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Table 3 Social accountability mechanisms for maternal health in two studied districts of Gujarat

From: How does social accountability contribute to better maternal health outcomes? A qualitative study on perceived changes with government and civil society actors in Gujarat, India

Structure Description Expected roles related to social accountability
Government
 Accredited Social Health Activist (ASHA) Community health volunteers selected locally in communities - Raise awareness among communities about health services, and government health schemes and entitlements through home visits, meetings, etc.
- Mobilize communities to claim their health entitlements
- Link communities with health system to communicate their concerns
 Female Health Worker (FHW) Auxiliary Nurse Midwives based at Health Sub-Centre – the lowest level health facility - Provide information about health services, and government health schemes and entitlements to communities during antenatal clinics and their facility visits
- Link communities with health system to communicate their concerns
 Gram Panchayat or Panchayat Locally elected village council headed by a Sarpanch - Inform communities about health services, and government health schemes and entitlements
- Listen to communities’ health needs and concerns in periodic village meetings (Gram Sabhas) and assist to resolve them
- Link communities with government and health system to communicate their needs and concerns
- Hold local-level health facilities accountable towards communities’ needs and concerns
 Village Health and Sanitation Committee (VHSC) Village-level health committee, a sub- or standing committee of Panchayat, including members from the health facility, CBOs and all community groups in the village - Inform communities about health services, and government health schemes and entitlements
- Act as an avenue for communities to voice their concerns related to health, address them through periodic health and village meetings, and/or communicate them to Panchayat and health system
- Ensure communities’ participation in planning, implementation and evaluation of local-level health plans through adequate representation of all community groups
Civil society
ANANDI and its women groups – Dai Sangathan and Devgadh Mahila Sangathan CBO oriented towards building a community of women, especially disadvantaged groups, to identify their collective needs and concerns, including health, and mobilize them to demand accountability from the government - Raise awareness in communities about health services, government health schemes and entitlements
- Empower women’s groups to identify their collective health issues and demand accountability from government through activities such as awareness raising, capacity building, networking, monitoring and supervision
- Mobilize women’s groups to identify their collective needs and concerns related to maternal health through activities such as women’s group meetings, community monitoring and maternal death review, and demand accountability from health system through activities such as protests, dialogues and negotiations with the health system and government