RESEARCH UTILIZATION IN THE CONTEXT OF AN EMERGING EVIDENCE BASE: SOCIAL ACCOUNTABILITY APPROACHES TO IMPROVING FAMILY PLANNING

Evidence Project IUSSP Side Event

October 29, 2017

Vicky BoydellRights and Accountability Advisor, The Evidence Project/IPPF

What is Social Accountability?

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The collective efforts of citizens and civil society to scrutinize and hold duty bearers (politicians, government officials and service providers) to

account for providing promised services, actions that most often take place at the sub-national or

community level.

What is Social Accountability?

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Types of Social Accountability

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Participatory Budgeting

Public Expenditure Tracking

Community Report Cards

Citizen Report Cards

Social Audits

Citizen Charters

Health Committees

Information Sharing & Campaigns

Complaint MechanismsCourtesy of Population Foundation of India

Our Evidence Generation and Use

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Findings Gaps

• Lack of rigorous body of evidence

• Impact of FP/RH-specific interventions yet to be adequately demonstrated, but promising results

• Clearly articulated theory of change

• Linkages to redress and remedy

• Distilling core enabling factors

Back in 2014 - a nascent evidence base

11 review papers and 16 case studies related to FP/RH

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2014 2015 2016 2017

2 PUBLICATIONS

2014Literature

Review

2014Expert

Meeting

Prospective StudyRetrospective Study

RHU Pilot

ARC

Learning Exchange RHSC A&A WG

Transparency International

Access to Medicines

Photovoice Study

Chemonics

USAID Governance

Citizen Hearing, PMNCH

Dev Dialogue’s Berlin

COP

IDS Technical Consultation

Various WHO TA

Scale Up Meeting

Fox Scale Up

RHSC A&A WG

IPPF Working Group

Scale Up to Four Countries

WHO Study in Ghana and Tanzania

Bottleneck Analysis TZ & UG

WHO Review

RHU Scale Up

Dev Dialogue’s Berlin

Various WHO TA

Chemonics

IDS Technical Consultation

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Scaling Approaches Scaling MethodsYouth Friendly social accountability work in Uganda to Ghana, Kenya, Ethiopia and Pakistan

Bottleneck Analysis pilot in Tanzania and Uganda

Process evaluation and scales adopted in WHO multi-country study of social accountability in family planning programs

RU Headlines to Date

Reflections

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• Formal consultation and presence in conversations

• Working on shared issues• Building on the work of others

Get Further Together ….

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• Explicit priority• Trained support• Real funds• Supportive Manager

Priority for Research Utilization

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• Serendipity - take advantage of unexpected and unplanned opportunities

• Gambles – expect some failure and dead ends part of the process

Serendipity and gambles …

The Evidence Now

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Service utilizationIncreased immunizations (3); Increased examinations (3) Improved access to services (5); Increased antenatal visits (4) Use of skilled birth attendants (4)

Service DeliveryAvailable medical equipment (2,4); Available supplies (3,4,7) Increased resources(6); Increased staffing (2) ; Improved Infrastructure (2); Reduction in waiting time (7)

Service ProvidersLess absenteeism (4,7); Improved morale (6); Improved training and supervision (6) ; More engaged provider-client interaction (2)

Knowledge & information Safe Sex/high risk behaviour (8,9)

Governance Participation (2); Transparency (2); Community and decision-making engagement (2)

Health outcomes Child weight (4); Maternal Mortality Ratio (10)

Existing Evidence on Social Accountability and Health

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• An increase of 22% in use of family planning after just one year in Uganda (Bjorkman and Svensson2009)

• An estimated increase of 57% in family planning use in Malawi (Gullo et al 2017)

Evidence on Social Accountability in the Context of Family Planning Programs

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• USAID/WHO’s Accountability, Health Governance, and Health Systems: Uncovering the Linkages

• JHU’s Social accountability in low- and middle-income country health systems: A scoping review of interventions, evidence, and key messages

• DFID’s Empowerment and Accountability Annual Technical Report 2016: What Works for Social Accountability

• DFID’s Accountability for Health Equity Programme

Evidence Reviews Underway this Year

THANK YOU

The Evidence Project is made possible by the generous support of the American people through the United States Agency for International Development (USAID) under the terms of cooperative agreement no. AID-OAA-A-13-00087. The contents of this presentation are the sole responsibility of the Evidence Project and Population Council and do not necessarily reflect the views of USAID or the United States Government.

The Evidence Project seeks to expand access to high quality family planning/reproductive health services worldwide through implementation science, including the strategic generation, translation, and use of new and existing evidence. The project is led by the Population Council in partnership with the INDEPTH Network, the International Planned Parenthood Federation, PATH, and the Population Reference Bureau.

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Boydell, Vicky. 2017. “Social Accountability: RU in the context of an emerging evidence base,” PowerPoint slides. Washington, DC: Evidence Project.