article · BMC Health Services Research
This research explored the role of Health Facility Committees (HFCs) in social accountability within primary healthcare settings in West and Central Africa. It found that while most HFCs offer a forum for social accountability, their current practices are often informal and lack systematic organisation. This informality, coupled with limited community consultation, can lead to the exclusion of marginalised groups' voices. To develop more inclusive, coherent, and authoritative social accountability practices, the study recommends making HFC mandates explicit in health service planning, monitoring, and supervision. It also suggests providing tools for organising local accountability processes, enhancing opportunities for community input and feedback, and strengthening connections to formal administrative accountability mechanisms within the health system.
Ensuring that community voices, especially those of marginalised groups, are heard in healthcare decisions is vital for equitable and effective health services. This research highlights how to strengthen community participation and accountability in primary healthcare, which can lead to better health outcomes and more responsive health systems for everyone.
This research offers policy and organisational recommendations for strengthening social accountability in primary healthcare. It could inform the development of guidelines, training programmes, or frameworks for health ministries, non-governmental organisations, and community health organisations. The findings are applicable for improving health governance and community engagement, representing applied research with direct implications for health system reform and capacity building.
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Most HFCs in this study offer a social accountability forum, but the informal and non-systematic character and limited community consultation leave opportunities for the exclusion of voices of marginalised groups. More inclusive, coherent and authoritative social accountability practices can be developed by making explicit the mandate of HFC in the planning, monitoring, and supervision of health services; providing instruments for organising local accountability processes; strengthening opportunities for community input and feedback; and strengthening links to formal administrative accountability mechanisms in the health system.
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DOI: 10.1186/s12913-017-2344-7
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