Table 2 Main roles and activities of health facility committees

1. Inward role: support health facility & workers

Co-management – of health facility resources and services

Resource generator – in the form of material resources, labour and funds for health facility

Community outreach – to help the health facility reach into the community for the purpose of health promotion and improving health-seeking behaviour; organisation of community-based health activities

2. Outward role: facilitating citizen voice and accountability

Advocacy – to act as a community voice to advocate (e.g. to local politicians and health managers higher up the health system) on behalf of the health facility

Social leveller - to help mitigate social stratification by defending rights of marginalised sections of the community/public

Control of quality and management – including the monitoring of use and quality of material, financial resources and the performance of health workers, results of health services

Provide accountability interface by initiating and facilitating feedback process between users/citizens and health providers and authorities by following the steps in an accountability cycle:

1. Information/data collection – information on performance through monitoring, the collection, interpretation and articulation of users’ and citizens’ views, demands and complaints.

2. Dialogue/forum - provide a means to transmit, question and discuss this information to/with health providers and authorities and claim improvements.

3. Consequences - follow up on responses and decisions taken and for results; when responses or explanations fail, there should be a possibility to reward/sanction health providers’ actions and results.

4. Counter feedback to users’ and citizens.