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Accountability for Health Equity: Galvanising a Movement for Universal Health Coverage (IDS Bulletin 49:2, 2018)

Since the publication of the 2004 World Development Report, a range of different attempts have been made to make the design, prioritisation and delivery of health services more accountable to different stakeholders. However, complex politics and power dynamics can limit or skew people’s abilities to access services or hold them to account, particularly for poor and marginalized people.

In July 2017, the IDS hosted a workshop in collaboration with Future Health Systems, the Impact Initiative, the Open Society Foundations, Unequal Voices, and Health Systems Global, to develop new thinking and practical approaches to improving accountability relationships and processes in favour of greater health equity.

This new issue of the IDS Bulletin focusses on three principal themes that emerged from this workshop as needing particular attention. First, the nature of accountability politics ‘in time’ and the importance of longitudinal approaches to change. Second, the contested politics of ‘naming’ and measuring accountability, and the intersecting dimensions of marginalisation and exclusion that are missing from current debates. Third, the shifting nature of power in global health and new configurations of health actors, social contracts, and the role of technology.

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Social norms and women’s risk of intimate partner violence in Nepal (Social Science & Medicine 202:162-169, 2017)

Social norms increasingly are the focus of intimate partner violence (IPV) prevention strategies but are among the least examined contextual factors in quantitative violence research. This study assesses the within-community, between-community, and contextual effect of a new measure of social norms (PVNS: Partner Violence Norms Scale) on women’s risk of IPV. Data come from baseline surveys collected from 1435 female, married, reproductive-age participants, residing in 72 wards in three districts (Chitwan, Kapilvastu, Nawalparasi) in Nepal who were enrolled in a cluster randomized trial testing the impact of a social behavioral change communication intervention designed to prevent IPV.

The study finds that PVNS is a promising measure of social norms underpinning women’s risk of IPV and warrants further psychometric testing.

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Empowering adolescent girls in developing countries: gender justice and norm change (ODI Study, 2018)

Adolescence is a pivotal time in a girl’s life. The development of educational, physical, psychosocial, familial, political and economic capabilities enable girls to reach their full potential and contribute to the wellbeing of their families and society. However, progress is still significantly constrained by discriminatory gender norms and the related attitudes and practices which restrict girls’ horizons, restrain their ambition and, if unfettered, allow exploitation and abuse.

This book explores the detrimental impact of discriminatory gender norms on adolescent girls’ lives across very different contexts. Grounded in four years of in-depth research in Ethiopia, Nepal, Uganda and Viet Nam, the book adopts a holistic approach, recognising the inter-related nature of capabilities and the importance of local context. By exploring the theory of gendered norm change, and contextualising and examining socialisation processes, the book identifies the patriarchal vested interests in power, authority and moral privilege, which combine in attempts to restrict and control girls’ lives.

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Girls’ clubs and empowerment programmes – Knowledge to action: Effective action on gender norms that affect adolescent girls (ODI Research Note, 2015)

This Research and practice note outlines the role girls’ club and empowerment programmes can play in promoting adolescent girls’ wellbeing and changing the gender norms that constrain their lives. It draws on fieldwork in Ethiopia, Nepal, Uganda and Viet Nam, an ODI systematic review of communications programmes, and secondary literature.

Girls’ clubs, which may be drop-in sessions or regular meetings, organised by community groups or girls themselves, are an increasingly popular approach to promoting adolescent girls’ wellbeing. They help girls cope with the physical and emotional changes they experience during adolescence, and equip them with knowledge and skills to help them challenge discriminatory norms within their home and wider community. Typically, they aim to empower girls by giving them access to information about their rights (including their sexual and reproductive health). They also equip them with life skills, which build their self-confidence and help them to negotiate for their rights and voice their concerns. The approach aims to broaden girls’ horizons and encourage them to envisage and realise a better future.

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Contested and Under Pressure: A Snapshot of the Enabling Environment of Civil Society in 22 Countries (CIVICUS 2017)

Between 2013 and 2016, civil society in 22 countries carried out an Enabling Environment National Assessment (EENA). The EENA is a civil society-led process that analyses the extent to which national conditions enable the work of civil society.
The EENA analysis explores in particular how laws and regulations relating to civil society are implemented in practice, and how they impact on civil society. The assessments, led by national civil society partners, employed a common methodology that encompassed interviews with key stakeholders, consultations, focus groups and desk research. In every country, six core dimensions were assessed: the ability of civil society groups to form, operate and access resources -all aspects of the freedom of association – plus the freedoms of peaceful assembly
and expression, and relations between civil society and governments.
Overall the EENA assessments reveal a picture of an environment for civil society that is volatile, contested and often under pressure, but also with some optimism in some contexts about the potential for progress.

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