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Lessons about intervening in accountability ecosystems: implementation of community scorecards in Bangladesh and Uganda

Funded by: Johns Hopkins Bloomberg School of Public Health

Social accountability (SA) initiatives facilitate engagement between service users and service providers to  stimulate the responsiveness of public and private authorities. Global health and development initiatives have shown renewed interest in social accountability, though less has been documented about the feasibility of implementing social accountability interventions with fewer investments external to the community and greater emphasis on working through the existing structures and relationships that form the local 'accountability ecosystem'.  In this collection, we summarize lessons from the DfID-funded Research Programme Consortium - Future Health Systems' experience of implementing community scorecards (CSCs) in Uganda and Bangladesh.  In both contexts, we focus on questions about improving quality, accessibility, and utilization of primary health care services; stimulating community participation; contextual and process factors that support or hinder effective application of community scorecards; and early lessons about sustaining and integrating CSCs in the health system.

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International Journal for Equity in Health publishes research which improves the understanding of issues that influence the distribution of health and healthcare within populations. Although there is a large amount of literature on the 'social determinants' of health, the journal focuses heavily on understanding what influences at the level of the individual, and, what influences at the community level.

View all collections published in International Journal for Equity in Health

  1. Planning for the implementation of community scorecards (CSC) is an important, though seldom documented process. Makerere University School of Public Health (MakSPH) and Future Health Systems Consortium set ou...

    Authors: Elizabeth Ekirapa Kiracho, Christine Aanyu, Rebecca Racheal Apolot, Suzanne Namusoke Kiwanuka and Ligia Paina

    Citation: International Journal for Equity in Health 2021 20:31

    Content type: Research

    Published on:

  2. This paper aimed at estimating the resources required to implement a community Score Card by a typical rural district health team in Uganda, as a mechanism for fostering accountability, utilization and quality...

    Authors: Anthony Ssebagereka, Rebecca Racheal Apolot, Evelyne Baelvina Nyachwo and Elizabeth Ekirapa-Kiracho

    Citation: International Journal for Equity in Health 2021 20:2

    Content type: Research

    Published on:

  3. This editorial provides an introduction to the special issue on “Lessons about intervening in accountability ecosystems: implementation of community scorecards in Bangladesh and Uganda”. We start by describing...

    Authors: Sara Bennett, Eizabeth Ekirapa-Kiracho, Shehrin Shaila Mahmood, Ligia Paina and David H. Peters

    Citation: International Journal for Equity in Health 2020 19:220

    Content type: Editorial

    Published on:

  4. Approximately 34.8% of the Ugandan population is adolescents. The national teenage pregnancy rate is 25% and in Kibuku district, 17.6% of adolescents aged 12–19 years have begun child bearing. Adolescents moth...

    Authors: Rebecca R. Apolot, Moses Tetui, Evelyne B. Nyachwo, Linda Waldman, Rosemary Morgan, Christine Aanyu, Aloysius Mutebi, Suzanne N. Kiwanuka and Elizabeth Ekirapa

    Citation: International Journal for Equity in Health 2020 19:191

    Content type: Research

    Published on:

  5. Engaging communities in health facility management and monitoring is an effective strategy to increase health system responsiveness. Many developing countries have used community scorecard (CSC) to encourage c...

    Authors: Shehrin Shaila Mahmood, Sabrina Rasheed, Asiful Haidar Chowdhury, Aazia Hossain, Mohammad Abdus Selim, Shahidul Hoque and Abbas Bhuiya

    Citation: International Journal for Equity in Health 2020 19:155

    Content type: Research

    Published on:

  6. The government of Bangladesh initiated community clinics (CC) to extend the reach of public health services and these facilities were planned to be run through community participation. However, utilisation of ...

    Authors: S. M. A. Hanifi, Aazia Hossain, Asiful Haidar Chowdhury, Shahidul Hoque, Mohammad Abdus Selim, Shehrin Shaila Mahmood and Abbas Bhuiya

    Citation: International Journal for Equity in Health 2020 19:149

    Content type: Research

    Published on:

  7. The community score card (CSC) is a participatory monitoring and evaluation tool that has been employed to strengthen the mutual accountability of health system and community actors. In this paper we describe ...

    Authors: Elizabeth Ekirapa Kiracho, Noel Namuhani, Rebecca Racheal Apolot, Christine Aanyu, Aloysuis Mutebi, Moses Tetui, Suzanne N. Kiwanuka, Faith Adong Ayen, Dennis Mwesige, Ahmed Bumbha, Ligia Paina and David H. Peters

    Citation: International Journal for Equity in Health 2020 19:145

    Content type: Research

    Published on: