Leveraging Communities’ Capabilities to Increase Accountability for Health Rights: The Case of Citizen Voice and Action

Citizen Voice and Action (CV&A), a rights- and strengths-based social accountability approach developed in the global South, helps communities marginalized by unfair power relations to counter low accountability. By creating a dynamic of entitlement within communities and obligation by duty-bearers, it improves power relations and frees communities to build shared agency through reciprocity which advances health rights claims. After outlining capability theory and linking it to human rights, this paper explains CV&A’s origins in democratic struggles for rights and its current praxis. Using Ugandan case studies, it examines how people suffering its low accountability claim health and human rights by culturally engaging with each other and with duty-bearers. When interpreted as a set of collective freedoms and capabilities to struggle, social accountability helps explain how democratic action with and for communities at multiple levels aligns policy implementation with service performance to produce standards of public healthcare that community members value.