Strengthening accountability: A mapping of studies in Sub-Saharan Africa
This paper describes the types, implementation, effectiveness and future potential of MNH accountability mechanisms in Sub-Saharan Africa, for improving MNH outcomes in the 2030 development agenda.
The review provides a conceptual framework presenting types of accountability and the mechanisms through which they operate, which are:
Performance Accountability: eg. implemented through maternal and perinatal death surveillance and response (MDSR), professional associations or the use of assessment tools and scorecards.
Political/Democratic Accountability: eg. through social accountability mechanisms (e.g. through civil society campaigns), political accountability (through tracking government commitments) and human rights (eg. treaties).
Financial Accountability: feg. through use of financial and budget tracking mechanisms and performance-based financing and vouchers.
The authors conclude that the most effective approaches involve collective implementation of performance accountability, reinforced through social and political advocacy and financial accountability. Efforts were found to be most successful when they:
- worked through local stakeholders
- were evidence based
- were context specific
- had clear social and political aims for action
- involved multiple stakeholders; and
- had locally defined outcomes.