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Background How do governance interventions that engage citizens in public service delivery planning, management and oversight impact the quality of and access to services and citizens’ quality of life? This systematic review examined high quality evidence from 35 citizen engagement programmes in low- and middle-income countries that promote the engagement of citizens in service delivery through four routes: participation (participatory priority setting); inclusion of marginalised groups;...
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Inequality is a key political issue of our times. It has political consequences, fuelling conflict and raising legitimacy chal‑ lenges for regimes around the world, in democratic and non‑demo‑ cratic settings alike. At the centre of these challenges is the question of accountability: who can be held accountable, on what basis, how and by whom for tackling or failing to tackle which inequalities. In the field of global health, inequality has long been a key issue. A significant body of work —...
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This article aims to understand the inversion of roles between the state and citizens, by exploring its historical roots and current implications for processes of social accountability in Mozambique, particularly in the health sector. This is a practice-based reflection grounded in the evidence collected through the implementation of Community Scorecards in the health sector in 13 districts of Mozambique. The evidence has revealed a transfer of responsibilities from local governance...
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Social accountability in the health sector has been promoted as a strategy to improve the quality and performance of health providers in low- and middle-income countries. Whether improvements occur, however, depends on the willingness and ability of health providers to respond to societal pressure for better care. This article uses a realist approach to review cases of collective citizen action and advocacy with the aim to identify key mechanisms of provider responsiveness. Purposeful...
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Empirical evidence of tangible impacts of social accountability initiatives is mixed. This meta-analysis reinterprets evaluations through a new lens: the distinction between tactical and strategic approaches to the promotion of citizen voice to contribute to improved public sector performance. Field experiments study bounded, tactical interventions based on optimistic assumptions about the power of information alone, both to motivate collective action and to influence the state. Enabling...
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The Citizen Engagement Program (CEP) in Mozambique is an empowerment and accountability program aiming to improve the quality of health and education services through supporting citizens to monitor them. The program supports citizens to engage with service providers to address identified problems; it also aims to generate evidence for policy and program improvement at the local and national levels. This case study is structured in three main sections. The first section provides a background...
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