Fiji’s health outcomes are impressive given the geographical barriers to accessing services in a country with over 150 inhabited islands and where it can take two weeks on a ship to reach some of the islands furthest from the capital.

The social accountability framework implemented through a handful of CSOs is innovative and path breaking, and helping to forge new cultural norms around the legitimacy of citizen voice. The photo above shows information displayed at a Commune Council in Banteay Srey on what citizens can expect from education, health and commune services


In April 2016, a year after the first earthquake, emergency tents are still standing outside Charikot Primary Health Care Centre but they are mainly being used for storage and staff quarters. However many Health Posts in the district are still operating from tents after they were damaged or destroyed by the earthquakes and reconstruction is yet to begin.

The team at the DFID funded UHSSP celebrating Bangladesh’s New Year. The project has been launched in the three focal cities of Dinajpur, Jessore and Mymensingh. The baseline survey, which includes a sample of over 3,000 households, a separate sample of floating populations, as well as focus group discussions, will provide critical evidence for government and NGO health service planning.

With our experience of working on health systems reform from the inside and fostering community voice and empowerment to trigger change from the outside, we see that context is key. Opening up space for institutional reform and for citizen participation are complementary processes that move systems closer to being more responsive and more inclusive but sequencing and synchronizing these moves depends on local realities.

Page 5 of 5

Share This