From facility scorecards to budget advocacy

This case study is part of our book, MamaYe Evidence for Action Stories of Change: Selected Case Studies. Through illustrative case studies, we describe how Evidence for Action - MamaYe has strategically combined evidence with advocacy and accountability activities in
six countries, across Africa, and globally.

This book brings to light new learning about the specific ways in which evidence, advocacy and accountability must work together to bring about change. One major area of learning has been the conditions under which evidence is used for decision-making.

In this case study, we indicate that favourable conditions involve strong accountability mechanisms to review the evidence and mandate action. Accountability mechanisms set up by E4A-MamaYe involve non-governmental stakeholders such as citizens, civil societyorganisations, professional associations and the media having access to the same evidence as the government. It also means that these stakeholders have a space to engage government over what the evidence brings to light and what actions are required.

These mechanisms have taken many different forms, including district-level engagement forums in Sierra Leone. We also learned that greater use of evidence and higher political will lead to better use of resources only when the decision-makers with the power over those resources are the ones engaged through evidence, advocacy and accountability mechanisms.

There were numerous occasions where health managers complained that they could not take action for lack of funds. This underscores the vital necessity of including health budgets and financing as part and parcel of any initiative seeking to drive change for maternal and newborn survival.