literature where consolidated
and sector-wise challenges to social accountability implementation by CSOs are
inventoried. This study goes beyond the existing literature by:
• Taking into account the qualitative perception of individuals on the state
of service delivery in social sectors. Our aim here is to (i) inquire from the
household and community as to how they would like CSOs to intervene and
in which social sectors; (ii) inquire from the practitioners of social account-
ability about the risks faced on the ground and how these may be mitigated
in the future.
• Categorisation of challenges into immediate, medium and longer-term time
situations. We then go on to suggest that immediate challenges, if addressed
properly, may prevent many of the medium to longer term challenges or
risks to occur.
Methodology
A mix of a qualitative and quantitative approach has been used to access the
potential risks and challenges to social accountability in Pakistan. We validate our
results in the light of existing literature. As part of our quantitative methodology,
we provide findings from one of our household-level survey (n = 800) seeking
information from people regarding key areas where service delivery is lacking.
There were three main objectives of conducting this survey and FGDs with the
households:

• There are existing social accountability forums at the local level, for
example, SMCs, Health Management Committees and we wanted to know
their effectiveness.
• We also wanted to know what challenges (even threats) people face while
they become part of the social accountability processes and what are major
issues Pakistani society is facing and how they can be solved.
• Do people feel that their giving time and resource to social accountability
activities is rendering on-ground results?
Respondents for KIIs and FDGs were selected on the basis of their expertise and
experiences in the field of voice and accountability in Pakistan, KIIs were those
who are helping in the sustainability, efficiency and scaling-up of the social
accountability agenda in the country. KII (10 in number) and participants of FGDs
were selected from five different categories: CSOs and experts; donor agencies in
Pakistan; head of organisations working on social accountability; government
officials and lastly, from the business community.
We surveyed 800 households, selected through a well-structured process
of random selection from urban and rural areas in select districts. The sample
included the four largest provinces in the country (see Table 1) and demographic
distribution was also taken into account—however, it ignored Azad Jammu and
Kashmir (Gilgit-Baltistan and tribal area).1
The questionnaire was subjected
to thorough pilot-testing and the feedback from pilots helped in improving the
survey instruments further.
Results I: Institutional and Quantitative Analysis
Institutional Formation and Implementation
The government has institutionalised accountability structures for internal
and external accountability in the country. There exists, the Auditor General
Departments, Public Accounts Committee, Ombudsman, Federal Investigation
Agency, Anti-Corruption Establishments and National Accountability Bureau.
There are clear laws relating to the conduct of business for the public servant and
for curbing the menace of corruption in Pakistan falling under the Government
Servant Rules, 1964; the Civil Servants (Efficiency and Discipline) Rules, 1973;
Table 1. Survey Sampling Methodology
Provinces Sample Size Districts
Punjab 300 Faisalabad and Multan
Sindh 300 Karachi and Sukkur
Khyber Pakhtunkhwa 100 Peshawar
Balochistan 100 Quetta
Total sample size 800
Source: SDPI (2013).

