A review of social accountability approaches in health in Tanzania

Social accountability is achieving a greater profile at global, regional and national levels and gaining wide acceptance in facilitating improvements in health services and strengthening governance. Citizens are not only beneficiaries, they are catalysts for change. Definitions for social accountability are numerous, one that is frequently used is “formal or informal mechanisms through which citizens and/or civil society organisations engage to bring state officials or service providers to account”. In Tanzania, social accountability is a recognised approach to improving health services as it is entrenched in many government documents and guidelines.

We were commissioned by Irish Aid to conduct a review of social accountability approaches in health in Tanzania. A review of literature on best practices in implementing strong social accountability initiatives and key stakeholder interviews were undertaken. Learnings on the successes and challenges of social accountability approaches, with a focus on the pathways of change and enabling conditions through which health services and outcomes can be realised in Tanzania were captured. This briefing note summarises the key guiding principles emerging from the review and provides a recommended theory of change for designing and delivering effective social accountability approaches in health.