Social Accountability and Improvement of Health Services in Zimbabwe: The Case of Shamva District
By: Olivia Gumbo
Zimbabwe Open University, Harare
The study examined the nexus between social accountability and the improvement of the quality of the health services in Shamva District. Its objectives were to determine the social accountability strategies used by Civic Society Organizations (CSOs) in Shamva District to build capacity for citizens to demand their health rights and entitlements; explore the extent to which the state responds to accountability demands for health services tabled by the citizens; assess the capacity level of both the rural citizens and state to conduct deliberate dialogue on health service provisions; and analyse the impact of social accountability mechanisms on rural health services in Zimbabwe. The study was guided by the interpretive paradigm. It was based on qualitative methodology utilising semi-structured interviews, focus group discussions, in-depth interviews with key informants and participant observation. The data generated were analysed using grounded theory, assisted by the NVivo qualitative software. The four themes that emerged were social accountability strategies used to empower citizens; state responsiveness to accountability demands; capacity level to conduct deliberative dialogue; and impact of social accountability mechanisms. The study found out three social accountability strategies utilised in Shamva District. These were community scorecard; results-based financing: and village worker model. The study concluded that continuous funding and sustainable plans are essential for improving service delivery in health using social accountability strategies. The study recommends the Government of Zimbabwe to provide adequate human, financial and physical resources for the successful implementation of social accountability in Shamva District health sector.