Abbas and Ahmed 565
Pakistan’s Penal Code XLV of 1860; the Prevention of Corruption Act, 1947 and
the Federal Investigation Act, 1974.
At the national level, social accountability structures have been facilitated
through an amendment in the Constitution of Pakistan. Article 19-A in the con-
stitution says, every citizen will have RTI in all matters of public importance.
Given that after the 18th constitutional amendment, provinces have power to pass
their own RTI bills, PILDAT (2016) produced a comparative scorecard for all
the country’s provinces on the RTI and Freedom of Information (FoI) regimes.
The overall ranking of the provinces is given below:
1. Khyber Pakhtunkhwa with 73 per cent secured the first position for its
Right to Information Act, 2013 and because of the formation of Right to
Information Commission in the province.
2. Punjab Province with 65 per cent secured the second position for the
Transparency and Right to Information Act, 2013, and the formation of the
Punjab Information Commission.
3. Balochistan Province with 29.3 per cent secured third position for it
Freedom of Information Act, 2005.
4. The federal government with 25.6 per cent was placed fourth for its
Freedom of Information Ordinance, 2002.
5. Sindh’s provincial government with 24 per cent was positioned last.
As part of the Constitutional Amendment No. 18, the following article was added
to Chapter 1 of the Constitution entitled ‘Fundamental Rights’. The fundamental
Right to Education was also guaranteed for all citizens of Pakistan by the
Constitution. The article says: ‘The State shall provide free and compulsory
education to all children of the age of 5 to 16 years in such a manner as may
be determined by law’ (Constitution of Pakistan, Article 25-A, Chapter 1:
Fundamental Rights).
Implementation and Effectiveness Issues
The major issues relating to accountability structures in Pakistan are the loopholes
in the systems and procedures. In Pakistan accountability processes are complex
and non-standardised and they are designed according to the needs of each depart-
ment not for the public at large (Iftikhar, 2010). In major public offices, proce-
dures are cumbersome and operated manually.
Astudy conducted by government of Khyber Pakhtunkhwa on Citizen’s Centric
Governance (2011) provides issues and challenges to social accountability in the
province which resonate with the qualitative results below.
The dream of effective social accountability mechanisms cannot be fulfilled
until or unless the government realises the need to revamp the local government
system in Pakistan (Guess, 2005). There is significant evidence to validate this
argument especially in the context of Pakistan where local governments offer direct
contact between local policy makers and people for whom it served as a better
channel for to communicate their demands to the government (Hasnain, 2010).

Local Government System
According to the 18th Constitutional Amendment, Balochistan Province passed
the Local Government Act in 2010, provinces of Punjab, Khyber Pakhtunkhwa
and Sindh passed their Local Government Acts in 2013. UNDP (2013) defines
these laws as a great achievement towards decentralisation despite the lack of
passion and an effective consultation process during their formulations stage.
There are a number of important distinctions in the Local GovernmentActs passed
by the provinces in comparison to the Local Government Act of 2001, passed by
the President General Musharraf’s government, in that the provinces did not
devolve sufficient functions and powers to the local government and that they still
had the power to dismiss representatives on the basis of an executive order from
the provincial government.
The Khyber Pakhtunkhwa Act only gave the discretion to the local government
to utilise financial resources and it empowered the Village and Neighbourhood
Councils to supervise all local government functionaries including the revenue
division of the district (UNDP, 2013). Other provinces did not pass on the dis-
cretion to use financial resources and the provincial government would allocate
funds on their own.
Women, on the other hand, faced many challenges to their right to vote.
In a number of districts in Khyber Pakhtunkhwa women were barred from voting
and the sad part was that political parties mutually agreed not to allow women
to vote (Boone, 2015). The districts where women were not given due chance to
vote in the local elections include some parts of the Malakand Division, the Hangu
District and the Lower Dir district.
On the Issue of Corruption
Our survey findings, as explained above, also brought to light that a significant
high number of businesses have reported that corruption is one of the big issues,
coupled with unemployment and the law and order situation, facing the country.
According to the Corruption Perception Index by Transparency International
(2015), Pakistan globally stands at 117 out of 168 countries with overall score of
only 30 out of 100. The corruption index organised by Transparency International
ranks countries based on how corrupt a country’s public sector is perceived to be.
Pakistan’s corruption ranking has improved significantly over the years: in 2006,
Pakistan was ranked 142 but the overall score still remained on the lower side.
The recent investigations, entitled the Panama papers, have also highlighted
how bad the situation of corruption is in the country, and indicated how the
Prime Minister’s family and many other notables were named for holding off-
shore companies and using the system for their own benefits. In order to effec-
tively tackle corruption, the country needs a comprehensive national-level anti-
corruption strategy.
Relevant Survey Findings
Figure 1 exhibits survey findings related to major demands for public service
delivery at large. Our results revealed that respondents clearly highlighted that the

Figure1.IssuesAffectingPakistaniSociety
Source:SDPISurveyUnit,Pakistan.

