Strengthening accountability for improved maternal and newborn health: a mapping of studies in Sub-Saharan Africa

Martin Hilber, A., Blake, C. , Bohle, L. F., Bandali, S., Agbon, E. and Hulton, L. (2016) Strengthening accountability for improved maternal and newborn health: a mapping of studies in Sub-Saharan Africa. International Journal of Gynecology and Obstetrics, 135(3), pp. 345-357. (doi: 10.1016/j.ijgo.2016.09.008) (PMID:27802869)

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Abstract

Objective: To describe the types of maternal and newborn health program accountability mechanisms implemented and evaluated in recent years in Sub-Saharan Africa, how these have been implemented, their effectiveness, and future prospects to improve governance and MNH outcomes. Method: A structured review selected 38 peer-reviewed papers between 2006 and 2016 in Sub-Saharan Africa to include in the analysis. Results: Performance accountability in MNH through maternal and perinatal death surveillance was the most common accountability mechanism used. Political and democratic accountability through advocacy, human rights, and global tracking of progress on indicators achieved greatest results when multiple stakeholders were involved. Financial accountability can be effective but depend on external support. Overall, this review shows that accountability is more effective when clear expectations are backed by social and political advocacy and multistakeholder engagement, and supported by incentives for positive action. Conclusion: There are few accountability mechanisms in MNH in Sub-Saharan Africa between decision-makers and those affected by those decisions with both the power and the will to enforce answerability. Increasing accountability depends not only on how mechanisms are enforced but also, on how providers and managers understand accountability.

Item Type:Articles
Additional Information:This paper was written in the framework of the Evidence for Action (E4A) program, funded by the UK Government’s Department forInternational Development (DFID).
Keywords:Accountability, advocacy, Evidence for Action (E4A), health systems strengthening, maternal health, neonatal health, quality of care, Sub-Saharan Africa.
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Blake, Ms Carolyn
Authors: Martin Hilber, A., Blake, C., Bohle, L. F., Bandali, S., Agbon, E., and Hulton, L.
Subjects:J Political Science > JS Local government Municipal government
R Medicine > RG Gynecology and obstetrics
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > MRC/CSO SPHSU
Journal Name:International Journal of Gynecology and Obstetrics
Journal Abbr.:Int J Gyneco Obstet
Publisher:Elsevier
ISSN:0020-7292
ISSN (Online):1879-3479
Published Online:14 October 2016
Copyright Holders:Copyright © 2016 International Federation of Gynecology and Obstetrics
First Published:First published in International Journal of Gynecology and Obstetrics 135(3): 345-357
Publisher Policy:Reproduced under a Creative Commons License

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