Stewardship & Accountability
Governments are responsible for providing high-quality public health services to their citizens and ensuring that private health services are well-regulated. As such, governments must manage health services effectively; be accountable for policy and implementation decisions; and make budget, spending, and performance information publicly accessible. Still, there are inevitable political dimensions to health sector decision making, including competition between special interests on one hand, and technical criteria and data findings on the other.
Decentralization (shifting responsibility to local governments) is a policy reform increasingly employed by national governments to improve efficiency and strengthen democracy. As local governments adopt new roles and responsibilities, citizens at the local level have greater opportunities to influence health policy decisions. However, local officials may need incentives to listen to and act upon citizen input. How citizens interact with these new levels of government will increase the likelihood that governments will improve their stewardship, accountability, and transparency. Strong structures and processes can make these interactions positive and productive, and can improve service quality and health outcomes.
What We Do
HP+ seeks to improve health services by strengthening the policy environment for stewardship, accountability, and transparency. To support governments in policy development, we
- Assist them in making health data available to the public
- Work to ensure that they hear and respond to the voices of critical stakeholders
- Help them in creating positive incentives for improved performance in health services
- Collaborate with them to ensure effective governmental oversight and regulation of health services
- Work with civil society organizations to support their ability to hold their government accountable for its commitments
What Will Success Look Like?
HP+ succeeds when governments develop policies that support strong health sector stewardship, when civil society participates fully in policy processes, and when health data are available to the managers and advocates who need them. We measure our progress using both quantitative and qualitative methods. Quantitatively, we look at such objective measures as the number of progressive governmental steps taken to move new policy toward adoption, or the number of meetings convened between civil society and government. Qualitatively, we use tools such as network analysis, process mapping, and political economy analysis to gain insights into how complex governance relationships are affecting health outcomes. These evaluation methods offer HP+ the opportunity to understand the factors that lead to successful interventions and guide future health policy assistance.