weak supply side of public sector service delivery was the biggest challenge to
community engagement. For example, 54.6 per cent replied that a lack of social
services was the biggest issue, 28.9 per cent replied that corruption was the
major issue, 53.3 per cent replied the issue was unemployment and 36.8 per cent
responded that the volatile law and order situation in the country was a huge
challenge.
The relevance of this data related to social accountability frameworks could be
seen in the highest percentage of responses associated with the lack of an effective
public service delivery. This survey revealed that social accountability mecha-
nisms and initiatives would need to be tailored for each sector if communities
were to be enabled in demanding better quality services from the public sector.
Private Sector and Social Accountability
As government’s revenue collection in most developing countries is meagre and
therefore not be sufficient to deliver effectively public goods, a case could be
made for limiting the government’s role to formulating socio-economic policies
and regulation and leaving the management of public sector units to the private
sector. Figure 2 elaborates where the private sector could be useful in dealing with
the major issues confronting Pakistan. Twenty-one per cent believed that it could
be helpful in creating employment; 9.3 per cent felt that private sector involve-
ment could improve social services, 9.8 per cent believed that competition and
entry of more firms could benefit the energy sector and end the ongoing energy
crisis; 5 per cent favoured private sector participation in education and 5.3 per
cent opted for its involvement in the health sector.
Ahmad (2008) also emphasised that the private sector could join hands with
communities for strong accountability mechanisms in the country which would
lead to better service delivery and good governance in the country: indeed, a per-
ception strongly supported by the survey’s respondents. Such a nexus was also
in the interest of the private sector which was perceived as safe and secure and
vibrant communities will imply a rising future demand, free and fair markets, and
a more educated and skilled pool of labour force.
Results II: Qualitative Results
Security and Safety Issues
Mainly all of the key informants were of the view that internal security was the
biggest risk as well as a challenge to social accountability in Pakistan (for detailed
challenges to social accountability, see Figure 3). The programmes and people
who are actively involved in strengthening social accountability in Pakistan face
security threats from the extremists and terrorist groups. Pakistan is facing this
menace from over a decade now and these threats have placed a huge obstacle in
the smooth functioning of overall social accountability system in the Khyber
Pakhtunkwa and Balochistan Provinces. The security risk to social accountability
comes from both security outfits and the extremists. Educating people is an unde-
sirable activity in the views of the extremists which effectively hampers service
delivery in public sector schools and colleagues (Buchanan & Tollison, 1984).

Figure2.WherePrivateSectorCanHelp?
Source:SDPISurveyUnit,Pakistan.

Figure 3. Negative Impacts on Social Accountability Initiatives.
Source: Authors’ own depiction from KIIs and FGDs.
Functioning of Local Government System
Devolution and decentralisation in Pakistan have in the past helped communities
to stimulate pro-accountability processes at the local level. The basic idea behind
decentralisation was to take the public representatives closer to citizens (World
Bank, 2005). All the provinces have now passed legislation and implemented the
local government system. However, Provincial Local Government Acts provide
inadequate autonomy to local authorities, both in terms of exercise of power for
service delivery and financial management, except for the Khyber Pakhtunkhwa
government, so there is still a dire need for improvement (UNDP, 2013).
Government’s Priorities and Lack of Political Motivation
The forces of clergy and traditional feudal lords still exercised substantial power
over formal and informal power systems. Further, parliamentarians had their own
political agendas and bureaucracy have their own interests. In Pakistan, there was
a fear of adopting a social accountability framework at the local government level
because it was felt that vulnerabilities of the government might get exposed
(Hasnain, 2008). The government was only interested in leading those initiatives
that were performing under their own umbrella. The KIs (key informants) also
said that whenever any government officials were aware of a programme and they
were ready to work in close collaboration with CSOs and communities, suddenly
the relevant government official would get posted somewhere else. Once this
happened, the community lost the entire social capital and the rapport that had
been with the government and associated officials.
Flaws in the Supply Side of Service Delivery
There were certain risks and challenges to social accountability that were contin-
gent upon the supply side of the system: these were a lack of an enabling environ-
ment, legal and regulatory frameworks, an accommodating political environment
and an inaccessible government. Practitioners who were working for demand
side, talked about the rights of citizens, freedom of speech and RTI without

