ICT-facilitated accountability and engagement in health systems: a review of Making All Voices Count mHealth for accountability projects

Date added: July 10, 2017

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Information and communication technologies (ICTs) and mHealth innovations hold great potential to improve health systems and health outcomes while at the same time enhancing citizen engagement and accountability. Yet there has been little assessment of the impact of mHealth innovations on the ground.

This paper reviews the experiences of seven mHealth initiatives funded by the Making All Voices Count programme: OurHealth, eThekwini WACs and Thuthuzela Voices (all in South Africa), Mobile Mapping for Women’s Health (Tanzania), Text2Speak (Nigeria), SMS Gateway (Indonesia), and Citizen Journalism for Quality Governance of Universal Health Insurance Scheme (also Indonesia). The authors discuss the accountability model adopted by each project, and the challenges they faced.

Key findings include:

engaging existing community-level groups or forums is more likely to lead to success in uptake of ICTs for improving health services and strengthening accountability
other stakeholders (e.g. health workers) must be involved to maximise impact and sustainability and to allay any fears about consequences of negative feedback
unless those in positions of power to change things (locally and / or nationally) are allies in the process, efforts are unlikely to meet with success
offline spaces can strongly complement online innovations to leverage individual citizens’ feedback and translate that feedback into action to improve services.

All seven projects saw the technology that was embedded in, or made possible through, mobile phones, tablets or other portable electronic devices as critical to their vision of accountability. However, the report concludes that there are limits to what technology can deliver in terms of augmenting citizen voice and enhancing accountability, particularly in the absence of other offline activities such as engaging citizens in meaningful ways and building good relationships with key government actors and departments.

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