Social Accountability and Community Engagement
The CIHLC created the resource Community Engagement for Health System Change: Starting from Social Accountability to assist those interested in becoming involved with a socially-accountable, community-engaged transformative change initiative.
Framework for Social Accountability and Community Engagement
Unique to this leadership program, the CIHLC project has embedded the principles and evaluation structure of the Training for Health Equity Network (THEnet) social accountability framework into the core curriculum development and evaluation process. These four principles of quality, equity, relevance, and cost effectiveness used in the education process will ground the collaborative leadership program through the lens of social accountability. Developments in the curriculum support the contextual awareness of collaborative leadership skills and attitudes that foster a broad social environment of partnerships, sustainable relationships through partnerships in identifying priority health concerns and an awareness of all levels of health systems. Not unlike the Lancet Commission Report, IHI Triple Aim, and the Macy Report where strong recommendations advocate for transformational learning that ensures learners understand their community priority health problems and population health management, CIHLC is ensuring learning outcomes adequately prepare them to respond to the health of communities through collaborative leadership attributes. Work is in progress ensuring that building a curriculum that is anchored in social accountability and can be adaptive to local needs and conditions is an integral part of ongoing discussions and developments.
Community engagement strategies are grounded in the recognition that local social and physical environments powerfully influence what works and how solutions must be tailored to be effective in particular contexts. The CIHLC partook in studying the evidence around community-engaged medical education (CEME) and its key dimensions. A systematic literature review and realist review were conducted and approximately 800 relevant articles were identified. In addition, approximately 40 international experts participated in the review process. The study aimed to identify the ways in which different relationships between medical education programs and communities impact educational and health outcomes.
Through investigating the relationship between communities and educational programs, the literature review on community engagement helped us better understand the conditions in which to ground the curriculum in the principles of community engagement and social accountability. Understanding the integrity of relationships in working with communities and addressing priority health concerns from a collaborative leadership perspective will transform health systems in ways that will have the best possible impact on socially marginalized and medically underserved people in our communities.
The results of this research helped the team identify the competencies that underlie social responsibility, best practice approaches to developing CEME, and the principles that collaborative leaders should apply in their own social accountability or that of their organizations.
The CIHLC has identified 6 principles of community engagement key to the collaborative leadership program. These include:
- the drive of the community to improve the life of its citizens, through the process of engagement with others and to pragmatic solutions that take local contexts, including values and beliefs, into account;
- the community’s awareness of its needs and reliance on “expert” knowledge and general principles of social accountability and community engagement;
- partners with expert knowledge reach out to the community, provide information and involve the community in a partnership grounded in reciprocity and mutual respect;
- information concerning the drive to improve the community is collected and issues identified;
- the lived experience of community members and their own expert knowledge emerge to develop pragmatic solutions that are contextually relevant; and
- all partners shift to collaborative engagement with shared decision-making and community empowerment.