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Accountability is increased when civil society is equipped with the skills and resources to use evidence to demand action for improved reproductive, maternal, newborn, child and adolescent health (RMNCAH).  

Building the capacity of civil society to participate at all stages of health planning and budgeting processes - consultation, decision making, dissemination and review – is a core part of our Theory of Change.

We support advocates, media partners, activists, health professionals and community leaders to understand and communicate evidence, so strengthening their advocacy for improved quality of care.

Our scorecards help monitor the health system and are used by civil society organisations to hold leaders to account for the quality and reach of health services, and to influence decision making.  

E4A also works with decision makers to identify opportunities to engage civil society in health planning and budgeting, making decision making processes more participatory and transparent and, as a result, more accountable. 

E4A has had a demonstrable impact in achieving more accountable processes for health planning and strengthening the transparency around finance and resource allocation.

E4A develops accountability approaches that work.  

MamaYe Nigeria

In Nigeria E4A-MamaYe supports health sector partners to use a strategic combinaton of evidence and evidence-driven advocacy to drive accountability at Federal and State level via State Level Accountability Mechanisms (SLAMS).

In 2016 the Lagos State SLAM for maternal and newborn health (LASAM) tracked the transparency of that year's budget cycle and identified weak civil society participation in the budget process. The State government took this on board and actively invited civil society participation in the following years' budget development process.

MamaYe Malawi 

MamaYe Malawi works with district level health planners to improve survival of mothers and newborn babies through holding local councils to improve consultation and transparency around district level health budgeting. Our team uses evidence on the status of health facilities to identify deficits in emergency obstetric and newborn care.

MamaYe Sierra Leone

In Sierra Leone, E4A-MamaYe have made Government Facility Improvement Team (FIT) assessment reports easier to understand by translating dense written reports into visual scorecards. The scorecards summarise health facilities' readiness to provide life-saving, emergency obstetric and newborn care, and are used by health planners and civil society who hold health planners to account in meeting safe clinical standards.

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