Accountability in the Reproductive Health Sector

This project, funded by the Results for Development Institute under William and Flora Hewlett Foundation support, aimed to better understand and overcome problems with public spending and service delivery in reproductive health in Tanzania.

The project generated evidence-based information through the use of Citizen Report Cards to persuade local government authorities to allocate funding for family planning during stock outs. The project also influenced the contraceptive supply chain management system to address stock outs at the district level, and strengthened the capacity of two local organizations and women’s and youth groups in the use of the Citizen Report Card for accountability.

The project engaged beneficiaries and health workers to measure access to contraceptives, identify inefficiencies and gaps, and develop appropriate solutions to respond to the public's contraceptive needs. Training of community-based organizations and meetings with women of reproductive age, health workers, and district and regional authorities culminated in a national stakeholders' forum to produce a joint strategy to ensure family planning supplies are available at all facilities.

Through the use of the Citizens Report Card, Pathfinder obtained feedback from FP clients in the regions of Dodoma, Shinyanga, and Dar es Salaam on the quality of FP services they received through public health facilities. Pathfinder worked on a three-level dissemination plan to distribute reports with findings and analyses from the Citizen Report Cards: a national level plan targeting key Ministry of Health and Social Welfare officials and Family Planning partners; a district level plan targeting district officials and health facility level service providers; and a community level plan which targeted community members. The dissemination meetings presented specific findings of FP client feedback and suggested actions.