The Impact of Social Accountability Interventions on Healthcare Delivery and Health Outcomes in UP, India

Achieving the Millennium Development Goals for health is likely to be a challenge in many low-income countries around the world. In light of this challenge, improving the quantity and quality of publicly provided social services has become a priority for donor countries and organizations as well as the governments of many low-income countries. It is widely believed to be the case that in some regions of India, the health sector suffers from poor overall performance as well as high rates of provider absence from work. The low level of accountability of public providers toward the communities they serve is theorized as being a major cause of the poor quality of public health services. Since improvements in the supply-side of health care are likely to be essential for making progress in population-level health outcomes, there is a vital need to evaluate and scale-up innovative approaches to improving the quantity and quality of health services. The proposed research will examine the impact of social accountability interventions in India’s health sector. Social accountability is an approach toward building accountability based on civic engagement; i.e., in which citizens and civil society organizations participate directly or indirectly in exacting accountability from the public sector. It involves the provision of information on individuals’ rights to services and on health sector performance as well as opportunities for community engagement with public sector healthcare providers and officials. While information interventions aim to create transparency through a range of information provision mechanisms, the other key aspect of social accountability interventions is to foster civic engagement by enabling citizens to channel their complaints (grievance redressal). In India’s largest state of Uttar Pradesh (UP), which also has among the lowest per-capita income and lowest health indicators in India, the Government of UP is piloting social accountability interventions and considering them for scale-up as part of a World Bank-supported project. This project will evaluate specific components of these interventions (information and community engagement) and provide guidance on how to implement them at a large scale in Uttar Pradesh.

Principal Investigators: Harsha Thirumurthy, Manoj Mohanana

Funding Source: Duke University World Bank Group

Grant Number: 7177109

Funding Period: 10/27/2015 - 3/31/2017

Primary Research Area: Population Health

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