Gerry Bloom (IDS)

Vera Schattan P Coelho (CEBRAP/CEM/UFABC)

Alex Shankland (IDS)

Denise Namburete (N’Weti)


Many low- and middle-income countries have experienced rapid growth in their health systems. Many now have pluralistic health systems with a wide variety of providers in terms of their ownership, their relationship to the regulatory system and their sources of finance. In many cases, the public health care system became a multiprovider system supported by public and private providers and managers. There are complex inter-relationships between markets for medical care, drugs, and diagnostic services and between local, national and transnational organisations and governments. In many countries, the development of institutional arrangements to influence the performance of these pluralistic systems has lagged behind. This session will explore emergent approaches for building effective accountability mechanisms and the role of local and national citizen groups, professional and business associations, governments and global governance agreements. We will look at local/national dynamics inquiring how accountability mechanisms are “imported” and “exported” within national frontiers and between countries. When do partnerships promote mutual learning? Which actors, private and public (e.g. NGOs, donor agencies, think-tanks, foundations, corporations, networks, states, international organisations), are engaged in these learning processes?

We look forward to receiving papers that focus on the following (or related) issues:

  • Emerging forms of relationship between government and non-state providers in pluralistic health care systems
  • Evidence on which combinations of accountability approaches are contributing for reducing health inequalities
  • The ways in which civil society organisations, such as NGOs, social movements, organized professions, business associations and patient groups, are becoming involved in building accountability arrangements
  • Practical strategies for building accountability in multiprovider public health care systems
  • Experiences of building systematic learning between pluralistic health systems
  • What are the factors affecting the diffusion of accountability mechanisms in pluralistic health systems?