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Using Accountability to Improve Reproductive Health Care

By: Asha George

This paper focuses on how accountability mechanisms can improve communities’ access to high quality health care. Specifically, Asha George explores how accountability approaches mediate between service providers and communities, and between different kinds of health personnel at the primary health care level. Information, dialogue and negotiation are important elements that enable accountability mechanisms to address problems by supporting change and engagement between participants. Efforts to improve accountability in reproductive health can partner communities with lower level health workers to improve health service delivery that can be lifesaving. In order to succeed, however, efforts towards better accountability that broaden the participation of users must take into account the social contexts and the policy and service delivery systems in which they are applied, address power relations and improve the representation of marginalized groups within communities and service delivery systems. Furthermore, efforts to improve dialogue between health workers and communities can lead to alliances that negotiate with higher level authorities for improvements.

This tool references case studies of participatory processes for improving sexual and reproductive health service delivery.