Online Program

Innovative model for promoting citizens voice and enabling greater accountability in marginalized and low resource settings

Monday, November 2, 2015 : 11:09 a.m. - 11:22 a.m.

Amina Aminu, MBBS; MPH, Partnership for Transforming Health Systems Phase II (PATHS2) Nigeria, FCT, Nigeria
Mike Egboh, BSc; MPH, Partnership for Transforming Health Systems Phase II (PATHS2) Nigeria, Abuja; FCT, Nigeria
Marleen Vellekoop, Options Consultancy UK, London, England
Ibrahim Yisa, MBBS; MPH; FMCPH, Partnership for Transforming Health System Systems Phase II (PATHS2) Nigeria, Abuja, Nigeria
Studies have shown that citizen’s participation in health service planning, delivery and monitoring is valuable in improving service quality and utilization. In many Nigerian communities however, mechanisms are not in place for citizens to adequately participate in healthcare service delivery. Channels for communicating needs and dissatisfaction are poorly structured, with few health committees that are largely dominated by elites. Advocacy efforts for health were insensitive, non-inclusive and ineffective, owing to low awareness of health rights and uncoordinated means of engagement.

The Partnership for Transforming Health Systems in Nigeria adapted the World Bank’s Accountability Triangle in strengthening citizen’s voice and participation while taking into account relationships between the client, provider and policymakers. The programme trained, mentored and provided consistent support to 600 Facility Health Committees (FHCs) in five states along the three operational areas of facility management, community involvement in health decision making and mobilization for health service uptake.

Following a three-year interface, an average of 95% improvement was recorded against all three operational areas in the five supported states while 77.8% issues raised with health facilities and 84.4% issues advocated with government received positive actions. Responses by government include increased coverage for free services to pregnant women  and children under five, improved allocation and implementation of free health care programmes and reversion of a policy which required women to present their husband’s tax clearance certificate before accessing healthcare.

The FHC model is essential in promoting citizens’ voice and enabling greater accountability of government and health providers to service users.

Learning Areas:

Advocacy for health and health education

Learning Objectives:
Define the accountability framework for strengthening citizen’s voice and participation in health care in resource poor settings Describe the role of Facility Health Committees in enhancing health system accountability for Nigerian citizens

Keyword(s): Accountability, Consumer Rights & Protection

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been leading the service delivery component of the Partnership for Transforming Health systems in Nigeria which focuses on improving the delivery of quality services to women and children in underserved areas within focal states. As part of this programme, I provided technical support and guidance towards setting up and strengthening Facility Health Committees to hold governments accountable for the delivery of quality health care for its citizens.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.