Promoting transparency and accountability with district league tables in Sierra Leone and Malawi. Issue 1 (March 2018)

• Record Type: Journal Article
• Authors: Sæbø, Johan Ivar; Mesheck Moyo, Christon; Nielsen, Petter
• Is Part Of: Health policy and technology. Volume 7:Issue 1(2018)
• Page Start: 35
• Page End: 43
• Publication Date: 2018-03
• Subjects: Transparency -- Accountability -- HMIS -- Sierra Leone -- Malawi; Medical policy -- Periodicals; Medical technology -- Periodicals; Medical policy; Medical technology; Health Policy -- Periodicals; Biomedical Technology -- Periodicals; Technology Assessment, Biomedical -- Periodicals; Periodicals; 362.105
• DOI: 10.1016/j.hlpt.2018.01.003
• Languages: English
• ISSNs: 2211-8837

Abstract

Abstract: Objectives: This paper looks at the effects on transparency and accountability of introducing league tables in the health sector in Sierra Leone and Malawi. Methods: Drawing on long-term action research in the two countries, we have supported development of league tables at district levels. Our practical aim of this work has been to design and develop a tool that helps districts create and change league tables as they please, based on indicators relevant for them. This has been done in a participative manner. The research covers 3 years in Sierra Leone and 2 years in Malawi. Results: Our findings show that such tools have positive immediate effects, most notably on providing new information about relative performance, and improving data quality. They contribute to understanding of health indicators, their applicability, reliability, and relevance at various levels of the health sector. League tables are also suitable for communicating priorities, giving higher levels a way to signal what health facilities are held accountable by Conclusion: League tables are a promising tool for advancing transparency and accountability at district levels. An implication for policy is that access to peer data is necessary to evaluate your own performance. The true benefits of league tables at district level can only be reaped when they are easily changed and replicated, becoming an integral part of routine district monitoring and evaluation. Highlights: League tables are suitable for promoting transparency and accountability in health sector management Data quality improvement and awareness of relative performance are immediate gains At district levels, league tables should be changeable and replicable to cater local needs