ReviewJournal of evaluation in clinical practice2026
The Contingent Payoff of Transparency: The Mediating Roles of Citizen Participation and Enforcement in Health Service Delivery Improvement.
Review in Journal of evaluation in clinical practice, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed.
- An Evaluation of AI-Generated Clinical Notes in the OpenNotes Era: A Thematic Analysis of Clinician Discourse.Journal of evaluation in clinical practice · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundHow transparency reforms affect frontline health service delivery remains uncertain. Research presents a transparency paradox, where some studies report service improvements when transparency is combined with oversight, while others find minimal impact on outcomes such as staff absence or medicine availability.
objectiveThis article addresses the conditions under which transparency improves health services. We argue that inconsistent findings stem from construct slippage, where distinct reforms are grouped together. We propose an unbundled conceptualisation distinguishing three types: Passive Transparency (information only disclosure), VOICE Interventions (disclosure plus citizen participation), and TEETH Interventions (disclosure linked to credible sanctions).
methodsWe conducted a scoping review of studies from 2000 to 2025 following PRISMA guidelines. Database searches yielded 6636 records, resulting in 49 included experimental, quasi experimental, and observational studies. Each intervention was coded as Passive Transparency, VOICE or TEETH based on its actual components rather than author labels.
resultsThe evidence shows that Passive Transparency alone rarely shifts health service outcomes, though it can modestly increase citizen knowledge. Interventions that combine disclosure with empowered VOICE mechanisms show more consistent gains, such as large mortality reductions found in Uganda and Malawi. Similarly, TEETH interventions with credible enforcement, such as centralised drug procurement, produced large price reductions. Where enforcement was weak, transparency had little effect.
conclusionThe impact of transparency on health service delivery is conditional rather than automatic. The transparency paradox is largely resolved when interventions are unbundled. Transparency functions as a diagnostic input whose effectiveness depends on being coupled with functional accountability arrangements: either empowered citizen VOICE or credible state TEETH.
Indexed as
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.