1. Building evidence and
supporting effective social
accountability
Results for Development Institute
Washington, D.C.
May 6th, 2014
Name of presenter(s)

2. Agenda
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1. R4D’s Social Accountability Experience
2. Transparency for Development (T4D)
3. Social Accountability Atlas & Center

3. R4D’s Social Accountability Experience
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4. Context & R4D’s Social Accountability Work
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Since 2006, R4D has been providing direct support to civil society
organizations carrying out SAc projects
 Financial and technical support; peer learning
 PETS; absenteeism studies; CRC; CSC
Take-aways:
1. More evidence is needed about when and how SAc has
an impact
2. Evidence and experience need to be shared & leveraged
for better SAc
Evaluation work & Social Accountability Atlas

5. R4D’s Evaluation and Evidence Work:
Transparency for Development (T4D)
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• Practical information about effective
design features for different contexts
• Smarter, more effective SAc
CSOs
• Evidence about SAc’s impact on health
outcomes
• SAc for strengthened health delivery
Health sector
experts and
policymakers
• SAc interventions with high potential for
impact
• Investing in better and smarter SAc
Donors
• Help shape the agenda for the next
generation of research around SAc
• More actionable evidence
Academics
T4D Goal:
To generate actionable evidence on whether and how a well-
designed social accountability intervention can improve health
outcomes.

7. T4D basics
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• Partner: Harvard Kennedy School
• Funding from Hewlett Foundation, Gates
Foundation, DfID
• 5 year project, 2014-8
• Focus countries: Tanzania and Indonesia
• Community scorecard “plus” (CSC-plus)
• Health Focus: Maternal & Newborn Health
• Two phases; mixed methods

8. T4D : Methods and Research Questions
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RCTs:
 What is the effect of the intervention on the quality of health service
delivery?
 What is the effect of the intervention on individual health outcomes?
Case Study/ Qualitative Research:
 What are the mechanisms through which these occur?
 What is the role of context in shaping these effects?
 How do interventions affect citizen’s perceptions of empowerment &
efficacy?
 How can the design of the intervention be improved?
Cost-Effectiveness Analysis Research Questions:
 How do SAc interventions compare to alternatives in terms of cost-
effectiveness?

9. T4D intervention – “CSC plus”
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 Intervention
 Builds upon existing literature and experience
 Co-designed with local partners
Information
Gathering
about outcomes
and problems in
maternal and
newborn health
Community
Meeting
to (1) review
information and (2)
decide on
community action
Social Action
based on
discussions,
community will
decide social action
to take to improve
health

10. T4D intervention – “CSC plus”
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Information
Gathering
about
outcomes and
problems in
maternal and
newborn
health
1. Collect data on potential health and
service delivery problems
• information on community health status
and health outcomes
• issues with facilities - resource and
staffing levels, absentee rates, client
satisfaction, or comparative
2. Generate a simple scorecard
• Analyze data
• Summarize key findings

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Example of a “levers” scorecard
Indicator Local statistics
First antenatal visit
in first trimester
Quality of Antenatal
care
Giving birth in a
health facility
Seeing health
worker within 2
days of birth
11

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Example of a “levers and barriers” scorecard - giving
birth in a facility

13. T4D intervention – “CSC plus”
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Community
Meeting
to (1) review
information
and (2)
decide on
community
action
CSO Facilitators
• Present information to communities
• Facilitate discussion by communities and
possible actions to take to overcome the
problems
• Each community will make a decision about
what “social” action they want to take

14. T4D intervention – “CSC plus”
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Community
Meeting
to (1) review
information
and (2)
decide on
community
action
Communities
The intervention incorporates a flexible
social action or “accountability”
component, selected by community
• Carry out (independently) the Social Action
they choose based on context
• monitoring problems at the facility level,
• interface meetings with midwives to
improve service,
• going to sub-district health officers;
• public hearings;
• petitioning of policymakers; etc.

15. R4D’s: Social Accountability Atlas & Center
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16. Social Accountability Atlas
– Goal & approaches
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Goal: To improve the quality and impact of SAc
interventions
By creating a dynamic & user-friendly
online platform that will
• provide accessible, credible information on actual SAc
interventions facilitate knowledge sharing and collaboration
between and among CSOs, funders, researchers and
policymakers

17. Social Accountability Atlas and Center basics
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• Pilot in South East Asia
• Pilot funded by USAID
• Timeline: soft launch Summer 2014

18. Thank you!
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