The practice of social accountability is old however the use of this term is new at MakCHS. The terms social accountability and responsiveness are used interchangeably. The scope and practice of social accountability can be expanded, by creating opportunities to ensure that medical education, research and service activities engage more community orientation
Research in resource poor countries may be heavily influenced by funders hence creating a challenge in responding to local social needs as they may be seen in that particular environment
There are weak links in the current system that retard the process of ensuring social accountability; there is a lack of feedback from the communities we serve and lack of a concerted effort by institutions to solicit for regular feedback about not only relevance of services but also for equity, quality and cost effectiveness. Indeed the lack of efficient information flow back and forth from the field undermines the mission of fully realizing social accountability.
The views expressed in this study were acts of social responsiveness however; they were not explicitly linked to meeting priority healthy needs. Quality of health care, equity issues, relevance and cost effectiveness were not mentioned. The importance of soliciting feedback was mentioned several times but, integration and partnerships with other stakeholders were omitted.
Interestingly the views expressed by the students did not differ much from those of faculty however the head of the Institution had a more detailed account on the overall big picture, the Heads of departments focused on institution programs and the students mentioned some curriculum details.
The approach we used for this survey was a rapid inexpensive form of institutional self evaluation that could be replicated by other institutions in similar contexts. It was comprehensive since it targeted key personnel with long standing experience in education but were also in administrative positions. Whereas a component of external scrutiny should have been useful, there isn’t such a mechanism per se (in Uganda) that does accreditation for social accountability or for other aspects of quality assurance regularly and in a predictable manner.
Whereas in developed countries accrediting bodies assess for social accountability regularly
[17, 18], the existing accreditation body in Uganda lacks the capacity for regular accreditation as may be the case in most Sub Saharan countries.
The findings of this study through conduction of an evaluation exercise albeit on a small scale fills the gap for one institution but perhaps can serve as a catalyst or as an example for others in a similar context to document through self evaluation exercises what their successes and weaknesses are in the light of social accountability.
Mainly heads of units and department were interviewed and their views may not fully reflect the views held by the rest of the faculty however these are individuals that run the institution and therefore can be assumed to give reliable information on what is on the ground.
The lack of a clear understanding of the definition of social accountability may have derailed the respondents. However clarification of the term was given at the beginning of the interviews.