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Amplifying accountability by benchmarking results at district and national levels

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  • Alice Evans

Abstract

This multi†level ethnography of the Zambian health system illustrates the importance of top†down accountability, and how it has emerged in a historically neglected sector. Maternal healthcare indicators are prioritized when they are benchmarked, at district and national levels. The realization that Zambia was lagging behind African countries in making progress towards Millennium Development Goal (MDG) 5 (to reduce the maternal mortality ratio by three quarters) appears to have evoked reputational concerns and revealed inspirational possibilities. Growing prioritization also stems from a change in incentives, with some partner funding being conditional on the proportion of deliveries attended by skilled health personnel.

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  • Alice Evans, 2018. "Amplifying accountability by benchmarking results at district and national levels," Development Policy Review, Overseas Development Institute, vol. 36(2), pages 221-240, March.
    • Handle: RePEc:bla:devpol:v:36:y:2018:i:2:p:221-240
    DOI: 10.1111/dpr.12213
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    Cited by:

    1. Sochas, Laura, 2019. "Women who break the rules: Social exclusion and inequities in pregnancy and childbirth experiences in Zambia," Social Science & Medicine, Elsevier, vol. 232(C), pages 278-288.
    2. Thomas Hickmann & Frank Biermann & Matteo Spinazzola & Charlotte Ballard & Maya Bogers & Oana Forestier & Agni Kalfagianni & Rakhyun E. Kim & Francesco S. Montesano & Tom Peek & Carole‐Anne Sénit & Me, 2023. "Success factors of global goal‐setting for sustainable development: Learning from the Millennium Development Goals," Sustainable Development, John Wiley & Sons, Ltd., vol. 31(3), pages 1214-1225, June.
    3. Paolo Belardi & Ilaria Corazza & Manila Bonciani & Fabio Manenti & Milena Vainieri, 2022. "Evaluating Healthcare Performance in Low- and Middle-Income Countries: A Pilot Study on Selected Settings in Ethiopia, Tanzania, and Uganda," IJERPH, MDPI, vol. 20(1), pages 1-18, December.
    4. Sochas, Laura, 2021. "Challenging categorical thinking: A mixed methods approach to explaining health inequalities," Social Science & Medicine, Elsevier, vol. 283(C).
    5. Haaland, Marte E.S. & Haukanes, Haldis & Zulu, Joseph Mumba & Moland, Karen Marie & Blystad, Astrid, 2020. "Silent politics and unknown numbers: Rural health bureaucrats and Zambian abortion policy," Social Science & Medicine, Elsevier, vol. 251(C).

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