ICT-facilitated accountability and engagement in health systems: a review of Making All Voices Count mHealth for accountability projects

Information and communication technologies (ICTs) and mHealth innovations hold great potential to improve health systems and health outcomes while at the same time enhancing citizen engagement and accountability. Yet there has been little assessment of the impact of mHealth innovations on the ground. This paper reviews the experiences of seven mHealth initiatives funded by the Making All Voices Count programme. It discusses the accountability model adopted by each project, and the challenges they faced. The report concludes that there are limits to what technology can deliver in terms of augmenting citizen voice and enhancing accountability, particularly in the absence of other offline activities such as engaging citizens in meaningful ways and building good relationships with key government actors and departments. The initiatives discussed include: OurHealth, eThekwini WACs and Thuthuzela Voices (all in South Africa), Mobile Mapping for Women’s Health (Tanzania), Text2Speak (Nigeria), SMS Gateway (Indonesia), and Citizen Journalism for Quality Governance of Universal Health Insurance Scheme (also Indonesia).