Whose Accountability?: Participation and Partnership in a Disabling Environment

Summary The article reviews the development of community participation and accountability under the auspices of a donor?funded basic health services project in Benue state, Nigeria. The three?year work of the Benue Health Fund Project in a challenging policy and institutional environment is presented from the standpoint that community involvement in health and indeed in other sectors is fundamentally compromised without an enabling environment. The article highlights a number of environmental constraints faced by the project. These include an unstable and often unsupportive policy regime; a bureaucratic system not given to devolution and decentralisation; the limited capacity of managers to support a process of accountability through participation; and the breakdown in relations between the people and the state. While the article emphasises that modelling was not an option in such a context, the specific mechanisms evolved to strengthen participation might still offer some lessons for practice elsewhere.