Improving Maternal Health through Social Accountability: A Case Study from Orissa, India

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As maternal health specialists accelerate efforts towards Millennium Development Goal 5, which calls for a 75% reduction in maternal mortality by 2015, global attention is focusing on how to best improve service accountability to target communities. One approach that is receiving greater attention for improving policy implementation is social accountability. Social accountability is the pressure brought to bear when ordinary citizens are mobilized to voice their concerns and become publically engaged in efforts to ensure the government and other powerful groups are fulfilling their obligations to the people they serve. Social accountability approaches are increasingly being used in health campaigns to leverage the power of communities to assert their rights to access quality health care.

 

In recent years, the Indian government has stepped up efforts to address maternal mortality through the development of new government programs to improve community and maternal health such as the Janani Suraksha Yojana program and the Accredited Social Health Activist program. These efforts are aimed at serving the maternal health needs of poor women. While components of these programs have been successfully deployed, universal implementation has been spotty, and efforts to scale-up programs and ensure quality of care are proving challenging. As a result, maternal mortality remains high in certain parts of India.

 

Rabin Martin Vice President Susan Papp explored these issues in Improving Maternal Health through Social Accountability: A Case Study from Orissa, India, which was published in the peer-reviewed journal Global Public Health. The qualitative case study was conducted on behalf of the London School of Economics and Political Science to explore how the White Ribbon Alliance for Safe Motherhood, India (WRA-India) is employing social accountability approaches to improve the delivery of maternal health services in Orissa, India. The study examines how WRA-India is engaging with local women, key intermediary groups, health providers and elected representatives via public hearings in Orissa to: 1) generate demand for better maternal health services; 2) leverage intermediaries to add power to the demands of poor and marginalized women; and 3) sensitize leaders and health providers to women’s needs. The study evaluates the impact of social accountability efforts thus far and identifies ways in which activities can be enhanced in the future.

 

Reprints of the article will be available to Rabin Martin clients and partners in mid May. To request a copy, please contact Tina Flores.

10 April 2013
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