Accelerating Improved Quality of Care in Healthcare Facilities: Through an Accountability Lens

The USAID Health and Hygiene (Swachchhata) Activity (2016-2024), supported healthcare facilities in rural and urban areas of Dolpa, Salyan, Jajarkot, Rukum West, Rukum East, Dailekh and Surkhet. HHA prioritized increased accountability of stakeholders in the following areas: Improvements in access to water, sanitation and hygiene (WASH) facilities; Electrification and healthcare waste management assets; Overall infection prevention and control practices, and client counseling; and Awareness among health workers and community members on the importance of good hygiene practices. The brief highlights three forms of accountability—social, performance, and financial —addressing both effective approaches to improve accountability and challenges HHA faced. While this learning brief distinguishes the three forms of accountability to provide a more in-depth analysis, in reality, a holistic approach to strengthening systems-level WASH in healthcare is required to achieve and sustain quality health care services. Determining the right mix of accountability mechanisms makes for more effective and efficient interventions.