1. Social accountability theories of change: What are the critical success factors? Dr Fletcher Tembo, Research Fellow, Mwananchi GTF Programme Director Presentation at the Annual Meeting of the World Bank and International Monetary Fund, October 12, 2012 under the theme “Achieving Better Health Outcomes Through Investments in Social Accountability”

2. This presentation covers: Defining social accountability Background and approach to Mwananchi GTF Six main lessons Six implications for policy and practice in investing for better health 2

3. Defining Social Accountability (SA) “ An approach towards building accountability that relies on civic engagement, i.e. in which it is ordinary citizens and/or civil society organizations who participate directly or indirectly in exacting accountability” (Ackerman, 2005, p.1) 3

4. About the GTF £130m Fund created to “do much more at the grassroots end of political governance” (DFID White Paper, 2006) Up to 5 years of one-off grants (£5m max each) to 38 organisations all over the world, including ODI ODI - Six African countries (Ethiopia, Uganda, Ghana, Sierra Leone, Malawi and Zambia) ODI programme branded as ‘Mwananchi’ which is a Kiswahili word for ‘ordinary citizen’ but countries have local names as well – e.g. Leh Wi Tok in Sierra Leone

5. GTF background continued Maximum of ten projects for each country to enable deeper action learning Three funding phases for the same organisations – with different learning emphases 5

6. Main lessons from implementation Six main lessons from a total of 60 projects implemented across the six African countries 6

7. Theories of change 1. The question ‘how did we get here?’ informs many more of the answers to the question ‘how do we get from here to there?’ 7

8. Basic Needs Ghana example 8 2002 BN is established 20042006 2008 2010 2011 2012 1983 1996 1 st Mental Health Policy 2 nd mental health policy Draft Mental Health Bill 1 st Reading MPs’ visit to UK 2 nd Reading Bill passed waiting for sig. by the President Photo Book Published Funding + CB support from Mwananchi Ghana Chief Psychiatrist writes on mental health in Ghana Photo used to influence MPs NDC government includes in manifesto Funding from STAR Ghana to facilitate MP discussions Various initiatives on mental illness with Min. of Health & communities Bill as basis for delivery of services to 2.4m people

9. Main learning points from Basic Needs Several organisations/actors are undertaking activities that contribute to getting to the desired end – not just Basic Needs Building credibility with mid-level bureaucrats who often do the ‘behind-the -scene’ policy details Providing authentic evidence made Basic Needs an organisation of choice of parliamentary select committee Basic Needs can now effectively apply lessons to other projects. 9

10. Model for developing theories of change that embrace contextual dynamics 10

11. Interlocutors of CV &A change 2. ‘What can change rules of the game in this context?’ and, by implication, ‘who is a game changer on this issue?’ 11

12. Local politics matters 3. Embedding politics back into the socio-cultural roots of societies – but be aware that the process can be vulnerable to political party distortions 12

13. Paramount Chief in East Gonja District – at a Palace meeting 13

14. Youths attending Palace meeting 14

15. Belandan Bo Platform- used to enhance role of Queen Mothers 15

16. Dealing with over-generalised policies 4. Dealing with over-generalised policies e.g. the case of health policies in Uganda 16

17. 17

18. Kalangala Round Table Initiative 18 VILLAGE LEVEL KAROT PARISH LEVEL KAROT DISTRICT LEVEL KAROT

19. Creating foundations for accountability 5. Raise the stakes for seeking accountability 19

20. Establishing dialogue mechanisms 6. Creating mechanisms where dialogue can take place – media is key 20

21. Six implications for policy and practice- making SA work 1.Social accountability should seek to address collective action problems, where politics plays a critical role 2.Thinking seriously about game changing and game changers (the entries and exits) 3.Don’t assume that formal local-level decentralised structures work for voice and accountability – they often exist just by name 21

22. Implications for policy and practice continued 4. Be patient with change – change evolves and is context-dependent 5. Focus capacity development support on building evidence-based civic engagement – effective grassroots-to-national linkages; communities of practice, and addressing systemic issues 6. Promote building a critical mass of evidence around governance initiatives even if funding sources are different 22

23. Thank you! Full contact address: Dr Fletcher Tembo Research Fellow Mwananchi Governance and Transparency Programme Director Research and Policy in Development Overseas Development Institute 203 Blackfriars Road London SE1 8NJ United Kingdom Tel: +44 (0)20 7922 0300 Direct: +44(0)2079220442 Email: f.tembo@odi.org.uk Web: www.odi.org.uk www.mwananchi-africa.orgf.tembo@odi.org.ukwww.odi.org.uk Skype: fletcher.tembo Follow Mwananchi on Twitter at http://www.twitter.com/MwananchiProghttp://www.twitter.com/MwananchiProg Follow me on http://www.twitter.com/ftcitizenvoicehttp://www.twitter.com/ftcitizenvoice Follow RAPID on Twitter at http://www.twitter.com/rapid_odihttp://www.twitter.com/rapid_odi 23

24. ODI is the UK’s leading independent think tank on international development and humanitarian issues. We aim to inspire and inform policy and practice to reduce poverty by locking together high-quality applied research and practical policy advice. The views presented here are those of the speaker, and do not necessarily represent the views of ODI or our partners. 203 Blackfriars Road, London, SE1 8NJ T: +44 207 9220 300 www.odi.org.uk f.tembo@odi.org.uk