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Comprehensive & Cost Effective Laboratory Monitoring of HIV/AIDS: an African Role Model
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Implementing social accountability for contraceptive services: lessons from Uganda.

Victoria Boydell1, Nanono Nulu2, Karen Hardee3

  • 1Global Health Centre, Geneva Graduate Institute, Chemin Rigot 2, 1202, Geneva, Switzerland. vickyboydell@gmail.com.

BMC Women'S Health
|October 13, 2020
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Summary

Social accountability initiatives can overcome barriers in women's contraceptive care. Despite sensitivities around sexual and reproductive health, these projects foster dialogue, improve services, and enhance access to family planning.

Keywords:
Case studiesContraceptionGenderSocial accountabilityUganda

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Area of Science:

  • Public Health
  • Health Services Research
  • Gender Studies

Background:

  • Social accountability shows promise for improving healthcare, particularly women's access to contraceptive care.
  • The complex and sensitive nature of sexual and reproductive health presents unique challenges for social accountability mechanisms.
  • Limited understanding exists on how social accountability functions within the specific context of contraceptive services.

Purpose of the Study:

  • To explore the operational dynamics of social accountability in contraceptive care.
  • To provide a grounded understanding of social accountability processes in sexual and reproductive health.
  • To investigate how gendered complexities influence social accountability in family planning.

Main Methods:

  • Employed an exploratory case study approach over one year in Uganda.
  • Observed two social accountability projects focused on contraceptive care.
  • Utilized multiple data collection instruments including 128 interviews and extensive document analysis.

Main Results:

  • Information, dialogue, and negotiation were central to social accountability in contraceptive care.
  • Projects led to improved community-health system relationships, empowerment, and provider responsiveness.
  • Contraceptive care transitioned from a taboo subject to one of public discussion.

Conclusions:

  • Social accountability, though sensitive in contraceptive services, effectively reduces resistance to family planning.
  • These processes facilitate more productive public discourse on sexual and reproductive health.
  • Social accountability can be a powerful tool for enhancing contraceptive access and utilization.