Faculty of Health (York University), 435 Health, Nursing & Environmental Studies Bldg, 4700 Keele St., Toronto, ON, M3J 1P3, Canada.
Dahdaleh Institute for Global Health Research, Community and Global Health, Health Policy and Management, Faculty of Health, York University, Toronto, Canada.
BMC Public Health. 2018 Apr 13;18(1):497. doi: 10.1186/s12889-018-5407-8.
Social accountability is a participatory process in which citizens are engaged to hold politicians, policy makers and public officials accountable for the services that they provide. In the Fifteenth Ordinary Session of the Assembly of the African Union, African leaders recognized the need for strong, decentralized health programs with linkages to civil society and private sector entities, full community participation in program design and implementation, and adaptive approaches to local political, socio-cultural and administrative environments. Despite the increasing use of social accountability, there is limited evidence on how it has been used in the health sector. The objective of this systematic review was to identify the conditions that facilitate effective social accountability in sub-Saharan Africa.
Electronic databases (MEDLINE, PsycINFO, Sociological Abstracts, Social Sciences Abstracts) were searched for relevant articles published between 2000 and August 2017. Studies were eligible for inclusion if they were peer-reviewed English language publications describing a social accountability intervention in sub-Saharan Africa. Qualitative and quantitative study designs were eligible.
Fourteen relevant studies were included in the review. The findings indicate that effective social accountability interventions involve leveraging partnerships and building coalitions; being context-appropriate; integrating data and information collection and analysis; clearly defined roles, standards, and responsibilities of leaders; and meaningful citizen engagement. Health system barriers, corruption, fear of reprisal, and limited funding appear to be major challenges to effective social accountability interventions.
Although global accountability standards play an important guiding role, the successful implementation of global health initiatives depend on national contexts.
社会问责制是一个参与式过程，公民参与其中，要求政治家、政策制定者和公职人员对他们提供的服务负责。在非洲联盟第十五届常会中，非洲领导人认识到需要有强大的、分散的卫生规划，与民间社会和私营部门实体建立联系，让社区充分参与规划设计和实施，并采取适应当地政治、社会文化和行政环境的方法。尽管社会问责制的使用越来越多，但关于它在卫生部门的使用情况，证据有限。本系统评价的目的是确定在撒哈拉以南非洲促进有效社会问责制的条件。
电子数据库（MEDLINE、PsycINFO、社会学摘要、社会科学摘要）检索了 2000 年至 2017 年 8 月期间发表的相关文章。符合纳入标准的研究是描述了撒哈拉以南非洲社会问责制干预措施的同行评审的英文出版物。合格的研究设计包括定性和定量研究。
本评价纳入了 14 项相关研究。研究结果表明，有效的社会问责制干预措施涉及利用伙伴关系和建立联盟；要切合实际；整合数据和信息收集与分析；明确领导者的角色、标准和责任；以及有意义的公民参与。卫生系统障碍、腐败、害怕报复以及资金有限，似乎是有效社会问责制干预措施的主要挑战。
尽管全球问责制标准发挥着重要的指导作用，但全球卫生倡议的成功实施取决于国家背景。