Abbas and Ahmed 571
highlighting the fact that those who were duty bearers did not care about these
things. According to these practitioners (Ahmad, 2008; Khan, 2001), while there
were laws related to the above-mentioned rights, however, two issues hindered
the receipt of such rights—a general lack of knowledge in claiming rights and a
lack of community-based platforms that could act as pressure groups.
Pakistan was among those countries where resource allocation for the non-
development expenditures was a serious problem which also resulted in poor
service delivery. Development expenditures were always on the lower side of
government priorities. The 2016–2017 Budget revealed that development expen-
ditures were PKR 1.05 trillion, whereas the current expenditures was PKR 4.03
trillion (MoF, 2016). The majority of funds that were allocated to development
expenditures was used for infrastructure projects like building roads, bridges,
railways and airports, while inadequate allocations were made for educa-
tion, health, water and sanitation. This year alone, infrastructure development
expenditures (roads, bridges, railways and so on) would be receiving more than
50 per cent of the development expenditures by the federal government.
Cultural Norms
Social accountability was highly dependent on the cultural norms and practices.
There was always a risk whenever social accountability initiatives were challeng-
ing the authority of those who were controlling systems and thought themselves
as an authority and possessor of all the powers (Jejeebhoy & Sathar, 2001).
Even in places where informal decision-making institutions were in place, tribal
elders or influential people, for example, felt threatened by the CSOs which
were trying to build upon scientific methods and introduce social accountability
interventions.
Different social accountability programmes in Pakistan resulted in developing
accountability committees and other relevant forums and they very often ignored
the presence of women and minorities (Mohmand & Cheema, 2007).
CSOs Acceptance in Society and within the Government
Most programmes that entailed social accountability were by CSOs in Pakistan.
Typically though such CSOs really worked under many restrictions, ranging from
signing Memorandums of Understanding (MoUs) with the government to general
acceptability by the general public. As in rest of the developing world these CSOs
not only faced restrictions in their formation but also certain faced constraints in
their functioning. There were also efforts made to tighten rules regarding their
foreign funding (UNDP, 2010).
The CSOs acceptance within the government was also fairly weak. For instance,
as pointed out by one of the KIs, the Securities and Exchange Commission of
Pakistan (SECP) now wanted all CSOs in Pakistan to be registered with them, a
step that reflected the weakness of the country’s legislation framework. In October
2015, the Interior Ministry of Pakistan issued a policy for regulation of interna-
tional non-governmental organisations (INGOs), under which the MoUs between

the government and INGOs was being revoked. The CSOs lodged new applica-
tions for no objection certificates (NOCs) but as of January 2016 a number of
INGOs reported that they had not received any response from the Interior Ministry
(ICNL, 2016).According to recent available statistics, there were 20 large interna-
tional aid organisations which had not been issued NoCs: some of these organisa-
tions included the International Republic Institute, National Democratic Institute,
Save the Children and Oxfam GB (Miraj, 2015). As it was, many CSOs working
in the Federally Administrative Tribal Areas (FATA) had to undergo extensive
legal procedures and also seek approval from the Frontier Disaster Management
Authority or the Provincial Disaster Management Authority to get a NoC.
Information Gap and Lack of Research
The KIs also suggested that there were clear information gaps which were not
conducive for strong social accountability framework. There was an underlying
fear that the voice of the people was not heard because that would prominently
publicise people’s wish lists (Keohane, 2003). When these were not fulfilled they
would lead to disappointment, hyper-responses and had a potential to create a
hostile environment. Demand-side accountability therefore needed to collaborate
with supply-side accountability which, in turn, needed to be facilitated by research
and a level of technical guidance and competence. In this context, KIs highlighted
that local communities were not provided with proper research and toolkits
that could help them with a better understanding of what social accountability
actually referred to. There was also the risk of creating hostile relationships
when communities misunderstood the concept of accountability (Pasha, Iqbal &
Mumtaz, 2002).
Among donors and local non-governmental organisations (NGOs), no exercise
was undertaken to learn from programmes that were already functional or had
finished. There was also no move to imbibe international best practices. Most of
the knowledge management toolkits, which were theoretically in place during
the programmes undertaken by CSOs, did not culminate in strong documentation
based either on lessons learnt or on experiences gained.
There were also a few challenges related to the evaluation and accurate captur-
ing of the impact of various social accountability initiatives in Pakistan. Social
accountability programmes and similar programmes, like voice and account-
ability, were aimed at reducing poverty. But there was not sufficient evidence
available that these programmes did indeed have an effect on reducing poverty
in Pakistan though in the surrounding regions there was plenty of proof available
(ANSA, 2012).
Flaws in Project Design and Lack of Follow-up
Most of the KIs stated that there were challenges arising from the basic design of
the programmes that were being implemented in Pakistan. The donors had their
own understanding of social accountability and its framework without taking into
account the major risks and challenges that these programmes would face in the

