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. 2019 Aug 2;15(1-2):e1025.
doi: 10.1002/cl2.1025. eCollection 2019 Jun.

Citizen engagement in public services in low- and middle-income countries: A mixed-methods systematic review of participation, inclusion, transparency and accountability (PITA) initiatives

Hugh Waddington  1 , Ada Sonnenfeld  1 , Juliette Finetti  1 , Marie Gaarder  1 , Denny John  2 , Jennifer Stevenson  3
Affiliations

Citizen engagement in public services in low- and middle-income countries: A mixed-methods systematic review of participation, inclusion, transparency and accountability (PITA) initiatives

Hugh Waddington et al. Campbell Syst Rev. .

Abstract

Background: How do governance interventions that engage citizens in public service delivery planning, management and oversight impact the quality of and access to services and citizens' quality of life? This systematic review examined high quality evidence from 35 citizen engagement programmes in low- and middle-income countries that promote the engagement of citizens in service delivery through four routes: participation (participatory priority setting); inclusion of marginalised groups; transparency (information on rights and public service performance), and/or citizen efforts to ensure public service accountability (citizen feedback and monitoring); collectively, PITA mechanisms. We collected quantitative and qualitative data from the included studies and used statistical meta-analysis and realist-informed framework synthesis to analyse the findings.

Results: The findings suggest that interventions promoting citizen engagement by improving direct engagement between service users and service providers, are often effective in stimulating active citizen engagement in service delivery and realising improvements in access to services and quality of service provision, particularly for services that involve direct interaction between citizens and providers. However, in the absence of complementary interventions to address bottlenecks around service provider supply chains and service use, citizen engagement interventions alone may not improve key wellbeing outcomes for target communities or state-society relations. In addition, interventions promoting citizen engagement by increasing citizen pressures on politicians to hold providers to account, are not usually able to influence service delivery.

Conclusions: The citizen engagement interventions studied were more likely to be successful: (1) where the programme targeted a service that citizens access directly from front-line staff, such as healthcare, as opposed to services accessed independently of service provider staff, such as roads; (2) where implementers were able to generate active support and buy-in for the intervention from both citizens and front-line public service staff and officials; and (3) where the implementation approach drew on and/or stimulated local capacity for collective action. From a research perspective, the review found few studies that investigated the impact of these interventions on women or other vulnerable groups within communities, and that rigorous impact evaluations often lack adequately transparent reporting, particularly of information on what interventions actually did and how conditions compared to those in comparison communities.

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Figures

Figure 1
Figure 1
PITA throughout the three domains of good governance Notes: P: Participation | I: Inclusion | T: Transparency | A: Accountability. Source: Authors
Figure 2
Figure 2
Indicative theory of change
Figure 3
Figure 3
Study search flow diagram
Figure 4
Figure 4
Geographical distribution of included impact evaluations
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Figure 5
intervention funding sources
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Figure 6
Type of publications
Figure 7
Figure 7
Summary of risk of bias appraisal for randomised studies Note: figures are rounded percentages hence may not add to 100 per cent
Figure 8
Figure 8
Summary risk of bias appraisal of non‐randomised studies Note: figures are rounded percentages hence may not add to 100 per cent
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Figure 9
Number of effect sizes collected from included studies
Figure 10
Figure 10
Number of effect sizes by outcome along causal chain
Figure 11
Figure 11
Forest plots showing service access outcomes Note: * effect sizes for negative outcomes are inverted for comparability
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Figure 12
Forest plots showing service use outcomes Note: * effect sizes for negative outcomes are inverted for comparability
Figure 13
Figure 13
Forest plots showing wellbeing outcomes Note: * effect sizes for negative outcomes are inverted for comparability
Figure 14
Figure 14
Forest plot showing state‐society relations outcomes Note: * effect sizes for negative outcomes are inverted for comparability
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Figure 15
Forest plot showing service user engagement outcomes
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Forest plot showing provider responsive outcomes
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Figure 17
Forest plots showing immediate and intermediate outcomes for rights information Note: * effect sizes for negative outcomes are inverted for comparability
Figure 18
Figure 18
Forest plots showing final outcomes for rights information
Figure 19
Figure 19
Forest plots showing immediate and intermediate outcomes for performance information Note: * effect sizes for negative outcomes are inverted for comparability
Figure 20
Figure 20
Forest plots showing final outcomes for performance information Note: * effect sizes for negative outcomes are inverted for comparability
Figure 21
Figure 21
Forest plots showing immediate and intermediate outcomes for participatory planning Note: * effect sizes for negative outcomes are inverted for comparability
Figure 22
Figure 22
Forest plots showing final outcomes for participatory planning Note: * effect sizes for negative outcomes are inverted for comparability
Figure 23
Figure 23
Forest plots showing immediate and intermediate outcomes for citizen feedback mechanisms Note: * effect sizes for negative outcomes are inverted for comparability
Figure 24
Figure 24
Forest plots showing final outcomes for citizen feedback mechanisms Note: * effect sizes for negative outcomes are inverted for comparability
Figure 25
Figure 25
Forest plots showing immediate and intermediate outcomes for CBNRM
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Figure 26
Forest plots showing final outcomes for CBNRM
Figure 27
Figure 27
Funnel graphs a) All study designs b) RCTs only
Figure 28
Figure 28
Theory of change for interventions providing information on rights to public service quantity and quality
Figure 29
Figure 29
Theory of change for interventions providing information on individual and institutional service provider performance
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Figure 30
Theory of change for citizen monitoring and feedback interventions
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Figure 31
Theory of change for participatory planning and priority setting interventions
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Figure 32
Theory of change for community‐based natural resource management interventions
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Figure 33
Immediate outcomes for pure public and merit goods
Figure 34
Figure 34
Intermediate outcomes for pure public and merit goods
Figure 35
Figure 35
Final outcomes for pure public and merit goods
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References

