Noble Elizabeth, Moinul Dina, Khairy Djim Sylla Oumou, Friedmann Sophia, Amick Kristen, Rowhani Nehal, Dua Rashi, Mannan Nowshin, Seaman Cathleen, Ayo Omobolanle, Pant Shubhra, Osoko Oluwatimilehin, Gogineni Srija, Malburg Carly, Dickey Chris, Peprah Emmanuel
Department of Global and Environmental Health, New York University, New York, New York, United States of America.
Department of Global and Environmental Health, Applied Global Public Health Initiative (AGPHI), New York University, New York, New York, United States of America.
PLoS One. 2025 May 28;20(5):e0324098. doi: 10.1371/journal.pone.0324098. eCollection 2025.
Downward accountability, defined as being answerable to beneficiaries for actions and giving affected populations influence in aid processes, remains unstandardized and underinvested across the humanitarian sector. Currently, numerous accountability mechanisms are being utilized by humanitarian non-governmental organizations (NGOs) in low- and middle-income countries (LMICs). However, the different mechanisms have varying degrees of effectiveness in providing true accountability to affected populations due to significant barriers or strengths in implementation.
To conduct a qualitative systematic review investigating the various downward accountability mechanisms employed by non-governmental organizations in LMICs, and to assess the effectiveness of these mechanisms in delivering downward accountability for populations in low-resource settings.
We searched 10 databases, including PubMed, Medline, Embase, Ovid, Web of Science, Global Health, EBSCO SocINDEX, ABI/INFORM, ALNAP, and Sociological Abstracts from 2008-2023. Grey literature was searched on Google Scholar. To capture any additional articles, the search was updated in November 2024. Our search produced 1521 articles. After applying our exclusion criteria and screening, 38 articles comprised our final dataset. Each article reported on the effectiveness of five downward accountability mechanisms, including participation, ownership, transparency, program auditing, and social auditing. Associated barriers to accountability included implementation, power asymmetry, and fragmentation within the humanitarian sector.
There are significant gaps in research on the effectiveness of downward accountability mechanisms amongst humanitarian NGOs in LMICs. This research deficit adversely affects the sustainability of local development initiatives and, on a broader scale, undermines overall organizational effectiveness. Implementing balanced accountability mechanisms that promote equality in power dynamics is pivotal to achieving meaningful outcomes for affected populations.
向下问责制被定义为对受益人就行动负责，并让受影响人群在援助过程中拥有影响力，在整个人道主义部门仍未标准化且投资不足。目前，低收入和中等收入国家（LMICs）的人道主义非政府组织（NGOs）正在使用众多问责机制。然而，由于实施过程中的重大障碍或优势，不同机制在为受影响人群提供真正问责方面的有效性各不相同。
进行一项定性系统评价，调查低收入和中等收入国家非政府组织采用的各种向下问责机制，并评估这些机制在为资源匮乏地区人群提供向下问责方面的有效性。
我们检索了10个数据库，包括2008年至2023年的PubMed、Medline、Embase、Ovid、科学引文索引、全球健康、EBSCO社会索引、ABI/INFORM、行动援助学习网络和社会学文摘。在谷歌学术上检索了灰色文献。为了获取任何其他文章，搜索于2024年11月更新。我们的搜索产生了1521篇文章。在应用我们的排除标准并进行筛选后，38篇文章构成了我们的最终数据集。每篇文章都报告了五种向下问责机制的有效性，包括参与、自主权、透明度、项目审计和社会审计。问责制的相关障碍包括实施、权力不对称和人道主义部门内部的分散化。
低收入和中等收入国家人道主义非政府组织向下问责机制有效性的研究存在重大差距。这一研究不足对地方发展倡议的可持续性产生不利影响，并且在更广泛的范围内破坏了整体组织效能。实施促进权力动态平等的平衡问责机制对于为受影响人群实现有意义的成果至关重要。
