Credit: MamaYe!/Sierra Leone

Advocacy and accountability

Effective accountability is essential to drive the change needed to improve health and social outcomes, especially for women, children and the most marginalised.

It can improve healthcare performance and equity by facilitating a more transparent and constructive dialogue between government, healthcare providers and the populations they serve. We bring these different groups together to explore the evidence around the issue, agree on solutions, advocate for change and monitor effectiveness.

We provide technical assistance on accountability in response to local request and need, and we work carefully with stakeholders to agree on programme approaches informed by the political economy of the context and issue. Examples of our approaches include:

  • Establishing and facilitating powerful coalitions: bringing together and forging trusted relationships between previously disparate actors, including government, healthcare workers, private sector providers, civil society, academics and media. We help broker these relationships, showing how those at different sides of the table can work together to jointly identify problems and implement and monitor solutions to improve the quality and responsiveness of health services. See our work on the Women’s Integrated Sexual Health (WISH) programme and Evidence-for Action MamaYe to learn more about the role of these coalitions and how they have transformed the way actors in the health system work together.
  • Supporting sub-national, national and global advocacy: we work with inspiring advocates to hold government accountable on their development policies and programmes and ensure additional resources are leveraged for priority issues. For example, through The Girl Generation and African Led Movement we have provided technical support and small grants to grassroots women, girl and youth-led organisations so they can effectively implement, sustain and scale ‘end female genital mutilation and cutting’ advocacy initiatives.
  • Strengthening community voice and participation: services users are in the best position to say which improvements are needed. We work with local actors through Facility Health Committees in Nigeria, Health Centre Advisory Committees in Malawi and community groups in Kenya, to ensure citizens are actively involved in the delivery of health services in their communities and have their voices heard and responded to through planning and budgeting processes.
  • Leveraging the power of media: understanding rights and entitlements is critical for accountability, as is the ability to shine a spotlight on successes and challenges. Media can be a powerful ally in this, helping to communicate and sensitively address rights, entitlements and norms to a broad audience. We have worked with media across multiple countries to ensure people know the quality of health services they are entitled to receive and at what cost and to change social norms around harmful practices such as FGM/C.

We work across all levels of the health system: from community groups to global forums, ensuring feedback on success, challenges and best practices is shared and incorporated into approaches. Our experts have helped to develop accountability frameworks and tools, including USAIDs High Impact Practices on Family Planning.


  • Increased budget allocation for Family Planning in Nigeria, Burkina Faso and Democratic Republic of Congo as a result of advocacy from multi-stakeholder coalitions.
  • Over 1.5 million people reached with end FGM messaging across Africa, through The Girl Generation youth networks and End FGM ambassadors.
  • Supported advocacy which prompted the government in Lagos, Nigeria, to increase the release for maternal and neonatal health (MNH) to 81.04% of allocated budget in August 2020, compared to 0% from March-June 2020.

Our experts

  • Oko Igado
    Oko is a social development in health expert with over 22 years’ experience in designing and leading the implementation of health systems strengthening, maternal health, health financing and sexual and reproductive health strategies to strengthen citizens’ voice and hold governments to account in Africa and Asia. As our Regional Evidence and Accountability Specialist, he oversees and coordinates WISH’s quality improvement and accountability work.

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