Abbas and Ahmed 573
context of Pakistan. The theory of a changed framework, followed by the usual
log framing exercise for project monitoring, did not comprehensively encompass
risks to life, assets and even livelihoods, a fact also mentioned by Watson and
Khan (2005). Log frames, once set, were rarely changed during the project course
as development partners feared a complete re-evaluation and uncertainty if they
requested for revisions in log frames.Another problem highlighted by the KIs was
that due to flaws in the programmes aimed at social accountability the follow-up
of accountability interventions in latter periods became difficult.
It was found that development partners were still reluctant to commit to long-
term funding of social accountability interventions. It was proposed by some that
the indicators to evaluate accountability interventions should also include trickle
down impacts for marginalised communities. Lastly, another failing in most
programmes was weak exit strategies.
Duplication of Efforts
Many local organisations also felt that they were unaware of similar projects
being undertaken by other like-minded bodies. Fragmented interventions, and a
certain level of ‘donor fatigue’, could be seen in instances where the donors were
placing large funds for similar projects thus negatively effecting patterns of
accountability interventions. Overtime, CSOs became competitors in the same
geographic area. Some had even been working for decades yet no effort was made
in creating a coalition of these groups. This resulted in different departments
being reached by many different groups ending up with the message being diluted.
Several local-level CSOs complained that donors who financed social accounta-
bility interventions preferred sticking to a short-term project mode and not scaling
interventions in a consolidated and programmatic manner (Ebrahim, 2003).
Media Engagement
It was said that social accountability interventions were not usually on the
radar of media organisation which offered little space to project such initiatives.
Besides, most media entities worked from urban areas and their understanding of
civil society work in rural communities was weak. It was also felt that any impact
or changes at the micro-level should be well documented in the print, electronic
and social media so that examples and role models could be made more visible.
Results III: Focus Group Discussions
This section outlined lapses in service delivery and provided a general entry point
for various CSOs designing their social accountability interventions. We conducted
FGDs with women in six districts from the Punjab province of Pakistan (including
Lodran, Sialkot, Pakpattan and Jhang) and Khyber Pakhtunkwa Province (includ-
ing Dera Ismail Khan and Upper Dir). We briefly discuss the results below.

Service Delivery in Education
In Khyber Pakhtunkhwa, a participant in the FGD said that they did not send their
children to government schools, because there was no accountability of govern-
ment teachers. In the boys’school there was also an additional problems of teacher
absenteeism. Some comments included. ‘The teacher is not serious; he just goes
around having meals at other people’s homes, not teaching’. Such an attitude basi-
cally showed the lack of social accountability and interest of communities.
The problems with the education system in Punjab and its service delivery
were different from those found in Khyber Pakhtunkhwa. Female participants
reported that though there were plenty of government schools the public preferred
private schools for their children. It was felt that children received better atten-
tion in private schools. Furthermore, enabling facilities, including washrooms and
drinking water, in female schools were missing.
Service Delivery in Health
FGD results from Khyber Pakhtunkhwa portrayed a dismal picture of the health
situation in the province: there were no proper hospitals; the medical staff, if it
was there at all, was not very supportive and one could see long queues of patients
waiting to receive treatment. Some of the participants also added that in their
areas there were no lady health workers who could facilitate the treatment of
female patients. Weak monitoring systems in the public sector health systems also
undermined the effectiveness of grievance redressal mechanisms.
In the case of Punjab, there were clear differences seen in the rural and urban
areas of Punjab. People from urban areas reported that there were many improve-
ments in the hospital in the area; especially in the emergency wards. However,
improvements depended on the availability of a good doctor. If he/she left things
would fall apart again. In rural areas some irregularities were reported by female
participants. For example, they said there were no medicines available in the
hospitals. The likelihood of sustained disease and even death seemed higher in
the case of female patients.
Water and Sanitation
Female participants from Khyber Pakhtunkhwa reported that getting clean drink-
ing water was quite difficult. Many of them had to go fill cans from the river
which located 2–2.5 kilometres away from their home. With regard to sanitation
there were no formal amenities. Said respondent: ‘Most of us go into the fields for
urination or defecation.’ Some people would dig a hole in the ground and then
build a temporary shed on the top. Some schemes and programmes had put in
place by the government but the respondents showed dissatisfaction over the
condition of sanitation facilities and clean water supply in the countryside and
even in urban localities.
Sanitation and potable water was an issue in most districts of the Punjab,
female participants reported there was contaminated water in their areas and but

