Reducing maternal mortality and morbidity requires among others that maternal health services take citizens’ needs into consideration, in particular those of women. If citizens take part in decision-making there is a better chance that maternal health services are adapted to their needs.

One way of achieving this is to develop mechanisms enabling citizens to hold policy-makers and health workers in maternal health services accountable for their performance and to evaluate performance against perceived needs of citizens. This is refered to as social or political accountability. Especially in fragile states, citizen involvement is important because government services are generally weak.

This research assesses whether and how political accountability mechanisms increase responsiveness and performance of maternal health services in Burundi and DR Congo. It further assesses in which contexts these mechanisms are successful and why. Lessons learned will advise policy-makers, development actors and civil society organizations in fragile states, in particular Burundi and DR Congo, on how to engage with citizens in order to improve maternal health services.

The research is action-oriented and uses a transdisciplinary approach, involving different types of actors. It covers a 5-years period and is organised as follows:

• Preparation and exploration (6 months): Selection and training of PhD students and researchers, stakeholder analysis in each intervention area, insight in current situation concerning maternal health and accountability mechanisms, networking, capacity development
• In-depth study (12 months): Situational analysis of existing political accountability mechanisms for maternal health services
• Integration and intervention planning (6 months): Integration of results of the situational analysis, selection and planning political accountability interventions in Burundi/Congo, and development of monitoring and evaluation framework
  • a. Implementation and assessment of the intervention (24 months): Implementation, monitoring and evaluation of interventions
  • b. Descriptive case studies in other fragile states (24 months): Identification and analysis of experiences on political accountability mechanisms for maternal health services in four selected fragile states, so as to complement the country-level intervention studies
• Reflexive learning and developing policy advice (48 months): Comparative analysis of results in Burundi/Congo and other fragile states, translation of results in policy advice, development of conceptual framework for political accountability for maternal health in fragile state.

Policy advice will be drawn from the country-intervention studies and the comparative analysis of results in Burundi/Congo and other fragile states. Three PhD students (Burundi, Congo and the Netherlands) and three senior researchers (Burundi, Congo and the Netherlands) jointly conduct the research.

BURUNDI ,DRC PRODUCTS

• Policy Brief:   Social accountability for maternal health services in DRC: Women’s concerns and means to express them.