Accountability mechanisms are catalysts in making this happen. They are critical to ensure funding flows down to the frontline health workers who want to be able to provide quality family planning services to women and young people, including the most marginalised. And they are critical to ensure that sustained financing translates into sustained access to quality family planning.
Accountable health systems are built by bringing together multi-stakeholder groups to use evidence to prioritise together, plan together and then monitor progress against those priorities together. Our UKAid and Gates-funded Evidence4Action-MamaYe programme facilitates this process. We work with partners to look for opportunities that already exist - within the constitution, the health system or the health budgeting and planning cycle - to bring multi-stakeholders together: media, health professional organisations, CSOs, private sector and government.
An example of this is in Nigeria where we support health sector partners to use a strategic combination of evidence and evidence-driven advocacy to drive accountability at Federal and State level. In Lagos State, the 2015 budget scorecards developed by the Lagos State Level Accountability Mechanism for maternal and newborn health (LASAM) tracked the transparency of that year’s budget cycle and identified weak civil society participation in the budget process. The State government took this on board and actively invited civil society participation in the next year’s budget development process.
Scorecards also help monitor services provided and enable civil society to influence decision-making. LASAM’s maternal and newborn health scorecard, tracked progress against priority health indicators. This showed low uptake of modern family planning methods at government run facilities. LASAM spoke with health workers and communities, discovering that women and young people were being charged for the consumables – syringes, gloves etc – needed to deliver Family Planning services, which were supposed to be free.
In the following year’s budget process, LASAM pushed for family planning to be prioritised, based on these findings. As a result, the 2017 budget included a specific budget line for family planning consumables.
Evidence and scorecards have the power to facilitate evidence-based prioritisation in health budgets. They can support joined-up advocacy to maintain visibility of priorities such as family planning. and keep family planning budget discussions grounded in the experience of women and young people who are using the services.