Scorecards and social accountability in the Ashanti and Volta regions

This paper presents the results of a pilot multi-stakeholder social accountability intervention that aimed to improve the provision of quality maternal and newborn care in Ghana. This is the fourth paper in the MamaYe-Evidence for Action (E4A) series on accountability.

In response to limited availability of quality emergency obstetric and newborn care (EmONC), the MamaYe-E4A programme initiated a pilot intervention using a social accountability approach (that is, when ordinary people or civil society are involved in how the accountability operates)  in two regions of Ghana.

The pilot study aimed to:

  • improve the provision of quality maternal and newborn care; and
  • build on the limited evidence around the success of this approach.

In this paper, the authors present evidence on the effectiveness of engaging multiple, health and non-health sector stakeholders at district level including the use of scorecards, to improve the enabling environment for quality EmONC.


The authors highlight that active engagement of multiple stakeholders to support MNH services helps to create a culture of accountability for improved quality of care in MNH. 

Strong leadership at district and community level was identified as key for engaging with regional and national government.

The authors conclude that social accountability initiatives can have great potential if they are context appropriate and fully engage government and civil society stakeholders.

Blake, C., Annorbah-Sarpei , N. A., Bailey, C., Ismaila, Y., Deganus, S., Bosomprah, S., Galli, F. & Clark, S. (2016). Scorecards and social accountability for improved maternal and newborn health services: A pilot in the Ashanti and Volta regions of Ghana. International Journal of Gynecology and Obstetrics, 135: 372-379.