ICT-facilitated accountability and engagement in health systems: a review of Making All Voices Count mHealth for accountability projects

ICT-facilitated accountability and engagement in health systems: a review of Making All Voices Count mHealth for accountability projects

Information and communication technologies (ICTs) and mHealth innovations hold great potential to improve health systems and health outcomes while at the same time enhancing citizen engagement and accountability. Yet there has been little assessment of the impact of mHealth innovations on the ground.

This paper reviews the experiences of seven mHealth initiatives funded by the Making All Voices Count programme: OurHealth, eThekwini WACs and Thuthuzela Voices (all in South Africa), Mobile Mapping for Women’s Health (Tanzania), Text2Speak (Nigeria), SMS Gateway (Indonesia) and Citizen Journalism for Quality Governance of Universal Health Insurance Scheme (also Indonesia). It discusses the accountability model adopted by each project, and the challenges they faced.

All seven projects worked on the underlying assumption that citizen engagement and voice are central to strengthening accountability. Information gathering was seen as a prerequisite for advocating for service improvements; hence all seven projects used mobile phones or tablets to capture information on local service provision as a way of augmenting citizen voice. Five of the seven used technology to solicit people’s feedback on their experiences of service delivery, their needs and / or concerns, and then shared this information with government actors.

Key themes in this paper:
  • engaging existing community-level groups or forums is more likely to lead to success in uptake of ICTs for improving health services and strengthening accountability
  • other stakeholders (e.g. health workers) must be involved to maximise impact and sustainability and to allay any fears about consequences of negative feedback
  • unless those in positions of power to change things (locally and / or nationally) are allies in the process, efforts are unlikely to meet with success
  • offline spaces can strongly complement online innovations to leverage individual citizens’ feedback and translate that feedback into action to improve services
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