Sharing success stories: Transparency and accountability for better health outcomes

Last month during the Open Government Partnership (OGP) conference in Brazil, ONE hosted a side event to explore the ways in which opening governance –- making it more transparent and accountable -– can lead to better health outcomes. Chaired by Lu Ecclestone from the UK’s development agency, DFID, the panel included John Ulanga from the Foundation for Civil Society, Tanzania; Claire Schouten from Tiri: Making Integrity Work; Diego de la Mora Maurer from Fundar in Mexico; and me.

Drawing on his experience in Tanzania, John Ulanga talked about a number of ways in which greater transparency and accountability in the health sector had led to improvements in performance. Public Expenditure Reviews had increased the proportion of funds actually making it to the point of service delivery, monitoring had thrown light on the abuse of subsidies for malaria drugs, and the simple wearing of name tags had improved citizens’ interactions with those at the front line of service delivery. However, as John emphasized, initiatives often remain as good ideas on the drawing board, with limited implementation by politicians reluctant to rock the boat.

In his presentation, Diego de la Mora Maurer drew on Fundar’s many years of experience in relation to budgets and public policy processes. Diego talked in particular about how Fundar used its knowledge of the budget and legislative processes to push for more transparency about spending on health.

Claire Schouten presented a number of examples from the many and varied places where Tiri works, showing the value of community-powered accountability and the difference that it can make. Tiri tailors its approach to the various contacts in which it works, enabling local communities to come up with solutions to the problems that they face.

Finally, in my presentation –- based on a two-pager produced in collaboration with the Transparency and Accountability Initiative –- I introduced a number of examples to make the case that greater transparency and accountability at the level of the health sector can lead to more, better-used resources delivering improved results. In South Africa, the Treatment Action Campaign in South Africa has helped 1.4 million people access antiretroviral treatment. In Tanzania, SMS monitoring of drug stocks has improved people’s access to malaria treatment by 240 percent. And in Uganda, community monitoring of health service delivery has contributed to a 33 percent reduction in child mortality.

Up until now, the Open Government Partnership has given little attention to the impact that better governance can have on outcomes, such as health, that matter to ordinary people. This will need to change -– as Tanzania’s President Kikwete put it “To a pregnant woman, open government needs to be about the safe delivery of her baby.” Watch this space!


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