Building evidence and supporting effective social accountability

Results for Development Institute

Washington, D.C.

May 6th, 2014

Name of presenter(s)

Agenda

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1. R4D’s Social Accountability Experience

2. Transparency for Development (T4D)

3. Social Accountability Atlas & Center

R4D’s Social Accountability Experience

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Context & R4D’s Social Accountability Work

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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

R4D’s Evaluation and Evidence Work: Transparency for Development (T4D)

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• 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.

T4D basics

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• 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

T4D : Methods and Research Questions

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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?

T4D intervention – “CSC plus”

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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 Actionbased on

discussions, community will

decide social action to take

to improve health

T4D intervention – “CSC plus”

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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

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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

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Example of a “levers and barriers” scorecard - giving birth in a facility

T4D intervention – “CSC plus”

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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

T4D intervention – “CSC plus”

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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.

R4D’s: Social Accountability Atlas & Center

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Social Accountability Atlas– Goal & approaches

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Goal: To improve the quality and impact of SAc interventions

By creating a dynamic & user-friendlyonline platform that will• provide accessible, credible information on actual SAc

interventions facilitate knowledge sharing and collaboration between and among CSOs, funders, researchers and policymakers

Social Accountability Atlas and Center basics

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• Pilot in South East Asia• Pilot funded by USAID• Timeline: soft launch Summer 2014

Thank you!

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