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How does social accountability contribute to better maternal health outcomes? A qualitative study on perceived changes with government and civil society actors in Gujarat, India

Overview of attention for article published in BMC Health Services Research, August 2018
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Title
How does social accountability contribute to better maternal health outcomes? A qualitative study on perceived changes with government and civil society actors in Gujarat, India
Published in
BMC Health Services Research, August 2018
DOI 10.1186/s12913-018-3453-7
Pubmed ID
Authors

Mukesh Hamal, Tjard de Cock Buning, Vincent De Brouwere, Azucena Bardají, Marjolein Dieleman

Abstract

Social accountability mechanisms have been highlighted as making a contribution to improving maternal health outcomes and reducing inequities. But there is a lack of evidence on how they contribute to such improvements. This study aims to explore social accountability mechanisms in selected districts of the Indian state of Gujarat in relation to maternal health, the factors they address and how the results of these mechanisms are perceived. We conducted qualitative research through in-depth interviews and focus group discussions with actors of civil society and government health system. Data were analyzed using a framework of social determinants of maternal health in terms of structural and intermediary determinants. There are social accountability mechanisms in the government and civil society in terms of structure and activities. But those that were perceived to influence maternal health were mainly from civil society, particularly women's groups, community monitoring and a maternal death review. The social accountability mechanisms influenced structural determinants - governance, policy, health beliefs, women's status, and intermediary determinants - social capital, maternal healthcare behavior, and availability, accessibility and the quality of the health service delivery system. These further positively influenced the increased use of maternal health services. The social accountability mechanisms, through the process of information, dialogue and negotiation, particularly empowered women to make collective demands of the health system and brought about changed perceptions of women among actors in the system. It ultimately improved relations between women and the health system in terms of trust and collaboration, and generated appropriate responses from the health system to meeting women's groups' demands. Social accountability mechanisms in Gujarat were perceived to improve interaction between communities and the health system and contribute to improvements in access to and use of maternal health services. The influence of social accountability appeared to be limited to the local/district level and there was lack of capacity and ownership of the government structures.

Twitter Demographics

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Mendeley readers

The data shown below were compiled from readership statistics for 137 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 137 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 26 19%
Researcher 14 10%
Student > Ph. D. Student 13 9%
Student > Bachelor 11 8%
Student > Doctoral Student 8 6%
Other 25 18%
Unknown 40 29%
Readers by discipline Count As %
Social Sciences 26 19%
Medicine and Dentistry 25 18%
Nursing and Health Professions 16 12%
Business, Management and Accounting 4 3%
Psychology 4 3%
Other 21 15%
Unknown 41 30%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 23 August 2018.
All research outputs
#8,401,406
of 13,411,840 outputs
Outputs from BMC Health Services Research
#3,193
of 4,489 outputs
Outputs of similar age
#160,263
of 268,091 outputs
Outputs of similar age from BMC Health Services Research
#2
of 2 outputs
Altmetric has tracked 13,411,840 research outputs across all sources so far. This one is in the 23rd percentile – i.e., 23% of other outputs scored the same or lower than it.
So far Altmetric has tracked 4,489 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 6.5. This one is in the 19th percentile – i.e., 19% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 268,091 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 31st percentile – i.e., 31% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 2 others from the same source and published within six weeks on either side of this one.