Using accountability to improve reproductive health care

Asha George

Research output: Contribution to journalArticlepeer-review

52 Scopus citations


Accountability is best understood as a referee of the dynamics in two-way relationships, often between unequal partners. The literature on accountability distinguishes between political, fiscal, administrative, legal and constitutional accountability. This paper focuses on accountability mechanisms in health care and how they mediate between service providers and communities and between different kinds of health personnel at the primary health care level. It refers to case studies of participatory processes for improving sexual and reproductive health service delivery. Information, dialogue and negotiation are important elements that enable accountability mechanisms to address problems by supporting change and engagement between participants. In order to succeed, however, efforts towards better accountability that broaden the participation of users must take into account the social contexts and the policy and service delivery systems in which they are applied, address power relations and improve the representation of marginalised groups within communities and service delivery systems.

Original languageEnglish (US)
Pages (from-to)161-170
Number of pages10
JournalReproductive Health Matters
Issue number21
StatePublished - May 2003
Externally publishedYes


  • Accountability
  • Participatory processes
  • Provider-patient relations
  • Reproductive health services

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Reproductive Medicine


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