Assessing and enhancing health stakeholders’ impact on people’s health using a social accountability conceptual framework

Abstract

There is a growing worldwide concern about the capacity of health systems to effectively address both current and future health needs and challenges faced by societies and individuals. The key players in this context, referred to here as "health stakeholders", must reconsider how they can enhance their response to health needs in society. This paper introduces a conceptual framework grounded on principles of social accountability that is designed to help stakeholders critically assess their contributions. The framework supports the alignment of stakeholder missions and actions with evolving social needs and enables the evaluation of their impact on population health and well-being.

The uniqueness of this framework lies in its starting point: it prioritizes relevant broad features of health in a society rather than beginning with the stakeholder itself and its conferred mandate. This shift in focus enhances the relevance and effectiveness of the dynamic interplay between health in society and various stakeholder roles. The three-gradients stepwise approach of social accountability put forward encourages and guides each stakeholder through a progressive and continuous journey of quality improvement, moving through three stages of awareness, transformation and measurable impact.

The application of this framework offers health stakeholders an opportunity to update and develop more relevant quality indicators and accreditation standards at the institutional level. The presented example of medical schools can be extended and applied to other stakeholders. The framework should enable all of them to assess their contribution to health, identify pathways for improvement and strengthen their social accountability. Avenues for further research and development projects are identified.