References to included studies

    1. Alhassan, R. K. , Nketiah‐Amponsah, E. , Spieker, N. , Arhinful, D. K. , & Rinke de wit, T. F. (2016). Assessing the Impact of Community Engagement Interventions on Health Worker Motivation and Experiences with Clients in Primary Health Facilities in Ghana: A Randomized Cluster Trial. PLoS One, 11(7), e0158541. - PMC - PubMed
    1. Alhassan, R. K. , Nketiah‐Amponsah, E. , Spieker, N. , Arhinful, D. K. , Ogink, A. , Van Ostenberg, P. , & Rinke de wit, T. F. (2015). Effect of community engagement interventions on patient safety and risk reduction efforts in primary health facilities: Evidence from Ghana. PLoS One, 10. - PMC - PubMed
    1. Ananthpur, K , Malik, K , & Rao, V. (2014). The Anatomy of Failure: An Ethnography of a Randomized Trial to Deepen Democracy in Rural India. The World Bank, Development Research Group, Poverty and Inequality Team.
    1. Rao, V. , Ananthpur, K. , & Malik, K. (2017). The Anatomy of Failure: An Ethnography of a Randomized Trial to Deepen Democracy in Rural India. World development, 99, 481–497.
    1. Bandyopadhyay, S. , Shyamsundar, P. , & Xie, M. (2010). Transferring irrigation management to farmer's associations: Evidence from the Philippines. Water Policy, 12, 444–460.

References to ongoing studies

    1. Taylor, B ., & Hidalgo, F. D. ONGOING: Accountability and Incumbent Performance in the Brazilian Northeast.
    1. Nassul, K. , Mogues, T ., van Campenhout, B ., & Sseguya, H. ONGOING: Impact Evaluation of Community Advocacy Forums (Barazas) in Uganda.
    1. Khwaja, A ., Acemoglu, D ., & Cheema, A. ONGOING: Trust in State Authority and Non‐State Actors.
    1. Horacio, L ., Lucas, C ., & Marshall, J. ONGOING: When do Media Stations Support Political Accountability? A Field Experiment in Mexico. J‐PAL ongoing.
    1. Laudati, A ., Mvukiyehe, E ., & van der Windt, P. (2016). Participatory Development in Fragile and Conflict‐affected Contexts: An Impact Evaluation of the Tuungane Programme Pre‐Analysis Plan.

References to studies awaiting classification

    1. Tohari, A. , Parsons, C. , & Rammohan, A. (2017). Does Information Empower the Poor? Evidence from Indonesia's Social Security Card (No. 11137). IZA Discussion Papers.

Additional references

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    1. Banerjee, A. , Hannah, R. , Kyle, J. , Olken, B. , & Sumarto, S. (2015). “Tangible Information and Citizen Empowerment: Identification Cards and Food Subsidy Programs in Indonesia. NBER Working Paper No. 20923. Available at: http://www.nber.org/papers/w20923

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