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. 2021 Apr;30(4):766-785.
doi: 10.1002/hec.4219. Epub 2021 Jan 17.

Impact of social accountability monitoring on health facility performance: Evidence from Tanzania

Igor Francetic  1   2   3   4 , Günther Fink  2   3 , Fabrizio Tediosi  2   3
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Impact of social accountability monitoring on health facility performance: Evidence from Tanzania

Igor Francetic et al. Health Econ. 2021 Apr.

Abstract

Social accountability programs are increasingly used to improve the performance of public service providers in low-income settings. Despite their growing popularity, evidence on the effectiveness of social accountability programs remains mixed. In this manuscript, we assess the impact of a social accountability intervention on health facility management exploring quasiexperimental variation in program exposure in Tanzania. We find that the social accountability intervention resulted in a 1.8 SD reduction in drug stockouts relative to the control group, but did not improve facility infrastructure maintenance. The results of this study suggest that social accountability programs may be effective in areas of health service provision that are responsive to changes in provider behavior but may not work in settings where improvements in outcomes are conditional on larger health systems features.

Keywords: Tanzania; community monitoring; essential medicines; health infrastructure; social accountability.

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