PANEL 8.4 CAN COMMUNITY MONITORING ENHANCE ACCOUNTABILITY FOR NUTRITION?
NICK NISBETT AND DOLF TE LINTELO P
ublic accountability can work through both short routes (between citizens and nutrition service providers) and long routes (between citizens and elected officials) (World Bank 2003). Strengthening both routes has the potential to
• enhance the quality of nutrition service delivery;
• increase the motivation of frontline staff and midlevel bureaucrats and raise their ability to advocate for appropriate resources;
• facilitate mainstreaming of nutrition across sectors such as agriculture, health, social protection, water, and sanitation;
• make undernutrition more visible to affected communities, giving them a greater voice and amplifying their demands on this issue; and
• increase the responsiveness of public poli- cymakers and political leaders to nutrition as a national development issue.
Global nutrition commitment initiatives inevitably suffer from extended and blurred short and long routes of accountability (te Lintelo 2014). For instance, taxpayers in donor countries do not directly enjoy the nutrition services they contribute to and rarely vote on the performance of donor aid. Conversely, cit- izens of aid-recipient countries, as taxpayers, may have weaker incentives for holding their governments to account for the performance of nutrition services, unless it is clear that they are co-funding these services.
Can community-level feedback mech- anisms strengthen short- and long-route accountability? The potential of mechanisms such as social audits and community monitor- ing to promote accountability and to improve
the provision of direct public services is clear (Gillespie et al. 2013; Haddad et al. 2010; Mansuri and Rao 2013). The experience in health has been mixed (see, for example, Joshi 2013) with some startlingly positive results (for example, Björkman and Svensson 2009). Apart from some appraisal work (Swain and Sen 2009), however, the impact of such mechanisms on provision of nutrition services has not been empirically evaluated. Further work is required in this area to find out which models work best when applied to nutrition service delivery. Such work may have the potential to combine with the growing use of information and communication technol- ogies and mobile technology to link citizens to policy advocacy and provide real-time data on community-level indicators to national accountability mechanisms.
with Concern Worldwide). We observed these tendencies on several occasions. These occurrences seem counter to the spirit of the accountability exercise, and we will explore ways of addressing this issue in the 2015 Global Nutrition Report.
• A number of process improvements need to be made in preparing the 2015 Global Nutrition Report.4
In sum, the 2014 experience constructing an N4G account- ability mechanism should be regarded as a learning experience. As with any baseline, the data reported should become more useful as data from subsequent years accumulate.
STRENGTHENING ACCOUNTABILITY FOR IMPROVED NUTRITION
Chapter 9 focuses on filling key data gaps to improve account- ability, but data are just one important component of account- ability systems. Accountability systems evolve through a series of public commitments, the tracking of those commitments, comparing progress to targets, making use of the assessment of progress, and then strategizing about how to respond to that accountability. In addition to data, this cycle of accountability strengthening requires actors and mechanisms. This section presents innovations from the wider nutrition community in these two areas.
Actors
When civil society and communities put pressure on stakehold- ers, social change happens more quickly (Gaventa and Barrett 2012), because this kind of pressure strengthens accountability. Panel 8.2 describes the experiences from national civil society alliances within SUN. They are proving effective because they can scale up their efforts, mobilize communities, join together in alliances, transcend political cycles, and reach into district-level administrative units, which are so crucial for effective decentral- ization. The SUN civil society experience, so far, is in the context of undernutrition. Panel 8.3 focuses on the role of civil society in influencing policy and governance actions on noncommunicable diseases and obesity.
What about communities themselves? How can they be
more effective at closing the “short” loops between citizens and service providers and the “long” loops between citizens and governments? Panel 8.4 focuses on program delivery in an un- dernutrition context and highlights some community monitoring experiences from a range of sectors.
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