What do we want to know?
- What is the evidence that interventions aimed at improving community accountability mechanisms and processes influence inclusive service delivery?
- What factors impact on these accountability mechanisms?
The goal of this systematic review was to identify those interventions which have been shown to have impact (positive or negative) in promoting community accountability and influencing inclusive service delivery. Community accountability is notoriously difficult to define. This review was guided by an understanding that is grounded in a rights-based approach and recognises the importance of community participation and giving ‘voice’ to people who are normally excluded from social engagement. Consequently, the review was interested in interventions designed to increase citizen participation, support good governance and increase the transparency of evaluations assessing the effectiveness of interventions. The remit for the review was very broad and therefore included interventions across a wide range of settings, including education, employment and health. The review was initially focused on all low- and middle-income countries (LMICs). As it progressed, and in the light of the huge body of literature identified and the limited resources available, the main part of the review focused on six priority populations identified by AusAID (women, children, people living in rural areas, people with a disability, older people and tribal groups).
What did we find?
The included studies all contained at least two types of accountability mechanisms, and all seven studies included interventions directed at enhancing processes. Three of the seven studies included all three interventions – community accountability, enhanced processes and fiscal mechanisms. Four themes emerged as being central to community accountability and inclusive service delivery. They were capacity development, empowerment, corruption and health.
What are the implications?
1. Interventions aimed at promoting community accountability must invest in capacity development and the empowerment of vulnerable communities. Interventions are most effective when they are grounded in grassroots communities and adopt cross-cutting approaches, for example, combining cash transfer interventions with education and training opportunities or combining community infrastructure programmes with quotas for participation of women in governance roles.
2. There is an urgent need for studies to evaluate the impact of interventions on older people and people with disabilities. The global demographic transition is resulting in a rapid growth in the numbers and percentage of older people in Africa; there is, however, a major gap in the evidence for interventions aimed at strengthening community accountability and inclusive service delivery for this group.
3. AusAID and other funders must give careful consideration to the risks of using microfinance as a tool to enhance community accountability. This Summary study and a related systematic review (Stewart et al., 2010) point to the risks, including debt dependency, associated with microfinance.
4. The quality literature evaluating the impact of interventions is dominated by non-African researchers. There is therefore a need for investment in capacity development amongst practitioners and researchers in Africa to maximise dissemination of learning from interventions, and to ensure that the African ‘voice’ is strengthened, in practice, policy and research.
5. By necessity this review focused on six population groups in Africa. The review found 131 papers focused on community accountability mechanisms targeted at the general population. This literature could be relatively easily analysed and incorporated into an augmented review that would include evidence on interventions not reported on in this review, including interalia, the impact of community score cards.
6. Similarly, as part of the review process 1,437 papers focused on LMICs other than Africa were identified. This material could be examined in complementary reviews on Asia and Latin America. The findings of which could potentially be pooled to identify causative pathways between interventions and outcomes.
How did we get these results?
This was a two-stage systematic review. The first stage focused on the identification of potential studies. We cast our net wide at the start and included all LMIC. The search resulted in 14,500 citations. This huge number of potential papers went through a number of screening steps, and papers were excluded if they did not meet predetermined criteria.
The EPPI-Centre reference number for this report is 2107. This report should be cited as:
Lynch U, McGrellis S, Dutschke M, Anderson M, Arnsberger P, Macdonald G (2013) What is the evidence that the establishment or use of community accountability mechanisms and processes improves inclusive service delivery by governments, donors and NGOs to communities? London: EPPI-Centre, Social Science Research Unit, Institute of Education, University of London.