Abbas and Ahmed 575
their request for redressal was not being heard by the government. Additionally,
no collective effort was being made to tackle these basic necessities. From the
FDGS it emerged that there were no sewage lines or septic tanks, and sometimes
when water was drawn there sewage was found. The water systems were so inad-
equate and unhygienic that at times drinking water had the smell of gutter water.
Military Operation and Its Impact on the Social Sector in Khyber
Pakhtunkhwa
Since 2008, more than five million people from Khyber Pakhtunkhwa and the
FATAhad been registered as displaced.According to statistics from the UNOCHA,
the military operations in North Waziristan (NW) and Bara Agency that began in
2014 further aggravated the situation, adding 770,000 to the count of internally
displaced persons (IDPs).2
The huge influx of IDPs in Khyber Pakhtunkhwa had
resulted in further pressure on the already inadequate services in the province.
Nearly half of IDPs children, in the age group of 5–18 years, were not attend-
ing schools. The major reasons that were highlighted in the IVAP (2015) study
were proximity to schools, unavailability of teachers, no separate schools for
girls and children had to work to financially support their families. When asked
about the use of government health facilities, significantly, a huge number of IDPs
reported that they visited government health facilities in the region. The study
also showed that those who visited government health facilities reported that
institutions lacked proper medicines, equipment and female doctors. Almost one-
third of the IDPs surveyed by the study showed they were not using safe water for
drinking which came from wells and canals.
Conclusion
This study essentially aimed to find out at the household level, possible social
accountability tools, that could used for improving public service delivery.
We also inquired from practitioners of social accountability in Pakistan, the
current and future challenges facing this issue at the local level. This paper used
both qualitative and quantitative research methods to access the potential risks
and challenges to social accountability in Pakistan, and these results were
validated through a comprehensive literature review.
The access to public service delivery of basic social services remained a
challenge for the people living in Punjab and Khyber Pakhtunkhwa. This situa-
tion was further exacerbated by corruption in accessing entitlements and sluggish
resolution of localised conflicts. Our findings suggested that social accountability
mechanisms would need to be tailored for each of these issues if communities
were to be enabled in demanding better quality services from officials. The tailor-
ing of such mechanisms would be aided by local political economy analysis.
The major challenge to social accountability was the volatile law and order
situation spread across the country; fragmented government priorities; multipli-
city of programmes by federal and provincial governments; flaws in the supply

side of service delivery; political intervention in the appointments of education
and health officials; cultural norms that prevented participation of women, lack of
local-levelresearchondriversofsocialaccountability;thelackofCSOsacceptance
by society and government; difficulties in carrying out impact assessments of pilot
social accountability initiatives, weak follow-ups of existing initiatives and a lack
of donor coordination on similar projects, which, in turn, threatened sustainability
of existing initiatives. The households in most locations surveyed for this paper
were found to be ignorant about the grievance redressal mechanisms in turn
leading to a feeling of general helplessness.
Weaknesses in the implementation of local government acts by provincial
governments were also one of the important reasons for poor service delivery and
weak social accountability mechanisms in the country. The provincial assemblies,
it was felt, should recognise how important a strong local government system
was for good governance and an improved service delivery. Women were again
marginalised in the new local government system, and in a number of districts
they were even barred from using their very basic right of voting. The lack of
civil service reform to improve public services was also missing in the current
narrative.
We saw in this paper that current strategies, aimed at strengthening social
accountability, were often found to be short term, while the long-term and sustain-
ability dimension were ignored. Other multiple issues were also bypassed while
formulating such strategies such as the lack of trained human resources, enabling
institutions and trained CSOs.
Demand-side accountability could not achieve a level of sustainability until
and unless it was supported by a responsive supply-side accountability. So CSOs
needed to work simultaneously with the state machinery in order to strengthen
and shape political will towards community development and to make both
communities and officials responsive towards their responsibilities. In this
respect, a game changer could be a deregulated media and relatively independent
senior judiciary in Pakistan. Both these quarters had the mandate and reach to
bring to the attention of policy stakeholders issues that are critical to a society’s
well-being.

