Transparency for Development Team, April 2021
Programs to improve the transparency and accountability of public services are an increasing focus of international commitments to sustainable development. We ask whether involving officials in one common approach—community scorecard programs—brokers state-society collaboration that improves public services. We compare two scorecard programs focused on improving maternal and newborn health care that were offered in 215 communities similarly stratified across five countries. The first program, offered in 200 communities in Indonesia and Tanzania, involved facilitated meetings among community members. A similar program in 15 communities in Ghana, Malawi, and Sierra Leone involved facilitated meetings among community participants as well as between community members and hereditary authorities (in Malawi) or district-level elected and appointed officials (in Ghana and Sierra Leone). Interviews, focus groups, and systematic observations consistently suggest that in the program in Malawi, participants took similar approaches to improving their health care to participants in Indonesia and Tanzania—focusing primarily on improving care themselves and with health-care providers and others in their communities—and that the results of their efforts were similar to the program in Indonesia and Tanzania, where a randomized controlled impact evaluation found that average community outcomes did not improve significantly faster than in a control group of communities. In both Ghana and Sierra Leone, participants collaborated more with officials and saw tangible changes to health care that they and others noticed and remembered in nearly twice the proportion of communities as in the program in Indonesia and Tanzania. We conclude that involving officials in these programs may increase their effectiveness.