CARE International works to strengthen accountability in health services through rights-based approaches and advocacy.

The importance of accountable health services 

Social accountability tools are increasingly recognized as a means of improving service delivery and governance. It is an approach that relies on the engagement of citizens to demand accountability from service providers and public officials. 

Accountable health services require the integration of several structures to ensure that communities receive safe and effective healthcare. CARE International works to achieve strengthened accountability through rights-based approaches, community engagement and advocacy. 

Accountability is not a one-time assessment or action. Genuine accountability mechanisms must be both formal and informal, action oriented and ongoing. Without rights-based accountability, we cannot enact the change needed to create more equitable and effective health services. 

Partnership is central to our effort to ensure that people of all genders can realize their right to health. 

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Our partners: Our approach to partnership is informed by our values. We seek opportunities to act as allies to our partners, helping them access funding and decision-making spaces.

What is CARE International doing to improve accountability in health services?  

CARE International has deep roots at the community level as well as relationships with leaders at higher levels of the health system and government ministries. These relationships offer a unique ability to promote resilient community health ecosystems by strengthening accountability between health systems and communities.  

CARE International’s approach brings communities and duty bearers together to develop more accountable, resilient, and responsive health systems that, in better providing to those who are underserved, also ensures improved services for all. We work to quickly mobilize and respond to public health emergencies and ensure that response efforts address the gendered dimensions of health before, during, and after emergencies 

A critical focus of our partnership effort is supporting frontline workers of government health services to improve accessibility, availability, acceptability, and quality of primary health care services.  

CARE’s Community Score Card© (CSC) is a citizen-driven accountability approach that creates spaces for dialogue, negotiation, and collaboration between citizens and services to use of services, come up with solutions, and work together to implement and track the effectiveness of them. 

In our Malawi pilot CSC program, randomized controlled trials found increases in citizen empowerment, service provider and powerholder effectiveness, improved accountability and responsiveness, and a significant effect on use of contraceptive services. The CSC methodology has been adapted to a range of different sectors and settings, including humanitarian, and has been featured as a best practice approach by the World Bank.  

CARE International is using this approach to improve government responsiveness during public health emergencies, including the COVID-19 pandemic