Helpdesk Report: Nutrition Data and Accountability

Abstract

Query (1) What is the evidence of impact of community score cards in general, and what are the key lessons for making them work? Are there published examples of where they have been used to improve access and quality of nutrition services? (2) What evidence is there for using SMS to report data on nutrition outcomes?  Could you briefly summarise the literature, and also contact UNICEF for their experience.  Are there 'stand out' examples in other sectors of development for using SMS technology and linking this to instant mapping? (3) What strategies have been used in the health and agriculture sectors to empowering communities to use information / data to drive greater accountability? Summary This report includes the following sections: Use of community scorecards (CSCs) to improve nutrition services: A World Bank pilot project in Maharashtra, India measured improvements in child malnutrition as a result of CSCs. An IDS paper concludes that it is unknown if social audits improve nutrition status, but can reasonably infer improvements from improvements in delivery and uptake. Impact of CSCs in general: Use of CSCs in primary healthcare services in Andhra Pradesh resulted in increased user satisfaction levels and better understanding of the constraints providers face. A decrease in teacher absenteeism and increase in child enrolment. The use of a citizen scorecard survey in China has helped influence urban service provision design and implementation, helping policymakers to 'reveal weaknesses and monitor progress in public service delivery'. Other examples are presented from Malawi and Uganda Key lessons for CSCs are also included in the report. Mobile technology Relatively new but increasingly pertinent method of addressing the burden of under-nutrition as well as other health related development work. Evidence from Malawi and Kenya is presented. Evidence exists that both support and refute that mobile technology assists healthcare in developing countries. As many people in low income countries share mobile phones, privacy and stigma may be a disadvantage. Evidence from India suggests voice messages were more accurate compared to SMS or electronic forms. This report also includes strategies for empowering communities to use information to drive greater accountability