Abbas and Ahmed 577
Appendix ANSA Framework

TableA1.FewImportantInitiativesbyCivilSocietyOrganisationsinPakistan
MajorPartnerOrganisationsSocialAccountabilityApproach/ProjectsGeographicalCoverage
TheAsiaFoundationandFreeFairElection
Network(FAFEN)andTrustforDemocratic
EducationandAccountability(TDEA).
Donor:USAID
ProjectName:StrengtheningCitizensVoiceandPublic
Accountability(Citizen’sVoiceProject)1
SocialAccountability(SA)tool:Multiple
AllthefourProvincesofPakistan.
TDEAandTheAsiaFoundation
Donor:DepartmentforInternational
Development(DfID),UKaid.
ProjectName:SupportingTransparency,Accountability,
andElectoralProcessesinPakistan(STAEP)2
SAtools:CivicEducation,ParticipatoryPlanning,Social
Budgetingetc.
AffiliatedNetworkforSocialAccountability
(ANSA)andSustainableDevelopmentPolicy
Institute(SDPI)
Donor:ANSA
ProjectName:EquitableEducationinPakistan:
AddressingGenderandRural-UrbangapsinLower
SecondaryEducationinPakistan.
SAtools:CitizensReportCard(CRC)
RawalpindiandIslamabad.
ANSAandCentreforPeaceandDevelopment
Initiative
Donor:ANSA
ProjectName:PromotingTransparentandAccountable
RegimeforPublicprocurementRegimeinPakistan.
SAtools:RighttoInformation(RTI)andBudgetTracking.
RawalpindiandJhang
ANSAandShehri-CBE
Donor:ANSA
Project:PeopleandLand:EmpoweringCommunitiesfor
SocialJustice-ACaseStudy
SAtools:CitizensScoreCard
RuralKarachi
CentreforCivicEducationinPakistanProject:MultipleinitiativesonCivicEducationand
involvementofcommunities.
SAtools:RTI,civiceducationetc.
DAIandDFIDProject:IlmIdeas
SATools:DemandAccountabilityandpromoteinnovation
inPakistan’seducationsector
(TableA1continued)

MajorPartnerOrganisationsSocialAccountabilityApproach/ProjectsGeographicalCoverage
JohnHopkinsUniversityandDFIDProject:Empowerment,VoiceandAccountabilityfor
BetterHealthandNutrition
SAtools:TBD
KhyberPakhtunkhwaandPunjab
CPDIandNEDProject:StrengtheningCivilSocietytoImprove
Accountability
SATools:BudgetTrackingandMonitoring
Rawalpindi
InternationalRepublicanInstitute(IRI)Project:DemocraticGovernanceAllthefourProvincesofPakistan.
SATool:CivicEngagementandStrengtheningPoliticalParties
AccountabilityLabProject:AccountabilityIncubatorFlagshipProgramforYoung
LeadersinPakistan
NationalEndowmentforDemocracy(NED)Project:‘TheAwakening’ASocietyforSocial&Cultural
Development
SATools:Civicengagement
Swat,KhyberPakhtunkhwa
Source: ANSA,CentreforCivicEducation,TheAsiaFoundation,NED,Accountabilitylab,IRI,CPDI,DfIDandSDPI.
1 Available:http://asiafoundation.org/project/projectsearch.php?country=pakistan#
2 Ibid.
(TableA1continued)

Notes
1. The views expressed are those of the authors and not of the Council of Social
Development or Social Change.
2. For more details please visit: http://www.humanitarianresponse.info/system/files/
documents/files/PAK691_Pakistan_Humanitarian_Snapshot_Jan15_v1_A4_20150130_
0.pdf
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