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The Institute for Global Health and Development

Permanent URI for this collectionhttps://eresearch.qmu.ac.uk/handle/20.500.12289/9

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Subject: search.filters.subject.Accountability

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    Empowering parents and promoting school and teacher accountability and responsiveness: Case of Kyrgyzstan
    (Elsevier, 2023-10-02) Jailobaeva, Kanykey; Jailobaev, Temirlan; Baialieva, Gulsaadat; Ismanbaeva, Rakhat; Kirbasheva, Dilbara; Adam, Marc-Antoine
    The Aga Khan Foundation in Kyrgyzstan implemented the Community Engagement for Better Schools project in Kyrgyzstan in 2017–2022. The project promoted three key mechanisms - performance and budget hearings, social contracts, and community scorecards – that were innovative for schools in the post-Soviet lower-middle-income country with multiple education reforms. This paper examines to what extent the project succeeded in improving the accountability and responsiveness of teachers and school management and empowering parents from the perspective of parents/caregivers. It draws on the survey with 1750 parents/caregivers from the project and comparison schools collected at the baseline and endline stages. The paper concludes that the project improved the accountability and responsiveness of teachers and school management to some extent from the perspective of parents/caregivers, especially women and those from low-income households. Most changes were observed in relation to making budget information available and reporting on school expenses. The project outcomes offer validated mechanisms for promoting accountability and responsiveness of schools that can be rolled out to other schools. However, a multi-actor commitment at the national and local levels is required for long-term sustainable results.
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    Understanding fragility: Implications for global health research and practice
    (Oxford University Press, 2019-12-10) Diaconu, Karin; Falconer, Jennifer; Vidal, Nicole L.; O'May, Fiona; Azasi, Esther; Elimian, Kelly; Bou-Orm, Ibrahim; Sarb, Cristina; Witter, Sophie; Ager, Alastair
    Advances in population health outcomes risk being slowed—and potentially reversed—by a range of threats increasingly presented as ‘fragility’. Widely used and critiqued within the development arena, the concept is increasingly used in the field of global health, where its relationship to population health, health service delivery, access and utilization is poorly specified. We present the first scoping review seeking to clarify the meaning, definitions and applications of the term in the global health literature. Adopting the theoretical framework of concept analysis, 10 bibliographic and grey literature sources, and five key journals, were searched to retrieve documents relating to fragility and health. Reviewers screened titles and abstracts and retained documents applying the term fragility in relation to health systems, services, health outcomes and population or community health. Data were extracted according to the protocol; all documents underwent bibliometric analysis. Narrative synthesis was then used to identify defining attributes of the concept in the field of global health. A total of 377 documents met inclusion criteria. There has been an exponential increase in applications of the concept in published literature over the last 10 years. Formal definitions of the term continue to be focused on the characteristics of ‘fragile and conflict-affected states’. However, synthesis indicates diverse use of the concept with respect to: level of application (e.g. from state to local community); emphasis on particular antecedent stressors (including factors beyond conflict and weak governance); and focus on health system or community resources (with an increasing tendency to focus on the interface between two). Amongst several themes identified, trust is noted as a key locus of fragility at this interface, with critical implications for health seeking, service utilization and health system and community resilience.
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    Balancing authority, deference and trust across the public-private divide in health care: Tuberculosis health visitors in western Maharashtra, India
    (2014-08) Kielmann, Karina; Datye, Vinita; Pradhan, Anagha; Rangan, Sheela
    While concepts such as 'partnership' are central to the terminology of private-public mix (PPM), little attention has been paid to how social relations are negotiated among the diverse actors responsible for implementing these inter-sectoral arrangements. India's Revised National Tuberculosis Control Programme (RNTCP) has used intermediary agents to facilitate the involvement of private providers in the expansion of Directly Observed Therapy, Short-Course (DOTS). We examine the roles of tuberculosis health visitors (TB HVs) in mediating working relationships among private providers, programme staff and patients that underpin a PPM-DOTS launched by the RNTCP in western Maharashtra. In addition to observations and informal interactions with the programme and participating health providers, researchers conducted in-depth interviews with senior programme officers and eight TB HVs. Framed by a political discourse of clinical governance, working relationships within the PPM are structured by the pluralistic context, social and professional hierarchies and paternalism of health care in India. TB HVs are at the nexus of these relationships, yet remain undervalued partly because accountability is measured through technical rather than social outcomes of the 'partnership'. Close attention to the dynamics of power relations in working practices within the health system can improve accountability and sustainability of partnerships. 2014 2014 The Author(s). Published by Taylor & Francis.