Evidence and accountability
Evidence strengthens accountability and can be used to make health systems more responsive to people’s needs, which means a healthier population, reduced health inequalities, and fewer people dying from preventable causes. But in many resource-poor settings, robust and up-to-date evidence is often unavailable or inaccessible and the skills to collect, analyse and use data need building.
We use evidence to drive action in all our work by:
- Strategically packaging evidence into infographics, traffic light scorecards, policy briefs, evidence summaries and factsheets
- Exposing resource gaps and needs, and highlighting insufficient budget allocations or bottlenecks
- Reinvigorating maternal death reviews, rolling them out and institutionalising their practice to ensure that evidence drives action
- Driving advocacy messaging through sharing evidence and using it tactically
- Training journalists and activists to understand the data and evidence in their national context so they can hold their decision-makers to account
- Tracking progress through scorecards and dashboards with critical indicators on outcomes and then using these data to influence change
- Holding decision-makers to account by establishing and strengthening accountability mechanisms which use data to review and track progress
- Improving transparency and public access to the details of government commitments so that success can be celebrated and shortfalls highlighted.
Our Evidence for Action (E4A) programme is saving lives of mothers and newborns in Ethiopia, Ghana, Malawi, Nigeria, Sierra Leone and Tanzania – all by focusing on better use of evidence. It improves access to data so that decision-makers have the right information at the right time and in the right format to enable better decisions. It also means that the wider public, civil society organisations and the media can use data to expose resource deficiencies, advocate more effectively and hold decision-makers to account.
In Tanzania, our E4A team worked with the government to implement Reproductive Maternal Newborn and Child Health scorecards. These were designed to track progress under the Sharpened One Plan that brings existing plans into an overarching strategy, and is intended to promote high quality facility-based care around the time of birth and address inequities. You can view a scorecard, which has been rolled across all mainland regions, and the background to the approach here.
Quality of Institutional Care (QuIC) is a tool designed for the fast, frequent, low-cost and scalable collection of data that can show the quality of care in facilities. In Sierra Leone, QuIC has been used to collect facility data on maternal health care. It has now been adapted to include vital data on infection control in the wake of Ebola.
We developed scorecards for the Campaign on Accelerated Reduction of Maternal Mortality in Africa (CARMMA) to create an easy, visual way to compare maternal, newborn and child health indicators across African countries. This approach informed the design of African Health Stats – a one-stop shop of the latest maternal and neonatal health indicators from across Sub-Saharan Africa.
We also established the Africa Health Budget Network (AHBN), a group of African and global organisations and individuals using or wishing to use budget advocacy as a tool to improve health service delivery in Africa. The first AHBN scorecard was launched at a plenary session of the World Health Organisation Partners’ Forum in Johannesburg in July 2014.
80% of regions in Tanzania now use scorecards to track progress in maternal and newborn health
Nigeria is using scorecards to track progress against UN indicators
The Africa Health Budget Network is leveraging resources to improve health service delivery
Dr Babatunde SegunDr Babatunde Segun is a public health physician with over 22 years' experience, particularly in adolescent reproductive health, and maternal and newborn health. He is Country Director for the Evidence for Action (E4A) programme in Nigeria, responsible for the effective coordination of efforts across evidence, advocacy and accountability in maternal and newborn health. Tunde has worked in collaboration with WHO, UNFPA, UNICEF, the World Bank, and various government ministries, as well as national and local NGOs. He is a member of various national coordinating bodies on maternal and reproductive health in Nigeria.
Sara Bandali, DrPHSara Bandali has over 15 years’ experience in health sector development, including research, policy development and programme design and implementation. She has worked within government, for implementing organisations and the UN. Sara has expertise in maternal and child health, HIV/AIDS, malaria, community health, health systems strengthening, and water supply and sanitation. She has facilitated policy dialogue on cross-sectorial initiatives including HIV/AIDS and gender and early childhood development. Sara is a leading expert on use of evidence and development of accountability mechanisms to advocate for better maternal and newborn health services.
Rachel CullenRachel Cullen is a population and health specialist with 20 years’ experience providing monitoring, evaluation and research support to international and UK health sector organisations. She has skills in methodological design, data collection and analysis for the evaluation of studies ranging from small-scale pilots to large district-wide quantitative and qualitative surveys. She combines technical monitoring and evaluation skills with practical experience as a UK NHS commissioner, performance manager and trustee of health services and applies her understanding of the challenges in health service delivery in the UK to promoting improved quality of care in Africa and Asia.