The Transparency for Development (T4D) study was designed to answer the question of whether a community-led transparency and accountability program can improve health outcomes and community empowerment, and, if so, how and in what contexts. To answer this question, researchers and civil society organization partners began by co-designing a program that would activate community participation to address myriad barriers to proper maternal and newborn care, with the ultimate goal of improving maternal and newborn health outcomes. This report presents the design of the program that was then implemented in 200 villages in Tanzania and Indonesia and studied using a mixed methods impact evaluation. In addition to detailing the program, this report outlines how the project team got there—describing a number of principles that informed some distinguishing features of the program, as well as an iterative design process that defined other features through trial and error.
Policy Brief
In this paper, Mary W. Graham examines how unintended information inequities undermine critical health and safety alerts. Focusing on three key policies — wildfire alerts, drinking water reports, and auto safety recalls — she identifies common roots of these disparities and highlights efforts by policymakers to address them.
Testimony
A community scorecard program in Indonesia and Tanzania showed no measurable health improvements — but a nearly identical version in Ghana, Malawi, and Sierra Leone worked in almost twice as many communities. Stephen Kosack, Archon Fung, and their coauthors trace the difference to one design choice: whether local officials were in the room.
Paper
Instead of telling communities how to fix their maternal health systems, researchers just handed them information and let them design their own plans — no prescribed targets, no required tactics. The result: 1,139 separate actions, from road repairs to ambulance funds to confronting health officials directly. Would people converge on one obvious strategy, or scatter in every direction?
