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Scorecards and social accountability for improved maternal and newborn health services: A pilot in the Ashanti and Volta regions of Ghana
Author(s) -
Blake Carolyn,
AnnorbahSarpei Nii Ankonu,
Bailey Claire,
Ismaila Yakubu,
Deganus Sylvia,
Bosomprah Samuel,
Galli Francesco,
Clark Sarah
Publication year - 2016
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/j.ijgo.2016.10.004
Subject(s) - accountability , medicine , transparency (behavior) , context (archaeology) , social accounting , government (linguistics) , nursing , quality management , health care , clarity , environmental health , public relations , economic growth , business , marketing , political science , accounting , paleontology , linguistics , accounting information system , philosophy , biochemistry , chemistry , economics , law , biology , service (business)
Background With the limited availability of quality emergency obstetric and newborn care (EmONC) in Ghana, and a lack of dialogue on the issue at district level, the Evidence for Action (E4A) program (2011–2015) initiated a pilot intervention using a social accountability approach in two regions of Ghana. Objective Using scorecards to assess and improve maternal and newborn health services, the intervention study evaluated the effectiveness of engaging multiple, health and non‐health sector stakeholders at district level to improve the enabling environment for quality EmONC. Methods The quantitative study component comprised two rounds of assessments in 37 health facilities. The qualitative component is based on an independent prospective policy study. Results Results show a marked growth in a culture of accountability, with heightened levels of community participation, transparency, and improved clarity of lines of accountability among decision‐makers. The breadth and type of quality of care improvements were dependent on the strength of community and government engagement in the process, especially in regard to more complex systemic changes. Conclusion Engaging a broad network of stakeholders to support MNH services has great potential if implemented in ways that are context‐appropriate and that build around full collaboration with government and civil society stakeholders.