In the context of primary health care, social accountability is a measure of whether a country is held accountable to existing and emerging social concerns and priorities based on need. Social accountability strategies “try to improve institutional performance by bolstering both citizen engagement and the public responsiveness of states and corporations”.1 Social accountability offers a set of approaches and tools to promote citizen engagement and monitoring to improve system performance, effectiveness, and responsiveness to public needs. Because different countries, regions, or even communities face different breakdowns in primary healthcare, this set of approaches provides a mechanism for citizens and civil society, together with service providers and government, to identify and seek solutions to the specific problems they observe with their local health system. Effective social accountability is enabled though regular feedback loops between health system users and administrators.
While citizen-driven social accountability approaches have existed for decades, it is important to note that integration of social accountability into health sector initiatives is relatively new. Thus, research on these initiatives has shown mixed results. In this module, we will distill these mixed results to highlight practices that have shown the most promise based both on results of field research and thought papers within the sector.