Times are changing. Increasingly, health professionals are accountable for the way they use the resources, the services they avail to people and more generally, the results they deliver. In the wake of the Arab Spring and the progress of democracy throughout the African continent, the push of citizen's voice is amplifying this trend.
In response, the African Development Bank increasingly engages with African governments towards enhanced voice and accountability. It is currently preparing a second budget support operation for Tunisia, which among other things supports the establishment of mechanisms for citizens' participation and better access to information.
A variety of tools are available to give a say to people in the design, management and monitoring of the services they receive and Africa's experience is promising. One such tool is the citizen report cards, which is increasingly used in Africa and shows promising results. In Uganda, utilization of citizen report cards is associated with a reduction of waiting time at health facilities and a reduction of over 25% of staff absenteeism. Similarly, treatment practices have improved in the areas where citizen report cards have been introduced (e.g., blood pressure equipment being more systematically used by health personnel). People are also better informed about health services. As a result, they are more inclined to use services, as evidenced by an increase of 20% of the number of those who use outpatient, antenatal and family planning services.
The African Development Bank works towards allying partners behind the accountability agenda. On July 4-5, 2012, the African Development Bank in collaboration with Harmonization for Health in Africa (HHA) partners organized a high level dialogue between Ministers of Finance and Health on "Value for Money, Sustainability and Accountability". The conference gathered Ministers of Finance and Health and/or their representatives from 54 African countries, African parliamentarians as well as over 400 participants from the public and private sectors, academia, civil society and media globally. His Excellency Hamadi Jebali, Prime Minister of Tunisia, Dr. Donald Kaberuka, President of the African Development Bank, and Dr. Margaret Chan, Executive Director of the World Health Organisation delivered the opening remarks.
Distinguished guests such as Dr. Michel Sidibe, Executive Director of UNAIDS, Dr. Babatunde Osotimehim, Executive Director for UNFPA, Mr. Gabriel Jaramillo, General Manager of the Global Fund to Fight AIDS, Tuberculosis and Malaria and Mr. Seth Berkeley, CEO of the Global Alliance for Vaccines and Immunizations (GAVI) delivered keynote speeches High-profile speakers like Julio Frenk, Dean of the School of Public Health, Harvard University and Hans Rosling, Chairman of Gapminder Foundation also delivered keynote speeches during the conference.
This conference emphasized the urgent need for greater domestic accountability, reduced dependence on foreign aid and value for money in the delivery of health services in Africa. It gathered the expertise from all over Africa as well as globally featuring speakers from India, China, Brazil, Vietnam and Kyrgyzstan.
This high level dialogue culminated in a Tunis Declaration endorsing, among other things, the right for every African citizen to have a say in the equitable delivery of health services.