Voice and accountability

Strategies for extending citizen voice, and promoting greater accountability between policy makers, health providers and service users, are essential components of a health systems strengthening approach.

Health Partners International provides consultancy services in the design, implementation and review of a range of voice and accountability initiatives in the health sector.

Finding practical and locally appropriate ways to address issues of voice, accountability and responsiveness in the health sector can be challenging. Different strategies used by HPI to date include:

  • Supporting the creation of an enabling environment for voice and accountability initiatives to flourish, through legislation and policy.
  • Introducing supply-side interventions such as patient charters.
  • Supporting joint government-civil society initiatives, such as facility health committees.
  • Supporting citizen-led voice initiatives through advocacy and capacity building.

Many people encounter a range of service delivery and health system problems when trying to access health care, leading to a distrust of health providers and low service utilisation rates. Supply-side improvements can help to address service delivery failures. But if service utilisation rates are to improve, these changes need to be implemented alongside strategies that enhance the responsiveness of health providers to community needs and by placing a stronger emphasis on voice and accountability within a broad-based health systems strengthening programme.

Other Technical Experts who work in this field include: Andrew McKenzie, Fatima Adamu, and Mary Surridge.