ArticleBMC health services research2020
A strategic approach to social accountability: Bwalo forums within the reproductive maternal and child health accountability ecosystem in Malawi.
Article in BMC health services research, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed, 24 citations in OpenAlex.
- [Use of Boelen's conceptual model to develop a portrayal of the evolution of social accountability at a Canadian medical school].Canadian medical education journal · 2025Article
- A qualitative exploration of how a community engagement approach influences community and health worker perceptions related to family planning service delivery in Togo.Frontiers in reproductive health · 2024Article
- Social Accountability in Health System Governance: A Scoping Review.Iranian journal of public health · 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
- Exploring a framework for demandable services from antenatal to postnatal care: a deep-dive dialogue with mothers, health workers and psychologists.BMC pregnancy and childbirth · 2023Article
- How does power shape district health management team responsiveness to public feedback in low- and middle-income countries: an interpretive synthesis.Health policy and planning · 2023Article
- What's in a name? Unpacking 'CommunityBMJ global health · 2023Article
- A summative content analysis of how programmes to improve the right to sexual and reproductive health address power.BMJ global health · 2022Article
- Use of implementation science to advance family planning programs in low- and middle-income countries: A systematic review.Frontiers in global women's health · 2022Review
- Stakeholder engagement in the health policy process in a low income country: a qualitative study of stakeholder perceptions of the challenges to effective inclusion in Malawi.BMC health services research · 2021Article
- Strengthening social accountability in ways that build inclusion, institutionalization and scale: reflections on FHS experience.International journal for equity in health · 2020Article
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Authors and funding
7 authors at 3 institutions in 3 countries.
Funding
Abstract
backgroundThe majority of documented social accountability initiatives to date have been 'tactical' in nature, employing single-tool, mostly community-based approaches. This article provides lessons from a 'strategic', multi-tool, multi-level social accountability project: UNICEF's 'Social Accountability for Every Woman Every Child' intervention in Malawi.
methodsThe project targeted the national, district and community levels. Three Civil Society Organisations (CSOs) were engaged to carry out interventions using various tools to generate evidence and political advocacy at one or more levels. This article focuses on one of the social accountability methods - the bwalo forum (a meeting based on a traditional Malawian method of dialogue). A detailed political economy analysis was conducted by one of the co-authors using qualitative methods including interviews and group discussions. The authors conducted in-country consultations and analysed secondary data provided by the CSOs.
resultsThe political economy analysis highlighted several ways in which CSO partners should modify their work plans to be more compatible with the project context. This included shifting the advocacy and support focus, as well as significantly expanding the bwalo forums. Bwalos were found to be an important platform for allowing citizens to engage with duty bearers at the community and district levels, and enabled a number of reproductive, maternal, newborn, child and adolescent health issues to be resolved at those levels. The project also enabled learning around participant responses as intermediate project outcomes.
conclusionsThe project utilised various tools to gather data, elevate community voices, and facilitate engagement between citizen and state actors at the community, district and national levels. This provided the scaffolding for numerous issues to be resolved at the community or district levels, or referred to the national level. Bwalo forums were found to be highly effective as a space for inter-level engagement between citizens and state; however, as they were not embedded in existing local structures, their potential for sustainability and scalability was tenuous. A key strength of the project was the political economy analysis, which provided direction for partners to shape their interventions according to local and national realities and be sensitive to the barriers and drivers to positive action.
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