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Citizen Voice and Action for Government Accountability and Improved Services: Maternal, Newborn, Infant and Child Health Services

Daniel Ball, Gill Westhorp


October 2018

The ‘Citizen Voice and Action for Government Accountability and Improved Services: Maternal,Newborn, Infant and Child Health Services’ project was funded through the World Bank’s Global Partnership for Social Accountability (GPSA) program. The overall aim of the project was to improve maternal, newborn, child health, and nutrition (MNCHN) services, and specifically to achieve “Improved quantity and quality of Midwives and District Health Office’s Services for MNCHN” in the three districts.

The project used World Vision’s ‘Citizen Voice and Action’ (CVA) approach. This approach involves training facilitators at village level, who then, with support from project staff, facilitate a series of processes at village, sub-district and district level. Those processes enable villagers and local staff to assess services against both official standards and villager-determined standards, to develop local plans for service improvement, and to advocate to higher levels of the service delivery system for improvements.

This is the final evaluation report of this project. The evaluation was undertaken using realist evaluation methodology (Pawson and Tilley, 1997). Realist evaluation does not ask “Did this work”, but “For whom did this work, in what contexts, in what respects, to what extent, and how?”

The evaluation used a variety of data sources including a survey of households with children under 5 and/or a pregnant woman and another survey of officials and health cadres; assessments against government standards, community score cards and action plans; Most Significant Change stories and interviews, and program administrative data. It was undertaken over a four-year time frame (2014-2018) and involved annual rounds of data collection and analysis, with interim reports being fed into the program to inform program improvements.

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