ArticleInternational journal of health policy and management2019
Social Accountability in Maternal Health Services in the Far-Western Development Region in Nepal: An Exploratory Study.
Article in International journal of health policy and management, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- Enhancing Health and Empowerment: Assessing the Satisfaction of Underprivileged Rural Women Participating in a Functional Literacy Education Program in Kailali District, Nepal.Healthcare (Basel, Switzerland) · 2024Article
- Understanding communication in community engagement for maternal and newborn health programmes in low- and middle-income countries: a realist review.Health policy and planning · 2023Article
- Institutionalising community engagement for quality of care: moving beyond the rhetoric.BMJ (Clinical research ed.) · 2023Article
- What's in a name? Unpacking 'CommunityBMJ global health · 2023Article
- Universal coverage of the first antenatal care visit but poor continuity of care across the maternal and newborn health continuum among Nepalese women: analysis of levels and correlates.Globalization and health · 2021Article
- Policies and actions to reduce maternal mortality in Nepal: perspectives of key informants.Sexual and reproductive health matters · 2021Article
- Improving maternal health services through social accountability interventions in Nepal: an analytical review of existing literature.Public health reviews · 2020Review
- Maternal health challenges experienced by adolescents; could community score cards address them? A case study of Kibuku District- Uganda.International journal for equity in health · 2020Article
- Do social accountability approaches work? A review of the literature from selected low- and middle-income countries in the WHO South-East Asia region.Health policy and planning · 2020Review
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9 authors.
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Abstract
backgroundSocial accountability or citizen-led accountability has been promoted in many low- and middle-income countries to improve the quality, access to and use of maternal health services. Experiences with social accountability in maternal health services in Nepal have not yet been documented. This study identifies existing social accountability structures and activities in maternal health services in two districts of Far-Western Nepal and explores their functions, implementation and gaps/challenges.
methodsAn exploratory study was conducted that included in-depth interviews with purposively selected policy advisors (8), healthcare officials (11), healthcare providers (12) and non-governmental staff (3); and focus group discussions (FGDs) with 54 women. Data analysis was conducted using thematic content analysis based on George's information, dialogue and negotiation framework.
resultsSocial accountability in maternal health existed in terms of structures such as mothers' groups (MGs), female community health volunteers (FCHVs) and Health Facility Operation and Management Committees (HFOMCs); and activities such as social audits and community health score board (CHSB). MGs and FCHVs were perceived as trusted intermediaries, but their functioning was limited to information. HFOMCs were not fully functional. Social audits and CHSBs were implemented in limited sites and with poor participation by women. Health-sector responses were mainly found at the local level. Factors contributing to these challenges were the absence of a mandate and limited capacity, including resources.
conclusionFormal structures and activities existed for social accountability in maternal health services in the Far-Western Development Region of Nepal, but there were limitations pertaining to their implementation. The main recommendations are: for clear policy mandates on the social accountability roles of MGs and FCHVs; wider implementation of social audits and CHSBs, with emphasis on the participation of women from disadvantaged groups; improved capacity of HFOMCs; and improved engagement of the health sector at all levels to listen and respond to women's concerns.
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